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Samir A, Abdeltawab R, Stein U, Thabit S, El Tayebi H. 42P Apigenin: An immunomodulatory nutraceutical overriding PD-L1 inhibitors by halting AKT/mTOR pathway in triple-negative breast cancer (TNBC). ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101008] [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: 04/05/2023] Open
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Samir A, Abdeltawab R, Stein U, El Tayebi H. 226P LncRNA DILC and PD-L1 inhibitors: Opposing metastatic and anti-oxidative roles in TME of locally advanced triple-negative breast cancer. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100337] [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: 12/13/2022]
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Staudacher JJ, Arnold A, Kühl AA, Pötzsch M, Daum S, Winterfeld M, Berg E, Hummel M, Rau B, Stein U, Treese C. Prognostic impact of activin subunit inhibin beta A in gastric and esophageal adenocarcinomas. BMC Cancer 2022; 22:953. [PMID: 36064338 PMCID: PMC9446826 DOI: 10.1186/s12885-022-10016-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Adenocarcinomas of the esophagus (AEG) and stomach (AS) are among the most common cancers worldwide. Novel markers for risk stratification and guiding treatment are strongly needed. Activin is a multi-functional cytokine with context specific pro- and anti-tumorigenic effects. We aimed to investigate the prognostic role of activin tumor protein expression in AEG/ASs. METHODS Tissue from a retrospective cohort of 277 patients with AEG/AS treated primarily by surgery at the Charité - Universitätsmedizin Berlin was collected and analyzed by immunohistochemistry using a specific antibody to the activin homodimer inhibin beta A. Additionally, we evaluated T-cell infiltration and PD1 expression as well as expression of PD-L1 by immunohistochemistry as possible confounding factors. Clinico-pathologic data were collected and correlated with activin protein expression. RESULTS Out of 277 tumor samples, 72 (26.0%) exhibited high activin subunit inhibin beta A protein expression. Higher expression was correlated with lower Union for International Cancer Control (UICC) stage and longer overall survival. Interestingly, activin subunit expression correlated with CD4+ T-cell infiltration, and the correlation with higher overall survival was exclusively seen in tumors with high CD4+ T-cell infiltration, pointing towards a role of activin in the tumor immune response in AEG/ASs. CONCLUSION In our cohort of AEG/AS, higher activin subunit levels were correlated with longer overall survival, an effect exclusively seen in tumors with high CD4+ cell infiltration. Further mechanistic research is warranted discerning the exact effect of this context specific cytokine.
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Affiliation(s)
- J J Staudacher
- Medical Department, Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
- Berlin Institute of Health at Charité Universitätsmedizin Berlin, Charitéplatz1, 10117, Berlin, Germany.
| | - Alexander Arnold
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A A Kühl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, iPATH.Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - M Pötzsch
- Medical Department, Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - S Daum
- Medical Department, Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Berlin Institute of Health at Charité Universitätsmedizin Berlin, Charitéplatz1, 10117, Berlin, Germany
| | - M Winterfeld
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - E Berg
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Hummel
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - B Rau
- Department of Surgery, Campus Virchow-Klinikum and Campus Mitte, Charité - Universitätsmedizin, Berlin, Germany
| | - U Stein
- Experimental and Clinical Research Center, Charité - Universitätsmedizin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - C Treese
- Medical Department, Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Berlin Institute of Health at Charité Universitätsmedizin Berlin, Charitéplatz1, 10117, Berlin, Germany
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Gassian N, Clairet AL, Goujon M, Frontczak A, Calcagno F, Almotlak H, Mouillet G, Maurina T, Stein U, Nguyen T, Jeannin M, Thiery-Vuillemin A. Evaluation of drug-drug interactions among patients with metastatic prostate cancer in routine care. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
111 Background: Prostate cancer often occurs in an elderly population, at higher risk of drug-drug interactions (DDIs). There is a medical need to increase the knowledge of DDI prevalence and their severity among patients coming from routine care. This study used a prospective approach with the aim to quantify and describe DDIs in medical prescription of prostate cancer treatments. Methods: DDIs were assessed from two perspectives: 1) “real DDI” between the patient’s comedications and the actual anti-cancer agent prescribed; 2) “modelized DDI” between the patient’s comedications and drugs that have proven activity in metastatic endocrine sensitive prostate cancer (MESPC) or castrate resistant prostate cancer (CRPC) settings with positive phase 3 trial and gained EMA approval. French national thesaurus, Micromedex software and complementary manual analysis by pharmacist were used to identified DDIs. Clinical relevance of DDIs was scored using the validated scale of Hatoum. Results: A total of 91 patients were included, 15% of whom were participating in a clinical trial. Some imbalances were observed between patients from clinical trial and routine care (age, ECOG, MESPC/MCRPC). The median number of comedications used per patient was 6 [1-16]. Among real DDI, Enzalutamide was the anticancer agent with the higher risk of interaction (18-54% of patients). In modelized DDI, Enzalutamide and Apalutamide were the two most risky drugs (35-76% and 22-73% depending on Micromedex or Thesaurus analyze). Not all DDIs discovered were clinically significant according to Hatoum scale. Conclusions: DDIs are frequents, according to Micromedex and National Thesaurus tools but pharmacist and physician advices are essentials to determine their potential impacts.
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Affiliation(s)
| | | | - Morgan Goujon
- Department of Medical Oncology, University Hospital, Besançon, France
| | | | - Fabien Calcagno
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Guillaume Mouillet
- Department of Medical Oncology, University Hospital, Besancon Cedex, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital, Besancon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Thierry Nguyen
- Department of Medical Oncology, University Hospital, Besançon, France
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Thiery-Vuillemin A, Barthelemy P, Lebret T, Bigot P, Stein U, Dourthe LM, Longo R, De La Cruz J, Sevaux S, Tindel M, Albiges L, Escudier B. Real-word evidence in patients treated with pazopanib for advanced/metastatic renal cell carcinoma (mRCC): The APOLON study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.6_suppl.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
299 Background: The efficacy and safety of pazopanib (PZP) have been evaluated in pivotal randomized, clinical trials Real-world evidence (RWE) is required to further assess its use, effectiveness and safety in mRCC in clinical routine practices. Methods: APOLON is a non-interventional, multicentric prospective study with mRCC patients who receive frontline PZP treatment. The study is designed to assess PZP Progression-Free Survival (PFS) (under treatment), Overall Survival (OS), Objective Response Rate (ORR) assessed by investigators, tolerability and subsequent post-pazopanib therapy sequences. Impact of COVID-19 on patient’s care was also assessed. Eligible patients were recruited from Nov 2017 to Jan 2019 in 55 participant sites in France. This interim analysis presents results 30 months (mo) after last patient was enrolled in the study. Results: The 217 patients were 71.1% males, with a median age of 69.6 years and had mRCC with a favourable (27.1%), intermediate (52.1%) or poor (20.8%) IMDC risk score according to physician. ECOG-PS was 0, 1 and ≥2 in respectively 43.3%, 39% and 17.6% of patients. Metastases were mainly located in lungs (64.1%), bones (28.6%), mediastinal (18%)/abdominal (17.1%). Patients had an history of partial/total nephrectomy in 54.8% of cases and previous local treatments for metastases in 27.6%. Median PFS, assessed by investigator, was 10.5 mo (95%CI: 9-12.4), similarly in patients < 65-year-old (YO) with 11.3 mo (95%CI: 7-16.3) and in those ≥ 65 YO with 9.9 mo (95%CI: 8.9-12). When assessed according to the IMDC risk score, mPFS was 18.1 mo (95%CI: 9.9-23.3) in favourable, 11.5 mo (95%CI: 8.7-14.4) in intermediate and 6.2 mo (95%CI: 3.5-9.5) in poor mRCC. The median OS was 27.3 mo (95%CI: 24.3 - ND). Investigator-assessed ORR was 48.3% with a CR in 6 patients (3.5%) and a PR in 77 (44.8%). After a median treatment duration of 10.1 mo, 190 patients (87.6%) discontinued PZP and 67.9% received at least one post-PZP line. Second line post-PZP consisted in nivolumab (71.3%), cabozantinib (14.7%), sunitinib (7%) or other (7%). Adverse Event (AE) leading to PZP dose reduction and discontinuation were reported in 42% and 40.9% of patients and treatment-related serious AE in 22.2% of patients. No safety signal was newly identified. The impact of the Covid 19 pandemic was limited on patients’ cares and study follow-up. Visits during the pandemic included 84.1% of tumour evaluation. For 29 patients (14.1%), follow-up visits were carried out as a teleconsultation. Few patients (5,7%) had no visits during the pandemic. Conclusions: The APOLON study confirms PZP effectiveness and safety in patients with mRCC in real-life setting. The efficacy of pazopanib remains significant in patients aged 65 years and older. It is highly associated with risk score. The COVID pandemics had limited impact on patients’ cares.
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Affiliation(s)
| | - Philippe Barthelemy
- Institut de Cancérologie Strasbourg Europe,Strasbourg, France, Strasbourg, France
| | | | - Pierre Bigot
- Service d’Urologie CHU Angers, Université d’Angers, Angers, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital, Besançon, France
| | | | | | | | | | | | - Laurence Albiges
- Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
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Samir A, Abdeltawab R, Stein U, El Tayebi H. 175P Combined efforts of LncRNAs DILC and atezolizumab to regulate MMP-9 release in tumor microenvironment of TNBC TAMs and cells lines. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.195] [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: 10/19/2022] Open
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Mansi L, Spehner L, Daguindau E, Bouiller K, Almotlak H, Stein U, Bouard A, Kim S, Klajer E, Jary M, Meynard G, Vienot A, Nardin C, Bazan F, Lepiller Q, Westeel V, Adotévi O, Borg C, Kroemer M. Study of the SARS-CoV-2-specific immune T-cell responses in COVID-19-positive cancer patients. Eur J Cancer 2021; 150:1-9. [PMID: 33882374 PMCID: PMC7997727 DOI: 10.1016/j.ejca.2021.03.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/09/2021] [Accepted: 03/18/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cancer patients are considered highly vulnerable to the COVID-19 pandemic. However, delaying cancer-specific therapies could have a deleterious effect on survival. The potential suppressive effects of chemotherapies or cancer-related microenvironment raised the question on how cancer patients' immune system responds to SARS-CoV-2 virus. METHODS We have started a prospective monocentric trial entitled COV-CREM (NCT04365322) in April 2020. The primary objective of the trial was to assess specific immune response's intensity and diversity to SARS-CoV-2 in infected patients. RESULTS In this study, we showed that cancer patients (28 solid tumours, 11 haematological malignancies) exposed to SARS-CoV-2 produced a high rate of specific antibodies, as observed in patients without a cancer history (n = 29). However, our results highlight a lack in the generation of T-cell responses against CoV-N, M and S proteins from the SARS-CoV-2 virus, suggesting that cancer patients failed to mount a protective T-cell immunity. Nevertheless, SARS-CoV-2 infection did not impair established immune memory since specific responses against common viruses were not hampered in cancer patients. CONCLUSION Given the severity and the unknown evolution of the ongoing COVID-19 pandemic, it is of fundamental importance to integrate cancer patients in vaccination programs.
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Affiliation(s)
- Laura Mansi
- Department of Medical Oncology, University Hospital of Besançon, France; INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France.
| | - Laurie Spehner
- Department of Medical Oncology, University Hospital of Besançon, France; INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France
| | - Etienne Daguindau
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France; Department of Hematology, University Hospital of Besancon, France
| | - Kevin Bouiller
- Department of Infectious Disease, University Hospital of Besançon, France; UMR-CNRS 6249 Chrono-Environnement, Université Bourgogne Franche-Comté, F-25000, Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital of Besançon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital of Besançon, France
| | - Adeline Bouard
- Department of Hematology, University Hospital of Besancon, France
| | - Stefano Kim
- Department of Medical Oncology, University Hospital of Besançon, France
| | - Elodie Klajer
- Department of Medical Oncology, University Hospital of Besançon, France
| | - Marine Jary
- Department of Medical Oncology, University Hospital of Besançon, France; INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France; Department of Medical Oncology, Biotechnology and Immune-oncology Platforme, University Hospital of Besançon, France
| | - Guillaume Meynard
- Department of Medical Oncology, University Hospital of Besançon, France
| | - Angélique Vienot
- Department of Medical Oncology, University Hospital of Besançon, France; INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France; Department of Medical Oncology, Biotechnology and Immune-oncology Platforme, University Hospital of Besançon, France
| | - Charlée Nardin
- Department of Dermatology, University Hospital of Besançon, France; INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France
| | - Fernando Bazan
- Department of Medical Oncology, University Hospital of Besançon, France
| | - Quentin Lepiller
- Department of Virology, University Hospital of Besançon, France; Research Unit EA3181, Université de Franche Comté, F-25000 Besançon, France
| | - Virginie Westeel
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France; Department of Pneumology, University Hospital of Besancon, France
| | - Olivier Adotévi
- Department of Medical Oncology, University Hospital of Besançon, France; INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France
| | - Christophe Borg
- Department of Medical Oncology, University Hospital of Besançon, France; INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France; Department of Medical Oncology, Biotechnology and Immune-oncology Platforme, University Hospital of Besançon, France
| | - Marie Kroemer
- INSERM, EFS BFC, UMR1098 RIGHT, University of Bourgogne Franche-Comté, France; Department of Medical Oncology, Biotechnology and Immune-oncology Platforme, University Hospital of Besançon, France; Department of Pharmacy, University Hospital of Besançon, France
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Goujon M, Anota A, Frontczak A, Charton E, Maurina T, Almotlak H, Nguyen T, Fabien C, Stein U, Mouillet G, Thiery-Vuillemin A. Association of health-related quality of life (HRQOL) variations with biological biomarkers for patients with metastatic castrate-resistant prostate cancer (MCRPC) treated by abiraterone/prednisone combination or prednisone. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
54 Background: A potential link between Health-Related Quality of life (HRQoL) and oncologic outcomes such as overall survival or progression-free survival has been underlined for endocrine therapies in patients with metastatic castrate resistant prostate cancer (mCRPC). Other surrogates such as circulating tumor cells (CTCs) or PSA can be used to evaluate disease control. This study explored the associations between HRQoL and biological biomarkers for patients with mCRPC treated by abiraterone / prednisone or prednisone within registration phase III trial COU-AA-301. Methods: Baseline differences of HRQoL evaluated with FACT-P total score (FACT-P TS) according to biological parameters (including CTCs and PSA) and links between HRQoL's change and variations of these parameters were assessed. The primary objective was to estimate the association between improvement or deterioration in FACT-P TS and the variations of CTCs and PSA. All analyses were conducted using clinically meaningful improvement and deterioration in FACT-P TS and subscales. Results: Among 1130 patients enrolled, 1111 (98.3%) had a baseline FACT-P TS available. At baseline, a favorable CTCs count was associated with higher FACT-P TS compared to unfavorable CTCs (difference in means 8 points, [95% CI, 4 to 12] p < 0.001). At 3 months, there were differences in mean change from baseline FACT-P TS favoring patients with biomarkers response, with clinically meaningful difference for CTCs (12.7 points, [95% CI, 6 to 19.5%] p < 0.001) and PSA (11.64 points, [95% CI, 9.3 to 14] p < 0.0001). Biological progression was associated with higher risk of FACT-P TS worsening for PSA (Odds Ratio (OR) 2.8 [95% CI, 1.9 to 4.2]) with more frequent FACT-P TS improvement in case of response for CTCs (OR 3.14 [95% CI, 1.3 to 7.7]) and PSA (OR 2.9 [95% CI 2.1 to 4]). Significantly longer time until definitive deterioration was observed for patients with CTCs or PSA response (p < 0.001) and shorter time in case of progression (p < 0.001). Conclusions: QUA-lify is the first study to show an association between HRQoL and biomarkers outcomes in patients with mCRPC treated with endocrine therapy in a post-taxane setting. This concept is reinforced by the consistency of the association for all analyses carried out.
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Affiliation(s)
- Morgan Goujon
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Amelie Anota
- Quality of Life in Oncology Clinical Research Platform; Methodological and Quality of Life in Oncology, INSERM UMR 1098, University Hospital of Besancon, Besancon, France
| | | | - Emilie Charton
- Methodology and Quality of Life Unit, Department of Oncology, INSERM UMR 1098, University Hospital of Besancon; French National Platform Quality of Life and Cancer, Besançon, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Thierry Nguyen
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Calcagno Fabien
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Guillaume Mouillet
- Department of Medical Oncology, Methodological and Quality of Life Unit in Oncology (INSERM UMR 1098), University Hospital, Besançon, France
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Pötzsch M, Berg E, Hummel M, Stein U, von Winterfeld M, Jöhrens K, Rau B, Daum S, Treese C. Better prognosis of gastric cancer patients with high levels of tumor infiltrating lymphocytes is counteracted by PD-1 expression. Oncoimmunology 2020; 9:1824632. [PMID: 33101772 PMCID: PMC7553533 DOI: 10.1080/2162402x.2020.1824632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 12/20/2022] Open
Abstract
The prognostic potential of anti-tumor immune responses is becoming increasingly important in adenocarcinoma of the gastroesophageal junction and stomach (AGE/S) especially regarding the use of immune checkpoint inhibitors. This study analyzes for the first time the prognostic impact of tumor-infiltrating lymphocytes (TILs) and checkpoint inhibitors in a large Caucasian cohort in patients with AGE/S. We screened tissue samples from 438 therapy-naïve patients with AGE/S undergoing surgery between 1992 and 2005, examined in a tissue microarray (TMA) and stained against human CD3, CD4, CD8, PD-1, and PD-L1. Out of 438 tissue samples, 210 were eligible for multivariate analysis. This revealed that high infiltration with CD3+, CD4+, or CD8+ TILs was associated with an increased overall survival in AGE/S patients, which could only be confirmed in multivariate analysis for CD3 (HR: 0.326; p = .023). Independent improved survival was limited to gastric cancer patients and to early tumor stages as long as TILs did not express PD-1 (HR: 1.522; p = .021). Subgroup analyses indicate that TIL-dependent anti-tumor immune response is only effective in gastric cancer patients in early stages of disease in PD-1 negative TILs. Combined analysis of PD-1 and CD3 could serve as a prognostic marker for the clinical outcome of gastric cancer patients and could also be of interest for immunotherapy.
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Affiliation(s)
- M. Pötzsch
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Berlin, Germany
| | - E. Berg
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Berlin, Germany
| | - M. Hummel
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- 1.Institute for Pathology, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - U. Stein
- Experimental and Clinical Research Center, Charité - Universitätsmedizin, Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - M. von Winterfeld
- Institute of Pathology Heidelberg, University Hospital Heidelberg, Germany
| | - K. Jöhrens
- Institute of Pathology, University Carl Gustav Carus, Dresden, Germany
| | - B. Rau
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Surgery, Campus Virchow-Klinikum and Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S. Daum
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - C. Treese
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Berlin, Germany
- Experimental and Clinical Research Center, Charité - Universitätsmedizin, Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
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Mouillet G, Falcoz A, Barthélémy P, Geoffrois L, Ladoire S, Eymard JC, Plaza J, Viel E, Maurina T, Calcagno F, Stein U, Fritzsch J, Djoumakh O, Paget-Bailly S, Thiery-Vuillemin A. 1878P Health-related quality of life (HRQoL) assessment for patients with advanced renal cell carcinoma (aRCC) treated with a tyrosine kinase inhibitor (TKI) using electronic patient reported outcomes in daily clinical practice: QUANARIE trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1525] [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: 11/25/2022] Open
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Barthelemy P, Albiges L, Escudier B, Lebret T, Bigot P, Stein U, Dourthe LM, De La Cruz J, Tindel M, Thiery-Vuillemin A. Prospective observational study on pazopanib in patients treated for advanced/metastatic renal cell carcinoma (RCC): APOLON Study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
629 Background: Pazopanib (PZP), has been granted for advanced or metastatic RCC. In addition to pivotal clinical trials, real-world evidence (RWE) is required to evaluate effectiveness and safety in clinical routine practices. Methods: APOLON is a non-interventional, multicentric prospective study to assess PZP Progression-Free Survival (PFS) (8-month PFS rate as primary endpoint), Overall Survival (OS), Objective Response Rate (ORR), tolerability, subsequent post-pazopanib therapy sequences. It is conducted in France with 55 sites (hospital or private practitioners) in patients with mRCC, naïve to anti-VEGF therapy, who initiated PZP treatment. Data are collected at baseline and at 1, 2-3, 6, 9, 12, 18, 24, 30, 36 months (mo). Patients (n= 218) were recruited from Nov 2017 to Jan 2019. This interim analysis presents results 6 months after last patient was enrolled. Results: Patients were 71,1% males, with a median age of 69.6 years. They had clear-cell type RCC for 97.7% with a favourable (26.4%), intermediate (52.9%) or poor (20.7%) IMDC risk score. Comorbidities were: hypertension (75.1%), diabetes (26%), arterial disorders (20.1%), other pathologies (47.3%); 81.7% received co-medications. ECOG-PS was 0 (42.9%), 1 (40%), 2 (15.7%), Metastases were mainly located in lungs (62.8%), bones (28.9%), mediastinal (17.9%)/abdominal (17%) lymph nodes, glands (pancreas, thyroid, adrenals) (17.4%). Of them, 56% had an history of partial/total nephrectomy, 28.1% previous local treatments for metastases. Median PFS, assessed by investigator, was 11.3 mo (95%CI: 8.7-13), with an 8-mo PFS rate at 62.9%. ORR was 47.2% and 1-year OS rate was 71.2%. Treatment-related serious adverse events were reported in 17.3% of patients. No new safety signal was identified. After a median follow-up of 8.8 mo, of the 121 patients with discontinuation, 74 received post-PZP lines comprising firstly nivolumab (67.6%), cabozantinib (16.2%), sunitinib (10.8%), other (5.6%). Conclusions: APOLON study represents real-life population including elderly and frail patients with clinically meaningful ORR and PFS with PZP. Reported adverse events were consistent with known safety PZP profile.
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Affiliation(s)
| | - Laurence Albiges
- Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Bernard Escudier
- Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Pierre Bigot
- Service d’Urologie CHU Angers, Université d’Angers, Angers, France
| | - Ulrich Stein
- Medical Oncology - CHRU Jean Minjoz, Besançon, France
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Wimberger P, Link T, Herrmann P, Kobelt D, Vassileva Y, Kerstin F, Kuhlmann J, Stein U. Clinical relevance of circulating MACC1 and S100A4 transcripts in serum of ovarian cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.174] [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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13
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Hagemann C, Neuhaus N, Dahlmann M, Kessler AF, Kobelt D, Herrmann P, Eyrich M, Freitag B, Freitag B, Linsenmann T, Monoranu CM, Ernestus R, Löhr M, Stein U. P01.050 Circulating MACC1 transcript plasma levels in glioblastoma patients segregate together with prognostic markers and treatment response. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Hagemann
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - N Neuhaus
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - M Dahlmann
- Experimental and Clinical Research Center, Charite Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz-Association, Berlin, Germany
| | - A F Kessler
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - D Kobelt
- Experimental and Clinical Research Center, Charite Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz-Association, Berlin, Germany
| | - P Herrmann
- Experimental and Clinical Research Center, Charite Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz-Association, Berlin, Germany
| | - M Eyrich
- University of Würzburg, Department of Pediatric Hematology/Oncology, Würzburg, Germany
| | - B Freitag
- University of Würzburg, Department of Pediatric Hematology/Oncology, Würzburg, Germany
| | - B Freitag
- University of Würzburg, Department of Pediatric Hematology/Oncology, Würzburg, Germany
| | - T Linsenmann
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - C M Monoranu
- University of Würzburg, Department of Neuropathology, Würzburg, Germany
| | - R Ernestus
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - M Löhr
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - U Stein
- Experimental and Clinical Research Center, Charite Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz-Association, Berlin, Germany
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Mouillet G, Paillard MJ, Maurina T, Vernerey D, Nguyen Tan Hon T, Almotlak H, Stein U, Calcagno F, Berthod D, Robert E, Meurisse A, Thiery-Vuillemin A. Open-label, randomized multicentre phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen (dose modification or dose interruptions) in patients with advanced or metastatic renal cell carcinoma: study protocol of the SURF trial. Trials 2018; 19:221. [PMID: 29650037 PMCID: PMC5898055 DOI: 10.1186/s13063-018-2613-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/27/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sunitinib is a tyrosine kinase inhibitor approved in the first-line metastatic renal cell carcinoma (MRCC) setting at the dose of 50 mg daily for 4 weeks followed by a pause of 2 weeks. Due to toxicity, this standard schedule (50 mg daily 4/2) can induce up to 50% of sunitinib dose modification (reduction and/or interruption). The current recommendation in such case is to reduce the dose to 37.5 mg per day (standard schedule 4/2). Recent data highlight an alternative schedule: 2 weeks of treatment followed by 1 week of pause (experimental schedule 2/1). The SURF trial is set up to evaluate prospectively experimental schedule 2/1 when toxicity occurs. This article displays the key elements of the study protocol. METHODS/DESIGN SURF [NCT02689167] is a prospective, randomized, open-label phase IIb study. Patients are included at sunitinib initiation while receiving standard schedule 4/2 (50 mg daily) according to the marketing authorization indication. When a dose adjustment of sunitinib is required, patients are randomized between standard schedule 4/2 (37.5 mg daily) and experimental schedule 2/1 (50 mg daily). Key eligibility criteria are the following: patients with locally advanced inoperable or MRCC who are starting first-line treatment with sunitinib, with histologically or cytologically confirmed renal cancer clear cell variant or with a clear cell component, and with Karnofsky performance status ≥70%. The primary objective is to assess the median duration of sunitinib treatment (DOT) in each group. The key secondary objectives are progression-free survival, overall survival, time to randomization, objective response rate, safety, sunitinib dose intensity, health-related quality of life, and the description of main drivers triggering randomization. We hypothesized that experimental schedule 2/1 would result in an improvement in median DOT from 6 to 8.5 months. It was estimated that 112 patients would be needed in each arm during 24 months. In order to take into account the possibility of treatment discontinuation before randomization, 248 patients are necessary. DISCUSSION The SURF trial is asking a pragmatic question adapted to the current practice on what is the best way to adapt sunitinib when treatment-related adverse events occur. The results of the SURF trial will bring high-value data to support the use of an alternative schedule in sunitinib treatment. TRIAL REGISTRATION ClinicalTrials.gov, NCT02689167 . Registered on 26 February 2016.
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Affiliation(s)
- Guillaume Mouillet
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France. .,Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besancon, France. .,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France.
| | - Marie-Justine Paillard
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France.,Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Dewi Vernerey
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besancon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
| | - Thierry Nguyen Tan Hon
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Fabien Calcagno
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
| | - Diane Berthod
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France
| | - Elise Robert
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
| | - Aurelia Meurisse
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, 25000, Besancon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
| | - Antoine Thiery-Vuillemin
- Department of Medical Oncology, University Hospital of Besançon, 25000, Besancon, France.,Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besancon, France
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Rohr UP, Herrmann P, Ilm K, Zhang H, Lohmann S, Reiser A, Muranyi A, Smith J, Burock S, Osterland M, Leith K, Singh S, Brunhoeber P, Bowermaster R, Tie J, Christie M, Wong HL, Waring P, Shanmugam K, Gibbs P, Stein U. Prognostic value of MACC1 and proficient mismatch repair status for recurrence risk prediction in stage II colon cancer patients: the BIOGRID studies. Ann Oncol 2017; 28:1869-1875. [DOI: 10.1093/annonc/mdx207] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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16
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Dénommé F, Kroemer M, Montcuquet P, Nallet G, Thiery-Vuillemin A, Bazan F, Mouillet G, Villanueva C, Demarchi M, Stein U, Almotlak H, Chaigneau L, Curtit E, Meneveau N, Maurina T, Dobi E, Hon TNT, Cals L, Mansi L, Verlut C, Pana-Katatali H, Caubet M, Paillard MJ, Limat S, Pivot X, Nerich V. [Prevalence and management of pain in patients with metastatic cancer in Franche-Comté]. Bull Cancer 2016; 103:849-860. [PMID: 27692731 DOI: 10.1016/j.bulcan.2016.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/15/2016] [Accepted: 08/29/2016] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Pain management is a major public health problem, especially in oncology. In order to assess professional practice, the IRFC-FC conducted a survey amongst patients with metastatic osteophilic solid tumor in Franche-Comté. The aims were to assess the pain prevalence, and its characteristics, its management and its impact on patients' quality of life in patients in pain. METHODS An observational, prospective and multicenter survey was conducted using a self-report questionnaire. Patients with metastatic breast or prostate cancer managed in 5 day-hospitals of the IRFC-FC over a period of three months were included. RESULTS Two hundred thirty-three questionnaires were analyzed. Pain prevalence rate was 48.5%. Three quarters of patients in pain had chronic background pain, moderate to severe, with or without breakthrough pain. Considering their pain intensity and their analgesic therapy, 42.0% of patients seem to have an inadequate treatment. Eighty-five percent of treated patients reported to be compliant and felt that their pain was well managed despite a strong impact on their quality of life. CONCLUSION The setting of a specific clinical pathway is essential to secure the standardized, optimal and efficient management of patients in pain. The assessment of patient satisfaction and quality of life must be integrated in clinical practice to identify patients in pain for which the treatment is inappropriate.
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Affiliation(s)
- Fanny Dénommé
- CHRU de Besançon, pôle pharmacie, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Marie Kroemer
- CHRU de Besançon, pôle pharmacie, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France
| | - Philippe Montcuquet
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Gilles Nallet
- Oncolie, réseau de cancérologie de Franche-Comté, pôle cancérologie, 2, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Antoine Thiery-Vuillemin
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France; CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Fernando Bazan
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Guillaume Mouillet
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Cristian Villanueva
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Martin Demarchi
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Ulrich Stein
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Hamadi Almotlak
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Loïc Chaigneau
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Elsa Curtit
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France; CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Nathalie Meneveau
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Tristan Maurina
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Erion Dobi
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Thierry Nguyen Tan Hon
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Laurent Cals
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Laura Mansi
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France; CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Clotilde Verlut
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Héloïse Pana-Katatali
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Mathieu Caubet
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Marie-Justine Paillard
- CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Samuel Limat
- CHRU de Besançon, pôle pharmacie, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France
| | - Xavier Pivot
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France; CHRU de Besançon, service d'oncologie médicale, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France
| | - Virginie Nerich
- CHRU de Besançon, pôle pharmacie, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, interactions hôte-greffon-tumeur - ingénierie cellulaire et génique, Besançon, France.
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Mouillet G, Maurina T, Paillard MJ, Montcuquet P, Hon TNT, Almotlak H, Stein U, Berthod D, Robert E, Meurisse A, Bonnetain F, Thiery-Vuillemin A. Surf: Open label, randomized multi-centre phase II study to assess the efficacy and tolerability of sunitinib by dose administration regimen (dose modification or dose interruptions) in patients with advanced or metastatic renal cell carcinoma (mRCC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.70] [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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Saalmüller M, Stein U. Bed & Breakfast und Betreuung (BBB). Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1578897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Caubet M, Dobi E, Pozet A, Almotlak H, Montcuquet P, Maurina T, Mouillet G, N'guyen T, Stein U, Thiery-Vuillemin A, Fiteni F. Carboplatin-etoposide combination chemotherapy in metastatic castration-resistant prostate cancer: A retrospective study. Mol Clin Oncol 2015; 3:1208-1212. [PMID: 26807222 PMCID: PMC4665308 DOI: 10.3892/mco.2015.628] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 06/22/2015] [Indexed: 11/26/2022] Open
Abstract
The combination of cisplatin or carboplatin and etoposide is the standard treatment for certain poorly differentiated neuroendocrine cancers, such as small-cell lung cancer. The aim of this study was to assess the efficacy and tolerability of the carboplatin-etoposide regimen in metastatic castration-resistant prostate cancer (mCRPC). A total of 27 patients treated by carboplatin [area under the curve (AUC)=5] and etoposide (100 mg/m2 intravenous infusion on days 1–3 or 75 mg orally/day for 10 days) for mCRPC were included for analysis. The median progression-free survival was 3.3 months [95% confidence interval (CI): 1.9–4.2] and the median overall survival (OS) was 8.1 months (95% CI: 4.06–12.36). The main grade 3–4 toxicities were haematological, namely anemia (33.3%), neutropenia (25.9%) and thrombocytopenia (22.2%), whereas the most common non-hematological toxicity was asthenia (22.2%). The efficacy, compliance and safety profile were generally similar between the oral and intravenous etoposide groups. Pretreated patients with mCRPC may benefit from the carboplatin-etoposide regimen in terms of OS. The toxicities were acceptable, without reported treatment-related mortality. Therefore, the oral etoposide regimen may be an viable alternative for improving the quality of life of the patients. However, this regimen requires further prospective investigation to confirm its efficacy.
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Affiliation(s)
- Matthieu Caubet
- Department of Radiotherapy, University Hospital of Besançon, 25030 Besançon, France
| | - Erion Dobi
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Hospital of Montbéliard, 25200 Montbéliard, France
| | - Astrid Pozet
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, 25030 Besançon, France
| | - Hamadi Almotlak
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Hospital of Lons-le-Saunier, 39000 Lons-le-Saunier, France
| | - Philippe Montcuquet
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Vesoul Hospital, 70000 Vesoul, France
| | - Tristan Maurina
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Hospital of Montbéliard, 25200 Montbéliard, France
| | - Guillaume Mouillet
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Hospital of Montbéliard, 25200 Montbéliard, France
| | - Thierry N'guyen
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France
| | - Ulrich Stein
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Department of Medical Oncology, Vesoul Hospital, 70000 Vesoul, France
| | | | - Frederic Fiteni
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France; Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, 25030 Besançon, France
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Bock H, Chenards BL, Rittmeyer P, Stein U. Radical Ions, 78 [1, 2] The Oxidative Desulfuration of Organic Cyclic Polysulfides to Disulfide Radical Cations in AlCl3 /H2 CCl2 Solution. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znb-1988-0121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Organodisulfide radical cations R2S2'® and R2C2S2'® can be generated from aliphatic as well as aromatic cyclic polysulfides in A1C13/H2CC12 solutions and characterized by their ESR spectra. Examples presented are the oxidations of 1,2,3-trithiolanes to 1,2-dithiolane radical cations, in which energetically favored planarized 3 electron/2 center bonds - S a r e formed.
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Affiliation(s)
- H. Bock
- Chemistry Department, University of Frankfurt, Niederurseier Hang. D-6000 Frankfurt 50. Germany
| | - B. L. Chenards
- Corporate Research Contribution No. 4441 from E. I. du Pont de Nemours Company. Central Research and Development Department, Experimental Station, Wilmington. Delaware 19898 U.S.A
- Pfizer, Inc., Central Research. Eastern, Point Rd., Groton, CT 06340
| | - P. Rittmeyer
- Chemistry Department, University of Frankfurt, Niederurseier Hang. D-6000 Frankfurt 50. Germany
| | - U. Stein
- Chemistry Department, University of Frankfurt, Niederurseier Hang. D-6000 Frankfurt 50. Germany
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Nerich V, Hugues M, Paillard MJ, Borowski L, Nai T, Stein U, Nguyen Tan Hon T, Montcuquet P, Maurina T, Mouillet G, Kleinclauss F, Pivot X, Limat S, Thiery-Vuillemin A. Clinical impact of targeted therapies in patients with metastatic clear-cell renal cell carcinoma. Onco Targets Ther 2014; 7:365-74. [PMID: 24600236 PMCID: PMC3942215 DOI: 10.2147/ott.s56370] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction The aim of this retrospective clinical study was to assess, in the context of the recent evolution of systemic therapies, the potential effect of targeted therapies on overall survival (OS) of patients with metastatic clear-cell renal cell carcinoma (mccRCC) in daily practice. Patients and methods All consecutive patients with histologically confirmed mccRCC who received systemic therapy between January 2000 and December 2010 in two oncology treatment centers in our Franche-Comté region in eastern France were included in the analysis. The primary end point was OS. The analysis of prognostic factors was performed using a two-step approach: univariate then multivariate analysis with a stepwise Cox proportional hazards regression model. Results For the entire cohort of 111 patients, the median OS was 17 months (95% confidence interval [CI]; 13–22 months) and the two-year OS was 39%. Three prognostic factors were independent predictors of long survival: prior nephrectomy (hazard ratio =0.38 [0.22–0.64], P<0.0001); systemic therapy by targeted therapy (hazard ratio =0.50 [0.31–0.80], P=0.005); and lack of liver metastasis (hazard ratio =0.43 [0.22–0.82], P=0.002). Median OS was 21 months [14–29 months] for patients who received at least one targeted therapy compared with 12 months [7–15 months] for patients who were treated only by immunotherapy agents (P=0.003). Conclusion Our results suggest that targeted therapies are associated with improved OS in comparison with cytokines, which is in line with other publications.
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Affiliation(s)
- Virginie Nerich
- Department of Pharmacy, University Hospital, Besançon, France ; Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France
| | - Marion Hugues
- Department of Pharmacy, University Hospital, Besançon, France
| | | | | | - Thierry Nai
- Department of Pharmacy, University Hospital, Besançon, France
| | - Ulrich Stein
- Department of Medical Oncology, Besançon, France
| | | | | | | | | | - François Kleinclauss
- Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Urology, University Hospital, Besançon, France
| | - Xavier Pivot
- Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Medical Oncology, Besançon, France
| | - Samuel Limat
- Department of Pharmacy, University Hospital, Besançon, France ; Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France
| | - Antoine Thiery-Vuillemin
- Inserm U645 EA-2284 IFR-133, University of Franche-Comté, Besançon, France ; Department of Medical Oncology, Besançon, France
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Schmid F, Wang Q, Huska M, Andrade M, Fichtner I, Schlag P, Stein U. 211 SPON2, a Newly Identified Transcriptional Target Gene of MACC1, is Associated with Colorectal Cancer Metastasis. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72009-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
The occurrence of the multidrug resistance phenotype still represents a limiting factor for successful cancer chemotherapy. Numerous efforts have been made to develop strategies for reversal and/or modulation of this major therapy obstacle through targeting at different levels of intervention. The phenomenon of MDR is often associated with overexpression of resistance-associated genes. Since the classical type of MDR in human cancers is mainly mediated by the P-glycoprotein encoded by the multidrug resistance gene 1, mdr1, the majority of reversal approaches target the expression and/or function of the mdr1 gene/P-glycoprotein. Due to the fact that the multidrug phenotype always represents the net effect of a panel of resistance-associated genes/gene products, other resistance genes, e.g. those encoding the multidrug resistance-associated protein MRP or the lung resistance protein LRP, were included in the studies. Cytokines such as tumor necrosis factor alpha and interleukin-2 have been shown to modulate the MDR phenotype in different experimental settings in vitro and in vivo. Several studies have been performed to evaluate their potential as chemosensitizers of tumor cells in the context of a combined application of MDR-associated anticancer drugs like doxorubicin and vincristine with cytokines. Moreover, the capability of cytokines to modulate the expression of MDR-associated genes was demonstrated, either by external addition or by transduction of the respective cytokine gene. Knowledge of the combination effects of cytokines and cytostatics and its link to their MDR-modulating capacity may contribute to a more efficient and to a more individualized immuno-chemotherapy of human malignancies.
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Affiliation(s)
- U Stein
- Max-Delbrück-Center for Molecular Medicine, Robert-Rössle-Strasse 10, 13122, Berlin, Germany.,
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Stein U, Fleuter C, Siegel F, Smith J, Kopacek A, Scudiero DA, Hite KM, Schlag PM, Shoemaker RH, Walther W. Impact of mutant β-catenin on ABCB1 expression and therapy response in colon cancer cells. Br J Cancer 2012; 106:1395-405. [PMID: 22460269 PMCID: PMC3327894 DOI: 10.1038/bjc.2012.81] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [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] [Indexed: 11/17/2022] Open
Abstract
Background: Colorectal cancers are often chemoresistant toward antitumour drugs that are substrates for ABCB1-mediated multidrug resistance (MDR). Activation of the Wnt/β-catenin pathway is frequently observed in colorectal cancers. This study investigates the impact of activated, gain-of-function β-catenin on the chemoresistant phenotype. Methods: The effect of mutant (mut) β-catenin on ABCB1 expression and promoter activity was examined using HCT116 human colon cancer cells and isogenic sublines harbouring gain-of-function or wild-type β-catenin, and patients’ tumours. Chemosensitivity towards 24 anticancer drugs was determined by high throughput screening. Results: Cell lines with mut β-catenin showed high ABCB1 promoter activity and expression. Transfection and siRNA studies demonstrated a dominant role for the mutant allele in activating ABCB1 expression. Patients’ primary colon cancer tumours shown to express the same mut β-catenin allele also expressed high ABCB1 levels. However, cell line chemosensitivities towards 24 MDR-related and non-related antitumour drugs did not differ despite different β-catenin genotypes. Conclusion: Although ABCB1 is dominantly regulated by mut β-catenin, this did not lead to drug resistance in the isogenic cell line model studied. In patient samples, the same β-catenin mutation was detected. The functional significance of the mutation for predicting patients’ therapy response or for individualisation of chemotherapy regimens remains to be established.
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Affiliation(s)
- U Stein
- Charité Medical Faculty, Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.
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Walther W, Petkov S, Kuvardina ON, Aumann J, Kobelt D, Fichtner I, Lemm M, Piontek J, Blasig IE, Stein U, Schlag PM. Novel Clostridium perfringens enterotoxin suicide gene therapy for selective treatment of claudin-3- and -4-overexpressing tumors. Gene Ther 2011; 19:494-503. [PMID: 21975465 DOI: 10.1038/gt.2011.136] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Bacterial toxins are known to be effective for cancer therapy. Clostridium perfringens enterotoxin (CPE) is produced by the bacterial Clostridium type A strain. The transmembrane proteins claudin-3 and -4, often overexpressed in numerous human epithelial tumors (for example, colon, breast, pancreas, prostate and ovarian), are the targeted receptors for CPE. CPE binding to them triggers formation of membrane pore complexes leading to rapid cell death. In this study, we aimed at selective tumor cell killing by CPE gene transfer. We generated expression vectors bearing the bacterial wild-type CPE cDNA (wtCPE) or translation-optimized CPE (optCPE) cDNA for in vitro and in vivo gene therapy of claudin-3- and -4-overexpressing tumors. The CPE expression analysis at messenger RNA and protein level revealed more efficient expression of optCPE compared with wtCPE. Expression of optCPE showed rapid cytotoxic activity, hightened by CPE release as bystander effect. Cytotoxicity of up to 100% was observed 72 h after gene transfer and is restricted to claudin-3-and -4-expressing tumor lines. MCF-7 and HCT116 cells with high claudin-4 expression showed dramatic sensitivity toward CPE toxicity. The claudin-negative melanoma line SKMel-5, however, was insensitive toward CPE gene transfer. The non-viral intratumoral in vivo gene transfer of optCPE led to reduced tumor growth in MCF-7 and HCT116 tumor-bearing mice compared with the vector-transfected control groups. This novel approach demonstrates that CPE gene transfer can be employed for a targeted suicide gene therapy of claudin-3- and -4-overexpressing tumors, leading to the rapid and efficient tumor cell killing in vitro and in vivo.
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Affiliation(s)
- W Walther
- Experimental and Clinical Research Center, Charité University Medicine Berlin, Berlin, Germany.
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Villanueva C, Chaigneau L, Dufresne A, Thierry Vuillemin A, Stein U, Demarchi M, Bazan F, N'guyen T, Pivot X. Phase II trial of paclitaxel and uracil--tegafur in metastatic breast cancer. TEGATAX trial. Breast 2011; 20:329-33. [PMID: 21439823 DOI: 10.1016/j.breast.2011.02.018] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/08/2011] [Accepted: 02/21/2011] [Indexed: 10/18/2022] Open
Abstract
UNLABELLED This Phase II trial investigated the combination paclitaxel (P) and uracil-tegafur (UFT) in patients with metastatic breast cancer (MBC). METHODS Main eligibility criteria included HER-2 negative MBC, ECOG performance status of 0-2, exposure to 1-2 prior chemotherapy regimen in the metastatic setting, previous exposure to an anthracycline containing regimen either at metastatic or adjuvant setting. Each 35-day cycle consisted of P at 80 mg/m(2) by intravenous infusion on days 1, 8, 15, 22 and 29 and oral UFT at 300 mg/m(2) TID (three time a day) from days 1-28 and oral folinic acid at 90 mg QD (one a day). RESULTS Between March 2003 and December 2007, 31 patients were enrolled. Median age was 66 years (range 44-78). All tumours were HER-2 negative and 7% were triple negative (ER, PgR, HER-2). The majority of patients had visceral disease (81%). All patients had received an anthracycline containing regimen and 74% had a previous docetaxel containing treatment. Median of 4 and 3 cycles of P and UFT were administered with a relative dose intensity of 85.3% and 94.3%, respectively. Twelve (40%)(95% CI: 22.5-57.5) confirmed ORR were observed. Stable and progression disease were reported in 43% and 17% of cases. Median Response duration was 8.4 month (95% CI: 4.9-11.7), median Time to progression was 9.5 months (95% CI: 6.6-13.8) and median Overall Survival was 23.5 months (95% CI: 16.8-37.2). Thirteen pts (43%) experienced a grade 3 or 4 adverse events (AEs): One death occurred related to the study drugs (febrile neutropenia). Chemotherapy was discontinued due to toxicity in 30% of pts CONCLUSIONS Accrual was closed in January 2008 due to concerns regarding the degree and accumulative nature of AEs. Nonetheless, the ORR is encouraging and warranted further studies with adapted doses and schedules.
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Affiliation(s)
- C Villanueva
- Centre Hospitalier Universitaire de Besançon, Service d'Oncologie Médicale, 25030 Besancon cedex, France.
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Stein U, Burock S, Herrmann P, Wendler I, Niederstrasser M, Wernecke K, Schlag P. 13LBA S100A4 transcripts in blood of colon, rectal, and gastric cancer patients: development of a new blood-based assay for improved diagnosis and prognosis. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)72048-8] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Guardiola E, Delroeux D, Heyd B, Combe M, Lorgis V, Demarchi M, Stein U, Royer B, Chauffert B, Pivot X. Intra-operative intra-peritoneal chemotherapy with cisplatin in patients with peritoneal carcinomatosis of ovarian cancer. World J Surg Oncol 2009; 7:14. [PMID: 19203351 PMCID: PMC2644300 DOI: 10.1186/1477-7819-7-14] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [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: 06/21/2007] [Accepted: 02/09/2009] [Indexed: 02/01/2023] Open
Abstract
Background Intra-peritoneal (i.p.) chemotherapy is an encouraging treatment option for ovarian cancer with peritoneum involvement in addition with intravenous (i.v.) chemotherapy. Intra-operative i.p. chemotherapy is an interesting method of administration by enhancing the diffusion of chemotherapy. This study had assessed the feasibility of intra-operative i.p. chemotherapy in patients with peritoneal carcinoma of ovarian cancer. Methods From January 2003 to February 2006, 47 patients with stage III ovarian cancer were treated with standard paclitaxel carboplatin intravenous chemotherapy and debulking surgery with intra-operative i.p. chemotherapy. After optimal cytoreductive surgery, defined by no unresectable residual disease > 1 cm, i.p. chemotherapy was performed during surgery. The peritoneal cavity was filled by 3 litres of isotonic saline pre-heated at 37 degrees and 90 mg of cisplatin. The sequence was repeated twice during 2 hours based on previous published studies which optimized the cisplatin dosage and exposure duration. Optimal diffusion was obtained by stirring by hands during the 2 hours. Results Median age was 59.6 years. No severe haematological or non-haematological toxicity induced by intra operative i.p. chemotherapy was reported. No patient died due to the complications of surgery or the i.p. chemotherapy. No neurotoxicity occurred, and one patients had renal impairment. Conclusion This study demonstrates the feasibility of intra-operative i.p. chemotherapy with cisplatin after optimal resection of peritoneal tumor nodules. Further randomized trials are planned to investigate the clinical benefit of this therapeutic modality.
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Affiliation(s)
- Emmanuel Guardiola
- University Hospital Jean Minjoz, Department of Medical Oncology, Besançon Cedex, France.
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Pivot X, Villanueva C, Chaigneau L, Nguyen T, Demarchi M, Maurina T, Stein U, Borg C. Ixabepilone, a novel epothilone analog in the treatment of breast cancer. Expert Opin Investig Drugs 2008; 17:593-9. [PMID: 18363523 DOI: 10.1517/13543784.17.4.593] [Citation(s) in RCA: 12] [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: 11/05/2022]
Abstract
BACKGROUND Natural epothilones and their analogs promote tumor cell death by binding to tubulin and stabilizing microtubules, causing cell death. Ixabepilone (BMS-247550, Ixempra) is an epothilone analog that optimizes the properties naturally observed with epothilone B. OBJECTIVE To provide an overview of the results achieved by ixabepilone in metastatic breast cancer. METHODS A PubMed search was performed to provide an extensive review of all published data on ixabepilone, in addition to all data reported from international congresses, from 2003 to 2007. RESULTS/CONCLUSION There is a clear need for new agents active against resistant metastatic breast cancer and ixabepilone might be a welcome new compound in this situation.
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Affiliation(s)
- Xavier Pivot
- Oncologie Médicale, CHU J Minjoz, 25000 Besançon, France.
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Thiery-Vuillemin A, Chaigneau L, Meaux-Ruault N, Villanueva C, N'guyen T, Maurina T, Stein U, Lorgis V, Demarchi M, Pivot X. Anticancer therapy in patients with porphyrias: evidence today. Expert Opin Drug Saf 2008; 7:159-65. [DOI: 10.1517/14740338.7.2.159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Müller C, Wagner A, Stein U, Remberger K, Tilgen W, Pföhler C. Erythema gyratum repens bei einem Patienten mit großzelligem B-Zell-Non-Hodgkin-Lymphom des Hodens. Akt Dermatol 2007. [DOI: 10.1055/s-2007-966974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Stein U, Arlt F, Walther W, Smith J, Schlag P, Birchmeier W, Shoemaker R. 95 POSTER Invasion knock down of human colon cancer cells by siRNA specific for S100A4, a newly identified target gene of beta-catenin/TCF signaling. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Walther W, Minow T, Martin R, Fichtner I, Schlag PM, Stein U. Uptake, biodistribution, and time course of naked plasmid DNA trafficking after intratumoral in vivo jet injection. Hum Gene Ther 2006; 17:611-24. [PMID: 16776570 DOI: 10.1089/hum.2006.17.611] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Nonviral jet injection is an applicable technology for in vivo gene transfer of naked DNA. However, little is known about the biodistribution and clearance of jet-injected DNA, or about its localization within tissue and cells. Therefore, in this study we analyzed the intratumoral and systemic biodistribution of jet-injected naked DNA in human colon carcinoma-bearing NCr-nu/nu mice, which were jet-injected with the pCMVbeta plasmid DNA. Intratumoral and systemic plasmid DNA biodistribution was analyzed 5, 10, 20, and 40 min and 3, 6, 24, 48, and 72 hr after jet injection, using quantitative real-time polymerase chain reaction. In the tumors, a rapid drop in naked DNA load within 24 hr of jet injection was shown. Detailed analysis of intratumoral distribution of rhodamine-labeled DNA revealed the presence of plasmid DNA within tumor cells 5 min after jet injection and further accumulation of significant DNA amounts in the cell nuclei 30 to 60 min after jet injection. In the blood, DNA amounts rapidly dropped within 10 to 40 min of jet injection to less than 0.001 pg of plasmid per 250 ng of tissue DNA and only minimal plasmid DNA dissemination was detected in liver, lung, spleen, kidney, and ovaries, which was cleared 3 to 6 hr after jet injection. By contrast, in heart, bone marrow, and brain almost no plasmid DNA was detectable.
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Affiliation(s)
- W Walther
- Max Delbrück Center for Molecular Medicine, 13092 Berlin, Germany.
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Chaigneau L, Guardiola E, N'Guyen T, Dufresne A, Stein U, Villanueva C, Thiery-Vuillemin A, Lorchel F, Pivot X. [Induction chemotherapy in patients with head and neck cancer]. Bull Cancer 2006; 93:677-82. [PMID: 16873076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2006] [Accepted: 02/01/2006] [Indexed: 05/11/2023]
Abstract
Neoadjuvant chemotherapies for patients with advanced head and neck squamous cell carcinoma have been widely studied for twenty years. Despite a high level of activity on the primary tumor, no study has demonstrated a survival benefit suggesting the use of neoadjvant chemotherapy. One can consider that the only benefit of such strategy is for larynx preservation in patients with operable hypopharnx or larynx cancer. Nevertheless, recently the well established preservation strategy based on induction chemotherapy following according to the activity by radiotherapy has been knocked over by a strategy developed by Forastiere et al. using primary concomitant chemoradiotherapy. However, the lack of benefit reported by neoadjuvant chemotherapy has been thwarted by the recent results provided by the EORTC study which assessed the survival benefit of neoadjuvant chemotherapy by docetaxel-cisplatin-fluorouracile. Interestingly, since 2002 the clearly established strategies for patients with advanced head and neck cancer have been challenged and new options are emerging. This paper reviews the standard strategy of the past and the future proposal emerging from recent studies.
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Affiliation(s)
- Loïc Chaigneau
- Service d'oncologie médicale, centre hospitalier universitaire Jean Minjoz, boulevard Fleming, 25000 Besançon.
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Limat S, Bracco-Nolin CH, Legat-Fagnoni C, Chaigneau L, Stein U, Huchet B, Pivot X, Woronoff-Lemsi MC. Economic impact of simplified de Gramont regimen in first-line therapy in metastatic colorectal cancer. Eur J Health Econ 2006; 7:107-13. [PMID: 16474968 DOI: 10.1007/s10198-006-0338-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The cost of chemotherapy has dramatically increased in advanced colorectal cancer patients, and the schedule of fluorouracil administration appears to be a determining factor. This retrospective study compared direct medical costs related to two different de Gramont schedules (standard vs. simplified) given in first-line chemotherapy with oxaliplatin or irinotecan. This cost-minimization analysis was performed from the French Health System perspective. Consecutive unselected patients treated in first-line therapy by LV5FU2 de Gramont with oxaliplatin (Folfox regimen) or with irinotecan (Folfiri regimen) were enrolled. Hospital and outpatient resources related to chemotherapy and adverse events were collected from 1999 to 2004 in 87 patients. Overall cost was reduced in the simplified regimen. The major factor which explained cost saving was the lower need for admissions for chemotherapy. Amount of cost saving depended on the method for assessing hospital stay. In patients treated by the Folfox regimen the per diem and DRG methods found cost savings of Euro 1,997 and Euro 5,982 according to studied schedules; in patients treated by Folfiri regimen cost savings of Euro 4,773 and Euro 7,274 were observed, respectively. In addition, travel costs were also reduced by simplified regimens. The robustness of our results was showed by one-way sensitivity analyses. These findings demonstrate that the simplified de Gramont schedule reduces costs of current first-line chemotherapy in advanced colorectal cancer. Interestingly, our study showed several differences in costs between two costing approaches of hospital stay: average per diem and DRG costs. These results suggested that standard regimen may be considered a profitable strategy from the hospital perspective. The opposition between health system perspective and hospital perspective is worth examining and may affect daily practices. In conclusion, our study shows that the simplified de Gramont schedule in combination with oxaliplatin or irinotecan is an attractive option from the French Health System perspective. This safe and less costly regimen must compared to alternative options such as oral fluoropyrimidines.
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Walther W, Minow T, Martin R, Fichtner I, Schlag P, Stein U. Uptake, Biodistribution, and Time Course of Naked Plasmid DNA Trafficking After Intratumoral In Vivo Jet Injection. Hum Gene Ther 2006. [DOI: 10.1089/hum.2006.17.ft-207] [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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Madry H, Kaul G, Cucchiarini M, Stein U, Zurakowski D, Remberger K, Menger MD, Kohn D, Trippel SB. Enhanced repair of articular cartilage defects in vivo by transplanted chondrocytes overexpressing insulin-like growth factor I (IGF-I). Gene Ther 2006; 12:1171-9. [PMID: 15815701 DOI: 10.1038/sj.gt.3302515] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Traumatic articular cartilage lesions have a limited capacity to heal. We tested the hypothesis that overexpression of a human insulin-like growth factor I (IGF-I) cDNA by transplanted articular chondrocytes enhances the repair of full-thickness (osteochondral) cartilage defects in vivo. Lapine articular chondrocytes were transfected with expression plasmid vectors containing the cDNA for the Escherichia coli lacZ gene or the human IGF-I gene and were encapsulated in alginate. The expression patterns of the transgenes in these implants were monitored in vitro for 36 days. Transfected allogeneic chondrocytes in alginate were transplanted into osteochondral defects in the trochlear groove of rabbits. At three and 14 weeks, the quality of articular cartilage repair was evaluated qualitatively and quantitatively. In vitro, IGF-I secretion by implants constructed from IGF-I-transfected chondrocytes and alginate was 123.2+/-22.3 ng/10(7) cells/24 h at day 4 post transfection and remained elevated at day 36, the longest time point evaluated. In vivo, transplantation of IGF-I implants improved articular cartilage repair and accelerated the formation of the subchondral bone at both time points compared to lacZ implants. The data indicate that allogeneic chondrocytes, transfected by a nonviral method and cultured in alginate, are able to secrete biologically relevant amounts of IGF-I over a prolonged period of time in vitro. The data further demonstrate that implantation of these composites into deep articular cartilage defects is sufficient to augment cartilage defect repair in vivo. These results suggest that therapeutic growth factor gene delivery using encapsulated and transplanted genetically modified chondrocytes may be applicable to sites of focal articular cartilage damage.
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Affiliation(s)
- H Madry
- Laboratory for Experimental Orthopaedics, Department of Orthopaedic Surgery, Saarland University, Homburg, Germany
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Conroy T, Paillot B, François E, Bugat R, Jacob JH, Stein U, Nasca S, Metges JP, Rixe O, Michel P, Magherini E, Hua A, Deplanque G. Irinotecan plus oxaliplatin and leucovorin-modulated fluorouracil in advanced pancreatic cancer--a Groupe Tumeurs Digestives of the Federation Nationale des Centres de Lutte Contre le Cancer study. J Clin Oncol 2005; 23:1228-36. [PMID: 15718320 DOI: 10.1200/jco.2005.06.050] [Citation(s) in RCA: 174] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To evaluate response rate and toxicity of irinotecan and oxaliplatin plus fluorouracil (FU) and leucovorin (Folfirinox) in advanced pancreatic adenocarcinoma (APA). PATIENTS AND METHODS Chemotherapy-naive patients with histologically proven APA and bidimensionally measurable disease were treated with Folfirinox therapy every 2 weeks, which comprised oxaliplatin 85 mg/m(2) and irinotecan 180 mg/m(2) plus leucovorin 400 mg/m(2) followed by bolus FU 400 mg/m(2) on day 1, then FU 2,400 mg/m(2) as a 46-hour continuous infusion. Quality of life (QOL) was assessed using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). RESULTS Forty-seven patients were entered, and 46 received treatment. Thirty-five patients (76%) had metastatic disease. A total of 356 cycles were delivered, with a median of eight cycles per patient (range, one to 24 cycles). All patients were assessable for safety. No toxic death occurred. Grade 3 to 4 neutropenia occurred in 52% of patients, including two patients with febrile neutropenia. Other relevant toxicities included grade 3 to 4 nausea (20%), vomiting (17%), and diarrhea (17%) and grade 3 neuropathy (15%; Levi's scale). The confirmed response rate was 26% (95% CI, 13% to 39%), including 4% complete responses. Median time to progression was 8.2 months (95% CI, 5.3 to 11.6 months), and median overall survival was 10.2 months (95% CI, 8.1 to 14.4 months). Between baseline and end of treatment, patients had improvement in all functional scales of the EORTC QLQ-C30, except cognitive functioning. Responders had major improvement in global QOL. CONCLUSION With a good safety profile, a promising response rate, and an improvement in QOL, Folfirinox will be further assessed in a phase III trial.
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Affiliation(s)
- Thierry Conroy
- Department of Medical Oncology, Centre Alexis Vautrin, 54511 Vandoeuvre-lès-Nancy Cedex, France.
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Siemer S, Lehmann J, Loch A, Becker F, Stein U, Schneider G, Ziegler M, Stöckle M. CURRENT TNM CLASSIFICATION OF RENAL CELL CARCINOMA EVALUATED: REVISING STAGE T3a. J Urol 2005; 173:33-7. [PMID: 15592020 DOI: 10.1097/01.ju.0000146719.43269.e8] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE : Recent studies of rare cases of pT3a renal cell carcinoma extending directly into the adrenal gland showed worse survival than in other pT3a cases and recategorization as stage pT4 was suggested. We assessed the prognostic validity of a stage pT3a diagnosis based on perirenal fat infiltration. MATERIALS AND METHODS : The records of 1,794 patients with renal cell carcinoma who underwent surgical resection between 1975 and 2000 at our institution were analyzed retrospectively. Focusing on pT3a tumors, as defined by perirenal fat infiltration, numerous clinical and histopathological parameters were investigated by univariate and multivariate statistical methods with cancer specific survival as the primary end point. RESULTS : We identified 237 of 1,794 patients with perirenal fat infiltration, classified as having pT3a disease. In patients with pT3a tumors tumor size was a significant parameter predicting survival. The most significant cutoff value for tumor size in pT3a disease was 7 cm. Patients with distant metastasis had a worse prognosis independent of T classification. Therefore, to assess the prognostic value of the current T classification in regard to T3a tumors we excluded patients with tumor stage cM+ for further subgroup analysis. Survival comparison of pT1 pNall, cM0 (744 of 1,794 cases) and pT3a pNall, cM0 7 cm or less (100 of 237) as well as pT2 pNall, cM0 (265 of 1,794) and pT3a pNall, cM0 greater than 7 cm (93 of 237) yielded similar results. After splitting pT3a into a modified T1/T2 classification a significant difference in 5-year survival analysis for a modified T1/T2 stage was found (pT1 plus pT3a less than 7 cm 90% vs pT2 plus pT3a greater than 7 cm 73%, p <0.001). Subsequently multivariate analysis in all 1,794 patients showed that modified T stage was an independent significant predictor of cancer specific survival. CONCLUSIONS : We suggest revising the current pT3a classification based on perirenal fat infiltration but rendering a modified pT1/pT2 classification, which resolves pT3a cases without the loss of prognostic validity. Perirenal fat infiltration should not be used to assign T category. Tumors directly infiltrating the adrenal gland should be reclassified as T4.
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Affiliation(s)
- S Siemer
- Department of Urology, University of the Saarland, Kirrbergerstrasse, 66421 Homburg/Saar, Germany.
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Abstract
Interstitial cystitis is a chronic, heterogeneous syndrome that is characterized by the classic symptoms of bladder pain, nycturia, and pollakiuria. Population studies have shown an increase in prevalence and incidence. Different hypotheses exist about the etiology and pathogenesis. Epithelial dysfunction and neuro-urothelial interaction are the most frequently used causal models. Utilization of the official diagnosis criteria of the NIDDK (National Institute of Diabetes, Digestive and Kidney Disease) should be flexible and individual in order not to overlook early forms of IC. Since there is no pathognomonic marker, diagnosis of IC is a combination of typical patient history and exclusion of differential diagnoses. Cystoscopy and biopsies are not specific; however, they can provide useful information on extent and aid in treatment choice. The effectiveness of conservative therapy has been increased by using electromotive drug administration (EMDA) in instillation therapy.
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Affiliation(s)
- A Loch
- Universitätsklinik und Poliklinik für Urologie, Homburg/Saar.
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Abstract
AIMS To investigate the prognostic significance of chromosomal alterations in colorectal cancer patients. Histopathological tumour classification is still considered to be the gold standard for the characterization of solid tumours. However, it is well known that such established parameters do not satisfactorily predict the clinical outcome in individual cases. Markers that reliably predict survival are needed. These markers should guide the clinical treatment of neoplastic disease. METHODS AND RESULTS Chromosomal imbalances in 61 colorectal carcinoma specimens in 37 patients determined by comparative genomic hybridization were correlated with patient survival using custom-made computer software which enabled the assessment of individual chromosomal loci. Kaplan-Meier analysis revealed that over-representations of 2p14-15, 6q23-6q24, 15q22-15q23, 22q11.2 and deletions of 1p36.1-36.2, 4q31.3, 4q35, 8q12-q21, 8p11.2 and 9p22 were significantly associated with shorter disease-specific survival, whereas over-expression of 20q13.3 and deletion of 18q11.2 were significantly associated with longer disease-specific survival in this collection of colorectal cancers. Multivariate Cox proportional hazards regression models consistently identified gains of 2p14-15, 15q22-23, 22q11.2 and losses of 1p36.1-36.2 and 4q35 as independent markers of shorter patient survival carrying greater significance than the classical clinicopathological parameters of nodal status and tumour grade. CONCLUSIONS These five markers allow a molecular categorization of patients into high and low clinical risk groups. Thus, the genomic data have refined the histopathological classification highlighting the necessity for a supplementary genetically based stratification of colorectal cancer.
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Affiliation(s)
- T Knösel
- Institute of Pathology, Charité-Campus Mitte, Berlin, Germany
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Häuser W, Dietz N, Grandt D, Steder-Neukamm U, Janke KH, Stein U, Stallmach A. Validation of the Inflammatory Bowel Disease Questionnaire IBDQ-D, German Version, for Patients with Ileal Pouch Anal Anastomosis for Ulcerative Colitis. Z Gastroenterol 2004; 42:131-9. [PMID: 14963785 DOI: 10.1055/s-2004-812835] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND AIMS The inflammatory bowel disease questionnaire (IBDQ) is the standard instrument for assessment of health-related quality of life (HRQOL) in patients with inflammatory bowel diseases. It has not been validated for patients with ileal pouch anal anastomosis (IPAA) and ulcerative colitis (UC). METHODS To determine acceptance (percentage of completed items), reliability (Cronbach's alpha of the IBDQ-D subscales) and convergent validity (correlations of the IBDQ subscales with the questionnaires used for validation) 61 patients with UC (age 52.7 +/- 13.9 years; 47 % female, 53 % male) and IPAA completed the German (Competence Network IBD) version of the Inflammatory Bowel Disease Questionnaire (IBDQ-D), the Short Form Health Survey (SF-36) the Hospital Anxiety and Depression Scale German Version (HADS-D) and the Giessener Symptom List (GBB 24). Face validity was assessed by a physicians' and patients' panel. All 37 patients underwent endoscopy making it possible to differentiate between patients with and without pouchitis (discriminant validity). RESULTS With 97.7 % completed items the acceptance was high. Cronbach's alpha value for the subscales ranged from 0.71 to 0.93. Missing items covering extraintestinal manifestations of IBD were criticized by patients. The correlation coefficients with comparable subscales of other instruments ranged between 0.41 and 0.76. Patients with clinical pouchitis scored significantly lower in all subscales than patients without pouchitis (p < 0.001). CONCLUSION The IBDQ-D has good acceptance, reliability, convergent and discriminant validity, but limited face and construct validity in patients with IPAA and UC.
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Affiliation(s)
- W Häuser
- Medizinische Klinik I, Klinikum Saarbrücken, Saarbrücken, Germany.
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Knösel T, Schlüns K, Stein U, Schwabe H, Schlag P, Dietel M, Petersen I. Chromosomal alterations during lymphatic and liver metastasis formation of colorectal cancer. Pathol Res Pract 2004. [DOI: 10.1016/s0344-0338(04)80410-2] [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: 10/26/2022]
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Bühling KJ, Kemper I, Elze L, Stein U, Dudenhausen JW. Wertigkeit der Glukosurie zur Detektion eines Gestationsdiabetes und Einfluss des Blutdruckes auf die Glukosurierate. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Chaigneau L, Nguyen T, Stein U, Guardiola E, Danzon A, Bontemps P, Pivot X. 140 Prognostic factors of overall survival for patients with recurrent head and neck cancer: a retrospective study. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90173-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Dufresne A, Gainet M, Stein U, Guardiola E, Pivot X. [Chemotherapy for patients with local-regional recurrent or metastatic carcinoma of the head and neck]. Bull Cancer 2003; 90:39-45. [PMID: 12609803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Chemotherapy has emerged to be a central component of curative strategies for patient with primary squamous cell carcinoma of the head and neck. The identification of agent active in head and neck cancer first occurred in patients with local regional recurrent and/or metastatic disease treated with palliative intent. The present paper reports the prognostic factors which based the understanding of these patients outcome. A review of the relevant results obtained by the standard chemotherapy in this recurrent population is performed. The current and future area of research were highlighted.
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Drobná Z, Stein U, Walther W, Barancík M, Breier A. Pentoxifylline influences drug transport activity of P-glycoprotein and decreases mdrl gene expression in multidrug resistant mouse leukemic L1210/VCR cells. Gen Physiol Biophys 2002; 21:103-9. [PMID: 12168720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The effects of pentoxifylline (PTX) on intracellular accumulation of doxorobicin (DOX), DOX cytotoxicity and expression of Pgp in multidrug resistant L1210/VCR cell line were investigated. PTX (100 mg/l) was able to enhance the DOX accumulation in resistant cells. The maximum intracellular levels of DOX were reached after treatment with PTX for 24 hours (total duration of PTX-treatment was 72 hours). The levels of mdrl mRNA (measured by RT-PCR method) were decreased 2-fold in the presence of 100 mg/l PTX (minimum reached within 48 hours) in comparison to control cells.
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Affiliation(s)
- Z Drobná
- Institute for Heart Research, Bratislava, Slovakia
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Rattanatayarom W, Dorfmeister C, Classen UG, Schimatschek HF, Stein U, Classen HG. Magnesium deficiency-induced anorexia in hyperphagic obese Zucker rats. Magnes Res 2001; 14:181-8. [PMID: 11599550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
In clinical practice diabetes mellitus is the most significant cause of hypomagnesemia and Mg depletion. The obese Zucker rat approaches non-insulin-dependent type II diabetes; lean Zucker rats being suitable controls. Using this disease model the influence of dietary Mg deficiency was studied: animals received a diet providing only approximately 25 per cent of the Mg requirement; controls received drinking water fortified with Mg (16 mmol/L). During 125 days ad libitum feeding, Mg-deficient obese rats consumed nearly 50 per cent less feed pellets and gained 50 per cent less body weight than their obese counterparts. This effect was not fully reversible indicating Mg depletion. Blood glucose reflected food consumption, no glucosuria was detectable using test strips. In the heart muscle Mg was decreased and Ca increased in Mg-deficient rats indicating increased cardiac risk. When the rats were pair fed with lean Mg-deficient controls the development of obesity was prevented. Despite pronounced Mg deficiency blood glucose remained unaffected and no glucosuria was detectable. In future experiments the production of marginal Mg deficiency not inducing anorexia should be applied to study the pathogenetic role of Mg depletion in obese Zucker rats.
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Affiliation(s)
- W Rattanatayarom
- Department of Pharmacology and Toxicology of Nutrition, University of Hohenheim, Stuttgart, Germany
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