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Meyer-Wilmes P, Huober J, Untch M, Blohmer JU, Janni W, Denkert C, Klare P, Link T, Rhiem K, Bayer C, Reinisch M, Bjelic-Radisic V, Zahm DM, Hanusch C, Solbach C, Heinrich G, Hartkopf AD, Schneeweiss A, Fasching P, Filmann N, Nekljudova V, Holtschmidt J, Stickeler E, Loibl S. Long-term outcomes of a randomized, open-label, phase II study comparing cabazitaxel versus paclitaxel as neoadjuvant treatment in patients with triple-negative or luminal B/HER2-negative breast cancer (GENEVIEVE). ESMO Open 2024; 9:103009. [PMID: 38663168 PMCID: PMC11061217 DOI: 10.1016/j.esmoop.2024.103009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/23/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND The GENEVIEVE study, comparing neoadjuvant cabazitaxel versus paclitaxel in triple-negative breast cancer (TNBC) and luminal B/human epidermal growth factor receptor 2 (HER2)-negative breast cancer (BC), previously reported significant differences in pathological complete response (pCR) rates. Effects on long-term outcome are unknown. PATIENTS AND METHODS GENEVIEVE randomized patients with cT2-3, any cN or cT1, cN+/pNSLN+, centrally confirmed TNBC or luminal B/HER2-negative BC (latter defined as estrogen/progesterone receptor-positive and >14% Ki-67-stained cells) to receive either cabazitaxel 25 mg/m2 q3w for four cycles or paclitaxel 80 mg/m2 weekly for 12 weeks. Anthracycline-containing chemotherapy was allowed in case of histologically proven invasive residuals as neoadjuvant treatment or after surgery as adjuvant treatment. Here we report the secondary endpoints invasive disease-free survival (iDFS), distant disease-free survival (DDFS), and overall survival (OS). RESULTS Of the 333 patients randomized, 74.7% and 83.2% completed treatment in the cabazitaxel and paclitaxel arms, respectively. After a median follow-up of 89.3 months (interquartile range 68.8-97.3 months), 80 iDFS events (43 after cabazitaxel and 37 after paclitaxel) and 47 deaths (23 after cabazitaxel and 24 after paclitaxel) were reported. IDFS rates were not significantly different between the cabazitaxel and paclitaxel arms after a 3-year (83.6% versus 85.0%) and 5-year follow-up (76.2% versus 78.3%) [hazard ratio (HR) = 1.27, 95% confidence interval 0.82-1.96, P = 0.294], respectively. DDFS rates at 3 years (88.6% versus 87.8%) and 5 years (82.1% versus 82.8%) for cabazitaxel and paclitaxel were comparable (HR = 1.15, P = 0.573). Similarly, OS rates at 3 years (91.6% versus 91.8%) and 5 years (89.2% versus 86.8%) showed no significant differences (HR = 1.05, P = 0.872). Subgroup analysis for TNBC and luminal B/HER2-negative BCs indicated no significant variations in 3- or 5-year iDFS, DDFS, or OS. CONCLUSIONS The significant differences in pCR rates observed in both treatment arms did not significantly impact long-term outcomes for patients treated with cabazitaxel versus paclitaxel in the GENEVIEVE trial.
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Affiliation(s)
- P Meyer-Wilmes
- Klinik für Gynäkologie und Geburtsmedizin, Uniklinik Aachen, Aachen, Germany
| | - J Huober
- Department of Interdisciplinary Medical Services, University Hospital Ulm & Cantonal Hospital St. Gallen, Breast Center, St. Gallen, Switzerland
| | - M Untch
- Helios Kliniken Berlin-Buch, Berlin
| | - J-U Blohmer
- Gynäkologie mit Brustzentrum, Charité-Universitätsmedizin Berlin, Berlin
| | | | - C Denkert
- Institut für Pathologie, Philipps-University Marburg and University Hospital Marburg (UKGM)-Universitätsklinikum Marburg, Marburg
| | - P Klare
- MediOnko-Institut GbR Berlin, Berlin
| | - T Link
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - K Rhiem
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln, Köln
| | - C Bayer
- Universitätsklinikum Erlangen, Erlangen
| | - M Reinisch
- Department of Gynecology with Breast Center, Evang. Kliniken Essen-Mitte, Charité - Universitätsmedizin Berlin, Berlin
| | - V Bjelic-Radisic
- Breast Unit, University Hospital Helios, University Witten Herdecke, Wuppertal
| | - D M Zahm
- SRH Waldklinikum Gera GmbH, Gera
| | | | - C Solbach
- Department of Gynecology and Obstetrics, Goethe University Frankfurt, University Hospital, Frankfurt
| | - G Heinrich
- Schwerpunktpraxis der Gynäkologie und Onkologie Fürstenwalde, Klinikum Offenbach
| | - A D Hartkopf
- AGO Study Group and Department of Women's Health, University Hospital Tübingen, Tübingen
| | - A Schneeweiss
- Nationales Centrum für Tumorerkrankungen, Universitätsklinikum und Deutsches Krebsforschungszentrum, Heidelberg
| | | | - N Filmann
- German Breast Group, Neu-Isenburg, Germany
| | | | | | - E Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Uniklinik Aachen, Aachen, Germany
| | - S Loibl
- German Breast Group, Neu-Isenburg, Germany.
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Sallam H, Lenga L, Solbach C, Becker S, Vogl TJ. Correlation of background parenchymal enhancement on breast MRI with breast cancer. Clin Radiol 2023:S0009-9260(23)00218-0. [PMID: 37330320 DOI: 10.1016/j.crad.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 03/05/2023] [Accepted: 05/11/2023] [Indexed: 06/19/2023]
Abstract
AIM To evaluate the prognostic value of background parenchymal enhancement (BPE) in breast magnetic resonance imaging (MRI) in women referred to radiological department as a high risk for breast cancer. MATERIALS AND METHODS A retrospective, cross-sectional study included 327 consecutive patients (mean age: 60 years, age range: 30-90 years) who underwent breast MRI and tissue biopsy between 2007 and 2016. All MRI images (T1, T2, and subtraction images) were evaluated visually. The relationship of BPE with patient age, fibroglandular tissue (FGT), Breast Imaging Reporting and Data System (BIRADS) categories, presence of breast cancer, and expression of human epidermal growth factor receptor 2 (HER2), progesterone receptor (PR), oestrogen receptor (ER), and Ki67 were analysed. Furthermore, all variables were correlated with pre- and postmenopausal status. RESULTS BPE of bilateral breast showed a weak correlation with FGT (right BPE: r=-0.14, p=0.004; left BPE: r=0.16, p=0.003), a weak negative correlation with patient age (right BPE: r=-0.14, p=0.007; left BPE: r=-0.15, p=0.006), and significant correlation with HER2 (right BPE, p=0.02), left BPE with HER2 was not significant. Among the correlations between BPE and BIRADS, only between right BPE and right BIRADS was significant (p=0.031). No clear evidence of an association between breast MRI BPE and breast cancer in premenopausal and postmenopausal status was observed, and no difference was found between the right and left breasts. CONCLUSIONS The results of the present study showed no significant correlations between BPE and breast cancer. In addition, there was no significant difference between the right and left breast. Hence, BPE of MRI may not be a reliable biomarker of breast cancer development.
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Affiliation(s)
- H Sallam
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
| | - L Lenga
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - C Solbach
- Department Gynaecology and Obstetrics, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - S Becker
- Department Gynaecology and Obstetrics, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - T J Vogl
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
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Luen SJ, Viale G, Nik-Zainal S, Savas P, Kammler R, Dell'Orto P, Biasi O, Degasperi A, Brown LC, Láng I, MacGrogan G, Tondini C, Bellet M, Villa F, Bernardo A, Ciruelos E, Karlsson P, Neven P, Climent M, Müller B, Jochum W, Bonnefoi H, Martino S, Davidson NE, Geyer C, Chia SK, Ingle JN, Coleman R, Solbach C, Thürlimann B, Colleoni M, Coates AS, Goldhirsch A, Fleming GF, Francis PA, Speed TP, Regan MM, Loi S. Genomic characterisation of hormone receptor-positive breast cancer arising in very young women. Ann Oncol 2023; 34:397-409. [PMID: 36709040 PMCID: PMC10619213 DOI: 10.1016/j.annonc.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/14/2022] [Accepted: 01/15/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Very young premenopausal women diagnosed with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+HER2-) early breast cancer (EBC) have higher rates of recurrence and death for reasons that remain largely unexplained. PATIENTS AND METHODS Genomic sequencing was applied to HR+HER2- tumours from patients enrolled in the Suppression of Ovarian Function Trial (SOFT) to determine genomic drivers that are enriched in young premenopausal women. Genomic alterations were characterised using next-generation sequencing from a subset of 1276 patients (deep targeted sequencing, n = 1258; whole-exome sequencing in a young-age, case-control subsample, n = 82). We defined copy number (CN) subgroups and assessed for features suggestive of homologous recombination deficiency (HRD). Genomic alteration frequencies were compared between young premenopausal women (<40 years) and older premenopausal women (≥40 years), and assessed for associations with distant recurrence-free interval (DRFI) and overall survival (OS). RESULTS Younger women (<40 years, n = 359) compared with older women (≥40 years, n = 917) had significantly higher frequencies of mutations in GATA3 (19% versus 16%) and CN amplifications (CNAs) (47% versus 26%), but significantly lower frequencies of mutations in PIK3CA (32% versus 47%), CDH1 (3% versus 9%), and MAP3K1 (7% versus 12%). Additionally, they had significantly higher frequencies of features suggestive of HRD (27% versus 21%) and a higher proportion of PIK3CA mutations with concurrent CNAs (23% versus 11%). Genomic features suggestive of HRD, PIK3CA mutations with CNAs, and CNAs were associated with significantly worse DRFI and OS compared with those without these features. These poor prognostic features were enriched in younger patients: present in 72% of patients aged <35 years, 54% aged 35-39 years, and 40% aged ≥40 years. Poor prognostic features [n = 584 (46%)] versus none [n = 692 (54%)] had an 8-year DRFI of 84% versus 94% and OS of 88% versus 96%. Younger women (<40 years) had the poorest outcomes: 8-year DRFI 74% versus 85% and OS 80% versus 93%, respectively. CONCLUSION These results provide insights into genomic alterations that are enriched in young women with HR+HER2- EBC, provide rationale for genomic subgrouping, and highlight priority molecular targets for future clinical trials.
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Affiliation(s)
- S J Luen
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - G Viale
- International Breast Cancer Study Group Central Pathology Office, IEO European Institute of Oncology IRCCS, University of Milan, Milan, Italy
| | - S Nik-Zainal
- Department of Medical Genetics & MRC Cancer Unit, The Clinical School, University of Cambridge, Cambridge, UK
| | - P Savas
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - R Kammler
- International Breast Cancer Study Group, Coordinating Center, Central Pathology Office, Bern, Switzerland
| | - P Dell'Orto
- International Breast Cancer Study Group Central Pathology Office, Department of Pathology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - O Biasi
- Division of Pathology and Laboratory Medicine, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - A Degasperi
- Department of Medical Genetics & MRC Cancer Unit, The Clinical School, University of Cambridge, Cambridge, UK
| | - L C Brown
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - I Láng
- Istenhegyi Health Center Oncology Clinic, National Institute of Oncology, Budapest, Hungary
| | - G MacGrogan
- Biopathology Department, Institut Bergonié Comprehensive Cancer Centre, Bordeaux, France
| | - C Tondini
- Osp. Papa Giovanni XXIII, Bergamo, Italy
| | - M Bellet
- Vall d'Hebron Institute of Oncology (VHIO) and Vall d'Hebron University Hospital, Barcelona, Spain
| | - F Villa
- Oncology Unit, Department of Oncology, Alessandro Manzoni Hospital, ASST Lecco, Lecco, Italy
| | - A Bernardo
- ICS Maugeri IRCCS, Medical Oncology Unit of Pavia Institute, Italy
| | - E Ciruelos
- University Hospital 12 de Octubre, Madrid, Spain
| | - P Karlsson
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - P Neven
- Gynecologic Oncology and Multidisciplinary Breast Center, University Hospitals UZ-Leuven, KU Leuven, Leuven, Belgium
| | - M Climent
- Instituto Valenciano de Oncologia, Valencia, Spain
| | - B Müller
- Chilean Cooperative Group for Oncologic Research (GOCCHI), Santiago, Chile
| | - W Jochum
- Institute of Pathology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Berne, Switzerland
| | - H Bonnefoi
- Institut Bergonié Comprehensive Cancer Centre, Université de Bordeaux, INSERM U1218, Bordeaux, France; European Organization for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - S Martino
- The Angeles Clinic and Research Institute, Santa Monica, USA
| | - N E Davidson
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, USA
| | - C Geyer
- Houston Methodist Cancer Center, NRG Oncology, Houston, USA
| | - S K Chia
- BC Cancer and Canadian Cancer Trials Group, Vancouver, Canada
| | - J N Ingle
- Mayo Clinic, Rochester, Minnesota, USA
| | - R Coleman
- National Institute for Health Research (NIHR) Cancer Research Network, University of Sheffield, Sheffield, UK
| | - C Solbach
- Breast Center, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - B Thürlimann
- Swiss Group for Clinical Cancer Research (SAKK), Berne, Switzerland; Breast Center, Kantonsspital, St. Gallen, Switzerland
| | - M Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A S Coates
- International Breast Cancer Study Group and University of Sydney, Sydney, Australia
| | - A Goldhirsch
- International Breast Cancer Study Group (IBCSG), Bern Switzerland and IEO European Institute of Oncology IRCCS, Milan, Italy
| | - G F Fleming
- Section of Hematology Oncology, The University of Chicago, Chicago, USA
| | - P A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - T P Speed
- Bioinformatics Division, Walter and Eliza Hall Institute, Melbourne, Australia
| | - M M Regan
- Division of Biostatistics, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Loi
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.
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Huober J, Janni W, Untch M, Blohmer JU, Zahm DM, Hanusch C, Jackisch C, Heinrich G, Schneeweiss A, Denkert C, Link T, Rhiem K, Furlanetto J, Solbach C, Klare P, Nekljudova V, Filmann N, Loibl S. 168P Long-term survival of a randomised, open-label, phase II study comparing the efficacy and safety of cabazitaxel versus weekly paclitaxel given as neoadjuvant treatment in patients with operable triple-negative or luminal B/HER2-negative breast cancer (GENEVIEVE). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Galas K, Gleitsmann M, Rey J, Solbach C, Witzel I, Seliger B, Karn T, Schmatloch S, Schneeweiss A, Sinn B, Fehm T, Denkert C, Litmeyer AS, Jank P, Furlanetto J, Ortmann O, Van Mackelenbergh M, Nekljudova V, Loibl S. 151P Tumor biology and immunology in patients (pts) with breast cancer occurring during pregnancy (BCP) compared to non-pregnant breast cancer pts. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Loibl S, Schneeweiss A, Huober J, Braun M, Rey J, Blohmer JU, Furlanetto J, Zahm DM, Hanusch C, Thomalla J, Jackisch C, Staib P, Link T, Rhiem K, Solbach C, Fasching PA, Nekljudova V, Denkert C, Untch M. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol 2022; 33:1149-1158. [PMID: 35961599 DOI: 10.1016/j.annonc.2022.07.1940] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [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: 02/18/2022] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Addition of immune checkpoint inhibitors (CPI) to neoadjuvant chemotherapy (NACT) is a promising strategy in early breast cancer, but the optimal duration of therapy is currently unknown. In the GeparNuevo (NCT02685059) trial, addition of durvalumab to NACT as previously reported led to a moderate increase in pCR rate by absolute 9% (p=0.287). PATIENTS AND METHODS Durvalumab or placebo 1.5g/placebo q4 weeks plus nab-paclitaxel 125mg/m2 weekly for 12 weeks, followed by 4 cycles durvalumab/placebo plus epirubicin/cyclophosphamide (EC) q2 weeks was given to cT1b-cT4a-d TNBC patients. Durvalumab was not continued after surgery. Primary objective was pathological complete response (pCR). Secondary endpoints included invasive disease-free survival (iDFS), distant disease-free survival (DDFS) and overall survival (OS). RESULTS 174 patients were randomised between June 2016 and October 2017. After a median follow-up of 43.7 months, 34 events had occurred. Despite a non-significant increase in the pCR rate, significant differences were observed for 3-year iDFS, DDFS and OS: iDFS was 85.6% with durvalumab vs 77.2% with placebo (HR 0.48, 95%CI 0.24-0.97, stratified log-rank p=0.036); DDFS 91.7% vs 78.4% (HR 0.31, 95%CI 0.13-0.74, p=0.005); OS 95.2% vs 83.5% (HR 0.24, 95%CI 0.08-0.72, p=0.006). pCR patients had 3-year iDFS of 95.5% with durvalumab and 86.1% without (HR 0.22, 95% CI 0.05-1.06). In non-pCR cohort 3-year iDFS was 76.3% vs 69.7% (HR 0.67, 95% CI 0.29-1.54). Multivariable analysis confirmed durvalumab effect independent of the pCR effect. No new safety signals occurred. CONCLUSION Durvalumab added to NACT in TNBC significantly improved survival despite a modest pCR increase and no adjuvant component of durvalumab. Additional studies are needed to clarify the optimal duration and sequence of CPIs in the treatment of early TNBC.
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Affiliation(s)
- S Loibl
- German Breast Group, Neu-Isenburg, Germany; Center for Hematology and Oncology Bethanien, Frankfurt, Germany.
| | - A Schneeweiss
- National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany
| | - J Huober
- Universitätsklinikum Ulm, Germany; Breast Center, Cantonal hospital St Gallen, Switzerland
| | - M Braun
- Department of Gynecology, Breast Center, Red Cross Hospital Munich, Germany
| | - J Rey
- German Breast Group, Neu-Isenburg, Germany
| | - J-U Blohmer
- Gynäkologie mit Brustzentrum, Charité-Universitätsmedizin Berlin, Germany
| | | | - D-M Zahm
- SRH Waldklinikum Gera GmbH, Germany
| | - C Hanusch
- Department of Gynecology, Breast Center, Red Cross Hospital Munich, Germany
| | - J Thomalla
- Praxis für Hämatologie und Onkologie Koblenz, Germany
| | | | - P Staib
- Klinik für Hämatologie und Onkologie, St.-Antonius Hospital, Eschweiler, Germany
| | - T Link
- Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | - K Rhiem
- Center for Hereditary Breast and Ovarian Cancer and Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Germany
| | - C Solbach
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt, Germany
| | - P A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-Nuremberg, National Center for Tumour Diseases, Erlangen, Germany
| | | | - C Denkert
- Institut für Pathologie, Philipps-Universität Marburg und Universitätsklinikum Marburg (UKGM), Marburg, Germany
| | - M Untch
- HELIOS Klinikum Berlin Buch, Berlin, Germany
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Reinisch M, Blohmer JU, Link T, Just M, Untch M, Stötzer O, Fasching P, Schneeweiss A, Wimberger P, Seiler S, Huober J, Thill M, Jackisch C, Rhiem K, Solbach C, Hanusch C, Denkert C, Engels K, Nekljudova V, Loibl S. 94P Patient quality of life (QoL) from the GeparX trial on the addition of denosumab (Dmab) added to two different nab-paclitaxel (nP) regimens as neoadjuvant chemotherapy (NACT) in primary breast cancer (BC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Romberg S, Solbach C, Louwen F, Yuan J, Ritter A. 257 Primary cilia in placental mesenchymal stem/stromal cells: Implication in placental development and preeclampsia. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.269] [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]
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Marmé F, Hanusch C, Furlanetto J, Denkert C, Link T, Untch M, Blohmer JU, Jackisch C, Reinisch M, Rhiem K, Schneeweiss A, Solbach C, Schöllhorn L, Fasching P, Rey J, Loibl S. 199TiP Phase III post-neoadjuvant study evaluating sacituzumab govitecan (SG), an antibody drug conjugate in primary HER2-negative breast cancer patients with high relapse risk after standard neoadjuvant treatment: SASCIA. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Labidi-Galy S, Schneeweiss A, Sinn H, Blohmer JU, Romanens L, Zahm DM, Huober J, Dohnal D, Link T, Hanusch C, Jackisch C, Fasching P, Solbach C, Rhiem K, Denkert C, Weber K, Lederer B, Untch M, Loibl S, Furlanetto J. 66P Baseline menopausal status, Ki-67 and stromal tumour-infiltrating lymphocytes (TILs) and association with outcome in triple-negative breast cancer (TNBC): Exploratory analysis in GeparSixto. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.080] [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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Leichsenring J, Vladimirova V, Solbach C, Karn T, Ataseven B, Sinn B, Barinoff J, Mueller V, Blohmer JU, Schem C, Engels K, Marmé F, Fissler-Eckhoff A, Fasching P, Stickeler E, van Mackelenbergh M, Denkert C, Stenzinger A, Loibl S, Gröschel S. 28P EVI1 expression in early-stage breast cancer patients treated with neoadjuvant chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.042] [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: 11/28/2022] Open
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Banys-Paluchowski M, Stickeler E, de Boniface J, Gentilini O, Thill M, Hartmann S, Fasching PA, Huebner H, Krawczyk N, Blohmer JU, Solbach C, Untch M, Kühn T. AXSANA (AXillary Surgery After NeoAdjuvant Treatment): A European prospective multicenter cohort study to evaluate different surgical methods of axillary staging (sentinel lymph node biopsy, targeted axillary dissection, axillary dissection) in clinically node-positive breast cancer patients treated with neoadjuvant chemotherapy. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
| | - E Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Uniklinik RWTH Aachen
| | - J de Boniface
- Dept. of Molecular Medicine and Surgery, Karolinska Institutet
- Dept. of Surgery, Capio St. Göran’s Hospital
| | | | - M Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus
| | - S Hartmann
- Universitäts-Frauenklinik, Klinikum Südstadt Rostock
| | - PA Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN
| | - H Huebner
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN
| | - N Krawczyk
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Düsseldorf
| | - JU Blohmer
- Klinik für Gynäkologie mit Brustzentrum der Charité, CCM
| | - C Solbach
- Brustzentrum, Universitätsklinikum Frankfurt
| | - M Untch
- Klinik für Gynäkologie und Geburtshilfe, Helios Klinikum Berlin-Buch
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen
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13
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Thill M, Anastasiadou L, Solbach C, Möbus V, Baier P, Ackermann S, Giesecke D, Schulmeyer E, Gabriel B, Mosch D, Buchen S, Krapfl E, Hurst U, Vescia M, Tesch H, Aulmann S, Jackisch C. The REMAR (Rhein-Main-Registry)-Study: Prospective evaluation of oncotype DX® Assay in Addition to Ki-67 for adjuvant treatment decisions in early breast cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Banys-Paluchowski M, Stickeler E, de Boniface J, Gentilini O, Thill M, Hartmann S, Fasching PA, Huebner H, Krawczyk N, Blohmer JU, Solbach C, Untch M, Kühn T. AXSANA (AXillary Surgery After NeoAdjuvant Treatment): A European prospective multicenter cohort study to evaluate different surgical methods of axillary staging (sentinel lymph node biopsy, targeted axillary dissection, axillary dissection) in clinically node-positive breast cancer patients treated with neoadjuvant chemotherapy. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714515] [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: 03/22/2023] Open
Affiliation(s)
| | - E Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Uniklinik RWTH Aachen
| | - J de Boniface
- Dept. of Molecular Medicine and Surgery, Karolinska Institutet
- Dept. of Surgery, Capio St. Göran’s Hospital
| | | | - M Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus
| | - S Hartmann
- Universitäts-Frauenklinik, Klinikum Südstadt Rostock
| | - PA Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN
| | - H Huebner
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN
| | - N Krawczyk
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Düsseldorf
| | - J-U Blohmer
- Klinik für Gynäkologie mit Brustzentrum der Charité, CCM
| | - C Solbach
- Brustzentrum, Universitätsklinikum Frankfurt
| | - M Untch
- Klinik für Gynäkologie und Geburtshilfe, Helios Klinikum Berlin-Buch
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen
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15
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Ditsch N, Untch M, Kolberg-Liedtke C, Jackisch C, Krug D, Friedrich M, Janni W, Müller V, Albert US, Banys-Paluchowski M, Bauerfeind I, Blohmer JU, Budach W, Dall P, Diel I, Fallenberg EM, Fasching PA, Fehm T, Gerber B, Gluz O, Hanf V, Harbeck N, Heil J, Huober J, Kreipe HH, Kühn T, Kümmel S, Loibl S, Lüftner D, Lux M, Maass N, Moebus V, Mundhenke C, Park-Simon TW, Reimer T, Rhiem K, Rody A, Schmidt M, Schneeweiss A, Solbach C, Solomayer EF, Stickeler E, Thomssen C, Witzel I, Wöckel A, Thill M. AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2020. Breast Care (Basel) 2020; 15:294-309. [PMID: 32774225 DOI: 10.1159/000508736] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Nina Ditsch
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Michael Untch
- Klinik für Gynäkologie und Geburtshilfe, Helios Klinikum Berlin-Buch, Berlin, Germany
| | | | - Christian Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach, Offenbach, Germany
| | - David Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Michael Friedrich
- Klinik für Frauenheilkunde und Geburtshilfe, Helios Klinikum Krefeld, Krefeld, Germany
| | - Wolfgang Janni
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
| | - Volkmar Müller
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Ute-Susann Albert
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Würzburg, Würzburg, Germany
| | | | - Ingo Bauerfeind
- Frauenklinik, Klinikum Landshut gemeinnützige GmbH, Landshut, Germany
| | - Jens-Uwe Blohmer
- Klinik für Gynäkologie mit Brustzentrum des Universitätsklinikums der Charité, Berlin, Germany
| | - Wilfried Budach
- Strahlentherapie, Radiologie Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Peter Dall
- Frauenklinik, Städtisches Klinikum Lüneburg, Lüneburg, Germany
| | - Ingo Diel
- Praxisklinik am Rosengarten, Mannheim, Germany
| | - Eva Maria Fallenberg
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Grosshadern, Munich, Germany
| | | | - Tanja Fehm
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Bernd Gerber
- Universitätsfrauenklinik am Klinikum Südstadt, Klinikum Südstadt Rostock, Rostock, Germany
| | - Oleg Gluz
- Ev. Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany
| | - Volker Hanf
- Frauenklinik Nathanstift (Brustzentrum und Gynäkologisches Krebszentrum, Klinikum Fürth, Fürth, Germany
| | - Nadia Harbeck
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany
| | - Jörg Heil
- Universitäts-Klinikum Heidelberg Brustzentrum, Heidelberg, Germany
| | - Jens Huober
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
| | - Hans H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Thorsten Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Germany
| | | | - Sibylle Loibl
- German Breast Group Forschungs GmbH, Neu-Isenburg, Germany
| | - Diana Lüftner
- Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Charité, Berlin, Germany
| | - Michael Lux
- Klinik für Gynäkologie und Geburtshilfe, St. Vinzenz-Krankenhaus GmbH Paderborn, Paderborn, Germany
| | - Nicolai Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Volker Moebus
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst GmbH, Frankfurt, Germany
| | - Christoph Mundhenke
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Tjoung-Won Park-Simon
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Hannover, Hannover, Germany
| | - Toralf Reimer
- Universitätsfrauenklinik am Klinikum Südstadt, Klinikum Südstadt Rostock, Rostock, Germany
| | - Kerstin Rhiem
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln, Cologne, Germany
| | - Achim Rody
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Marcus Schmidt
- Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Johannes-Gutenberg-Universität Mainz, Mainz, Germany
| | | | - Chistine Solbach
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - Erich-Franz Solomayer
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Elmar Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Universitätsklinikum Aachen, Aachen, Germany
| | - Christoph Thomssen
- Universitätsfrauenklinik, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany
| | - Isabell Witzel
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Achim Wöckel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Marc Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt, Germany
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16
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Müller-Schimpfle M, Bader W, Baltzer P, Bernathova M, Fuchsjäger M, Golatta M, Helbich TH, Hellerhoff K, Heywang-Köbrunner SH, Kurtz C, Mundinger A, Siegmann-Luz KC, Skaane P, Solbach C, Weigel S. Consensus Meeting of Breast Imaging: BI-RADS® and Beyond. Breast Care (Basel) 2019; 14:308-314. [PMID: 31798391 DOI: 10.1159/000503412] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 09/17/2019] [Indexed: 11/19/2022] Open
Abstract
Organizers of medical educational courses are often confronted with questions that are clinically relevant yet trespassing the frontiers of scientifically proven, evidence-based medicine at the point of care. Therefore, since 2007 organizers of breast teaching courses in German language met biannually to find a consensus in clinically relevant questions that have not been definitely answered by science. The questions were prepared during the 3 months before the meeting according to a structured process and finally agreed upon the day before the consensus meeting. At the consensus meeting, the open questions concerning 2D/3D mammography, breast ultrasound, MR mammography, interventions as well as risk-based imaging of the breast were presented first for electronic anonymized voting, and then the results of the audience were separately displayed from the expert votes. Thereafter, an introductory statement of the moderator was followed by pros/cons of two experts, and subsequently the final voting was performed. With ≥75% of votes of the expert panel, an answer qualified as a consensus statement. Seventeen consensus statements were gained, addressing for instance the use of 2D/3D mammography, breast ultrasound in screening, MR mammography in women with intermediate breast cancer risk, markers for localization of pathologic axillary lymph nodes, and standards in risk-based imaging of the breast. After the evaluation, comments from the experts on each field were gathered supplementarily. Methodology, transparency, and soundness of statements achieve a unique yield for all course organizers and provide solid pathways for decision making in breast imaging.
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Affiliation(s)
- Markus Müller-Schimpfle
- Clinic of Radiology, Neuroradiology, and Nuclear Medicine, Klinikum Frankfurt Höchst, Frankfurt am Main, Germany
| | - Werner Bader
- Department of Gynecology and Obstetrics, Klinikum Bielefeld, Bielefeld, Germany
| | - Pascal Baltzer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna and General Hospital, Vienna, Austria
| | - Maria Bernathova
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna and General Hospital, Vienna, Austria
| | | | - Michael Golatta
- Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas H Helbich
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna and General Hospital, Vienna, Austria
| | - Karin Hellerhoff
- Department of Diagnostic Radiology, Rotkreuzklinikum München, Munich, Germany
| | | | - Claudia Kurtz
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Alexander Mundinger
- Department of Radiology, Niels-Stensen-Kliniken, Marienhospital Osnabrück GmbH, Osnabrück, Germany
| | | | - Per Skaane
- Department of Radiology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Chistine Solbach
- Department of Gynecology and Obstetrics, University Hospital Frankfurt, Frankfurt, Germany
| | - Stefanie Weigel
- Institute of Clinical Radiology, Medical Faculty and University Hospital Münster, Münster, Germany
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17
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Marmé F, Solbach C, Michel L, Fasching P, Schneeweiss A, Blohmer JU, Rezai M, Huober J, Jackisch C, Nekljudova V, Link T, Rhiem K, Denkert C, Hanusch C, Tesch H, Lederer B, Loibl S, Untch M. Utility of the CPS+EG scoring system in triple-negative breast cancer treated with neoadjuvant chemotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.008] [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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18
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Tesch H, Loibl S, Kast K, Jackisch C, Möbus V, Buchen S, Untch M, Hanusch C, Seiler S, Weigel M, Fasching P, Rhiem K, Huober J, Blohmer JU, Solbach C, Denkert C, Nekljudova V, Link T, Schneeweiss A. Chemotherapy (CT)-induced anaemia in patients (pts) treated with dose-dense regimen: Results of the prospectively randomised anaemia substudy from the neoadjuvant GeparOcto study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Karn T, Denkert C, Sinn BV, Weber K, Nekljudova V, Rody A, Meissner T, Hatzis C, El-Balat A, Becker S, Solbach C, Untch M, Schneeweiss A, von Minckwitz G, Loibl S, Pusztai L, Holtrich U. Abstract P3-10-01: Single-cell profiling identifies hypoxic carcinoma cells as source of an immunosuppressive VEGFA metagene. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
We have previously shown that expression of the IL8/VEGFA-metagene eliminates the good prognostic effect of TILs in TNBC (PMID 21978456, 28750120). We also showed that the VEGFA metagene predicted response to neoadjuvant bevacizumab in the GeparQuinto trial (Karn 2017 SABCS #851166). The main cellular sources of the transcripts that comprise the VEGFA metagene are unknown since mRNA profiling of bulk biopsies contains signals from different cell types.
Methods:
Individual genes that comprise the VEGFA metagene were measured in bulk tissue- and single cell-RNA-Seq from breast cancer subtypes and normal cells on different platforms (Affymetrix n=4915, Agilent n=597, Illumina n=2433, RNA-Seq n=1215, Exome Capture RNA-Seq n=226, HTG-Seq n=243, sc-RNA-Seq n=24710). For blinded, orthogonal validation we performed immunohistochemistry. Effect of neoadjuvant chemotherapy with or without bevacizumab was studied by RNA-Seq and IHC on samples from GeparQuinto trial. SWOG S0800 (GSE114403), PROMIX (GSE87455), and GeparSixto trials were used for validation. TCGA was mined for mutations and somatic CNA. RNA-Seq from GeparNuevo was used for correlation with checkpoint inhibitor treatment.
Results:
We identified a stable core of six genes (VEGFA, ANGPTL4, ADM, NDRG1, DDIT4, CSTB) in different cohorts. Strong expression of this signature was mainly restricted to TNBC subtype and associated with poor prognosis within this subgroup. Single cell RNA-Seq of breast epithelial cells from 4 reduction mammoplasties and 4 TNBC revealed that these genes are coexpressed in individual epithelial cells and not associated with endothelial cells. In line with their presumed functions in cellular stress and hypoxia, immunohistochemistry revealed strong para-necrotic expression in TNBC. Moreover, high gene expression in TNBC was associated with mutations in DNA damage control pathways, somatic copy number alterations, and lower TILs. While chemotherapy led to downregulation, bevacizumab increased expression. In multivariate analysis, high pretreatment values predict pCR to both bevacizumab and chemotherapy (OR 2.40, P=0.006), which may be explained by sensitivity of tumors which are already under cellular stress. On the other hand, expression of the VEGFA metagene seems to create an immunosuppressive environment that counteracts the positive prognostic effect of TILs. In pre-treatment biopsies from the GeparNuevo checkpoint inhibitor trial we found a negative correlation of VEGFA metagene expression with the amount of the recently identified tissue-resident memory T cell subset (CD8TRM, PMID 29942092; P=0.002), while the subsequent increase of CD8TRM during treatment was larger in tumors with high VEGFA (P=0.019).
Conclusions:
Perinecrotic carcinoma cells under stress from hypoxia and or chromosomal instability are the source of the VEGFA metagene signature. Its predictive value in TNBC suggests estimating and reporting the amount of necrosis in the pathology report may be helpful in predicting response to preoperative chemotherapy, and could be used as stratification factor in clinical trials. The signature indicates an immunosuppressive environment and should be further studied in the context of immune therapies in combinations with anti-angiogenic treatment.
Citation Format: Karn T, Denkert C, Sinn BV, Weber K, Nekljudova V, Rody A, Meissner T, Hatzis C, El-Balat A, Becker S, Solbach C, Untch M, Schneeweiss A, von Minckwitz G, Loibl S, Pusztai L, Holtrich U. Single-cell profiling identifies hypoxic carcinoma cells as source of an immunosuppressive VEGFA metagene [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-10-01.
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Affiliation(s)
- T Karn
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - C Denkert
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - BV Sinn
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - K Weber
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - V Nekljudova
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - A Rody
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - T Meissner
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - C Hatzis
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - A El-Balat
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - S Becker
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - C Solbach
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - M Untch
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - A Schneeweiss
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - G von Minckwitz
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - S Loibl
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - L Pusztai
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - U Holtrich
- Goethe University, Frankfurt, Germany; Charite University, Berlin, Germany; German Breast Group, Neu-Isenburg, Germany; University Hospital Schleswig-Holstein, Lübeck, Germany; Avera Cancer Institute, Sioux Falls, SD; Yale Cancer Center, New Haven, CT; Helios Kliniken, Berlin-Buch, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
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20
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Huober J, Schneeweiss A, Blohmer JU, Denkert C, Tesch H, Hanusch CA, Salat C, Rhiem K, Rezai M, Solbach C, Fasching PA, Jackisch C, Mehta K, Nekljudova V, Seither F, von Minckwitz G, Loibl S, Untch M. Abstract P2-08-01: Factors predicting relapse in early breast cancer patients with a pathological complete response after neoadjuvant therapy – Results of a pooled analysis based on the GBG meta-database. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Even though patients with a pCR following neoadjuvant chemotherapy have an excellent prognosis still some of these patients will eventually relapse. A better identification of pts with an increased risk of relapse despite a pCR would be helpful to select these patients for additional post-neoadjuvant treatment strategies. Thus, the rationale of this retrospective analysis was to identify factors predicting relapse despite a pCR.
Methods
This pooled retrospective analysis based on the GBG meta-database includes the neoadjuvant trials GeparTrio, GeparQuattro, GeparQuinto, GeparSixto and GeparSepto. In these trials 2188 (27%) of 7933 pts had a pCR according to ypT0/ypTis ypN0 Definition and were included. The primary endpoint was disease-free survival (DFS), secondary endpoints were distant DFS (DDFS) and overall survival (OS). A multivariate Cox proportional hazards model was used to report hazard ratios with 95% confidence interval (CI). The two-sided significance level was set to α=0.05. Endpoints were analysed for all pts and in subgroups defined by intrinsic subtypes. The potential risk factors intrinsic subtype (HER2 negative/hormone receptor (HR) positive, triple negative, HER2 positive/HR positive, HER2 positive/HR negative), histological tumor type (lobular vs other), grade (G1/G2 vs G3), KI67 (≤20% vs higher), initial cT and cN stadium (cT1 vs cT2 vs cT3/4; cN0 vs cN+), age (≤40 vs 41-59 vs ≥60), BMI (< 25 vs 25-29 vs ≥ 30), planned number of cycles of chemotherapy (≤6 vs > 6), menopausal status (pre- vs postmenopausal) and clinical response after 2-4 cycles (SD vs PR vs CR vs PD) were included as covariates in multivariate Cox regression models as well as study identification.
Results
From 2188 evaluable patients DFS, DDFS and OS events were observed in 290/197/130 pts respectively; the median follow-up over all studies was 59 months. In multivariate analysis including study and all potential risk factors DFS was significantly different with regard to the initial cN status (cN+ vs cN0, hazard ratio (HR) 1.70; 95% CI [1.2, 2.4], p=0.002). Of borderline significance was histological type (non-lobular vs lobular, HR 0.52 95% CI [0.3, 1.1]; p=0.076) and initial tumor stage (cT3/4 vs cT1, HR 1.61 95% CI [1.0, 2.7]; p=0.064). In terms of DDFS significant differences were seen for the initial cN status (cN+ vs cN0, HR 2.34; 95% CI [1.5, 3.6], p<0.001) and initial tumor stage (cT3/4 vs cT1, HR 1.83 95% CI [1.0, 3.3]; p=0.044); histological type was again close to significance (non-lobular vs lobular, HR 0.46 95% CI [0.2, 1.1]; p=0.067). Multivariate analysis showed significantly worse OS with initial cT3/4 tumors (cT3/4 vs cT1, HR 2.48 95%CI [1.1, 5.7]; p=0.030), and the lobular type (non-lobular vs lobular, HR 0.35 95% CI [0.1, 0.9]; p=0.026) and a trend for worse OS in pts with cN+ (cN+ vs cN0, HR 1.67 95% CI [1.0, 2.9]; p=0.067).
Conclusions
Initial tumor load before start of neoadjuvant chemotherapy (tumor stage and nodal status) and lobular subtype were predictors of long term outcome after a pCR following neoadjuvant chemotherapy. Intrinsic subtype, KI67, grade and planned number of cycles were not predictive for a relapse.
Citation Format: Huober J, Schneeweiss A, Blohmer J-U, Denkert C, Tesch H, Hanusch CA, Salat C, Rhiem K, Rezai M, Solbach C, Fasching PA, Jackisch C, Mehta K, Nekljudova V, Seither F, von Minckwitz G, Loibl S, Untch M. Factors predicting relapse in early breast cancer patients with a pathological complete response after neoadjuvant therapy – Results of a pooled analysis based on the GBG meta-database [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-01.
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Affiliation(s)
- J Huober
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - A Schneeweiss
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - J-U Blohmer
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - C Denkert
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - H Tesch
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - CA Hanusch
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - C Salat
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - K Rhiem
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - M Rezai
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - C Solbach
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - PA Fasching
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - C Jackisch
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - K Mehta
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - V Nekljudova
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - F Seither
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - G von Minckwitz
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - S Loibl
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
| | - M Untch
- Universitätsfrauenklink, Brustzentrum, Ulm, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Brustzentrum, Charité-Universitätsmedizin, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany; Klinikum zum Roten Kreuz, München, Germany; Zentrum für Hämatologie und Onkologie, München, Germany; Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum, Köln, Germany; Medical Center, Luisenkrankenhaus, Düsseldorf, Germany; Universitätsklinikum, Frankfurt, Germany; Brustzentrum, Universitätsklinikum, Erlangen, Germany; Sana Klinikum, Offenbach, Germany; German Breast Group, Neu-Isenburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany
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Ritter A, Friemel A, Kreis NN, Hoock SC, Roth S, Kielland-Kaisen U, Brüggmann D, Solbach C, Louwen F, Yuan J. Primary cilia are dysfunctional in obese adipose-derived mesenchymal stem cells. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Ritter
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - A Friemel
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - NN Kreis
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - SC Hoock
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - S Roth
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - U Kielland-Kaisen
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - D Brüggmann
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - C Solbach
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - F Louwen
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - J Yuan
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
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Hoock SC, Kreis NN, Ritter A, Friemel A, Solbach C, Yuan J, Louwen F. The role of RITA in migration of breast cancer cells. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- SC Hoock
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - NN Kreis
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - A Ritter
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - A Friemel
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - C Solbach
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - J Yuan
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
| | - F Louwen
- Universitätsklinikum Frankfurt, ZFG – Molekulare Geburtshilfe, Frankfurt am Main, Deutschland
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Kaiser J, Amiri M, Rüschel I, Akbaba H, Hantke N, Senf B, Solbach C, Bledowski C. Kognitive Leistungsfähigkeit nach Brustkrebstherapie. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1668033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J Kaiser
- Goethe-Universität Frankfurt, Institut für Medizinische Psychologie, Frankfurt am Main, Deutschland
| | - M Amiri
- Goethe-Universität Frankfurt, Institut für Medizinische Psychologie, Frankfurt am Main, Deutschland
| | - I Rüschel
- Goethe-Universität Frankfurt, Institut für Medizinische Psychologie, Frankfurt am Main, Deutschland
| | - H Akbaba
- Goethe-Universität Frankfurt, Institut für Medizinische Psychologie, Frankfurt am Main, Deutschland
| | - N Hantke
- Goethe-Universität Frankfurt, Institut für Medizinische Psychologie, Frankfurt am Main, Deutschland
| | - B Senf
- Goethe-Universität Frankfurt, Universitätsklinikum Frankfurt, Universitäres Zentrum für Tumorerkrankungen, Frankfurt am Main, Deutschland
| | - C Solbach
- Goethe-Universität Frankfurt, Universitätsklinikum Frankfurt, Klinik für Frauenheilkunde und Geburtshilfe, Frankfurt am Main, Deutschland
| | - C Bledowski
- Goethe-Universität Frankfurt, Institut für Medizinische Psychologie, Frankfurt am Main, Deutschland
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Anastasiadou L, Aulmann S, Falk S, Baier P, Giesecke D, Buchen S, Hurst U, Krapfl E, Moebus V, Mosch D, Schulmeyer E, Solbach C, Ackermann S, Gabriel B, Jackisch C, Thill M. Abstract OT1-06-02: Oncotype DX®-REMAR(Rhein-Main-Registry)-study: Use of the oncotype DX® assay in early breast cancer in certified breast cancer centers in Rhine-Main Region, Germany. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot1-06-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
A brief background discussion:
The OncotypeDX® multigene assay is recommended by several international guidelines as a predictive and prognostic factor for HR+/HER2- early breast cancer (EBC). Several trials have shown the necessity of OncotypeDX® Recurrence Score (RS) as a decision tool for HR+/HER2- EBC with 0-3 lymph nodes (LN) involved. At present, though, only limited data from the routine setting are available on the impact of treatment decision making process based on the usage of classical proliferation marker Ki67 with or without knowing the individual RS prior and after a treatment decision from a multidisciplinary tumor board (MTB) for the decision making of the adjuvant therapy of EBC. The Oncotype DX® assay is still not reimbursed by every insurance, therefore we expect that this registry will have an impact on reimbursement in Germany.
Trial design:
The OncotypeDX®-REMAR(Rhein-Main-Registry) study is a prospective, non-interventional, multicenter and non-randomized, study. 13 certified breast cancer (BC) centers in the Rhine-Main region in Germany participate. The sponsor of this trial is the AGAPLESION, Markus Hospital Frankfurt, Genomic Health provides the financial support.
After registration, the patient´s case will be discussed in the respective institution's MTB, before and after the RS result. The adjuvant treatment will be recommended based on available clinical and histopathological data according to the guidelines and the RS result. After each meeting, the physician and patient will fill in a questionnaire. In addition to the local determination of Ki67 and nuclear grading, a central pathology assessment of these two markers will be provided in a blinded fashion. Only the sponsor has access to these results. Consequently, this independent test has no influence both on the local histopathology result and on the recommended treatment.
Eligibility criteria:
Inclusion criteria:
Female patients, ≥18 years, with a hormone-receptor positive, HER2-negative EBC and 0-3 positive LN, T1-3, nuclear grading 1-3, Ki67:10-40%, cM0.
Specific aims:
Primary endpoint is the decision impact of the RS result in patients with mid-range Ki67 on adjuvant chemotherapy in EBC.
Secondary endpoints include the correlation of Ki67 with tumor grade and RS result. Moreover, an economic subanalysis will be done.
Statistical methods:
The change in physicians' treatment recommendations will be measured pre-assay vs. post-assay. The proportion of patients for whom the treatment recommendation changed and the 95% confidence interval will be reported overall and by select groups. McNemar's test will be used to compare the proportion of patients' recommended chemo-hormonal therapy pre-assay vs. post-assay.
Present accrual and target accrual:
Thirteen participating centers recruited 97 patients by the end of April 2017. 600 patients are planned in total.
Contact information for people with a specific interest in the trial:
In case of interest you can contact Ms. Louiza Anastasiadou, Tel: +4969-9533-66395, Fax: +4969-9533-2385, email: louiza.anastasiadou@fdk.info
Citation Format: Anastasiadou L, Aulmann S, Falk S, Baier P, Giesecke D, Buchen S, Hurst U, Krapfl E, Moebus V, Mosch D, Schulmeyer E, Solbach C, Ackermann S, Gabriel B, Jackisch C, Thill M. Oncotype DX®-REMAR(Rhein-Main-Registry)-study: Use of the oncotype DX® assay in early breast cancer in certified breast cancer centers in Rhine-Main Region, Germany [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-06-02.
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Affiliation(s)
- L Anastasiadou
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - S Aulmann
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - S Falk
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - P Baier
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - D Giesecke
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - S Buchen
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - U Hurst
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - E Krapfl
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - V Moebus
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - D Mosch
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - E Schulmeyer
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - C Solbach
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - S Ackermann
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - B Gabriel
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - C Jackisch
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
| | - M Thill
- AGAPLESION, Markus Hospital, Frankfurt Main, Hessen, Germany; OptiPath, MVZ für Pathologie, Frankfurt Main, Hessen, Germany; Ketteler Hospital Offenbach; Hochtaunus-Hospital, Bad Homburg; Asklepios Paulinen Klinik, Wiesbaden; KKH Bergstrasse, Heppenheim; Asklepios Klinikum Langen; Klinikum Frankfurt Hoechst; Bad Soden Klinik; Main-Kinzig-Kliniken, Gelnhausen; University Hospital Frankfurt; Klinikum Darmstadt; St. Josefs Hospital, Wiesbaden; Sana Klinikum Offenbach; Frankfurt Diakonia Clinics
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Karn T, Meissner T, Weber K, Sinn B, Denkert C, Budczies J, Nekljudova V, Fasching PA, Holtrich U, Schem C, Solbach C, Hartmann A, Röcken C, Untch M, Young BM, Willis S, Leyland-Jones B, von Minckwitz G, Loibl S. Abstract P2-09-02: Blinded molecular subtyping analysis from RNA-Seq of FFPE samples in the GeparQuinto trial reveals predictive value of VEGFA metagene for bevacizumab treatment. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
RNA-Seq from total RNA in FFPE tissue can be more challenging due to limited capture of partially degraded RNA. Exome-capture based RNA-Seq may circumvent such problems and allow reproducible complete molecular characterization of low-quality RNA from small clinical samples.
Methods:
HER2 negative patients within the GeparQuinto trial were treated with neoadjuvant anthracycline-taxane-based chemotherapy +/- bevacizumab. Patients with bevacizumab therapy had a significantly higher pCR rate, especially within the triple negative subgroup. We performed exome-capture RNA-Seq on 5µm FFPE sections from pre-therapeutic cores of 400 HER2 negative samples from this trial. In a prospectively planned, blinded study we correlated molecular subtypes and metagenes for proliferation, stroma, MHC2, and VEGFA with clinical and histopathological data. Molecular subtypes were defined using the AIMS methods. Metagenes were calculated as mean values corresponding to previously described gene clusters after platform transfer (Rody et al. 2011 PMID 21978456, Hu et al. 2009 PMID 19291283) and then z-transformed.
Results:
296 samples with RNA-Seq data were classified as either of high (n=226) or of limited quality (n=70). For 22 samples RNA yield was insufficient and 82 did not pass initial QC. 121 (41%), 63 (21%), 34 (11.5%), 46 (15.5%), and 32 (11%) samples were defined as basal-like, HER2-enriched, luminal A, luminal B, and normal-like, respectively. Subtyping was robust with regard to gene filtering, normalization, and sample quality. ER and PR status from local IHC strongly correlated with gene expression (overall correctness 84% and 80% for ER, and 85% and 74% for PR, in samples with high and limited quality, respectively) and luminal subtypes (95% ER positive). Proliferation metagene correlated with histological grade (median -0.73, -0.39, and 0.53 in G1, G2, and G3, respectively; P<0.001) and MHC2 metagene correlated strongly with TIL counts (Rho=0.53, P<0.001). Among the high quality samples response rates (49.3% pCR overall) differed significantly by subtype, with higher pCR rates in basal-like (68.9%) and HER2-enriched (45.5%) than in luminal B (35.7%), luminal A (17.9%), and normal-like (20.0%). MHC2- (OR 1.60, 95%CI 1.21-2.12, P=0.001), proliferation- (OR 2.88, 95%CI 2.00-4.16, P<0.001), and VEGFA-metagenes (OR 1.92, 95%CI 1.41-2.60, P<0.001) were significant predictors for pCR. In a multivariate logistic regression (adjusted for bevacizumab treatment and hormone receptor status) both VEGFA metagene (OR 2.59, 95%CI 1.40-4.77, P=0.002) and the interaction between the VEGFA-metagene and bevacizumab treatment arm (P=0.023) significantly predicted pCR.
Conclusions:
Exome-capture RNA-Seq allows robust genomic characterization of clinical samples with limited FFPE material from core biopsies, and molecular subtypes and immune metagenes are predictive for pCR. The VEGFA metagene is a specific predictor for response to neoadjuvant bevacizumab treatment.
Citation Format: Karn T, Meissner T, Weber K, Sinn B, Denkert C, Budczies J, Nekljudova V, Fasching PA, Holtrich U, Schem C, Solbach C, Hartmann A, Röcken C, Untch M, Young BM, Willis S, Leyland-Jones B, von Minckwitz G, Loibl S. Blinded molecular subtyping analysis from RNA-Seq of FFPE samples in the GeparQuinto trial reveals predictive value of VEGFA metagene for bevacizumab treatment [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-02.
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Affiliation(s)
- T Karn
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - T Meissner
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - K Weber
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - B Sinn
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - C Denkert
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - J Budczies
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - V Nekljudova
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - PA Fasching
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - U Holtrich
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - C Schem
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - C Solbach
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - A Hartmann
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - C Röcken
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - M Untch
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - BM Young
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - S Willis
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - B Leyland-Jones
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - G von Minckwitz
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
| | - S Loibl
- Goethe University, Frankfurt; Avera Cancer Institute; German Breast Group; Charite University; University Hospital Erlangen; University Hospital Schleswig-Holstein Kiel; Helios Kliniken Berlin-Buch
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Witzel ID, Laakmann E, Fasching PA, Rezai M, Schem C, Solbach C, Tesch H, Klare P, Schneeweiss A, Zahm D, Blohmer J, Ingold-Heppner B, Huober J, Hanusch C, Jackisch C, Reinisch M, Untch M, von Minckwitz G, Müller V, Loibl S. Abstract P1-17-01: Development of brain metastases in breast cancer patients treated in the neoadjuvant trials Geparquinto and Geparsixto. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-17-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The incidence of brain metastases (BM) in breast cancer patients is rising and has become a major clinical challenge. So far, the incidence of BM after modern neoadjuvant treatment is not clear.
Materials and Methods: In Geparquinto, patients with untreated HER2-positive breast cancer (n=615) received either lapatinib or trastuzumab, patients with HER2 negative breast cancer (n=1925) received bevacizumab in addition to an anthracycline and taxane-containing regimen and those not responding paclitaxel and everolimus (n=32). In Geparsixto, patients with HER2-positive tumors (n=273) received trastuzumab and lapatinib and patients with triple-negative tumors (n=315) received bevacizumab in addition to chemotherapy. We analyzed clinical factors associated with the occurrence of BM as first site of metastatic relapse after neoadjuvant treatment in both trials (n=3160).
Results: After a median follow-up of 61 months, 108 (3%) of a total of 3160 patients developed BM as first site of recurrence and 411 (13%) patients had distant metastases outside the brain. Brain metastases as first site of recurrence occurred later than other metastases (3--year-relapse free-rate 96.7% for patients who developed BM and 89.5% for patients who developed metastases outside the brain). Regarding subtypes of the primary tumor, 1% of luminal A (11/954), 2% of luminal B (7/381), 4% of HER2 positive (34/809) and 6% of triple-negative patients (56/1008) developed BM as first site of recurrence. In multivariate analysis, risk factors for the development of BM were larger tumor size (cT3-4; HR 1.9, 95%-CI 1.3-2.8, p=0.0022), node positive disease (HR 2.8, 95% CI 1.8-4.4, p<0.0001), no pCR after neoadjuvant chemotherapy (HR 2.7, 95% CI 1.6-4.7, p=0.0003) and HER2 positive (HR 3.8, 95% CI 1.9-7.8, p=0.0002) or triple-negative subtype (HR 8.1, 95% CI 4.2 – 15.8, p< 0.0001). Breast cancer subtype remained the most relevant risk factor for BM. Patients who developed BM were more often HER2 positive or triple-negative tumors compared with patients who developed metastases outside the brain (HER2 positive subtype 32 vs. 19%, triple-negative subtype 52 vs. 40%, p< 0.001).
Conclusion: Especially patients with HER2-positive and triple negative tumors are at risk of developing BM despite active systemic treatment. A better understanding of the underlying mechanisms is required in order to develop potential preventive strategies.
Citation Format: Witzel ID, Laakmann E, Fasching PA, Rezai M, Schem C, Solbach C, Tesch H, Klare P, Schneeweiss A, Zahm D, Blohmer J, Ingold-Heppner B, Huober J, Hanusch C, Jackisch C, Reinisch M, Untch M, von Minckwitz G, Müller V, Loibl S. Development of brain metastases in breast cancer patients treated in the neoadjuvant trials Geparquinto and Geparsixto [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-17-01.
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Affiliation(s)
- ID Witzel
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - E Laakmann
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - PA Fasching
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - M Rezai
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - C Schem
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - C Solbach
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - H Tesch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - P Klare
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - A Schneeweiss
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - D Zahm
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - J Blohmer
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - B Ingold-Heppner
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - J Huober
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - C Hanusch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - C Jackisch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - M Reinisch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - M Untch
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - G von Minckwitz
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - V Müller
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
| | - S Loibl
- University Medical Center, Hamburg, Germany; German Breast Group, Neu Isenburg, Germany; University Medical Center, Erlangen, Germany; Medical Center Luisenkrankenhaus, Düsseldorf, Germany; University Medical Center, Kiel, Germany; University Medical Center, Frankfurt, Germany; Center for Hematology und Oncology Bethanien, Frankfurt, Germany; Praxisklinik, Standort Lichtenberg, Berlin, Germany; Medical Center for Hematology and Oncology, Munich, Germany; University Medical Center, Heidelberg, Germany; Breast Center Ostthüringen, Gera, Germany; University Medical Center, Charité- Campus Mitte, Berlin, Germany; University Medical Center, Institute for Pathology, Charité, Berlin, Germany; University Medical Center, Ulm, Germany; Rotkreuzklinikum, Munich, Germany; Hospital Offenbach, Offenbach, Germany; Kliniken Essen-Mitte, Essen, Germany; Klinikum Berlin-Buch, Berlin, Germany
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Untch M, Von Minckwitz G, Gerber B, Eidtmann H, Rezai M, Fasching P, Tesch H, Eggemann H, Schrader I, Kittel K, Hanusch C, Huober J, Solbach C, Jackisch C, Kunz G, Blohmer J, Hauschild M, Fehm T, Nekljudova V, Loibl S. 1801 Neoadjuvant chemotherapy with trastuzumab or lapatinib: Survival analysis of the HER2-positive cohort of the GeparQuinto study (GBG 44). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30755-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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von Minckwitz G, Loibl S, Untch M, Eidtmann H, Rezai M, Fasching PA, Tesch H, Eggemann H, Schrader I, Kittel K, Hanusch C, Huober J, Solbach C, Jackisch C, Kunz G, Blohmer JU, Hauschild M, Fehm T, Nekljudova V, Gerber B, Gnauert K, Heinrich B, Prätz T, Groh U, Tanzer H, Villena C, Tulusan A, Liedtke B, Blohmer JU, Kittel K, Mau C, Potenberg J, Schilling J, Just M, Weiss E, Bückner U, Wolfgarten M, Lorenz R, Doering G, Feidicker S, Krabisch P, Deichert U, Augustin D, Kunz G, Kast K, von Minckwitz G, Nestle-Krämling C, Rezai M, Höß C, Terhaag J, Fasching P, Staib P, Aktas B, Kühn T, Khandan F, Möbus V, Solbach C, Tesch H, Stickeler E, Heinrich G, Wagner H, Abdallah A, Dewitz T, Emons G, Belau A, Rethwisch V, Lantzsch T, Thomssen C, Mattner U, Nugent A, Müller V, Noesselt T, Holms F, Müller T, Deuker JU, Schrader I, Strumberg D, Uleer C, Solomayer E, Runnebaum I, Link H, Tomé O, Ulmer HU, Conrad B, Feisel-Schwickardi G, Eidtmann H, Schumacher C, Steinmetz T, Bauerfeind I, Kremers S, Langanke D, Kullmer U, Ober A, Fischer D, Kohls A, Weikel W, Bischoff J, Freese K, Schmidt M, Wiest W, Sütterlin M, Dietrich M, Grießhammer M, Burgmann DM, Hanusch C, Rack B, Salat C, Sattler D, Tio J, von Abel E, Christensen B, Burkamp U, Köhne CH, Meinerz W, Graßhoff ST, Decker T, Overkamp F, Thalmann I, Sallmann A, Beck T, Reimer T, Bartzke G, Deryal M, Weigel M, Huober J, Weder P, Steffens CC, Lemster S, Stefek A, Ruhland F, Hofmann M, Schuster J, Simon W, Kronawitter U, Clemens M, Fehm T, Janni W, Latos K, Bauer W, Roßmann A, Bauer L, Lampe D, Heyl V, Hoffmann G, Lorenz-Salehi F, Hackmann J, Schlag R. Survival after neoadjuvant chemotherapy with or without bevacizumab or everolimus for HER2-negative primary breast cancer (GBG 44-GeparQuinto)†. Ann Oncol 2014; 25:2363-2372. [PMID: 25223482 DOI: 10.1093/annonc/mdu455] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The GeparQuinto study showed that adding bevacizumab to 24 weeks of anthracycline-taxane-based neoadjuvant chemotherapy increases pathological complete response (pCR) rates overall and specifically in patients with triple-negative breast cancer (TNBC). No difference in pCR rate was observed for adding everolimus to paclitaxel in nonearly responding patients. Here, we present disease-free (DFS) and overall survival (OS) analyses. PATIENTS AND METHODS Patients (n = 1948) with HER2-negative tumors of a median tumor size of 4 cm were randomly assigned to neoadjuvant treatment with epirubicin/cyclophosphamide followed by docetaxel (EC-T) with or without eight infusions of bevacizumab every 3 weeks before surgery. Patients without clinical response to EC ± Bevacizumab were randomized to 12 weekly cycles paclitaxel with or without everolimus 5 mg/day. To detect a hazard ratio (HR) of 0.75 (α = 0.05, β = 0.8) 379 events had to be observed in the bevacizumab arms. RESULTS With a median follow-up of 3.8 years, 3-year DFS was 80.8% and 3-year OS was 89.7%. Outcome was not different for patients receiving bevacizumab (HR 1.03; P = 0.784 for DFS and HR 0.974; P = 0.842 for OS) compared with patients receiving chemotherapy alone. Patients with TNBC similarly showed no improvement in DFS (HR = 0.99; P = 0.941) and OS (HR = 1.02; P = 0.891) when treated with bevacizumab. No other predefined subgroup (HR+/HER2-; locally advanced (cT4 or cN3) or not; cT1-3 or cT4; pCR or not) showed a significant benefit. No difference in DFS (HR 0.997; P = 0.987) and OS (HR 1.11; P = 0.658) was observed for nonearly responding patients receiving paclitaxel with or without everolimus overall as well as in subgroups. CONCLUSIONS Long-term results, in opposite to the results of pCR, do not support the neoadjuvant use of bevacizumab in addition to an anthracycline-taxane-based chemotherapy or everolimus in addition to paclitaxel for nonearly responding patients. CLINICAL TRIAL NUMBER NCT 00567554, www.clinicaltrials.gov.
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Affiliation(s)
- G von Minckwitz
- Headquarter, German Breast Group, Neu-Isenburg; Department of Gynaecology and Obstetrics, University Hospital, Frankfurt.
| | - S Loibl
- Headquarter, German Breast Group, Neu-Isenburg
| | - M Untch
- Department of Gynaecology and Obstetrics, Klinikum Berlin-Buch, Berlin
| | - H Eidtmann
- Department of Gynaecology and Obstetrics, University Hospital, Kiel
| | - M Rezai
- Breast Center, Luisenkrankenhaus, Düsseldorf
| | - P A Fasching
- Department of Gynaecology and Obstetrics, University Hospital, Erlangen
| | - H Tesch
- Department of Medical Oncology, Chop GmbH, Frankfurt
| | - H Eggemann
- Department of Gynaecology and Obstetrics, University Hospital, Magdeburg
| | - I Schrader
- Department of Gynaecology and Obstetrics, Henriettenstiftung, Hannover
| | - K Kittel
- Department of Gynaecology and Obstetrics, Praxisklinik, Berlin
| | - C Hanusch
- Department of Gynaecology and Obstetrics, Rot-Kreuz-Klinikum, München
| | - J Huober
- Department of Gynaecology and Obstetrics, University Hospital, Ulm
| | - C Solbach
- Department of Gynaecology and Obstetrics, University Hospital, Frankfurt
| | - C Jackisch
- Department of Gynaecology and Obstetrics, Sana-Klinikum, Offenbach
| | - G Kunz
- Department of Gynaecology and Obstetrics, St Johannes Hospital, Dortmund
| | - J U Blohmer
- Department of Gynaecology and Obstetrics, St Gertrauden-Hospital, Berlin
| | - M Hauschild
- Department of Gynaecology and Obstetrics, Hospital, Rheinfelden
| | - T Fehm
- Department of Gynaecology and Obstetrics, University Hospital, Tübingen
| | | | - B Gerber
- Department of Gynaecology and Obstetrics, University Hospital, Rostock, Germany
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Loibl S, Mergler B, Eppel A, Solbach C, Lübbe KM, Eidtmann H, Rezai M, Hanusch C, Fehm T, Bartzke G, Burgmann DM, Krabisch P, Untch M, Nekljudova V, von Minckwitz G. Abstract P3-14-04: The choice of the indicator lesion impacts on the pCR rate – An analysis of 114 bilateral breast cancer patients treated within neoadjuvant trials. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-14-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Patients with bilateral breast cancer are usually excluded from participating in clinical trials. The German Breast Group has traditionally included these patients into their neoadjuvant trials. However, little is known about the outcome of the non-indicator lesion.
Methods: We prospectively captured the information on bilateral breast cancer in our database and collected retrospectively the information from the original histological and surgical reports on tumor size, nodal status, histology, grading, hormone receptor and HER2 status as well as type of surgery and pathological complete response defined as ypT0 ypN0 and ypT0/is ypN0 because both definitions have been used in our clinical studies. The treating physician decided on clinical presentation, which side to be the indicator lesion on which response was assessed for the purpose of the study. The synchronous carcinoma in the contralateral breast is considered as the non-indicator lesion.
Results: From the 6727 patients treated within the Gepartrio, Geparquattro, Geparquinto, and Geparsixto study 157 (2.3%) patients have been identified with the diagnosis of bilateral carcinoma. From the 114 bilateral patients with any information on the non indicator lesion 104 with information on pCR on both sides were used for further analysis. The median age was 51 (range 29-74) years. There were more cT1 (48.5% vs 9.6%, p<0.001) and cN0 (60.0% vs 38.4%, p = 0.004) tumors in the group of the non-indicator lesion compared to the indicator lesion group. In 56% the molecular subtype was identical 86% had a luminal A like tumor of indicator as well as the non-indicator lesion, none of the luminal B-like indicator lesions were identical, 27% of the HER2+/ HR +, 58% in the HER2+/ HR- group and 66% of the triple negative indicator lesions had an identical non indicator lesion. In general the tumor tended to be of lower malignant potential in the non- indicator lesion. Lobular carcinomas (23.4% vs 16.7%, p = 0.205); grade 3 (26% vs 36.7%, p = 0.101), ER positive (72% vs 67%, p = 0.427), HER2-positive (23.9 vs. 35.7%, p = 0.068). Overall the pCR rate (ypT0 ypN) was 20.2% in the non-indicator lesion group vs 13.9% the indicator lesion group (p = 0.276) and ypT0/is ypN0 was 30.8% and 17.6%, respectively (p = 0.0388). 64.4% had no pCR in the indicator as well as the non-indicator lesion, 11.5% had a pCR in the indicator as well as the non-indicator lesion, 4.8% in the indicator alone and 19.2% in the non-indicator alone. Breast conserving surgery was performed more often for non-indicator lesions than for indicator lesions (59% vs 44.4%, p = 0.144).
Conclusion: In general the selection for the indicator lesion was based on tumor size, nodal status and inclusion criteria. Probably, some of the indicator lesions would not have qualified for trial participation. The pCR rate including non-invasive residuals was significantly higher for the non-indicator lesions probably due to smaller tumors and less nodal involvement at baseline. However, based on our data bilateral breast carcinomas should not be excluded from neoadjuvant clinical trials.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-14-04.
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Affiliation(s)
- S Loibl
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - B Mergler
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - A Eppel
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - C Solbach
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - KM Lübbe
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - H Eidtmann
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - M Rezai
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - C Hanusch
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - T Fehm
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - G Bartzke
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - D-M Burgmann
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - P Krabisch
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - M Untch
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - V Nekljudova
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
| | - G von Minckwitz
- German Breast Group, Neu-Isenburg; Universität Mainz; Brustzentrum Universität Mainz; Henriettenstiftung, Düsseldorf; Luisenkrankenhaus Düsseldorf; Rotkreuzklinikum München gGmbH, Frauenklinik, München; Universitätsfrauenklinik Düsseldorf; Helios Kliniken Berlin; Universitätsfrauenklinik München; Klinik für Frauenheilkunde und Geburtshilfe, Chemnitz; Universitätsfrauenklinik Frankfurt
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Gerber B, Loibl S, Eidtmann H, Rezai M, Fasching PA, Tesch H, Eggemann H, Schrader I, Kittel K, Hanusch C, Kreienberg R, Solbach C, Jackisch C, Kunz G, Blohmer JU, Huober J, Hauschild M, Nekljudova V, Untch M, von Minckwitz G. Neoadjuvant bevacizumab and anthracycline-taxane-based chemotherapy in 678 triple-negative primary breast cancers; results from the geparquinto study (GBG 44). Ann Oncol 2013; 24:2978-84. [PMID: 24136883 DOI: 10.1093/annonc/mdt361] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND We evaluated the pathological complete response (pCR) rate after neoadjuvant epirubicin, (E) cyclophosphamide (C) and docetaxel containing chemotherapy with and without the addition of bevacizumab in patients with triple-negative breast cancer (TNBC). PATIENTS AND METHODS Patients with untreated cT1c-4d TNBC represented a stratified subset of the 1948 participants of the HER2-negative part of the GeparQuinto trial. Patients were randomized to receive four cycles EC (90/600 mg/m(2); q3w) followed by four cycles docetaxel (100 mg/m(2); q3w) each with or without bevacizumab (15 mg/kg; q3w) added to chemotherapy. RESULTS TNBC patients were randomized to chemotherapy without (n = 340) or with bevacizumab (n = 323). pCR (ypT0 ypN0, primary end point) rates were 27.9% without and 39.3% with bevacizumab (P = 0.003). According to other pCR definitions, the addition of bevacizumab increased the pCR rate from 30.9% to 41.8% (ypT0 ypN0/+; P = 0.004), 36.2% to 46.4% (ypT0/is ypN0/+; P = 0.009) and 32.9% to 43.3% (ypT0/is ypN0; P = 0.007). Bevacizumab treatment [OR 1.73, 95% confidence interval (CI) 1.23-2.42; P = 0.002], lower tumor stage (OR 2.38, 95% CI 1.24-4.54; P = 0.009) and grade 3 tumors (OR 1.68, 95% CI 1.14-2.48; P = 0.009) were confirmed as independent predictors of higher pCR in multivariate logistic regression analysis. CONCLUSIONS The addition of bevacizumab to chemotherapy in TNBC significantly increases pCR rates.
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Affiliation(s)
- B Gerber
- Department of Obstetrics and Gynaecology, University of Rostock, Rostock
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Patt M, Solbach C, Habermann B, Schildan A, Baur B, Sabri O. Influence of additives to the formulation of n.c.a. [¹¹C]PiB on sterile filter performance. Appl Radiat Isot 2013; 82:289-92. [PMID: 24128611 DOI: 10.1016/j.apradiso.2013.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 08/30/2013] [Accepted: 09/11/2013] [Indexed: 10/26/2022]
Abstract
The influence of different additives (PEG 300, PEG 400, PG) to the product solution of [(11)C]PiB was investigated with regard to tracer retention for a number of commonly used sterile filters for aseptic manufacturing of PET-tracers. The effect of the amount of additive with regard to tracer retention and the resulting viscosity of the filtration solution was determined. Recommendations for the individual combinations of filters and amounts of additives suitable for the different filtration methods that are implemented in commercially available synthesis modules are given as well.
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Affiliation(s)
- M Patt
- Department of Nuclear Medicine, University of Leipzig, Liebigstrasse 18, D-04103 Leipzig, Germany.
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32
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Denkert C, Loibl S, Kronenwett R, Budczies J, von Törne C, Nekljudova V, Darb-Esfahani S, Solbach C, Sinn B, Petry C, Müller B, Hilfrich J, Altmann G, Staebler A, Roth C, Ataseven B, Kirchner T, Dietel M, Untch M, von Minckwitz G. RNA-based determination of ESR1 and HER2 expression and response to neoadjuvant chemotherapy. Ann Oncol 2013; 24:632-9. [DOI: 10.1093/annonc/mds339] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schmidt M, van de Sandt L, Boehm D, Sicking I, Battista M, Lebrecht A, Solbach C, Koelbl H, Gehrmann M, Rahnenführer J, Hengstler JG. Abstract P2-10-13: CD4 positive tumor-infiltrating lymphocytes are associated with improved prognosis in node-negative breast cancer. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p2-10-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The prognostic significance of CD8 positive cytotoxic lymphocytes in breast cancer is well accepted. However, the role of CD4 positive lymphocytes is ambiguous. We examined the prognostic relevance of CD4 positive tumor-infiltrating lymphocytes in previously published node-negative breast cancer cohorts using RNA expression.
Methods: Microarray based gene-expression data for CD4 (203547_at) were analyzed in four previously published cohorts (Mainz, Rotterdam, Transbig, Yu) of node-negative breast cancer patients not treated with adjuvant therapy (n = 824). A meta-analysis of previously published cohorts was performed using a random effects model. Prognostic significance of CD4 on metastasis-free survival (MFS) was examined in the whole cohort and in different molecular subtypes (ER+/HER2−, ER−/HER2−, HER2+). Independent prognostic relevance was analyzed using multivariate Cox regression.
Results: Higher RNA expression of CD4 was related to better MFS in a meta-analysis of the whole cohort (HR 0.66, 95% CI 0.49–0.90, p = 0.0074). Prognostic significance was most pronounced in the HER2+ positive molecular subtype (HR 0.32, 95% CI 0.14–0.75, p = 0.0091) as compared to ER+/HER2− (HR 0.62, 95% CI 0.29–1.32, P>0.05) and ER−/HER2− (HR 0.61, 95% CI 0.28–1.35, P>0.05) carcinomas of the breast. CD4 showed independent prognostic significance (HR 0.60, 95% CI 0.37–0.96, p = 0.032) in multivariate analysis. In addition to CD4, only histological grade of differentiation (HR 2.43, 95% CI 1.50–3.94, P < 0.001) and tumor size (HR 1.87, 95% CI 1.19–2.94, p = 0.007), but not age, HER2 status or hormone receptor status retained an independent prognostic association with MFS.
Conclusion: CD4 positive tumor-infiltrating lymphocytes have independent prognostic significance in node-negative breast cancer. A higher expression is associated with improved outcome.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-10-13.
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Affiliation(s)
- M Schmidt
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - L van de Sandt
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - D Boehm
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - I Sicking
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - M Battista
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - A Lebrecht
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - C Solbach
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - H Koelbl
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - M Gehrmann
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - J Rahnenführer
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - JG Hengstler
- University Hospital, Mainz, Germany; Technical University, Dortmund, Germany; Bayer, Leverkusen, Germany; Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
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Al-Momani E, Zlatopolskiy BD, Machulla HJ, Reske SN, Solbach C. Radiosynthesis of carbon-11 labeled 6-methyldopamine ([¹¹C]MeDA). Appl Radiat Isot 2012; 70:1475-9. [PMID: 22728836 DOI: 10.1016/j.apradiso.2012.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 04/17/2012] [Accepted: 04/19/2012] [Indexed: 11/15/2022]
Abstract
A rapid and efficient n.c.a. radiosynthesis of 6-[(11)C]methyldopamine ([(11)C]MeDA) using the Stille cross-coupling reaction as a key step was developed. The labeling conditions for the formation of the intermediate compound (protected [(11)C]MeDA, [(11)C]7) were determined with respect to reaction temperature and time. The radiochemical yield 89 ± 1.4% (decay-corrected) of the protected intermediate [(11)C]7 was obtained at a reaction temperature of 60°C and a reaction time of 5 min using Pd(2)(dba)(3)/P(o-tolyl)(3) and CsF/CuBr as a co-catalyst system. The overall yield after deprotection with 45% HBr at 140°C for 10 min was 64 ± 3.9% (decay-corrected) within a total preparation time of 40 min, including hydrolysis, HPLC purification and formulation.
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Affiliation(s)
- E Al-Momani
- Clinic for Nuclear Medicine, University Ulm, Germany
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Böhm D, Kubitza A, Lebrecht A, Schmidt M, Gerhold-Ay A, Battista M, Stewen K, Solbach C, Kölbl H. Prospective randomized comparison of conventional instruments and the Harmonic Focus® device in breast-conserving therapy for primary breast cancer. Eur J Surg Oncol 2012; 38:118-24. [DOI: 10.1016/j.ejso.2011.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 10/30/2011] [Accepted: 11/15/2011] [Indexed: 10/14/2022] Open
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Von Minckwitz G, Darb-Esfahani S, Loibl S, Huober JB, Tesch H, Solbach C, Holms F, Eidtmann H, Diedrich K, Just M, Clemens M, Hanusch C, Schrader I, Henschen S, Hoffmann G, Tiemann K, Diebold K, Untch M, Denkert C. Responsiveness of adjacent ductal carcinoma in situ and changes in HER2 status after neoadjuvant chemotherapy/trastuzumab treatment in early breast cancer: Results from the GeparQuattro study (GBG 40). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.6] [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
6 Background: Adjacent ductal carcinoma in situ (DCIS) is in found in approximately 45% of invasive ductal carcinomas (IDC) of the breast. Pure DCIS overexpresses HER2 in approximately 45%. There is uncertainty whether adjacent DCIS impacts on the response to neoadjuvant chemotherapy and trastuzumab as well as whether HER2 expression in IDC component or adjacent DCIS changes throughout treatment. Methods: Core biopsies and surgical tissue from participants of the GeparQuattro study with HER2-positive IDC were centrally examined for the area of invasive ductal component and adjacent DCIS before and after receiving neoadjuvant anthracycline-taxane-trastuzumab containing chemotherapy. HER2 overexpression in IDC and adjacent DCIS was quantified separately by immunohistochemistry using the Ventana automated staining system. Pathological complete response (pCR) was defined as no residual invasive or non-invasive tumor tissue. Results: Fifty nine (37.3%) of 158 IDCs presented with adjacent DCIS at diagnosis. These tumors showed lower regression grades than pure IDC (p=0.033). Presence of adjacent DCIS was an independent negative predictor of pCR (odds ratio 0.42 [95% CI 0.2-0.9], p=0.027). Adjacent DCIS area decreased from pre-treatment to surgery (r=0.205) with 30 (50.8%) IDCs with adjacent DCIS showing complete eradication of adjacent DCIS. HER2 status of adjacent DCIS was highly correlated with HER2 status of IDC component before (r=0.892) and after treatment (r=0.676). Degree of HER2 overexpression of the IDC component decreased in 16 (33.3%) out of 49 patients without a pCR. These 16 IDCs showed lower RGs compared to the 33 IDCs with unchanged HER2 expression (p=0.055). Conclusions: HER2-positive IDCs with adjacent DCIS is less responsive to neoadjuvant chemotherapy and trastuzumab compared to pure IDC. However, complete eradication of adjacent DCIS is frequently observed. HER2-overexpression of the invasive ductal component decreases in a subset of tumors, which showed less tumor regression.
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Affiliation(s)
- G. Von Minckwitz
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - S. Darb-Esfahani
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - S. Loibl
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - J. B. Huober
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - H. Tesch
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - C. Solbach
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - F. Holms
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - H. Eidtmann
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - K. Diedrich
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - M. Just
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - M. Clemens
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - C. Hanusch
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - I. Schrader
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - S. Henschen
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - G. Hoffmann
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - K. Tiemann
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - K. Diebold
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - M. Untch
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - C. Denkert
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
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Bauman A, Piel M, Höhnemann S, Krauss A, Jansen M, Solbach C, Dannhardt G, Rösch F. Synthesis, labelling and evaluation of hydantoin-substituted indole carboxylic acids as potential ligands for positron emission tomography imaging of the glycine binding site of the N-methyl-d-aspartate receptor. J Labelled Comp Radiopharm 2011. [DOI: 10.1002/jlcr.1901] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A. Bauman
- Institute of Nuclear Chemistry; Johannes Gutenberg-University; Fritz-Strassmann-Weg 2; D-55128; Mainz; Germany
| | - M. Piel
- Institute of Nuclear Chemistry; Johannes Gutenberg-University; Fritz-Strassmann-Weg 2; D-55128; Mainz; Germany
| | - S. Höhnemann
- Institute of Nuclear Chemistry; Johannes Gutenberg-University; Fritz-Strassmann-Weg 2; D-55128; Mainz; Germany
| | - A. Krauss
- Institute of Pharmacy; Johannes Gutenberg-University; Staudingerweg 5; D-55128; Mainz; Germany
| | - M. Jansen
- Institute of Pharmacy; Johannes Gutenberg-University; Staudingerweg 5; D-55128; Mainz; Germany
| | - C. Solbach
- Radiopharmacy, PET Center; University of Tübingen; Röntgenweg 15; D-72076; Tübingen; Germany
| | - G. Dannhardt
- Institute of Pharmacy; Johannes Gutenberg-University; Staudingerweg 5; D-55128; Mainz; Germany
| | - F. Rösch
- Institute of Nuclear Chemistry; Johannes Gutenberg-University; Fritz-Strassmann-Weg 2; D-55128; Mainz; Germany
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Loibl S, Bruey J, Von Minckwitz G, Huober JB, Press MF, Darb-Esfahani S, Solbach C, Denkert C, Tesch H, Holms F, Fehm TN, Mehta K, Untch M. Validation of p95 as a predictive marker for trastuzumab-based therapy in primary HER2-positive breast cancer: A translational investigation from the neoadjuvant GeparQuattro study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.530] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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40
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Gerber B, Eidtmann H, Rezai M, Fasching PA, Tesch H, Eggemann H, Schrader I, Kittel K, Hanusch CA, Kreienberg R, Solbach C, Jackisch C, Kunz G, Blohmer JU, Huober JB, Hauschild M, Loibl S, Nekljudova V, Untch M, Von Minckwitz G. Neoadjuvant bevacizumab and anthracycline–taxane-based chemotherapry in 686 triple-negative primary breast cancers: Seconday endpoint analysis of the GeparQuinto study (GBG 44). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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41
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Zangos S, Eichler K, Mack MG, Mulert-Ernst R, Solbach C, Schwedler K, Müller C, Vogl TJ. Beurteilung der Sichtbarkeit kommerzieller Markierung-Clips für Brustinterventionen in den konventionellen Untersuchungsmethoden. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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42
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Al-Momani E, Zlatopolskiy BD, Solbach C, Reske SN, Machulla HJ. Synthesis of 15-(4-[11C]methylphenyl)pentadecanoic acid (MePPA) via Stille cross-coupling reaction. J Radioanal Nucl Chem 2011. [DOI: 10.1007/s10967-011-1022-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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43
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von Minckwitz G, Eidtmann H, Loibl S, Blohmer JU, Costa SD, Fasching P, Kreienberg R, Hilfrich J, Gerber B, Hanusch C, Fehm T, Strumberg D, Solbach C, Nekljudova V, Untch M. Integrating bevacizumab, everolimus, and lapatinib into current neoadjuvant chemotherapy regimen for primary breast cancer. Safety results of the GeparQuinto trial. Ann Oncol 2011; 22:301-6. [DOI: 10.1093/annonc/mdq350] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [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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44
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Al-Momani E, Zlatopolskiy BD, Solbach C, Reske SN, Machulla HJ. Synthesis of 15-(4-[131I]iodophenyl)pentadecanoic acid (p-IPPA) via tin-precursor using Chloramine-T as an oxidant. J Radioanal Nucl Chem 2010. [DOI: 10.1007/s10967-010-0643-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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45
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Neumaier B, Deisenhofer S, Sommer C, Solbach C, Reske S, Mottaghy F. Synthesis and evaluation of 18F-fluoroethylated benzothiazole derivatives for in vivo imaging of amyloid plaques in Alzheimer's disease. Appl Radiat Isot 2010; 68:1066-72. [DOI: 10.1016/j.apradiso.2009.12.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 12/21/2009] [Accepted: 12/28/2009] [Indexed: 11/16/2022]
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Weber T, Cammerer G, Schick C, Solbach C, Hillenbrand A, Barth TF, Henne-Bruns D, Blagieva R, Böhm BO, Reske SN, Luster M. C-11 methionine positron emission tomography/computed tomography localizes parathyroid adenomas in primary hyperparathyroidism. Horm Metab Res 2010; 42:209-14. [PMID: 20013649 DOI: 10.1055/s-0029-1243185] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In patients with primary hyperparathyroidism (pHPT), positive preoperative localization studies enable to perform a minimally invasive approach for parathyroid surgery. However, current imaging techniques are not always successful. We therefore conducted a study to determine the sensitivity of C-11 methionine positron emission tomography/computed tomography (Met-PET/CT) in localizing parathyroid adenomas in pHPT. Met-PET/CT scans of the neck and mediastinum of 33 patients undergoing parathyroidectomy for primary HPT were compared with intraoperative and histological findings. Primary HPT was caused by a single gland adenoma in 30 patients, while another 3 patients had multiglandular disease. Met-PET/CT scan correctly located a single gland adenoma in 25 out of 30 (83%) patients with pHPT, among them 2 patients with persistent disease, 7 patients with prior neck surgery, and 8 patients with concomitant thyroid nodules. In 3 patients with multiglandular disease, Met-PET/CT showed only one enlarged parathyroid gland in two individuals and was negative in the third patient. Statistical analysis found a significant correlation between true-positive results and the weight (2.42+/-4.05 g) and diameter (2.0+/-1.18 cm) of parathyroid adenomas while the subgroup with false negative findings had significantly smaller (0.98+/-0.54 cm) and lighter (0.5+/-0.38 g) glands. Sensitivity was 83% for single gland adenomas and 67% for multiglandular disease. Met-PET/CT correctly localized 83% of single gland parathyroid adenomas in patients with pHPT. However, preoperative localization of multiglandular disease due to double adenomas or parathyroid hyperplasia remained difficult.
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Affiliation(s)
- T Weber
- Department of Surgery, University Medical Center, Ulm, Germany.
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Karn T, Holtrich U, Ruckhäberle E, Hanker L, Schlieter A, Solbach C, Gätje R, Kaufmann M, Rody A. Methodischer Bias retrospektiver Follow-up-Untersuchungen und sein Einfluss auf die Erhebung von Qualitätssicherungsdaten. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0029-1240728] [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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48
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Rody A, Karn T, Solbach C, Ruckhaeberle E, Hanker L, Mueller V, Schmidt M, Gaetje R, Holtrich U, Kaufmann M. The Luminal B Marker NHERF1 Predicts Endocrine Resistance. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-3164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:Tumors of the luminal B subtype of ER postive breast cancer are characterized by high proliferation as compared to the luminal A subtype. The luminal B have a worse prognosis. We aimed to identify genes specifically expressed in the luminal B subtype of breast cancers and analyze the prognostic impact of these genes and their relationship to endocrine therapy.Methods:121 genes overexpressed in LumB tumors were identified in a test set of 171 Breast cancer samples and reproducibly obtained in four independent validation datasets. The scaffold protein NHERF1 was analyzed in a large scale meta-analysis of microarray datasets encompassing n=3030 breast cancer samples.Results:NHERF1 is an ER regulated gene located on chromosome 17 coding for a scaffold protein involved in growth factor signal transduction. NHERF1 expression among ER positive tumors is associated with larger tumor size, higher histolocigal grading, and HER2 expression. A prognostic value of NHERF1 was observed among ER positive tumors (univariate HR 1.49, 95% CI 1.23-1.80, P<0.001) but not among ER negative samples. NHERF1 remained significant in multivariate analysis (HR 1.37, 95% CI 1.05-1.79, P=0.020) and is not a surrogate marker for high proliferation. A benefit of endocrine treatment seems to be restricted to NHERF1 negative tumors.Conclusions:Markers like NHERF1 specific for the luminal B subtype of breast cancer correlate with poor prognosis and seem to be predictive for endocrine treatment response.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3164.
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Affiliation(s)
- A. Rody
- 1J.W. Goethe-University, Germany
| | - T. Karn
- 1J.W. Goethe-University, Germany
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Ruckhäberle E, Rody A, Holtrich U, Engels K, Gaetje R, Turley H, Hanker L, Solbach C, Karn T, Kaufmann M. Correlation of Thymidine Phosphorylase Expression and Lymphocyte Infiltration Detected by Microarray Analysis of Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:Thymidine phosphorylase (TP) expression in carcinoma cells has been described as a prognostic factor in breast cancer and a predictive factor for response to 5-FU chemotherapy in some studies. Analysis from prostate cancer reported a correlation of TP with lymphocyte infiltrates of tumors.Material and Methods:Affymetrix microarray data of n=79 normal tissue samples and n=1781 primary breast cancers were analyzed for TP mRNA expression. To study relationships of TP expression with immune cell infiltration of breast tumors we used several metagenes representing certain types of immune cells. Immunohistochemical analysis of TP protein expression using a monoclonal antibody was applied for validation studies.Results:Among normal tissues highest expression of TP mRNA was observed in cells and tissues of the immune system. The profile of TP expression displayed highest correlation with a metagene representing cells of the myeloid lineage as moncytes, macrophages and dendritic cells. Analysis of microarray data from 1781 breast cancer samples suggests that TP expression detected by this method originates mainly from infiltrating immune cells. In line with this observation TP mRNA expression correlated with a immune cell infiltration score determined by pathological inspection of the tumor. However, we also observed a correlation of TP with a metagene of interferone inducible genes which seem to be expressed by carcinoma cells. When we tried to validate these data on the protein level using immunohistochemistry TP expression was demonstrated both in carcinoma cells and stromal cells of the tumor to a varying degree.Discussion:We were able to confirm previous data from prostate cancer that TP expression is strongly correlated to the presence of an intense lymphocyte infiltrate of the tumor for breast cancer. However, microarray data of a bulk tumor sample cannot reveal the cellular origin of TP expression.Conclusion:Thus from this data it is not clear whether lymphocytes of the myeloid lineage either are the actual source of TP expression or induce its expression in carcinoma cells.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2139.
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Affiliation(s)
| | - A. Rody
- 1Goethe University Frankfurt, Germany
| | | | - K. Engels
- 2Goethe University Frankfurt, Germany
| | - R. Gaetje
- 1Goethe University Frankfurt, Germany
| | - H. Turley
- 3Cancer Research UK Molecular Oncology Laboratories, University of Oxford, United Kingdom
| | - L. Hanker
- 1Goethe University Frankfurt, Germany
| | | | - T. Karn
- 1Goethe University Frankfurt, Germany
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50
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von Minckwitz G, Bauerfeind I, Gerber B, Huober J, Eidtmann H, Solbach C, Tesch H, Loibl S, Nekljudova V, Untch M. Geparquinto: First Planned Safety Analysis on 60 Patients with HER2 Negative Primary Breast Cancer Receiving Neoadjuvant Chemotherapy ± Bevacizumab or ± RAD001 (GBG 44). Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:New targeted agents are investigated in neoadjuvant trials to estimate rapidly the potential efficacy of these drugs in early stage breast cancer. Patients (pts) without mid course response are in need for improved therapy. As the tolerability of these new treatment combinations is unknown, an internal pilot phase for safety was incorporated into the phase III GeparQuinto trial with an antiangiogenic treatment and RAD001 for HER2neg primary breast cancer pts.Patients and Methods:In the GeparQuinto trial with a planned overall sample size of 2500 pts we examine the additive effect of bevacizumab (BEV) to EC – docetaxel (DOC) on pathological complete response. Pts not responding to EC ± BEV are considered to be chemo-resistant. To overcome drug resistance, these non-responding pts were randomized to weekly paclitaxel (PAC) ± RAD (Everolimus; RAD001). Female pts with untreated, histologically confirmed uni- or bilateral, cT3/4a-d, HER2– breast cancer and no clinically relevant cardiovascular co-morbidities are randomized to 4 cycles of E (90mg/m²) + C (600 mg/m²) q3w ± BEV (15 mg/kg i.v.) q3w. After 4 cycles, the response was evaluated. Pts with response continue with DOC (100mg/m²) ± BEV (15mg/kg) q3w. If the tumor size did not decrease by ≥50%, pts were randomized to PAC (80mg/m² weekly) ± RAD (5mg orally daily, starting with a dose escalation over 14 days and 7-14 days prior the first PAC infusion) for 12 weeks. Surgery was performed in all pts after total treatment duration of 24 weeks. Grade 3+4 toxicities of the first cycle EC ± BEV, DOC ± BEV and PAC ± RAD was monitored for 20, 40, 60 P and an interim safety analysis was performed when 60 pts completed all cycles.Results:Of the 60 HER2 neg pts, 30 received 4xEC, 30 4xEC+BEV. 40 responders continued treatment with DOC (N=21) and DOC+BEV (N=19). 20 non-responders were randomized to PAC (n= 9) and PAC+RAD (n= 11). 2 pts discontinued treatment early.Premature treatment discontinuation was observed in 12 of 60 pts [during EC (2x), DOC (3x), DOC+BEV (1x), PAC (4x) and PAC+RAD (2x)], but only in 6 pts due to toxicity [DOC (2x); DOC+BEV (1x); PAC (3x)]. Other reasons were protocol violation (1x), incompliance (1x), progress [EC (1x), DOC (1x), PAC (2x)].BEV increased only the rate of leucopenia grade (gr) 3-4 during EC [gr 1-4 (3-4): –BEV: 93.8 % (40.6%) vs. +BEV: 90% (70.0%); p=0.666 (0.024)] and of mucositis during DOC [gr 1-4 (3-4): –BEV: 52.4% (9.5%) vs. +BEV: 100% (36.8%); p<0.0001 (0.06)]. RAD increased the rate of neutropenia during PAC [gr 1-4 (3-4): –RAD: 11.1% (0.0%) vs. +RAD: 80.0% (10.0%); p=0.005 (1.0)]. No significant differences were found for other hematologic and non-hematologic toxicities.Conclusion:The addition of BEV to EC-DOC was considered safe and the pilot phase was terminated. Safety data from all 60 pts treated with PAC ± RAD will be presented at the meeting.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1096.
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Affiliation(s)
| | | | | | - J. Huober
- 4Kantonsspital St. Gallen, Switzerland
| | | | | | | | | | | | - M. Untch
- 8Helios Klinikum Berlin-Buch, Germany
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