Oncology Research and Treatment最新文献

{"title":"Hochrisiko-MDS: Therapeutischer Ansatzpunkt Immunsystem","authors":"","doi":"10.1159/000529222","DOIUrl":"https://doi.org/10.1159/000529222","url":null,"abstract":"information@karger.com www.karger.com eine Hochrisiko-Konstellation vor. Bei diesen Erkrankten ist das Progressionsrisiko besonders hoch und die Überlebenszeit entsprechend eingeschränkt [2]. Die risikoadaptierte Klassifikation der MDS folgte dabei lange Zeit dem Risiko-Score des International Prognostic Scoring System (IPSS), der Niedrigrisiko(LR-MDS; niedrig/intermediär-1) und Hochrisiko-MDS (HR-MDS; intermediär-2/hoch) unterschied [1]. Die überarbeitete Version des IPSS (IPSS-R) stratifiziert Patient*innen in 5 Risikogruppen mit sehr hohem, hohem und mittelschwerem Risiko, die sich hinsichtlich des Risikos einer leukämischen Transformation und des Überlebens unterscheiden [1]. Die jüngste Klassifikation nach dem IPSS-M geht durch Einbeziehung hämatologischer Parameter, zytogenetischer Abnormalitäten und somatischer Mutationen noch weiter ins Detail und unterteilt in 6 Risikokategorien [6].","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 1","pages":"50 - 52"},"PeriodicalIF":2.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43783300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PharmaNews","authors":"","doi":"10.1159/000529189","DOIUrl":"https://doi.org/10.1159/000529189","url":null,"abstract":"Auf dem Kongress der American Society of Hematology (ASH) wurden im Dezember 2022 neue Ergebnisse der internationalen, offenen, randomisierten Phase-III-Studie GLOW* vorgestellt [1]. Ziel war es, die Wirksamkeit und Verträglichkeit von Ibrutinib (Imbruvica®) von Janssen Pharmaceutical Companies of Johnson & Johnson in der Kombination mit Venetoclax zu untersuchen. Für die erste rein orale, zeitlich begrenzte CLL-Erstlinientherapie Ibrutinib + Venetoclax (Ibr + Ven; n = 106) ergab sich bei einer medianen Nachbeobachtungszeit von 46 Monaten der Hinweis, dass das relative Risiko zu versterben unter Ibr + Ven um 51,3% geringer war verglichen mit Chlorambucil + Obinutuzumab (Clb + O; n = 105) (Hazard Ratio (HR) 0,487; 95%-Konfidenzintervall (KI): 0,262–0,907; nomineller p-Wert p = 0,0205; sekundärer Endpunkt) [1, 2] . Die geschätzte 42-Monats-Rate für das Gesamtüberleben (OS) lag im Ibr+Ven-Arm bei 87,5%, verglichen mit 77,6% im Kontrollarm. Die Kombinationstherapie aus Ibr + Ven stellt somit die erste rein orale, zeitlich begrenzte Behandlung für therapienaive CLL-Patient*innen dar, die verglichen mit Clb + O einen nominellen OS-Vorteil aufzeigte [1].","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 1","pages":"53 - 57"},"PeriodicalIF":2.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48752941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society Bulletins","authors":"T. Seufferlein","doi":"10.1159/000529047","DOIUrl":"https://doi.org/10.1159/000529047","url":null,"abstract":"Die steigende Zahl von Arzneimittelengpässen betrifft auch Krebspatientinnen und-patienten. Betroffen sind vor allem Medikamente, die schon seit vielen Jahren eingesetzt werden und heute als Generika auf dem Markt verfügbar sind. Sie machen die Hälfte der aktuell über 200 in Deutschland zugelassenen Krebsmedikamente aus. Da die Überlebenschance von Krebspatientinnen und-patienten von der Verfügbarkeit eines Arzneimittels abhängig sein kann, sind die Ängste groß. Eine besondere Aufgabe ist es deshalb, das Vertrauen in die Sicherheit der Arzneimittelversorgung zu erhalten bzw. wiederherzustellen. In einer gemeinsamen Pressekonferenz hat die DGHO Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie e. V. mit Repräsentanten von weiteren wissenschaftlichen medizinischen Fachgesellschaften und des Bundesinstituts für Arzneimittel und Medizinprodukte (BfArM) auf bereits funktionierende Maßnahmen und auf weiterhin bestehende Lücken in der Arzneimittelversorgung hingewiesen. Die Zahl der Arzneimittelengpässe in der Krebstherapie ist im letzten Jahr deutlich gestiegen. Betroffen waren vor allem Medikamente, die schon seit langem erfolgreich eingesetzt werden. Dazu gehörten Tamoxifen und nab-Paclitaxel, die u. a. bei Brustkrebs, Bauchspeicheldrüsenkrebs, Lungenkrebs und Karzinomen im Magendarmbereich als Standard eingesetzt werden. Darüber hinaus fehlten auch unterstützende Arzneimittel wie Calciumfolinat, Harnsäuresenker, Antibiotika und Immunglobuline. Prof. Dr. med. Hermann Einsele, GeSchutz vor Arzneimittelengpässen bei Krebspatienten","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 1","pages":"58 - 65"},"PeriodicalIF":2.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46507664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Report on Immune Thrombocytopenia: Current Diagnostics and Treatment - Recommendations from an Expert Group from Austria, Germany, and Switzerland.","authors":"Axel Matzdorff, Sonja R Alesci, Johanna Gebhart, Susanne Holzhauer, Marie Luise Hütter-Krönke, Thomas Kühne, Oliver Meyer, Helmut Ostermann, Ingrid Pabinger, Mathias Rummel, Ulrich J Sachs, Thomas Stauch, Karolin Trautmann-Grill, Bernhard Wörmann","doi":"10.1159/000529662","DOIUrl":"10.1159/000529662","url":null,"abstract":"no Abstract.","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 Suppl 2 ","pages":"5-44"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9529081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Structured Post-Operative Surveillance in Resected Pancreatic Adenocarcinoma: Results from a Retrospective Cohort Study.","authors":"Danmei Zhang, Stephan Kruger, Karoline Schirle, Volker Heinemann, Klara Dorman, Christoph Benedikt Westphalen, Lena Weiss, Leonie Gebauer, Michael Günther, Steffen Ormanns, Jens Werner, Michael von Bergwelt-Baildon, Stefan Boeck, Michael Haas","doi":"10.1159/000528722","DOIUrl":"10.1159/000528722","url":null,"abstract":"<p><strong>Introduction: </strong>To this date, surgery remains the only potentially curative approach in the treatment of pancreatic cancer. To analyse the clinical impact of a structured post-operative follow-up programme, we retrospectively analysed a cohort of resected pancreatic adenocarcinoma patients treated at LMU Munich.</p><p><strong>Methods: </strong>Pancreatic adenocarcinoma patients who underwent resection and presented for regular follow-up visits at our centre between 2002 and 2017 were identified from two existing study cohorts. Diagnosis of recurrences was categorised by timing (within or outside a scheduled follow-up visit) and detection modality (imaging, CA 19-9 increase, or clinical deterioration) and correlated with disease-free survival and overall survival (OS).</p><p><strong>Results: </strong>One hundred and twenty-five patients with resected pancreatic adenocarcinoma were included in this analysis. Median OS in the whole cohort was 21.1 months. Of these 125 patients, 103 (82.4%) patients had a documented relapse. Tumour recurrences detected within a scheduled follow-up visit (n = 86, 83.5%) compared to recurrences becoming apparent at an unplanned visit (n = 17, 16.5%) were associated with a significantly improved OS (median 25.5 vs. 20.2 months, p = 0.019). Compared to patients with recurrence detected by clinical deterioration (n = 4, 3.9%), patients with recurrences detected by imaging or laboratory abnormalities (n = 99, 96.0%) had a longer median OS (24.8 vs. 15.1 months, p = 0.007).</p><p><strong>Discussion: </strong>A structured follow-up after pancreatic ductal adenocarcinoma resection may have an impact on patient outcome. Prospective trials are needed to evaluate the clinical impact of post-operative follow-up programmes.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 3","pages":"106-115"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9096276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune System Activation in Patients with Metastatic Renal Cell Carcinoma Induced by the Systemic Abscopal Effects of Radiation Therapy.","authors":"Mark A D'Andrea,&nbsp;G Kesava Reddy","doi":"10.1159/000527959","DOIUrl":"https://doi.org/10.1159/000527959","url":null,"abstract":"<p><strong>Introduction: </strong>Renal cell carcinoma (RCC) is characterized by large histopathologic heterogeneity and classified with multiple histological subtypes. Radiation therapy has long played a key role in the management of both local and metastatic RCC. An out-of-field tumor regression (abscopal response) effect of radiation therapy has gained significant importance in the treatment of different tumor types including RCC. In this study, we provide a detailed overview of the current state of knowledge and clinical experience of radiation therapy-induced abscopal effects in patients with advanced RCC.</p><p><strong>Methods: </strong>The PRISMA guidelines were followed to identify the published articles for the study. Using electronic databases such as MEDLINE via PubMed and Google Scholar, a systematic literature review was performed to find published clinical evidence for radiation therapy-induced abscopal effects in patients with advanced RCC. The clinical data of radiation therapy-induced abscopal effects were reviewed, and the outcomes have been summarized.</p><p><strong>Results: </strong>In this study, we evaluated peer-reviewed published reports to find clinical evidence for the abscopal effect following radiation therapy in patients with advanced RCC. The clinical data on the systemic abscopal effects of radiation therapy were reviewed, and the outcomes were summarized. Our literature search indicated that the evidence for abscopal effects of radiation therapy in advanced RCC yielded over 20 case reports. The evidence indicates that abscopal effects of local radiation therapy may occur in RCC through tumor cell destruction with the subsequent release of tumor antigens that systemically stimulate the immune system of the host to activate the body's immune effector cells and produce distant nontarget antitumor effects. The activation of the immune system by local radiation therapy forms the basis to combine immunotherapy to boost its abscopal effects.</p><p><strong>Conclusions: </strong>Collectively, these findings suggest that radiation therapy can induce systemic abscopal effects through immune system activation, and thus, the addition of immunotherapeutic agents increases the potential to boost the systemic abscopal responses in patients with advanced cancers including RCC.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 1-2","pages":"33-44"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10644676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Oligometastatic Disease in Esophagogastric Cancer: What Is the Evidence?","authors":"Mohan Hingorani,&nbsp;Hannah Stubley","doi":"10.1159/000531590","DOIUrl":"https://doi.org/10.1159/000531590","url":null,"abstract":"<p><strong>Background: </strong>The concept of oligometastatic disease (OMD) was first introduced in 1995 by Hellman and Weichselbaum and described as stage of transition between localized and widespread metastatic disease. The presence of OMD in esophagogastric (OG) cancer remains controversial. Historically, most experts believe that OG cancer is systemic disease from the outset.</p><p><strong>Summary: </strong>More recently, there is emerging data indicating improved outcomes in patients with OG cancer and oligometastatic disease. The present manuscript focuses on reviewing the emerging evidence in management of metastatic OG cancer with OMD and highlighting the direction of future research.</p><p><strong>Key messages: </strong>Multiple retrospective and at least 2 phase II retrospective studies have reported on improved outcomes in patients with metastatic OG cancer and OMD. There is indication of improved outcome with combined systemic and local therapy (surgery or radiation). Further research should include phase III randomized studies to identify the optimal management algorithm in these groups of patients.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 7-8","pages":"312-319"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curative Polyendocrine Therapy in a 21-year-Old Patient with Endometrial Carcinoma: Case Report and Review of the Literature.","authors":"Henning Schäffler,&nbsp;Moritz Dimpfl,&nbsp;Fabienne Schochter,&nbsp;Wolfgang Janni,&nbsp;Nikolaus de Gregorio","doi":"10.1159/000531661","DOIUrl":"https://doi.org/10.1159/000531661","url":null,"abstract":"<p><strong>Introduction: </strong>As the numbers of young patients diagnosed with early-stage endometrial carcinoma continue to rise, the question regarding fertility-preserving therapeutic options will increasingly gain significance in the future.</p><p><strong>Case presentation: </strong>Here, we present the case of a 21-year-old patient diagnosed with symptomatic atypical endometrial hyperplasia. After 4 months of treatment with medroxyprogesterone acetate, a follow-up dilatation and curettage revealed early-stage, well-differentiated endometrioid endometrial carcinoma. Despite national guidelines recommending hysterectomy, the nulliparous patient expressed a desire to preserve her fertility. Subsequently, she underwent polyendocrine therapy with letrozole, everolimus, metformin, and Zoladex. Forty-three months after diagnosis, the patient successfully gave birth to a healthy child, and there have been no indications of recurrence thus far.</p><p><strong>Discussion: </strong>This case suggests that triple endocrine therapy may be an option for selected patients with early endometrial cancer and a desire for fertility-sparing therapy.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 7-8","pages":"330-335"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Phase II Study of Nab-Paclitaxel and Gemcitabine as First-Line Therapy in Patients with Cholangiocarcinoma Ineligible for Cisplatin-Based Chemotherapy (NACHO).","authors":"Isabel Virchow,&nbsp;Jürgen-Walter Treckmann,&nbsp;Nicole Prasnikar,&nbsp;Gabriele Linden,&nbsp;Peter Markus,&nbsp;Brigitte Schumacher,&nbsp;David Albers,&nbsp;Thomas Herold,&nbsp;Saskia Ting,&nbsp;Hartmut Schmidt,&nbsp;Sonja Radunz,&nbsp;Marcel Wiesweg,&nbsp;Jens Siveke,&nbsp;Martin Schuler,&nbsp;Stefan Kasper","doi":"10.1159/000529012","DOIUrl":"https://doi.org/10.1159/000529012","url":null,"abstract":"<p><strong>Introduction: </strong>Gemcitabine and cisplatin is the standard first-line systemic treatment in patients with advanced cholangiocarcinoma (CCA). However, a substantial number of patients do not qualify for cisplatin due to comorbidities or poor performance status. The phase II pilot study NACHO evaluated the efficacy of nab-paclitaxel (125 mg/m2) and gemcitabine (1000 mg/m2) given on days 1, 8, and 15 every 4 weeks as first-line therapy in patients with advanced CCA ineligible for cisplatin-based chemotherapy.</p><p><strong>Methods: </strong>Patients with any comorbidity precluding cisplatin therapy, such as renal impairment, impaired hearing, increased risk or history for thromboembolic events, intolerance of extensive hydration, or significant cardiovascular disease were eligible. Primary endpoint was overall response rate (ORR) per RECIST 1.1. Secondary endpoints were progression-free survival (PFS), overall survival (OS), safety, and patient reported outcome.</p><p><strong>Results: </strong>From December 2016 to July 2017, 10 patients were prospectively enrolled and treated. The ORR with nab-paclitaxel/gemcitabine was 50%, the disease control rate (DCR) was 90%. Median PFS was 5.7 months (95% CI: 5.3-6.1), and median OS was 7.8 months (95% CI: 5.4-10.2). In total, 13 SAEs were documented without any new safety signals. There were 14 grade 3-4 treatment-related adverse events (TRAEs) in 10 patients of the ITT population. Exploratory subgroup analyses including known prognostic markers were performed.</p><p><strong>Conclusions: </strong>The NACHO trial supports safety and efficacy of nab-paclitaxel and gemcitabine in patients with advanced CCA ineligible for cisplatin-based therapy and should be further evaluated in a larger prospective trial.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 3","pages":"89-99"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10845450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Geriatric Assessment on the Tolerability of Combination Chemotherapy in Older Patients with Advanced Cancer: A Matched-Pair Analysis.","authors":"Michael Konrad Stahl,&nbsp;Sebastian Willy Ertl,&nbsp;Pouneh Engelmeyer,&nbsp;Hans-Christoph Heuer,&nbsp;Daniel Christian Christoph","doi":"10.1159/000529097","DOIUrl":"https://doi.org/10.1159/000529097","url":null,"abstract":"<p><p>Because of their individual vulnerabilities, treatment decisions for older patients can be difficult. Geriatric assessment (GA) may help to select patients for systemic treatment, but its value is still unproven. Older cancer patients (≥65 years of age) with and without complex GA followed by discussion in the geriatric-oncologic conference, who had been treated in palliative intention with standard combination chemotherapy at the Evang. Kliniken Essen-Mitte, were retrospectively evaluated. All patients had been orally informed about the treatment options and had chosen chemotherapy beside supportive care. To reduce selection bias, the method of propensity-score matching was performed. Patient groups treated in the years 2011-2013 (without GA, group 1) and in the years 2014-2015 (with GA, group 2) were compared regarding different toxicity endpoints. The primary endpoint of the study was defined as numbers of patients with unplanned admission to the hospital or death during first-line chemotherapy and GA should reduce these events by 15%. Overall, 114 patients were evaluated in both groups. The median age was 74 years. Patients suffered from gastrointestinal carcinomas (47%), lung cancer (28%), breast cancer (12%), and other cancer types (3%). Consequently, most patients were treated with platinum-based (41%), fluoropyrimidine-based (35%), or anthracycline-based (13%) combination chemotherapy. In group 2, the events were numerically lower for all toxicity endpoints. The need for a premature stop of treatment was 54.4% in group 1 compared to 29.8% in group 2 (p < 0.01) and also the treatment-related mortality was significantly lower in group 2 (17.5% vs. 5.3%; p = 0.04). The primary endpoint, the rate of unplanned hospital admission, and death was 49.1% versus 35.1% (difference 14.0%), which did not reach the predefined border of 15%. There was a nonsignificant overall survival benefit in the group with GA (22.6 vs. 18.4 months). GA appears useful to better select older patients with advanced cancer for combination chemotherapy. The significant reduction of mortality during chemotherapy justifies the efforts and costs which need to be expended. To evaluate the effect of GA on overall survival, prospective trials are required.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"46 3","pages":"100-105"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}