Karger Kompass Pneumologie最新文献

{"title":"Frühzeitiges Ansprechen erhöht die Wahrscheinlichkeit für spätere «Super-Response» auf Reslizumab","authors":"","doi":"10.1159/000505005","DOIUrl":"https://doi.org/10.1159/000505005","url":null,"abstract":"","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122528365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erfolgreiche Behandlung eines Afatinib-refraktären nicht kleinzelligen Bronchialkarzinoms mit seltenen komplexen EGFR-Mutationen mit Pembrolizumab: ein Fallbericht","authors":"Yuri Taniguchi, Momoko Yamamoto, Hiroaki Ikushima, Sayaka Ohara, Hideyuki Takeshima, Toshio Sakatani, Kazuhiro Usui","doi":"10.1159/000503948","DOIUrl":"https://doi.org/10.1159/000503948","url":null,"abstract":"Trotz der signifikanten Fortschritte, die in der jüngeren Vergangenheit in der Behandlung mit Immuncheckpoint-Inhibitoren (ICI) erzielt wurden, ist nach wie vor umstritten, ob sie auch bei der Behandlung des nicht kleinzelliges Bronchialkarzinoms (NSCLC) mit Mutationen des epidermalen Wachstumsfaktor-Rezeptors (EGFR) zum Einsatz kommen sollten. Wir berichten hier über den Fall einer NSCLC-Patientin mit seltenen, komplexen EGFR-Mutationen (G719S und L861Q), die gegenüber Afatinib refraktär war, auf Pembrolizumab jedoch ein gutes Ansprechen zeigte. Bei einer 65-jährigen ehemaligen Raucherin wurde ein NSCLC des rechten Oberlappens diagnostiziert (klinisches Stadium IVB; cT2bN3M1c). Unter einer zweimonatigen Behandlung mit Afatinib war ihre Krankheit rapide weiter fortgeschritten. Die Behandlung mit Pembrolizumab wurde eingeleitet, weil mehr als 75% ihrer Tumorzellen PD-L1 exprimierten. Ihr Tumor sprach gut auf die Pembrolizumab-Behandlung an, und die Wirkung hielt mehr als ein Jahr an. Dieser Fall deutet darauf hin, dass Pembrolizumab eine Behandlungsoption für NSCLC-Patienten mit seltenen EGFR-Mutationen und einem hohen Maß an PD-L1-Expression darstellen könnte, die auf eine EGFR-TKI-Therapie nicht ansprechen.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128885168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oligometastasiertes nicht kleinzelliges Lungenkarzinom: Vorteile einer lokalen Konsolidierungstherapie nutzen","authors":"W. Schütte, M. Möller","doi":"10.1159/000503697","DOIUrl":"https://doi.org/10.1159/000503697","url":null,"abstract":"Background: Evidence from retrospective studies suggests that disease progression after first-line chemotherapy for metastatic non-small-cell lung cancer (NSCLC) occurs most often at sites of disease known to exist at baseline. However, the potential effect of aggressive local consolidative therapy for patients with oligometastatic NSCLC is unknown. We aimed to assess the effect of local consolidative therapy on progression-free survival. Methods: In this multicentre, randomised, controlled, phase 2 study, eligible patients from three hospitals had histological confirmation of stage IV NSCLC, three or fewer metastatic disease lesions after first-line systemic therapy, an Eastern Cooperative Oncology Group performance status score of 2 or less, had received standard first-line systemic therapy, and had no disease progression before randomisation. First-line therapy was four or more cycles of platinum doublet therapy or 3 or more months of EGFR or ALK inhibitors for patients with EGFR mutations or ALK rearrangements, respectively. Patients were randomly assigned (1:1) to either local consolidative therapy ([chemo]radiotherapy or resection of all lesions) with or without subsequent maintenance treatment or to maintenance treatment alone, which could be observation only. Maintenance treatment was recommended based on a list of approved regimens, and observation was defined as close surveillance without cytotoxic treatment. Randomisation was not masked and was balanced dynamically on five factors: number of metastases, response to initial therapy, CNS metastases, intrathoracic nodal status, and EGFR and ALK status. The primary endpoint was progression-free survival analysed in all patients who were treated and had at least one post-baseline imaging assessment. The study is ongoing but not recruiting participants. This study is registered with ClinicalTrials.gov, number NCT01725165. Findings: Between Nov 28, 2012, and Jan 19, 2016, 74 patients were enrolled either during or at the completion of first-line systemic therapy. The study was terminated early after randomisation of 49 patients (25 in the local consolidative therapy group and 24 in the maintenance treatment group) as part of the annual analyses done by the Data Safety Monitoring Committee of all randomised trials at MD Anderson Cancer Center, and before a planned interim analysis of 44 events. At a median follow-up time for all randomised patients of 12·39 months (IQR 5·52-20·30), the median progression-free survival in the local consolidative therapy group was 11·9 months (90% CI 5·7-20·9) versus 3·9 months (2·3-6·6) in the maintenance treatment group (hazard ratio 0·35 [90% CI 0·18-0·66], log-rank p=0·0054). Adverse events were similar between groups, with no grade 4 adverse events or deaths due to treatment. Grade 3 adverse events in the maintenance therapy group were fatigue (n=1) and anaemia (n=1) and in the local consolidative therapy group were oesophagitis (n=2), anaemia (n=1), pneumo","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116783374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nicht kleinzelliges Lungenkarzinom: Welche Rolle microRNA in der Behandlung spielt","authors":"N. Reinmuth","doi":"10.1159/000503018","DOIUrl":"https://doi.org/10.1159/000503018","url":null,"abstract":"Background: The role of microRNA-133a (miR-133a) in non-small cell lung cancers (NSCLCs) is controversial. Thus, we conducted a comprehensive study based on meta-analysis and The Cancer Genome Atlas (TCGA) database. Methods: Publications were searched in both English and Chinese databases, and meta-analysis was performed using Stata 12.0. The clinical value of miR-133a in NSCLC was investigated by collecting and calculating data from the TCGA database, and the statistical analysis was performed in R 3.5.0. Results: 5 studies with 364 cases were included in this meta-analysis. The combined pooled result showed that high expression of miR-133a was associated with a favorable survival outcome in NSCLC patients (hazard ratio 0.561, 95% confidence interval 0.396-0.794, p = 0.001). Meanwhile, a total of 984 NSCLC patients were extracted from the TCGA database. Results showed an area under the ROC curve value for miR-133a-3p of 0.902, and the expression of miR-133a-3p was linked with clinicopathologic parameters of NSCLC (p < 0.05), including sex, age, social status, and lymph node metastasis. Conclusion: Our study indicated that miR-133a might act as a tumor suppressor and be a valuable independent prognostic and diagnostic biomarker for NSCLC, and NSCLC patients with high expression of miR-133 might have a better prognosis.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132338691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Das Spaghetti-Monster und die Wissenschaft","authors":"H. Walach","doi":"10.1159/000504071","DOIUrl":"https://doi.org/10.1159/000504071","url":null,"abstract":"","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121731721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PharmaNews","authors":"","doi":"10.1159/000505009","DOIUrl":"https://doi.org/10.1159/000505009","url":null,"abstract":"Während eines Presse-Webinars im Nachgang des Kongresses der European Society for Medical Oncology (ESMO) 2019 zu Therapieentscheidungen bei Patienten mit fortgeschrittenem nichtkleinzelligen Lungenkarzinom (NSCLC) standen aktuelle Real-Life-Daten im Mittelpunkt des Interesses. «Daten aus der Versorgungsrealität bieten uns Orientierungshilfe und helfen uns zu verstehen, welchen Stellenwert Therapiestrategien haben – gerade im Hinblick auf ein therapeutisches Gesamtkonzept beim NSCLC», erläuterte Prof. Martin Reck, Chefarzt an der LungenClinic Grosshansdorf, der gemeinsam mit Prof. Dieter Ukena, Chefarzt am Lungenzentrum des Klinikums BremenOst, durch das Webinar leitete. So wurde aktuell auf dem ESMO 2019 eine neue Interimsanalyse der prospektiven, nicht interventionellen Studie VARGADO bei Patienten mit fortgeschrittenem Adenokarzinom der Lunge ohne therapierbare Mutation vorgestellt. Die Studie VARGADO untersucht unter anderem die Wirksamkeit des 3-fach zielgerichteten Angiokinase-Inhibitors Nintedanib (Vargatef®) [1] in Kombination mit Docetaxel nach Erstlinienchemotherapie und anschließender Immuncheckpoint-Inhibition* [3]. Mit erweiterter Datenbasis (n = 32) wurde eine aktuelle Analyse dieser Kohorte auf dem ESMO-Kongress präsentiert [2].","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131960984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training zu Hause verbessert die Schlafqualität und die Tagesschläfrigkeit älterer Menschen","authors":"H. Frohnhofen","doi":"10.1159/000504032","DOIUrl":"https://doi.org/10.1159/000504032","url":null,"abstract":"Background: Aging causes physiological changes which affect the quality of sleep. Supervised physical exercise is an important therapeutic resource to improve the sleep of the elderlies, however there is a low adherence to those type of programs, so it is necessary to implement an exercise program which is feasible and effective. The study aimed to test the hypothesis that a semi-supervised home exercise program, improves sleep quality and daytime sleepiness of elderlies of the community who present poor sleep quality. Methods: This was a randomized controlled trial study, conducted from May to September 2017, in Northeastern Brazil, with elderlies of the community aging 60 years old or older, sedentary, with lower scores or equal to 5 at the Pittsburgh Sleep Quality Index (PSQI) and without cognitive decline. From one hundred ninety-one potential participants twenty-eight refused to participate, therefore, one hundred thirty-one (mean age 68 ± 7 years), and 88% female, were randomly assigned to an intervention group - IG (home exercise and sleep hygiene, n = 65) and a control group - CG (sleep hygiene only, n = 66). Sleep assessment tools were used: PSQI, Epworth sleepiness scale (ESS) and clinical questionnaire of Berlin. The level of physical activity has been assessed by means of International Physical Activity Questionnaire adapted for the elderly (IPAQ) and Mini-Mental State Examination for cognitive decline. All participants were assessed before and after the 12-week intervention period and, also, the assessors were blind. Results: The IG showed significant improvement in quality of sleep with a mean reduction of 4.9 ± 2.7 points in the overall PSQI (p < 0.01) and in all its 7 components of evaluation (p < 0.05), and improvement of secondary endpoint, daytime sleepiness, a decline of 2.8 ± 2.2 points in the ESS (p < 0.01). Conclusion: Our results suggest that semi-supervised home exercise is effective in improving the quality of sleep and self-referred daytime sleepiness of sedentary elderlies of the community who presented sleep disorders. Trial registration: Ensaiosclinicos.gov.br process number: RBR-3cqzfy.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114367490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auswirkungen der Rebiopsie auf die Prognose von Patienten mit fortgeschrittenem nicht kleinzelligem Bronchialkarzinom nach Behandlung mit epidermalem Wachstumsfaktor-Rezeptor-Tyrosinkinase-Hemmer: ein systematischer Überblick","authors":"Takuma Imakita, Hirotaka Matsumoto, Katsuya Hirano, T. Morisawa, Azusa Sakurai, Yuki Kataoka","doi":"10.1159/000503985","DOIUrl":"https://doi.org/10.1159/000503985","url":null,"abstract":"Hintergrund: Osimertinib, ein epidermaler Wachstumsfaktorrezeptor-Tyrosinkinasehemmer (Epidermal Growth Factor Receptor-Tyrosine-kinase Inhibitor, EGFR-TKI) der 3. Generation, ist mittlerweile die Standardtherapie in Fällen, in denen die Rebiopsie nach der Erstlinienbehandlung mit EGFR-TKI eine T790M-Mutation ergibt. Die Prognose der Patienten nach Rebiopsie, dem wichtigsten Outcome bei Krebspatienten, wurde bislang jedoch nicht ausreichend beschrieben. Die vorliegende systematische Übersichtsarbeit sollte klären, ob die Rebiopsie bei Patienten, die gegenüber den EGFR-TKI der 1. und 2. Generation refraktär sind, zu einer verbesserten Prognose beiträgt. Methoden: Mithilfe freier Wort- und Kontrollbegriffe im Zusammenhang mit «nicht kleinzelligem Bronchialkarzinom» und «Rebiopsie» suchten wir Studien aus dem Medical Literature Analysis and Retrieval System Online über PubMed, Embase, Cochrane Central Register of Controlled Trials und die World Health Organization International Clinical Trials Registry Platform. Eingeschlossen wurden Kohortenstudien und Fallberichte in englischer Sprache und es erfolgte eine Beurteilung, ob die jeweilige Studie unsere wissenschaftliche Fragestellung beantwortete. Ergebnisse: Von den 144 eingeschlossenen Studien enthielt nur eine Studie Angaben zur Prognose von Patienten mit/ohne Rebiopsie und zeigte, dass bei EGFR-TKI-refraktären Patienten mit nicht kleinzelligem Bronchialkarzinom das Überleben nach Krankheitsprogression (post-progression survival, PPS) bei Patienten, die eine Rebiopsie sowie eine Behandlung entsprechend dem Resistenzmechanismus erhalten hatten, signifikant länger war (medianes PPS: 24,2 Monate) als bei Patienten die eine Rebiopsie und Salvage-Therapie erhalten hatten (medianes PPS: 15,2 Monate, p = 0,002) und solchen ohne Rebiopsie (medianes PPS: 9,7 Monate, p < 0,001). Die meisten anderen Studien berichteten über die Nachweisrate von T790M-Mutationen oder das Rebiopsieverfahren. Schlussfolgerungen: Nur wenige der bisher durchgeführten Studien untersuchten die Wirksamkeit der Rebiopsie. Daher sind weitere Untersuchungen erforderlich, um die Prognose oder Nebenwirkungen der Rebiopsie zu ermitteln.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132885450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lungenkrebs behandeln und begleiten - auf dem Weg zur chronischen Krankheit","authors":"C. Schumann, N. Dickgreber","doi":"10.1159/000504308","DOIUrl":"https://doi.org/10.1159/000504308","url":null,"abstract":"Lungenkrebs ist mit rund 50 000 Neuerkrankungen pro Jahr eine häufige Krebserkrankung in Deutschland. Zugleich ist die Sterblichkeit mit die höchste unter allen Krebserkrankungen. Ein Grund dafür ist, dass ein großer Anteil der Neuerkrankungen bereits zum Zeitpunkt der Erstdiagnose lokal fortgeschritten (Stadium III etwa 30%) oder metastasiert (Stadium IV etwa 40%) ist. Die bestimmende Frage ist daher, welche Entwicklungen das Potenzial zur Verbesserung der Prognose der an einem Lungenkarzinom Erkrankten haben, die wir in diesem Editorial stichpunktartig vorstellen möchten.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129166167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronisch-obstruktive Lungenerkrankungen: Die wichtigsten Änderungen im GOLD-Update 2019","authors":"M. Spielmanns, S. Pantev","doi":"10.1159/000503044","DOIUrl":"https://doi.org/10.1159/000503044","url":null,"abstract":"Der jüngste Report der Global Initiative for Chronic Obstructive Lung Disease (GOLD) aus 2019 beinhaltet die letzten Empfehlungen zur Früherkennung, Differenzialdiagnose sowie Initial- und Folgetherapie der COPD. Der Schwerpunkt des Reports liegt auf den aktualisierten therapeutischen Algorithmen für COPD im Zusammenhang mit dem Schweregrad und der Risikogruppe der Erkrankung. Neu wird die Eosinophilenzahl im Blut als wichtiger biochemischer Marker für Therapieentscheidungen bei vorbehandelten Patienten definiert. So wird die Indikation zur inhalativen Kortikosteroidtherapie (ICS) bei einer Eosinophilenzahl >300 Zellen/µl gestellt. Hingegen wird ein ICS-Versuch bei einer Eosinophilenzahl <100 Zellen/µl nicht empfohlen, auch wenn die Patienten exazerbieren.","PeriodicalId":306175,"journal":{"name":"Karger Kompass Pneumologie","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126921666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}