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  • 21
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2015
    In:  Cancer Research Vol. 75, No. 9_Supplement ( 2015-05-01), p. P6-08-39-P6-08-39
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 75, No. 9_Supplement ( 2015-05-01), p. P6-08-39-P6-08-39
    Abstract: Introduction: Influence of lifestyle behaviour in risk of developing breast cancer is supported by several lines. Data from 632 early breast cancer (EBC) patients were collected to evaluate the influence of lifestyle factors in progression free survival (PFS) and overall survival (OS). Results of disseminated tumor cell (DTC) in bone marrow and circulating tumor cells (CTC) in blood were available as well. A complete pathological data set and medical history were obtained. It was the purpose of the present study to correlate these data to compare the findings. Methods: We evaluated 629 bone marrow samples and 606 blood samples from EBC patients treatet between 2004 to 2010 at the time of first diagnosis. All samples underwent immunomagnetic enrichment using the AdnaTest BreastCancerSelect (AdnaGen AG, Germany) within 4 hours after blood withdrawal followed by RNA isolation and subsequent gene expression analysis by reverse transcription and Multiplex-PCR in separated tumor cells using the AdnaTest BreastCancerDetect. CTCs were analyzed for the three breast cancer associated markers: GA733-2, Muc-1, Her-2 and actin as an internal PCR control. BM aspirates were analyzed for DTCs by immunocytochemistry using the pan-cytokeratin antibody A45-B/B3. Lifestyle data icluding menopausal status, BMI, usage of Metformin, hormone replacement drugs, beta blockers and Bisphosphonates were collected by accessing the patient files. Histological data of the primary tumor were available for each patient. Results: The overall detection rate for CTCs was 15.41% (88/571 patients) and for DTC was 38.5% (242/628 patients), respectively. The mean BMI of 428 patients was 26.4 in 81/574 premenopausal, 426/574 postmenopausal and 67/574 perimenopausal patients. Medical history of smoking (128/394 patients), using hormone replacement therapy (92/354 patients), alcohol consumption (68/378 patients), having allergies (188/419), using Metformin (22/389 patients), taking beta blockers (83/392 patients) and Bisphosphonates (201/526 patients) were compared to PFS and OS as well as the histological data of the primary tumor. Conclusion: Lifestyle factors seems to influence the outcome in our cohort of EBC patients as shown in previous studies. Final data and results regarding to tumor cell dissemination compared to lifestyle behaviour will be available for the SABCS 2014. Citation Format: Bahriye Aktas, Anna Frackenpohl, Siegfried Hauch, Johann Kraus, Hans Armin Kestler, Rainer Klaus Kimmig, Sabine Kasimir-Bauer. Influence of lifestyle factors and tumor cell dissemination in 632 early breast cancer patients [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P6-08-39.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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  • 22
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2015
    In:  Cancer Research Vol. 75, No. 9_Supplement ( 2015-05-01), p. P4-01-07-P4-01-07
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 75, No. 9_Supplement ( 2015-05-01), p. P4-01-07-P4-01-07
    Abstract: Background: Disseminated tumor cells (DTCs) in the bone marrow and circulating tumor cells (CTCs) in blood of breast cancer patients (pts) were shown to provide independent prognostic information and can be regarded as an early indicator of therapy failure. Here we demonstrate a different prognostic value of DTCs and CTCs and explain these findings by early bisphosphonate intake. Patients and Methods: 10 ml blood and two bone marrow aspirates of 488 pts with first diagnosis of breast cancer between Aug 2006 and Dec 2010 were studied for DTCs and CTCs. CTCs were detected using the AdnaTest BreastCancer (AdnaGen AG, Hannover, Germany) for the detection of EpCAM, MUC-1 and HER2 transcripts. DTCs were analyzed by immunocytochemistry using the pan-cytokeratin antibody A45-B/B3. In addition to chemo-, radio- and anti-hormonal therapy, bisphosphonates were given to DTC-pos pts [clodronate (2×520 mg per day) for at least two years] and 69 DTC-neg, postmenopausal pts [zoledronic acid (4 mg, twice a year) for three years] . Results: After a median follow-up time of 48 months (range: 5 to 87 months), the overall survival rate was 93% (456/488 pts) and relapses occurred in 11% (56/488 pts) of cases. CTCs were detected in 109/488 pts (22%) and significantly correlated with reduced disease free survival (DFS; p=0.02). Negative prognostic relevance was predominantly related to the lobular subtype (p=0.0047), the ER-pos subtype, (pER+/Her2=0.01; pER+/Her2+=0.25; pER-/Her2+=0.5) and pts who had received chemotherapy (p=0.015) or radiation therapy (p=0.0083) but not to pts with anti-hormonal regimens (p=0.06). DTCs were detected in 162/488 pts (33%). In contrast to CTCs, no prognostic significance could be shown with regard to DFS (p=0.49), all clinical parameters as well as treatment regimens. In contrast, only in CTC-pos pts, the presence of DTCs significantly correlated with DFS (p=0.04). We further investigated whether this lack in prognostic significance was due to bisphosphonate intake in case of DTC-positivity. Predominantly, in the CTC-neg group, bisphosphonate treatment significantly influenced DFS in both histological subtypes (pCTC-/ductal=0.04; pCTC-/lobular=0.0021). However, in the CTC-pos group of pts, no such effect was observed (pCTC+/ductal=0.76; pCTC+/lobular=0.51).Conclusion: Here we show, that CTCs, rather than DTCs were significantly prognostic for early relapse. The ER-pos subtype was mostly affected which is in concordance with our previous studies, demonstrating that CTCs show EMT and tumor stem cell characteristics and, thus, down regulate ER which probably makes anti-hormonal treatment less effective. In addition, the presence of these CTC-subtypes might also explain the negative prognostic impact of CTCs in pts receiving chemo- or radiation therapy which we could verify in a subgroup of our pts (n=238) showing a significant correlation of CTCs and EMT/stem cell like CTCs (p=0.017; data not shown). The lack of prognostic significance of DTCs can be related to bisphosphonate intake in all DTC-pos pts, a subgroup of DTC-neg pts as well as in DTC-pos/CTC-neg pts, underlining our assumption that CTCs might be a high risk indicator for already ongoing metastasis not limited to bone metastasis. Citation Format: Sabine Kasimir-Bauer, Bahriye Aktas, Siegfried Hauch, Rainer Kimmig, Oliver Hoffmann. Different prognostic value of circulating and disseminated tumor cells in primary breast cancer. Influence of bisphosphonate intake? [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-01-07.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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  • 23
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 75, No. 15_Supplement ( 2015-08-01), p. 383-383
    Abstract: Background: The utility of circulating tumor cells (CTC) as promising prognostic biomarker to predict the risk of relapse in primary and metastatic breast cancer (BC) patients as well as to monitor disease progression has already been shown over the last years. Nevertheless, the clinical utility of CTC highly depends on a robust and standardized selection method which can be easily integrated in clinical routine. To adress this medical need, the AdnaCellector, a fully automated immunomagnetic cell capturing device, was developed to a prototype stage. Here we present a pilot study in a clinical setting to investigate the general assay performance of the AdnaCellector and the overall agreement with the manual AdnaTest BreastCancerSelect. Materials and Methods: In total, CTC were isolated from EDTA blood of 13 primary and 20 metastatic BC patients with the AdnaCellector and the manual AdnaTest BreastCancerSelect (AdnaGen GmbH, Langenhagen, Germany) in duplicates of 5ml. The lysates generated from both selection variants were processed manually with the AdnaTest BreastCancerDetect. Established cDNA was used for multiplex PCR (MUC-1, GA733-2, HER2). Resulting PCR fragments were analyzed with the Agilent Bioanalyzer 2100. Patients were classified as CTC positive if at least one marker was detected with a concentration ≥0.15 ng/μl. Assay positivity among the same patient was evaluated with regard to the selection method. To further estimate the ease of use of both methods a non-experienced trainee was choosen to perform the procedure. Results: Comparing all clinical samples, the detection rate was 32% (20/61) for the manual workflow and 42% (25/60) using the AdnaCellector with an overall concordance of 81% (p & lt;0.001). If samples were separately analyzed for blood from primary or metastatic patients, the manual procedure detected 35% (8/23) positive samples vs 30% (7/23) positivity by the AdnaCellector in primary blood samples and 33% (12/36) vs 50% (18/37) in metastatic blood samples, respectively. The overall concordance was 76% (p = 0.05) in the primary setting and 86% (p & lt;0.001) for the metastatic samples. Discussion: For CTC detection in a clinical setting, we were able to demonstrate a good concordance of the fully automated AdnaCellector prototype and the manual workflow of the AdnaTest BreastCancer. Most interestingly, in the metastatic setting we observed even substantial higher sensitivity vs the manual procedure which may indicate that this automated and, therefore, standardized procedure may provide better test performance if the AdnaTest is used by non-experienced personel. Citation Format: Maren Bredemeier, Natalie Fenjuk, Siegfried Hauch, Bahriye Aktas, Mitra Tewes, Rainer Kimmig, Sabine Kasimir-Bauer. The AdnaCellector, a new fully automated selection for circulating tumor cells in blood of primary and metastatic breast cancer patients. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 383. doi:10.1158/1538-7445.AM2015-383
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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  • 24
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2013
    In:  Cancer Research Vol. 73, No. 8_Supplement ( 2013-04-15), p. 1466-1466
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 73, No. 8_Supplement ( 2013-04-15), p. 1466-1466
    Abstract: Background: Improved treatment strategies for metastatic breast cancer (MBC) patients are urgently needed. Since metastatic tissue may be difficult to obtain for repeated analysis, circulating tumor cells (CTC) would be an ideal surrogate tissue to identify prognostic and predictive factors that will help to select the optimal therapeutic strategy for each individual patient. Assuming that the population of CTC contains epithelial-like, EMT (Epithelial-Mesenchymal-Transition)-like and stem cell-like cells, we established a multi-marker qPCR for the characterization of these cells.Materials and Methods: Establishment of a 16 gene qPCR panel was performed using various epithelial cancer cell lines for the markers: EpCAM, MUC1 (epithelial); PI3K, PTEN, TWIST, mTOR, KRAS, AKT2 (EMT); ALDH1, CD44, CD24L4 (stem cell); ER, PR, HER2 and EGFR (receptors) and CD45 as a leucocyte control. The prostate cancer cell line LNCAP, expressing most of these genes, was used for spiking experiments. 10 ml blood of eight healthy donors (HDs), five HDs spiked with 10 LNCAP cells and 25 MBC patients were selected for CTC using AdnaTest BreastCancerSelect (AdnaGen AG) resulting in cDNA1. Subsequently, the same sample (with removed target cells) was processed again using the same procedure resulting in cDNA2. cDNA1 and cDNA2 were gene specifically preamplified using TaqMan PreAmp Master Mix according to in house designed assays. qPCR was performed using Bio-Rad SYBR Green Mix. If the CD45 deltaCt was & gt; zero, deltaCt value of a given gene was calculated as the difference between Ct (cDNA2) and Ct(cDNA1). A gene with a deltaCt & gt; zero was considered positive.Results: When HDs were tested for all genes, no false positive findings were observed except for AKT2, CD24L4, CD44 (n=3 cases). All of the genes except for TWIST, ER and PR could be positively detected in samples spiked with 10 LNCAP cells. In patient samples, at least one of all studied markers was detected in 21/25 (84%) of the patients. The distribution of the markers across all patients was highly variable. However, PI3K expression was observed most frequently (n=8/21 patients), followed by the expression of CD44 (n=6/21 patients), HER2 (n=5/21 patients) and TWIST, KRAS, mTOR and EpCAM (4/21 patients), respectively. No expression was observed for MUC1, PR and CD45. In general, EMT- and stem cell-like CTC were predominantly detected. HER2 positive and epithelial-like CTC as well as CTC expressing ER, PR and EGFR were observed less frequently. Interestingly, some patients expressed only one CTC-subtype.Conclusion: Multi-gene expression profiling improves the characterization of CTC of an individual patient. Furthermore, it was possible to classify individual patient samples into CTC subtypes. Despite these promising preliminary findings, the method has to be further optimized and needs to be verified in a larger patient population. Citation Format: Maren Bredemeier, Bahriye Aktas, Rainer Kimmig, Sabine Kasimir-Bauer. Establishment of a multimarker gene panel for the characterization of circulating tumor cells in metastatic breast cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1466. doi:10.1158/1538-7445.AM2013-1466
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2013
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  • 25
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 77, No. 13_Supplement ( 2017-07-01), p. 3777-3777
    Abstract: Background: Blood analytes, as liquid biopsies, are discussed to be surrogate markers for therapy stratification of metastatic breast cancer (MBC) patients. Repeated analysis is enabled by the minimal invasive nature of blood draw. Analysis of RNA enclosed in circulating tumor cells (CTCs) or extracellular vesicles (EVs) may be sensitive enough to detect disease progression earlier than contemporary visual staging methods. A prediction of the ideal therapy strategy via characterization of CTCs or EVs would be even more beneficial. Here we compare RNA profiles of CTCs and EVs in MBC patients to get insight into their feasibility for therapy stratification. Patients and methods: Blood was collected from 10 MBC patients at the time of disease progression (T0) and at two consecutive clinical staging time points (T1 and T2) during therapy. Two cohorts were separated according to RECIST criteria a) Overall Responder showed response at T1 and T2 and b) Late Non-Responder displayed stable disease or partial remission at T1, but showed progressive disease at T2. CTCs were isolated from 5 ml blood by positive immunomagnetic selection targeting EpCAM, EGFR and HER2 (AdnaTest EMT2/StemCell Select TM, QIAGEN, Germany). EVs were isolated from 4 ml pre-filtered plasma by affinity-based binding to a spin column (exoRNeasy, QIAGEN, Germany). mRNA bound to Oligo-dT beads was purified and reverse transcribed (AdnaTest EMT2/StemCell Detect TM, QIAGEN, Germany). Pre-amplified cDNA was analysed by a multimarker qPCR (AdnaPanel TNBC, QIAGEN, Germany). RNA profiles of 18 genes (including AKT2, ALK, AR, AURKA, BRCA1, cKIT, cMET, EGFR, ERCC1, HER2, HER3, KRT5, mTOR, NOTCH1, PARP1, PI3K, SRC1, GAPDH) were normalized by data of healthy donors (n=20) and CD45 served as leukocyte control in the CTC preparation. Results: In general, data analysis showed great differences in RNA profiles of EVs and CTCs. However, PI3K and SRC1 signals were found in similar frequencies in the EV and CTC fraction. HER2, HER3, cKIT or cMET signals significantly correlated with disease progression by analysis of either CTCs or EVs (p=0.001). In EVs, BRCA1 signals positively indicated response, while AR and KRT5 signals were related to a negative response. No marker was exclusively found in CTCs to correlate to the therapy-response course. In CTCs and EVs, however, similar signal courses for PI3K and cMET were found across all time points, revealing PI3K as potential positive response marker and cMET as potential negative response marker in both blood analytes. Conclusions: Expression profiling in CTCs as well as in EVs is enabled by the described workflows. Preliminary data indicated great differences in RNA profiles of EVs and CTCs. The amount of included patients is continuously increased to validate the preliminary results obtained until now. Citation Format: Corinna Keup, Siegfried Hauch, Linda Plappert, Markus Sprenger-Haussels, Pawel Mach, Mitra Tewes, Bahriye Aktas, Hans-Christian Kolberg, Rainer Kimmig, Sabine Kasimir-Bauer. RNA profiles of circulating tumor cells and extracellular vesicles for therapy stratification of metastatic breast cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3777. doi:10.1158/1538-7445.AM2017-3777
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
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  • 26
    In: BMC Medicine, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2023-08-08)
    Abstract: Exercise training is beneficial in enhancing physical function and quality of life in cancer patients. Its comprehensive implementation remains challenging, and underlying cardiopulmonary adaptations are poorly investigated. This randomized controlled trial examines the implementation and effects of home-based online training on cardiopulmonary variables and physical activity. Methods Of screened post-surgical patients with breast, prostate, or colorectal cancer, 148 were randomly assigned (1:1) to an intervention (2 × 30 min/week of strength-endurance training using video presentations) and a control group. All patients received activity feedback during the 6-month intervention period. Primary endpoint was change in oxygen uptake after 6 months. Secondary endpoints included changes in cardiac output, rate pressure product, quality of life (EORTC QoL-C30), C-reactive protein, and activity behavior. Results One hundred twenty-two patients (62 intervention and 60 control group) completed the study period. Change in oxygen uptake between intervention and control patients was 1.8 vs. 0.66 ml/kg/min (estimated difference after 6 months: 1.24; 95% CI 0.23 to 2.55; p  = 0.017). Rate pressure product was reduced in IG (estimated difference after 6 months: − 1079; 95% CI − 2157 to − 1; p  = 0.05). Physical activity per week was not different in IG and CG. There were no significant interaction effects in body composition, cardiac output, C-reactive protein, or quality of life. Conclusions Home-based online training among post-surgery cancer patients revealed an increase of oxygen uptake and a decrease of myocardial workload during exercise. The implementation of area-wide home-based training and activity feedback as an integral component in cancer care and studies investigating long-term effects are needed. Trial registration DRKS-ID: DRKS00020499 ; Registered 17 March 2020.
    Type of Medium: Online Resource
    ISSN: 1741-7015
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 27
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    Online Resource
    Springer Science and Business Media LLC ; 2016
    In:  Der Gynäkologe Vol. 49, No. 5 ( 2016-5), p. 373-380
    In: Der Gynäkologe, Springer Science and Business Media LLC, Vol. 49, No. 5 ( 2016-5), p. 373-380
    Type of Medium: Online Resource
    ISSN: 0017-5994 , 1433-0393
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    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
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  • 28
    In: Breast Cancer Research, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2021-12)
    Abstract: Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes. Methods Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values. Results A total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by 〈  10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, NPV (proportion of correctly predicted tumor size ≤10 mm) of MRI and ultrasound was 0.92 and 0.83; PPV (correctly predicted tumor size 〉  10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR−/HER2+ tumors. Both methods had a comparable NPV and PPV in HR−/HER2− tumors. Conclusions In HR+/HER2+ and HR−/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT. Trial registration Clinicaltrials.gov , NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).
    Type of Medium: Online Resource
    ISSN: 1465-542X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 29
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. e12565-e12565
    Abstract: e12565 Background: Therapeutic decisions for the primary treatment of breast cancer is commonly based on the expression profiles of estrogen (ER), progesterone (PR) and the human epidermal growth factor 2 (HER2) receptors. However, breast cancer is a very heterogeneous disease, and receptor changes were manifold reported during progression. Little is known about receptor discordance in the primary setting. Here, we compared receptor expression profiles between core needle biopsy (CNB) of the breast tumor tissue and synchronous axillary lymph node metastases (LNM) not at recurrence, but at the primary treatment. Methods: In a German single center study, we retrospectively analyzed 175 breast cancer patients with axillary synchronous LNM. 69,7% of our patients were without any upfront therapy. Profiles of ER, PR and HER2 were immunohistochemically analyzed using the common cut-off at 10% positive tumor cells vs. the controversially discussed low-positive cut-off at 1%. Receptor status was compared between CNB specimens of the primary tumor tissue and axillary LNM. Further, clinicopathological characteristics were correlated to receptor changes. Results: The discordance rates between CNB and axillary LNM were 12.7% for HER2, 6.9% for ER and 22.6% for PR using the ≥1% cut-off, respective 7.5% for ER and 25.6% for PR when using the ≥10% cut-off-level. The most frequently occurring change was a PR loss. Analysis of clinical parameters revealed a significant association of ER change between CNB and LNM in younger patients (p 〈 0.01) with increased proliferation marker Ki-67 (p = 0.04). Conclusions: Receptor discordance between CNB and synchronous axillary LNM appears to exist at the primary setting already. Hence, receptor profiles of the tumor tissue and the synchronous axillary LNM should be considered for treatment decision.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
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  • 30
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. 1082-1082
    Abstract: 1082 Background: Conventional chemotherapy combined with novel molecular targeted agents has been proven effective and tolerable in metastatic breast cancer (MBC). Taxanes (T) plus bevacizumab (B) and T plus capecitabine (X) showed a benefit in progression free survival (PFS) compared to T alone. Life-threatening or highly symptomatic situations require poly-chemotherapies in MBC patients; therefore a combination of all 3 drugs appears reasonable. Methods: TABEA (NCT01200212) is a prospective, randomized, open label, phase III trial comparing T plus B +/- X as 1 st -line therapy in MBC. Patients with histologically confirmed HER2- locally advanced or MBC were included. All patients received T (paclitaxel 80 mg/m2 i.v. d1,8,15 q22 or docetaxel 75 mg/m2 i.v. d1 q22) and B (15 mg/kg i.v. d1 q22) (TB) and were randomized to X (1800 mg/m² daily d1-14 q22) in addition and concurrently to TB (TBX) or TB alone. Randomization was stratified by receptor status, planned taxane, and disease free interval (≤ or 〉 12 months). Primary objective was PFS. Secondary objectives were response rate and duration, clinical benefit rate (CR, PR, stable disease ≥ 24 weeks), 3yr overall survival, PFS in patients ≥ 65 years, toxicity, and compliance. Sample size calculation assumed a PFS of 10 and 13.3 months for TB and TBX, respectively (HR=0.75) requiring 432 patients and 386 events with 2-sided α=0.05 and β=0.2. Interim analysis was planned after 25% of required events (n=96). Results: Planned interim futility and safety analyses after 100 documented events in 202 patients have shown no efficacy benefit and higher toxicity in the TBX arm. For PFS, HR=1.061, 95% CI (0.715, 1.576) was observed, futility boundary was crossed. Overall grade 3-4 adverse events (e.g., thrombopenia, diarrhea, hand-foot-syndrome) (72.3 vs. 57.4%, p=0.039)and serious adverse events (40.6 vs. 24.8%, p=0.016) rates were higher for TBX after 16.3 months median follow up. There were 6 deaths in the TBX vs. 1 in the TB arm. Recruitment and therapy were stopped on 5 th Oct 2012 following the advice from the IDMC. Conclusions: TABEA failed to show an improvement using the 3 drug regimen TBX in high-risk MBC patients. Clinical trial information: NCT 01200212.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
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