Publications by authors named "Hans Ulrich Schildhaus"

The prognostication of individual disease trajectory and selection of optimal therapy in patients with localized, low-grade prostate cancer often presents significant difficulty. The phosphatase and tensin homolog on chromosome 10 (PTEN) has emerged as a potential novel biomarker in this clinical context, based on its demonstrated prognostic significance in multiple retrospective studies. Incorporation into standard clinical practice necessitates exceptional diagnostic accuracy, and PTEN's binary readout-retention or loss-suggests its suitability as a biomarker.

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Background: Whole lung transpulmonary chemoembolization using a combination of doxorubicin (DXO) and degradable starch microspheres (DSM-TPCE) might be a promising treatment option in soft tissue sarcoma. To pave the way for clinical studies, this study aimed to evaluate the short-term effects of DSM-TPCE with DXO using an ex vivo isolated lung perfusion (ILP) model.

Methods: Nine lung specimens retrieved from patients undergoing lobectomy underwent ex vivo ILP.

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Article Synopsis
  • Clear cell sarcoma (CCS) and its similar tumor, malignant gastrointestinal neuroectodermal tumor/sarcoma (GINET), often lead to local and distant relapses, with limited success from systemic treatments.
  • A study analyzed data from 43 patients, revealing a 5-year overall survival rate of 42%, with most tumors being EWSR1::ATF1-translocation-positive and showing a high rate of metastasis.
  • The findings highlighted that complete tumor resection significantly improves survival rates compared to incomplete resection, while systemic treatments and radiation were largely ineffective.
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Context.—: Recently, a new type of antibody-drug conjugate, trastuzumab-deruxtecan (T-DXd), has been approved for the treatment of metastatic breast cancer with low level of human epidermal growth factor receptor 2 (HER2) gene expression. Thereby, eligibility relies on an accurate diagnosis of HER2-low status defined by immunohistochemistry IHC 1+/2+ with no gene amplification.

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For mammary carcinomas in pet rabbits, prognostic biomarkers are poorly defined, and treatment is limited to surgical excision. Additional treatment options are needed for rabbit patients for which surgery is not a suitable option. In human breast cancer, the immunosuppressive enzyme indoleamine 2,3-dioxygenase 1 (IDO1) represents a prognostic biomarker and possible therapeutic target.

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Despite their unique histologic features, gliosarcomas belong to the group of glioblastomas and are treated according to the same standards. Fibroblast activation protein (FAP) is a component of a tumor-specific subpopulation of fibroblasts that plays a critical role in tumor growth and invasion. Some case studies suggest an elevated expression of FAP in glioblastoma and a particularly strong expression in gliosarcoma attributed to traits of predominant mesenchymal differentiation.

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Key Clinical Message: Hypophyseal dysfunction may be overlooked by the currently generally accepted laboratory routine for the differential diagnosis in patients suffering from symptoms of depression or dementia.

Abstract: Hypothyroidism is an important cause of depression and potentially reversible cognitive impairment. Whereas the determination of the plasma concentration of thyrotropin (TSH) is generally considered part of the laboratory screening tests for dementia, the measurement of total or free triiodothyronine (T3, FT3), thyroxine (T4, FT4) and cortisol in plasma does not belong to the routine diagnostic workup in patients with depression or suspected dementia.

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Purpose: Imatinib resistance in GI stromal tumors (GISTs) is primarily caused by secondary mutations, and clonal heterogeneity of these secondary mutations represents a major treatment obstacle. KIT inhibitors used after imatinib have clinical activity, albeit with limited benefit. Ripretinib is a potent inhibitor of secondary KIT mutations in the activation loop (AL).

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(1) Colorectal cancer (CRC) is a leading cause of cancer-related deaths globally. Cancer-associated fibroblasts (CAFs) are major components of CRC's tumour microenvironment (TME), but their biological background and interplay with the TME remain poorly understood. This study investigates CAF biology and its impact on CRC progression.

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Purpose: Current guidelines recommend combination chemotherapy for treatment of patients with unfavorable cancer of unknown primary (CUP). Biomarker-guided targeted therapies may offer additional benefit. Data on the feasibility and effectiveness of comprehensive genomic biomarker profiling of CUP in a standard clinical practice setting are limited.

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Fibroblast activation protein α (FAPα) is expressed at high levels in several types of tumors. Here, we report the expression pattern of FAPα in solitary fibrous tumor (SFT) and its potential use as a radiotheranostic target. We analyzed FAPα messenger RNA and protein expression in biopsy samples from SFT patients using immunohistochemistry and multiplexed immunofluorescence.

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Claudin 18.2 (CLDN18.2), the dominant isoform of CLDN18 in gastric tissues, is a highly specific tight junction protein of the gastric mucosa with variably retained expressions in gastric and gastroesophageal junction cancers.

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Article Synopsis
  • Testing for mismatch repair deficiency (dMMR) and high-grade microsatellite instability (MSI-H) is crucial for diagnosing colorectal cancer and predicting response to immune therapies.
  • Originally linked to Lynch syndrome, MSI is now important in the treatment of various cancers beyond CRC, including endometrial and gastric cancers.
  • The review highlights the importance of quality assurance measures in testing, the challenges of assessing results, and the potential of Next Generation Sequencing in improving diagnostic accuracy.
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Background: The International Thymic Malignancy Interest Group (ITMIG) proposed an internationally accepted division of the mediastinum into three compartments based on computed tomography (CT): anterior (prevascular), middle (visceral) and posterior (paravertebral) compartment. There is no generally accepted definition for the term "giant" when applied to middle mediastinal lesions. We defined the term "giant" and described our surgical experience in treating patients with giant lesions of the middle mediastinum.

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DNA mismatch repair deficient (dMMR) and microsatellite instable (MSI) metastatic colorectal cancer (mCRC) can be successfully treated with FDA- and EMA-approved immune checkpoint inhibitors (ICI) pembrolizumab and nivolumab (as single agents targeting the anti-programmed cell death protein-1 (PD-1)) or combinations of a PD-1 inhibitor with ipilimumab, a cytotoxic T-lymphocyte-associated protein 4 (CTLA-4)-targeting antibody. The best treatment strategy beyond progression on single-agent ICI therapy remains unclear. Here, we present the case of a 63-year-old male with Lynch-syndrome-associated, microsatellite instability-high (MSI-H) mCRC who achieved a rapid normalization of his tumor markers and a complete metabolic remission (CMR), currently lasting for ten months, on sequential ICI treatment with the combination of nivolumab and ipilimumab followed by nivolumab maintenance therapy after progression on single-agent anti-PD-1 ICI therapy.

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Article Synopsis
  • Testing for mismatch repair deficiency (dMMR) and high-grade microsatellite instability (MSI-H) is now standard in diagnosing colorectal cancer and influences therapy response to immune checkpoint inhibitors (ICI).
  • The review discusses the shift in focus from hereditary cancer risk (like Lynch syndrome) to the role of these tests in guiding treatment options for a variety of cancers, not just colorectal.
  • A practical flowchart is included for clinicians, highlighting challenges in testing methods and the importance of quality assurance and training in improving diagnostic accuracy.
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(1) Background: The main objectives of our study are (i) to determine the prevalence of () fusions in a routine diagnostic setting in NSCLC (non-small cell lung cancer) and (ii) to investigate the feasibility of screening approaches including immunohistochemistry (IHC) as a first-line test accompanied by fluorescence in situ hybridization (FISH) and RNA-(ribonucleic acid-)based next-generation sequencing (RNA-NGS). (2) Methods: A total of 1068 unselected consecutive patients with NSCLC were screened in two scenarios, either with initial IHC followed by RNA-NGS ( = 973) or direct FISH testing ( = 95). (3) Results: One hundred and thirty-three patients (14.

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Purpose: EGFR tyrosine kinase inhibitor (TKI) therapy in EGFR-mutated lung cancer is limited by acquired resistance. In half of the patients treated with first/second-generation (1st/2nd gen) TKI, resistance is associated with EGFR p.T790M mutation.

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  • The use of fibroblast activation protein inhibitors (FAPIs) in treating sarcomas represents a promising new strategy in oncology, particularly for advanced or metastatic cases with poor outcomes.
  • Sarcomas, which are rare and varied tumors, show a unique pattern of high fibroblast activation protein alpha expression on the tumor cells, making them distinct from other solid tumors.
  • Initial studies and case reports suggest that FAPI radioligand therapy is feasible and may lead to positive tumor responses in patients with sarcoma.
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Introduction: Systemic therapy is firmly established in patients with advanced or metastatic pancreatic ductal adenocarcinoma (PDAC). Clinical efficacy is still modest and options are limited. Combination therapy protocols such as FOLFIRINOX and gemcitabine/nab-paclitaxel (Gem/NP) define standard-of-care.

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We present an overview of our prospective fibroblast-activation protein inhibitor (FAPI) registry study across a 3-y period, with head-to-head comparison of tumor uptake in Ga-FAPI and F-FDG PET, as well as FAP immunohistochemistry. This is an interim analysis of the ongoing Ga-FAPI PET prospective observational trial at our department. Patients who underwent clinical imaging with Ga-FAPI PET between October 2018 and October 2021 were included.

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  • The overexpression of HER2 in breast cancer highlights the importance of molecular targeted therapy, with traditional treatments being effective only in HER2 high-expressing tumors.
  • Recent clinical trials show that the antibody-drug conjugate trastuzumab-deruxtecan can also treat tumors with low HER2 expression, prompting a need to reevaluate diagnostic criteria.
  • This shift necessitates rapid updates in diagnostic practices and raises new challenges for standardization in the assessment of tumors with low HER2 expression levels.
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Circulating tumor DNA (ctDNA) from circulating free DNA (cfDNA) in GIST is of interest for the detection of heterogeneous resistance mutations and treatment monitoring. However, methodologies for use in a local setting are not standardized and are error-prone and difficult to interpret. We established a workflow to evaluate routine tumor tissue NGS (Illumina-based next generation sequencing) panels and pipelines for ctDNA sequencing in an academic setting.

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