Publications by authors named "Prager G"
The effect of long-chain n-3 PUFA on liver transcriptome in human obesity.
Prostaglandins Leukot Essent Fatty Acids
December 2024
Background And Aims: Obesity is associated with a higher risk of severe diseases such as atherosclerotic cardiovascular disease, type 2 diabetes mellitus (T2DM), and metabolic dysfunction-associated steatotic liver disease (MASLD). Polyunsaturated fatty acids, of the omega-3 family (n-3 PUFA), have been shown to reduce adipose tissue inflammation in obesity, as well as to have lipid-lowering effects and improve insulin sensitivity. However, direct effects on liver transcriptome in humans have not been described.
View Article and Find Full Text PDFObjective: We investigate the prevalence of five affective temperaments (depressive, cyclothymic, hyperthymic, irritable, and anxious) in a large sample of cancer patients and associations of temperament with cancer site as well as the impact of temperament on overall survival of cancer patients.
Methods: Data for this prospective cohort study was collected in the outpatient clinic of a large cancer center. We used the Temperament Evaluation in Memphis, Pisa and San Diego - Münster Version (TEMPS-M) and recorded patient data.
Purpose: Multidisciplinary tumor boards (MTB) are associated with improved outcomes. Yet, most patients in Western countries receive cancer care at non-academic medical centers. Guideline adherence of MTB recommendations in non-academic medical centers as well as factors contributing to non-adherence remain largely unexplored.
View Article and Find Full Text PDFBackground: Obesity is a significant global health issue. Metabolic and bariatric surgery (MBS) is the gold standard in the treatment of obesity due to its proven effectiveness and safety in the short and long term. However, MBS is not suitable for all patients.
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- In the TOPAZ-1 trial, patients with biliary tract cancers (BTC) who had recurrence within 6 months of surgery were excluded, which often happens in practice. This study looked into the effectiveness of cisplatin-gemcitabine-durvalumab (CGD) in patients who did experience early recurrence.
- The study enrolled 178 BTC patients who had surgery and then underwent treatment with CGD after experiencing either early or late disease recurrence. Key goals were to measure overall survival (OS) and progression-free survival (PFS).
- Results showed no significant differences in OS and PFS between early and late relapse groups, suggesting CGD is effective regardless of when the cancer
The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic and bariatric surgery (MBS), replacing the previous guidelines established by the National Institutes of Health (NIH) over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams (MDTs), as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.
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- - Obesity is a long-term condition that often needs various treatments and increased intervention over time.
- - There was no common definition for recurrent weight gain and lack of adequate weight loss until the recent consensus from IFSO, which aims to standardize terminology for better data comparison.
- - The IFSO position statement offers guidance on managing weight regain after bariatric surgery, highlighting the importance of using these new definitions in future research and publications.
Article Synopsis
- There is no agreed-upon definition of clinically meaningful outcomes in randomized clinical trials (RCTs) for treating refractory metastatic colorectal cancer (mCRC), despite various recommendations since 2014.
- Many recent RCTs for oncology drug approvals fail to meet the recommended benchmarks set by organizations like ASCO and ESMO, highlighting the need for better standards.
- Quality of life (QoL) is increasingly emphasized alongside efficacy and safety in clinical trials, with the SUNLIGHT trial showing that treatment options like FTD/TPI with bevacizumab can achieve clinically meaningful outcomes while preserving QoL.
Article Synopsis
- This study evaluates the use of durvalumab combined with platinum and gemcitabine for treating biliary tract cancers, aiming to validate previous trial results in a real-world setting and investigate how molecular profiles may affect patient outcomes.* -
- The analysis involved 102 patients from multiple cancer centers, revealing a 71.57% disease control rate and a median overall survival of 13.61 months, with younger patients showing better outcomes.* -
- Findings indicate that while no specific molecular profiles predicted better responses to durvalumab, patients receiving tailored second-line therapy showed a potential survival advantage, highlighting the need for further research in this area.*
Article Synopsis
- Recommended first and second line treatments for unresectable metastatic colorectal cancer (mCRC) include fluorouracil-based chemotherapy, anti-VEGF therapy, and anti-EGFR-targeted therapies, with trifluridine/tipiracil (FTD/TPI) + bevacizumab (BEV) emerging as a significant third line option based on the SUNLIGHT trial results.
- For patients who are not candidates for intensive chemotherapy due to factors like age or comorbidities, capecitabine (CAP) + BEV is typically recommended; however, FTD/TPI + BEV has shown similar outcomes in certain cases.
- The SOLSTICE trial indicated that FTD/TPI + BE
Article Synopsis
- The ASMBS and IFSO updated the guidelines for Metabolic and Bariatric Surgery in 2022, replacing 30-year-old NIH recommendations.
- These new guidelines are based on stronger evidence and are designed to support healthcare professionals and patients in making informed decisions about surgery.
- The study evaluates the quality of evidence and the effectiveness of these updated recommendations compared to the old criteria.
Article Synopsis
- The global rise in obesity has led to the need for clear guidelines combining medical, endoscopic, and surgical methods for effective treatment.
- An expert panel formed by IFSO-EC created evidence-based recommendations for treating adults with a BMI of 30 or higher, focusing on integrating lifestyle interventions and various weight loss techniques.
- These guidelines emphasize a comprehensive approach to obesity management, recognizing it as a complex, chronic disease that requires understanding all therapeutic options available.
Article Synopsis
- The single anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S/SADS) is being recognized as an effective alternative to traditional bariatric surgery methods, such as biliopancreatic diversion with duodenal switch (BPD-DS), particularly for weight loss and managing type 2 diabetes.
- A systematic review of 93 studies was conducted to evaluate the outcomes of SADI-S/SADS, revealing benefits in weight loss and improvement in conditions like hypertension but showing inconclusive effects on other comorbidities.
- The review highlighted common nutritional deficiencies following the procedure and emphasized the need for ongoing monitoring, supplementation, and further high-quality research, with a position statement set for a review
Introduction: The role of the family history in the development and prognosis of gastroesophageal cancer is a controversially discussed topic as appropriate data from western cohorts are lacking. This study aims to explore its associations with disease and outcome parameters in a large European cohort.
Methods: We retrospectively analyzed self-reported family history in patients with gastroesophageal cancer treated between 1 January 1990 and 31 December 2021 at the Medical University of Vienna.
Article Synopsis
- Metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) are prevalent in obese individuals and may improve with metabolic/bariatric surgery (MBS).
- A study of 93 patients showed significant reductions in liver stiffness and indicators of liver health three months after MBS, correlating with weight loss.
- Improvements in liver conditions were evident as early as three months post-surgery, indicated by lower liver stiffness measurements and liver injury markers.
Article Synopsis
- The study highlights the increasing importance of metabolic and bariatric surgery (MBS) in addressing global obesity, emphasizing the need for rigorous academic and fellowship training for surgeons.
- A Modified Delphi method involving 89 surgeons from 42 countries was used to establish expert consensus on the necessary criteria for surgeons to obtain privileges for performing MBS, reaching agreement on 29 out of 30 statements.
- Key consensus points include the requirement for surgeons to hold a general surgery degree, complete a dedicated fellowship, and adhere to defined learning curves for various MBS procedures, alongside maintaining patient data and collaborating in a multidisciplinary team.
Background: Metabolic bariatric surgery (MBS) is standardized and safe. Nevertheless, complications such as anastomotic leakage (AL) or staple-line leakage (SLL) can occur. In upper GI or colorectal surgery, endoluminal vacuum therapy (EVT) offers a therapeutic alternative to revisional surgery.
View Article and Find Full Text PDFBackground: Biliary tract cancers (BTCs) exhibit high mortality rates and significant heterogeneity in both clinical and molecular characteristics. This study aims to molecularly characterize a cohort of patients with BTC, with a specific focus on genomic alterations within homologous recombination repair (HRR) genes in a real-world setting.
Patients And Methods: We carried out a retrospective analysis on 256 patients with BTC treated at five Austrian centers and one German comprehensive cancer center between 2016 and 2023 utilizing comprehensive genomic profiling platforms to assess HRR status and its correlation with clinical outcomes after platinum-based chemotherapy.
Background: The TOPAZ-1 phase III trial showed a survival benefit with durvalumab plus gemcitabine and cisplatin in patients with advanced biliary tract cancer (BTC). To understand this combination's real-world efficacy and tolerability, we conducted a global multicenter retrospective analysis of its first-line treatment outcomes.
Methods: We included patients with unresectable, locally advanced, or metastatic BTC treated with durvalumab, gemcitabine, and cisplatin at 39 sites in 11 countries (Europe, the United States, and Asia).
What Is This Summary About?: This is a summary describing the results from a phase 3 clinical trial called SUNLIGHT. The study looked at treatment with orally administered trifluridine/tipiracil plus intravenously administered bevacizumab in people with metastatic colorectal cancer (mCRC) that is refractory to treatment.This study included people whose cancer had grown or spread beyond its original location after no more than two previous treatments.
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