Publications by authors named "Richtig E"

Objective: One of the most severe endocrine side effects of immune checkpoint inhibitors (ICI) is hypophysitis leading to adrenal insufficiency. Recovery is rare, although it has been reported after high-dose glucocorticoid treatment. This is the first randomised study to evaluate whether hormonal recovery differs in patients treated with high-dose glucocorticoids versus glucocorticoid replacement therapy.

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Background: Patients with cancer treated with immune-checkpoint inhibitors (ICIs) have a substantial risk of venous thromboembolism (VTE). The association between ICI-induced inflammation and hypercoagulability is unclear, and no biomarkers currently exist to stratify VTE risk.

Objectives: The authors sought to determine the association between the early changes in C-reactive protein (CRP) after ICI initiation and the risk of VTE.

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Article Synopsis
  • Immune checkpoint inhibitors (ICIs) are a key treatment for melanoma but can cause pancreatic injury, which is not well-studied or managed.* -
  • A study involving 1516 melanoma patients found that 204 experienced elevated lipase levels, with many showing symptoms of pancreatitis, leading to treatment interruptions for nearly half of them.* -
  • Despite the lack of guidelines recommending routine lipase monitoring, it was performed in the study, revealing higher-than-expected rates of elevation, particularly in symptomatic patients.*
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Background: The impact of the order of treatment with checkpoint inhibitors or BRAF/MEK inhibitors on the development of brain metastases in patients with metastatic unresectable V600-mutant melanoma is unknown. The SECOMBIT trial examined the impact of the order of receipt of these treatments in such patients.

Methods: In this three-arm trial, we reviewed patients without brain metastases who received the BRAF/MEK inhibitors encorafenib and binimetinib until they had progressive disease followed by the immune checkpoint inhibitors ipilimumab and nivolumab (arm A); or treatment with ipilimumab and nivolumab until they had progressive disease followed by encorafenib and binimetinib (arm B); or treatment with encorafenib and binimetinib for 8 weeks followed by ipilimumab and nivolumab until they had progressive disease followed by retreatment with encorafenib arm binimetinib (arm C).

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Background: Despite ongoing research and recent advances in therapy, metastatic melanoma remains one of the cancers with the worst prognosis. Here we studied the postsynaptic cell adhesion molecule Neuroligin 4X (NLGN4X) and investigated its role in melanoma progression.

Methods: We analysed histologic samples to assess the expression and predictive value of NLGN4X in human melanoma.

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  • Uveal melanoma (UM) often leads to poor outcomes once it spreads to the liver, and the FOCUS study evaluated the effectiveness and safety of a treatment combining melphalan with a delivery system (melphalan/HDS) for patients with unresectable metastatic UM.
  • In the study, 102 patients were enrolled, with 91 receiving treatment; the objective response rate (ORR) was 36.3%, and the median duration of response was 14 months.
  • The findings suggest melphalan/HDS is effective, showing a median overall survival of 20.5 months and a good safety profile, with no treatment-related deaths reported.
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  • Prior to 2021, there was no available data to help choose between BRAF/MEK inhibitors and PD-1/CTLA-4 blockade for treating BRAFV600-mutant melanoma, leading to the SECOMBIT trial to study these options.
  • The trial assessed three treatment sequences: immunotherapy or targeted therapy first, or a combination approach, with the goal of evaluating overall survival.
  • Results indicated that immunotherapy followed by targeted therapy led to better long-term survival, and biomarker analyses suggested that specific genetic mutations may indicate improved outcomes, paving the way for future research on treatment predictions.
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  • Early C-reactive protein (CRP) kinetics may serve as a predictive biomarker for the effectiveness of immune checkpoint inhibitor (ICI) therapy across various cancer types, aiming to enhance treatment outcomes.
  • A study analyzed two patient cohorts receiving palliative ICI treatment, classifying CRP kinetics into four patterns and examining their association with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).
  • Results showed that patients with normal CRP levels had significantly better ORR, PFS, and OS compared to those with abnormal CRP kinetics, validating CRP kinetics as a reliable indicator of treatment efficacy regardless of cancer type.
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Objective: The efficacy of combined BRAF and MEK inhibition for BRAF V600-mutant melanoma in a broad patient population, including subgroups excluded from phase 3 trials, remains unanswered. This noninterventional study (DATUM-NIS) assessed the real-world efficacy, safety and tolerability of dabrafenib plus trametinib in Austrian patients with unresectable/metastatic melanoma.

Methods: This multicenter, open-label, non-interventional, post-approval, observational study investigated the effectiveness of dabrafenib plus trametinib prescribed in day-to-day clinical practice to patients ( N  = 79) with BRAF V600-mutant unresectable/metastatic melanoma with M1c disease (American Joint Committee on Cancer staging manual version 7), ECOG > 1, and elevated serum lactate dehydrogenase (LDH).

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The intestinal microbiome is by now an undebatable key player in the clinical outcome of ICI therapies. However, no microbiome profiling method to aid therapy decision is yet validated. We conducted a multi-centric study in patients with stage III/IV melanoma, NSCLC, or RCC receiving ICI treatment.

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Beall's list is widely used to identify potentially predatory journals. With this study, we aim to investigate the impact of Beall's list on the perception of listed journals as well as on the publication and citation behavior of the scientific community. We performed comprehensive bibliometric analyses of data extracted from the ISSN database, PubMed, PubMed Central (PMC), Crossref, Scopus and Web of Science.

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Article Synopsis
  • - The CheckMate 401 study aimed to evaluate the safety and effectiveness of combining nivolumab and ipilimumab, followed by nivolumab alone, in patients with advanced melanoma who historically have had poor outcomes.
  • - A total of 533 treatment-naive patients with unresectable stage III-IV melanoma were analyzed, revealing incidences of severe adverse events and varying overall survival rates across different patient subgroups.
  • - Results suggested the treatment was generally tolerable, with a 24-month overall survival rate of 63%, but efficacy was notably lower in patients with poorer performance status and specific melanoma subtypes, indicating a need for new treatment strategies.
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Background: Monoclonal antibodies, such as cemiplimab and pembrolizumab, against the programmed death receptor (PD)-1 have become the current standard of care and first-line treatment of advanced cutaneous squamous cell carcinoma (cSCC), proving remarkable clinical benefit and acceptable safety.

Objectives: To assess efficacy and safety of the anti-PD-1 antibody nivolumab in patients with locally advanced and metastatic cSCC.

Methods: Patients received open-label nivolumab 240 mg intravenously every 2 weeks for up to 24 months.

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Postoperative complications such as seroma formation and wound-site infection occur following completion axillary lymph node dissection (ALND) for melanoma. We analyzed the impact of time-to-drain removal and drainage volume on seroma formation after ALND. We retrospectively analyzed data from 118 patients after completion ALND for melanoma.

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Background: Programmed death-1 (PD-1) antibodies and BRAF + MEK inhibitors are widely used for adjuvant therapy of fully resected high-risk melanoma. Little is known about treatment efficacy outside of phase III trials. This real-world study reports on clinical outcomes of modern adjuvant melanoma treatment in specialized skin cancer centers in Germany, Austria and Switzerland.

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Purpose: Limited prospective data are available on sequential immunotherapy and BRAF/MEK inhibition for -mutant metastatic melanoma.

Methods: SECOMBIT is a randomized, three-arm, noncomparative phase II trial (ClinicalTrials.gov identifier: NCT02631447).

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Melanomas are aggressive tumors with a high metastatic potential and an increasing incidence rate. They are known for their heterogeneity and propensity to easily develop therapy-resistance. Nowadays they are one of the most common cancers diagnosed during pregnancy.

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