1,588 results match your criteria: "Kliniken Essen-Mitte; University of Duisburg-Essen[Affiliation]"

Effects of osteosynthesis of the bony thorax in the context of polytrauma compared to conservative treatment: a systematic review.

Eur J Trauma Emerg Surg

January 2025

Department of Intensive Care Medicine and Intermediate Care Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, D-52074, Aachen, Germany.

Purpose: Osteosynthesis seems to have effects regarding clinical outcomes in trauma patients. However, current knowledge on chest wall osteosynthesis in polytrauma patients is insufficient, leaving its potential unanswered. Therefore, the objective of this systematic review is to assess the safety and effects of chest wall osteosynthesis compared to conservative treatment on clinical outcomes in adult polytrauma patients.

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Background: Ribociclib + endocrine therapy (ET) showed significant progression-free survival (PFS) and overall survival (OS) benefits in the MONALEESA trials in patients with HR+ /HER2 - advanced breast cancer (ABC). We report efficacy, safety, and patient-reported outcomes (PROs) across age groups, including older patients, in these trials.

Methods: Data from the MONALEESA-2, -3, and -7 trials for pre- and postmenopausal patients receiving first-line treatment for ABC were pooled and analyzed by age (<65y, 65-74y, and ≥75y).

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The multicenter, phase III GMMG ReLApsE trial (EudraCT-No:2009-013856-61) randomized relapsed and/or refractory multiple myeloma (RRMM) patients equally to lenalidomide/dexamethasone (LEN/DEX, 25mg days 1-21/40mg weekly, 4-week cycles) re-induction, salvage high dose chemotherapy (sHDCT, melphalan 200mg/m2), autologous stem cell transplantation (ASCT) and LEN maintenance (10mg/day; transplant arm, n=139) versus continuous LEN/DEX (control arm, n=138). Ninety-four percent of patients had received frontline HDCT/ASCT. We report an updated analysis of survival endpoints with a median follow-up of 99 months.

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Predicting benefit from PARP inhibitors using deep learning on H&E-stained ovarian cancer slides.

Eur J Cancer

December 2024

Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany. Electronic address:

Article Synopsis
  • Ovarian cancer patients with Homologous Recombination Deficiency (HRD) may benefit from PARP inhibitor therapy after platinum chemotherapy, and predicting this benefit through whole slide images (WSIs) could provide a quicker and less costly alternative to molecular tests.
  • A Deep Learning (DL) model was trained on H&E stained WSIs using a specific HRD ground truth, and it was tested on a separate cohort to see how well it predicted HRD status and the benefit of olaparib treatment.
  • Although the model showed potential, with a significant improvement in progression-free survival (PFS) for HRD positive patients treated with PARP inhibitors, its overall prediction accuracy was lower than desired, indicating that further
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Background: Current guidelines discourage prophylactic plasma use in non-bleeding patients. This study assesses global plasma transfusion practices in the intensive care unit (ICU) and their alignment with current guidelines.

Study Design And Methods: This was a sub-study of an international, prospective, observational cohort.

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Background: In PAOLA-1/ENGOT-ov25, the addition of olaparib to bevacizumab maintenance improved overall survival in patients with newly diagnosed advanced ovarian cancer. We describe the safety profile and quality of life (QoL) of this combination in older patients in PAOLA-1.

Methods: Safety (CTCAE v4.

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Background: Antidepressant pharmacotherapy often does not result in the desired effect despite adequate duration and dose. Better evidence on second-step strategies is needed.

Objective: Overview of the current evidence for various pharmacological second-step strategies after nonresponse to antidepressant monotherapy.

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Article Synopsis
  • The model advanced training regulations outline the necessary content for qualifying as a medical specialist in internal medicine and rheumatology.
  • Currently, there are no established criteria for granting authorization in advanced training, which this position paper aims to address with proposed standards from the DGRh.
  • The criteria aim to create a standardized and transparent process for issuing authorization across Germany, ensuring high-quality training in rheumatology that can adapt to future changes in the field.
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Purpose: The CDK4/6 inhibitor palbociclib inhibits cyclin A, which is overexpressed in endometrial cancer. Combining palbociclib with endocrine therapy improves efficacy in hormone receptor-positive breast cancer. We investigated palbociclib combined with endocrine therapy for estrogen receptor-positive advanced/recurrent endometrial cancer.

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Can Morphology and Immune Infiltration Predict the Homologous Recombination Deficiency Status in Newly Diagnosed High-Grade Serous Ovarian Carcinoma?

Arch Pathol Lab Med

December 2024

From the Department of Pathology, Université Paris Cité, Faculté de Médecine Paris Cité, APHP, Centre, Hôpital Cochin, Paris, France (Kime, Just).

Context.—: A correlation between the morphology of ovarian high-grade serous carcinomas (HGSOCs) and BRCA mutations has been previously reported.

Objective.

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Use of individualized starting dose and niraparib hematologic adverse event management costs in ovarian cancer.

J Comp Eff Res

January 2025

Medical Oncology Department, Program in Solid Tumours, CIMA, Cancer Center Clínica Universidad de Navarra, Madrid, and Grupo Español de Investigación en Cancer ginecológicO (GEICO), Madrid, 28027, Spain.

Article Synopsis
  • The study analyzes the cost differences in managing hematologic adverse events (AEs) for the individualized starting dose (ISD) versus the fixed starting dose (FSD) of niraparib from a US payer perspective.
  • Data from a phase III trial provided AE occurrence rates, and costs were calculated based on 2020 adjustments from a healthcare database.
  • Results showed that managing AEs was significantly cheaper with ISD ($6744.93) compared to FSD ($12,987.71), suggesting ISD not only cuts costs but also improves patient safety.
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The randomized FIRE-4.5 (AIO KRK0116) trial compared first-line therapy with FOLFOXIRI (folinic acid, fluorouracil, oxaliplatin, and irinotecan) plus either cetuximab or bevacizumab in B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E-mutant metastatic colorectal cancer (mCRC) patients. This study was accompanied by a prospective translational project analyzing cell-free circulating tumor DNA (ctDNA) in plasma to test whether ctDNA analysis may help to guide clinical treatment decision making.

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Background: Partial adrenalectomy (PA), as an alternative to total adrenalectomy in selected cases, allows for the preservation of adrenocortical function, especially in hereditary and/or bilateral diseases. In this study, we analyze our experience in posterior retroperitoneoscopic PA (PRPA) and its impact on adrenocortical function.

Patients And Methods: From January 2010 to December 2023, 709 PRPAs were performed on 766 adrenal glands in a total of 697 patients (421F; 276M; and mean age 49.

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Article Synopsis
  • Ovarian cancer often leads to muscle loss, malnutrition, and fatigue, adversely affecting patients' quality of life, especially during first-line chemotherapy.
  • A new study aims to assess an app-based exercise and nutrition program's effectiveness over six months compared to standard care, with physical performance measured by the 6-Minute Walk Test as the main focus.
  • The study will involve a multicenter trial with a minimum of 182 participants, all diagnosed with advanced ovarian cancer, and assess various health and nutrition indicators alongside physical performance improvements.
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Efficacy of subsequent therapies in patients with advanced ovarian cancer who relapse after first-line olaparib maintenance: results of the PAOLA-1/ENGOT-ov25 trial.

Ann Oncol

February 2025

Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), France; Department of Medical Oncology, Centre Léon Berard, Lyon, France. Electronic address:

Background: The use of first-line poly(ADP-ribose) polymerase (PARP) inhibitor maintenance therapy is increasing in advanced ovarian cancer. Understanding the efficacy of first subsequent therapy (FST) in patients experiencing disease progression in the first-line setting is important to optimize postprogression treatments. We evaluated the efficacy of FST in patients from PAOLA-1/ENGOT-ov25 (NCT02477644) who received first-line olaparib maintenance.

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The Role of HE4 in the Follow-Up of Advanced Ovarian, Fallopian Tube, and Primary Peritoneal Cancer-CEEGOG OX-01 Study.

Cancers (Basel)

October 2024

Department of Gynecology and Obstetrics, Faculty of Medicine in Pilsen, University Hospital Pilsen, Charles University, 323 00 Pilsen, Czech Republic.

: Ovarian, fallopian tube, and primary peritoneal cancers often share clinical characteristics and are typically diagnosed at advanced stages due to nonspecific symptoms. The utility of tumor markers, particularly CA125 and HE4, in the diagnosis and follow-up of these cancers remains an area of active investigation. : The CEEGOG (Central and Eastern European Gynecologic Oncology Group) OX-01 study aimed to evaluate HE4's role alongside CA125 in follow-up for advanced-stage ovarian, fallopian tube, and primary peritoneal cancers.

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Findings from clinical trials have led to advancement of care for patients with gynecologic malignancies. However, restrictive inclusion of patients into trials has been widely criticized for inadequate representation of the real-world population. Ideally, patients enrolled in clinical trials should represent a broader population to enhance external validity and facilitate translation of outcomes across all relevant groups.

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DNA methyltransferase and poly(ADP-ribose) polymerase inhibitors (DNMTis, PARPis) induce a stimulator of interferon (IFN) genes (STING)-dependent pathogen mimicry response (PMR) in ovarian (OC) and other cancers. We now show that combining DNMTis and PARPis upregulates expression of a little-studied nucleic-acid sensor, NFX1-type zinc finger-containing 1 protein (ZNFX1). We demonstrate that ZNFX1 is a novel master regulator for PMR induction in mitochondria, serving as a gateway for STING-dependent PMR.

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Validation and clinical performance of a single test, DNA based endometrial cancer molecular classifier.

Int J Gynecol Cancer

December 2024

Gynecology and Obstetrics, Division of Gynecologic Oncology, UBC, Vancouver, British Columbia, Canada

Objectives: We have previously shown that DNA based, single test molecular classification by next generation sequencing (NGS) (Proactive Molecular risk classifier for Endometrial cancer (ProMisE) NGS) is highly concordant with the original ProMisE classifier and maintains prognostic value in endometrial cancer. Our aim was to validate ProMisE NGS in an independent cohort and assess the performance of ProMisE NGS in real world clinical practice to address if there were any practical challenges or learning points for implementation.

Methods: We evaluated DNA extracted from an external research cohort of 211 endometrial cancer cases diagnosed in 2016 from Germany, Switzerland, and Austria, across seven European centers, comparing standard molecular classification (NGS for status, immunohistochemistry for mismatch repair and p53) with ProMisE NGS (NGS for and microsatellite instability assay) for concordance metrics and Kaplan-Meier survival statistics across molecular subtypes.

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Objective: Mirvetuximab soravtansine-gynx (MIRV) is a novel antibody-drug conjugate targeting folate receptor alpha (FRα), which is overexpressed in epithelial ovarian cancer (EOC), with limited expression on normal tissues. This integrated safety summary sought to characterize the safety profile of MIRV monotherapy in participants with FRα-expressing recurrent EOC.

Methods: Safety data were retrospectively analyzed from 4 clinical studies (phase 1 trial [NCT01609556], phase 3 FORWARD I [NCT02631876], phase 2 SORAYA [NCT04296890], phase 3 MIRASOL [NCT04209855]) that evaluated participants with FRα-expressing recurrent EOC who received ≥1 dose of MIRV 6 mg/kg adjusted ideal body weight every 3 weeks.

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Consensus on drivers of maintenance treatment choice and patterns of care in advanced ovarian cancer.

Int J Gynecol Cancer

January 2025

Early phase trial unit in oncology (CITOHL- EPSILYON), Centre pour l'lnnovation en Cancérologie de Lyon (CICLY), Lyon University Hospital (HCL), Lyon, France.

Article Synopsis
  • Maintenance therapies like PARP inhibitors and bevacizumab have improved outcomes for advanced ovarian cancer patients, prompting a study to explore treatment variability across Europe.
  • A Delphi study was conducted with experts to understand maintenance treatment strategies and gauge consensus on best practices.
  • Key factors influencing treatment choices include tumor mutation status and perceived risk of disease progression, with high-risk cases defined by advanced FIGO stages or residual disease after initial treatment.
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Objective: FAPI-PET/CT exhibits high tumor uptake and low background accumulation, enabling high-sensitivity tumor detection. We compared the diagnostic performance of  Ga-FAPI-46 PET/CT plus contrast-enhanced CT (CE-CT), F-FDG PET/CT plus CE-CT, and standalone CE-CT in patients with various malignancies.

Methods: 232 patients underwent  Ga-FAPI-46 PET/CT,F-FDG PET/CT, and CE-CT each within 4 weeks.

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Objective: There are no data, and thus no consensus, on the optimal duration of poly(ADP-ribose) polymerase (PARP) inhibitor maintenance therapy for exceptional responders (here defined as progression-free for 5 years or longer) with platinum sensitive recurrent ovarian cancer. The current licence is to continue PARP inhibitors until progression or toxicity; however, international practice varies considerably. The risks of late progression and late-onset myeloid malignancies, defined as occurring beyond 5 years of PARP inhibition, are unknown.

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Background: Dual anti-human epidermal growth factor receptor 2 (HER2) blockade has improved the outcomes of patients with early and metastatic HER2-positive breast cancer. Here we present the final 10-year analysis of the ALTTO trial.

Patients And Methods: The ALTTO trial (NCT00490139) is a prospective randomized, phase III, open-label, multicenter study that investigated the role of adjuvant chemotherapy and trastuzumab alone, in combination or sequentially with lapatinib.

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Article Synopsis
  • Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are severe, drug-induced skin conditions that can be life-threatening and are now viewed as different levels of the same disease known as epidermal necrolysis (EN).
  • A new guideline has been created based on scientific literature and expert consensus to help medical professionals in diagnosing and treating EN.
  • This guideline targets various specialists like dermatologists and intensive care doctors, as well as informing patients, families, insurers, and policymakers about EN and includes recommendations for acute care and follow-up treatment.
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