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  • 1
    In: Geburtshilfe und Frauenheilkunde, Georg Thieme Verlag KG, Vol. 78, No. 11 ( 2018-11), p. 1089-1109
    Abstract: Zusammenfassung Im April 2018 erschien die erste deutsche interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge der Patientinnen mit Endometriumkarzinom. Von der Deutschen Krebshilfe im Rahmen des Leitlinienprogramms Onkologie gefördert, wurde sie von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Arbeitsgemeinschaft Onkologische Gynäkologie (AGO) der Deutschen Krebsgesellschaft (DKG) federführend koordiniert. Ziele Durch eine evidenzbasierte risikoadaptierte Therapie können bei den Frauen mit Endometriumkarzinom mit geringem Risiko eine unnötige Radikalität bei der Operation und nicht sinnvolle adjuvante Strahlen- und/oder Chemotherapie vermieden werden. Dies reduziert zum einen deutlich die therapieinduzierte Morbidität und erhöht die Lebensqualität der Patientinnen. Auf der anderen Seite werden unnötige Kosten vermieden. Für die Frauen mit einem Endometriumkarzinom mit hohem Rezidivrisiko definiert die Leitlinie die optimale operative Radikalität sowie die ggf. erforderliche Chemotherapie und/oder adjuvante Strahlentherapie. Durch den evidenzbasierten optimalen Einsatz der verschiedenen Therapiemodalitäten sollten Überleben und Lebensqualität dieser Patientinnen verbessert werden. Die S3-Leitlinie zum Endometriumkarzinom soll eine Grundlage für die Arbeit der zertifizierten gynäkologischen Krebszentren sein. Die auf dieser Leitlinie basierenden Qualitätsindikatoren sollen in den Zertifizierungsprozess dieser Zentren einfließen. Methoden Die Leitlinie wurde gemäß den Anforderungen eines S3-Niveaus erarbeitet. Dies umfasst zum einen die Adaptation der mittels des DELBI-Instruments selektierten Quellleitlinien. Zum anderen Evidenzübersichten, die anhand der in systematische Recherchen nach dem PICO-Schema in ausgewählten Literaturdatenbanken selektierten Literatur erstellt wurden. Ergänzend wurde ein externes Biostatistik-Institut mit der systematischen Literaturrecherche und -Bewertung eines Teilbereichs beauftragt. Diese Ergebnisse dienten den interdisziplinären Arbeitsgruppen als Basis für die Erarbeitung von Vorschlägen für Empfehlungen und Statements, welche in strukturierten Konsensuskonferenzen und/oder ergänzend im DELPHI-Verfahren auch online modifiziert und konsentiert wurden. Der Leitlinienreport ist online frei verfügbar. Empfehlungen Der Teil 2 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Therapie des Endometriumkarzinoms, inklusive der Präkanzerosen und des frühen Endometriumkarzinoms, zur Palliativmedizin, Psychoonkologie, Rehabilitation und Patientinnenaufklärung und zu den Versorgungsstrukturen des Endometriumkarzinoms: Das Management von Präkanzerosen und frühen Endometriumkarzinomen, inklusive fertilitätserhaltender Strategien, wird dargestellt. Das Konzept der operativen Primärtherapie des Endometriumkarzinoms wird behandelt. Weiterhin werden die Strahlentherapie und die adjuvante medikamentöse Therapie des Endometriumkarzinoms und der uterinen Karzinosarkome abgebildet. Es werden Empfehlungen zur Nachsorge des Endometriumkarzinoms, zum Rezidiv und zur metastasierten Situation gegeben. Die Bereiche Palliativmedizin, Psychoonkologie, einschließlich psychosozialer Betreuung und Patientinnenaufklärung, und Rehabilitation werden dargelegt. Abschließend werden der Versorgungsalgorithmus und die Qualitätssicherungsschritte für die Diagnostik, die Therapie und die Nachsorge der Patientinnen mit Endometriumkarzinom vorgestellt.
    Type of Medium: Online Resource
    ISSN: 0016-5751 , 1438-8804
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
    detail.hit.zdb_id: 2026496-3
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  • 2
    In: Human Immunology, Elsevier BV, Vol. 77, No. 9 ( 2016-09), p. 791-799
    Type of Medium: Online Resource
    ISSN: 0198-8859
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2016
    detail.hit.zdb_id: 2006465-2
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  • 3
    In: The Lancet Oncology, Elsevier BV, Vol. 20, No. 9 ( 2019-09), p. 1316-1326
    Type of Medium: Online Resource
    ISSN: 1470-2045
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2049730-1
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  • 4
    In: OncoImmunology, Informa UK Limited, Vol. 7, No. 1 ( 2018-01-02), p. e1376153-
    Type of Medium: Online Resource
    ISSN: 2162-402X
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2018
    detail.hit.zdb_id: 2645309-5
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  • 5
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2019-04-01)
    Abstract: Expression of the non-classical human leukocyte antigen-G (HLA-G) promotes cancer progression in various malignancies including epithelial ovarian cancer (EOC). As single nucleotide polymorphisms (SNPs) in the HLA-G 3′ untranslated region (UTR) regulate HLA-G expression, we investigated HLA-G 3′UTR haplotypes arranged by SNPs in healthy controls (n = 75) and primary EOC patients (n = 79) and determined soluble HLA-G (sHLA-G) levels. Results were related to the clinical status and outcome. Although haplotype frequencies were similar in patients and controls, (i) sHLA-G levels were increased in EOC independent of the haplotype, (ii) homozygosity for UTR-1 or UTR-2 genotypes were significantly associated with metastases formation and presence of circulating tumor cells before therapy, whereas (iii) the UTR-5 and UTR-7 haplotypes were significantly associated with a beneficial clinical outcome regarding negative nodal status, early FIGO staging, and improved overall survival. Lastly, (iv) the ambivalent impact on clinical EOC aspects could be deduced to specific SNPs in the HLA-G 3′UTR: +3187G, +3196G and +3035T alleles. Our results give evidence that even if the genetic background of the HLA-G 3′UTR is identical between patients and controls, certain SNPs have the potential to contribute to diametrical clinical status/outcome in EOC.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2615211-3
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  • 6
    In: Frontiers in Immunology, Frontiers Media SA, Vol. 14 ( 2023-5-22)
    Abstract: Triple negative breast cancer (TNBC) shows an aggressive growing and spreading behavior and has limited treatment options, often leading to inferior disease outcome. Therefore, surrogate markers are urgently needed to identify patients at high risk of recurrence and more importantly, to identify additional therapeutic targets enabling further treatment options. Based on the key role of the non-classical human leukocyte antigen G (HLA-G) and its related receptor immunoglobulin-like transcript receptor-2 (ILT-2) in immune evasion mechanisms of tumors, members of this ligand-receptor axis appear to be promising tool for both, defining risk groups and potential therapeutic targets. Materials and methods To follow this, sHLA-G levels before and after chemotherapy (CT), HLA-G 3’ UTR haplotypes, and allele variations rs10416697 at the distal gene promoter region of ILT-2 were defined in healthy female controls and early TNBC patients. The results obtained were associated with clinical status, presence of circulating tumor cell (CTC) subtypes, and disease outcome of patients in terms of progression-free or overall survival. Results sHLA-G plasma levels were increased in TNBC patients post-CT compared to levels of patients pre-CT or controls. High post-CT sHLA-G levels were associated with the development of distant metastases, the presence of ERCC1 or PIK3CA-CTC subtypes post-CT, and poorer disease outcome in uni- or multivariate analysis. HLA-G 3’ UTR genotypes did not influence disease outcome but ILT-2 rs10416697C allele was associated with AURKA-positive CTC and with adverse disease outcome by uni- and multivariate analysis. The prognostic value of the combined risk factors (high sHLA-G levels post-CT and ILT-2 rs10416697C allele carrier status) was an even better independent indicator for disease outcome in TNBC than the lymph nodal status pre-CT. This combination allowed the identification of patients with high risk of early progression/death with positive nodal status pre-CT or with non-pathological complete therapy response Conclusion The results of this study highlight for the first time that the combination of high levels of sHLA-G post-CT with ILT-2 rs10416697C allele receptor status is a promising tool for the risk assessment of TNBC patients and support the concept to use HLA-G/ILT-2 ligand-receptor axis as therapeutic targets.
    Type of Medium: Online Resource
    ISSN: 1664-3224
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2606827-8
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  • 7
    In: Journal of Cancer Research and Clinical Oncology, Springer Science and Business Media LLC, Vol. 149, No. 3 ( 2023-03), p. 1159-1174
    Abstract: Based on the tumor-promoting features of extracellular vesicles (EV) and PD-L1/2-bearing EV subpopulations (PD-L1/2 EV ), we evaluated their potential as surrogate markers for disease progression or eligibility criteria for PD-1 immune checkpoint inhibition (ICI) approaches in early triple-negative breast cancer (TNBC). Methods After enrichment of EV from plasma samples of 56 patients before and 50 after chemotherapy (CT), we determined levels of EV particle number and PD-L1/2 EV by nanoparticle tracking analysis or ELISA and associated the results with clinical status/outcome and the presence of distinct circulating tumor cells (CTC) subpopulations. Results Compared to healthy controls, patients had a tenfold higher EV concentration and significantly elevated PD L2 EV but not PD L1 EV levels. The most important clinical implications were found for PD-L2 EV . High PD-L2 EV levels were associated with a significantly reduced 3-year progression-free and overall survival (PFS and OS). A loss of PD-L2 EV after CT was significantly more prominent in patients achieving pathological complete response (pCR). Increased pre-CT PD-L2 EV levels were found in patients having NOTCH1-positive or ERBB3-positive CTC. The presence of ERBB3-positive CTC combined with high pre-CT PD-L2 EV resulted in a shorter PFS. Conclusion This study highlights PD L2 EV as a promising biomarker for risk assessment of TNBC patients and represents the basic for additional studies introducing PD-L2 EV as an eligibility criterion for PD-1 ICI approaches.
    Type of Medium: Online Resource
    ISSN: 0171-5216 , 1432-1335
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1459285-X
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  • 8
    In: Geburtshilfe und Frauenheilkunde, Georg Thieme Verlag KG, Vol. 78, No. 10 ( 2018-10), p. 949-971
    Abstract: Zusammenfassung Im April 2018 erschien die erste deutsche interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge der Patientinnen mit Endometriumkarzinom. Von der Deutschen Krebshilfe im Rahmen des Leitlinienprogramms Onkologie gefördert, wurde sie von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Arbeitsgemeinschaft Onkologische Gynäkologie (AGO) der Deutschen Krebsgesellschaft (DKG) federführend koordiniert. Ziele Durch eine evidenzbasierte risikoadaptierte Therapie können bei den Frauen mit Endometriumkarzinom mit geringem Risiko eine unnötige Radikalität bei der Operation und nicht sinnvolle adjuvante Strahlen- und/oder Chemotherapie vermieden werden. Dies reduziert zum einen deutlich die therapieinduzierte Morbidität und erhöht die Lebensqualität der Patientinnen. Auf der anderen Seite werden unnötige Kosten vermieden. Für die Frauen mit einem Endometriumkarzinom mit hohem Rezidivrisiko definiert die Leitlinie die optimale operative Radikalität sowie die ggf. erforderliche Chemotherapie und/oder adjuvante Strahlentherapie. Durch den evidenzbasierten optimalen Einsatz der verschiedenen Therapiemodalitäten sollten Überleben und Lebensqualität dieser Patientinnen verbessert werden. Die S3-Leitlinie zum Endometriumkarzinom soll eine Grundlage für die Arbeit der zertifizierten gynäkologischen Krebszentren sein. Die auf dieser Leitlinie basierenden Qualitätsindikatoren sollen in den Zertifizierungsprozess dieser Zentren einfließen. Methoden Die Leitlinie wurde gemäß den Anforderungen eines S3-Niveaus erarbeitet. Dies umfasst zum einen die Adaptation der mittels des DELBI-Instruments selektierten Quellleitlinien. Zum anderen Evidenzübersichten, die anhand der in systematische Recherchen nach dem PICO-Schema in ausgewählten Literaturdatenbanken selektierten Literatur erstellt wurden. Ergänzend wurde ein externes Biostatistik-Institut mit der systematischen Literaturrecherche und -Bewertung eines Teilbereichs beauftragt. Diese Ergebnisse dienten den interdisziplinären Arbeitsgruppen als Basis für die Erarbeitung von Vorschlägen für Empfehlungen und Statements, welche in strukturierten Konsensuskonferenzen und/oder ergänzend im DELPHI-Verfahren auch online modifiziert und konsentiert wurden. Der Leitlinienreport ist online frei verfügbar. Empfehlungen Der Teil 1 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Epidemiologie, Früherkennung, Diagnostik und hereditären Faktoren: Die Epidemiologie des Endometriumkarzinoms und Risikofaktoren für seine Entstehung werden dargestellt. Die Möglichkeiten der Früherkennung und die Methoden der Diagnostik des Endometriumkarzinoms, einschließlich der Pathologie, werden behandelt. Es werden Empfehlungen zur Prävention, Diagnostik und Therapie von hereditären Formen des Endometriumkarzinoms gegeben.
    Type of Medium: Online Resource
    ISSN: 0016-5751 , 1438-8804
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
    detail.hit.zdb_id: 2026496-3
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  • 9
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 76, No. 14_Supplement ( 2016-07-15), p. 3152-3152
    Abstract: Background: Extracellular vesicles (EVs) are released from cancer cells into the tumor microenvironment, there participating in intercellular communication by altering recipient cell function. Breast cancer (BC) derived EVs are hypothesized to have an impact on tumor growth, immunosuppression or metastatic development, indicating analytical significance of EV concentrations in BC patients. For this reason, we investigated plasmatic EV numbers from locally advanced, neoadjuvant treated (NACT) BC patients in association with clinical parameters and prognostic impact. Material and methods: Plasmatic extracellular vesicles were isolated using ExoQuick™ precipitation reagent (SBI Inc., Mountain View, CA, USA), according to manufacturer's instructions, from locally advanced BC patients before (n = 142) and after (n = 156) NACT as well as from healthy female controls (n = 16). Subsequently, number and EV particle size were analyzed using ZetaView Laser Scattering Video Microscope (Particle Metrix GmbH, Microtrac, Meerbusch, Germany). Samples were 1:50.000 in PBS pre-diluted to obtain particle concentrations of approx. 1 × 10⁁6 particles per ml. Circulating tumor cells (CTCs) and stem cell-like circulating tumor cells (slCTCs) were evaluated using the AdnaTests BreastCancer, StemCell and EMT, respectively (QIAGEN Hannover GmbH, Germany). Results: EV particle concentrations (mean ± SEM in 10⁁9/ml) were significantly (p & lt; 0.0001) elevated in BC patients (n = 104, respectively) before (2370 ± 170) and after (3524 ± 523) NACT compared to healthy females (90 ± 19). Paired analysis before and after NACT revealed higher EV levels after NACT (p = 0.008). In association studies, high EV numbers before NACT were related to less differentiated carcinomas and to lymph node spread. ROC analysis showed optimal cut-off values of EV levels (i) before NACT: 3540 × 10⁁9/ml (sensitivity: 66.7%; specificity: 78.1%; AUC = 0.706) and (ii) after NACT: 2480 × 10⁁9/ml (sensitivity: 100%; specificity: 44,3%; AUC = 0.654). In Kaplan-Meier analysis, a decreased 3-year PFS was significantly associated with EV particle concentrations after NACT & gt; 2480 × 10⁁9/ml (p = 0.005). A reduced OS of BC patients was significantly associated with (i) EV levels before NACT & gt; 3540 × 10⁁9/ml) (p = 0.001) and (ii) EV levels after NACT & gt; 2480 × 109/ml) (p = 0.003). Decreased EV levels were found in BC patients after NACT with CTCs expressing ERCC1 (p = 0.025) or the stem cell marker ALDH1 (p = 0.004). Conclusion: In conclusion, BC patients showed elevated plasmatic EV levels compared to healthy females, while increased EV levels after NACT might be due to therapeutic effects. The association between EV particle concentrations and clinical parameters as well as their prognostic impact on clinical outcome in BC indicate the importance of EVs as a mediator in the BC tumor microenvironment. Therefore, determination of plasmatic EV particle amount might serve as a biomarker for BC monitoring. Citation Format: Lisa König, Vera Rebmann, Oliver Hoffmann, Ann-Kathrin Bittner, Bettina Wagner, Luis Felipe Santos Manvailer, Sabine Schramm, Agnes Bankfalvi, Bernd Giebel, Rainer Kimmig, Peter A. Horn, Sabine Kasimir-Bauer. Breast cancer-derived extracellular vesicles: clinical and prognostic impact. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3152.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 10
    In: Frontiers in Immunology, Frontiers Media SA, Vol. 12 ( 2022-1-12)
    Abstract: Despite major improvements in diagnostics and therapy in early as well as in locally advanced breast cancer (LABC), metastatic relapse occurs in about 20% of patients, often explained by early micro-metastatic spread into bone marrow by disseminated tumor cells (DTC). Although neoadjuvant chemotherapy (NACT) has been a successful tool to improve overall survival (OS), there is growing evidence that various environmental factors like the non-classical human leukocyte antigen-G (HLA-G) promotes cancer invasiveness and metastatic progression. HLA-G expression is associated with regulatory elements targeting certain single-nucleotide polymorphisms (SNP) in the HLA-G 3’ untranslated region (UTR), which arrange as haplotypes. Here, we systematically evaluated the impact of HLA-G 3’UTR polymorphisms on disease status, on the presence of DTC, on soluble HLA-G levels, and on therapy and disease outcome in non-metastatic LABC patients. Although haplotype frequencies were similar in patients ( n  = 142) and controls ( n = 204), univariate analysis revealed that the UTR-7 haplotype was related to patients with low tumor burden, whereas UTR-4 was associated with tumor sizes & gt;T1. Furthermore, UTR-4 was associated with the presence of DTC, but UTR-3 and UTR-7 were related to absence of DTC. Additionally, increased levels of soluble HLA-G molecules were found in patients carrying UTR-7. Regarding therapy and disease outcome, univariate and multivariate analysis highlighted UTR-1 or UTR-2 as a prognostic parameter indicative for a beneficial course of disease in terms of complete response towards NACT or progression-free survival (PFS). At variance, UTR-4 was an independent risk factor for a reduced OS besides already known parameters. Taken into account the most common HLA-G 3’UTR haplotypes (UTR-1–UTR-7, UTR-18), deduction of the UTR-1/2/4 haplotypes to specific SNPs revealed that the +3003C variant, unique for UTR-4, seemed to favor a detrimental disease outcome, while the +3187G and +3196G variants, unique for UTR-1 or UTR-2, were prognostic parameters for a beneficial course of disease. In conclusion, these data suggest that the HLA-G 3’UTR variants +3003C, +3187G, and +3196G are promising candidates for the prediction of therapy and disease outcome in LABC patients.
    Type of Medium: Online Resource
    ISSN: 1664-3224
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2606827-8
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