@article{LoebLinsmeierHerbertetal.2023, author = {L{\"o}b, Sanja and Linsmeier, Eva and Herbert, Saskia-Laureen and Schlaiß, Tanja and Kiesel, Matthias and Wischhusen, J{\"o}rg and Salmen, Jessica and Kranke, Peter and Quenzer, Anne and Kurz, Florian and Weiss, Claire and Gerhard-Hartmann, Elena and W{\"o}ckel, Achim and Diessner, Joachim}, title = {Prognostic effect of HER2 evolution from primary breast cancer to breast cancer metastases}, series = {Journal of Cancer Research and Clinical Oncology}, volume = {149}, journal = {Journal of Cancer Research and Clinical Oncology}, number = {8}, doi = {10.1007/s00432-022-04486-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324068}, pages = {5417-5428}, year = {2023}, abstract = {Purpose Therapeutic options for breast cancer (BC) treatment are constantly evolving. The Human Epidermal Growth Factor 2 (HER2)-low BC entity is a new subgroup, representing about 55\% of all BC patients. New antibody-drug conjugates demonstrated promising results for this BC subgroup. Currently, there is limited information about the conversion of HER2 subtypes between primary tumor and recurrent disease. Methods This retrospective study included women with BC at the University Medical Centre Wuerzburg from 1998 to 2021. Data were retrieved from patients' records. HER2 evolution from primary diagnosis to the first relapse and the development of secondary metastases was investigated. Results In the HR-positive subgroup without HER2 overexpression, HER2-low expression in primary BC was 56.7 vs. 14.6\% in the triple-negative subgroup (p < 0.000). In the cohort of the first relapse, HER2-low represented 64.1\% of HR-positive vs. 48.2\% of the triple-negative cohort (p = 0.03). In patients with secondary metastases, HER2-low was 75.6\% vs. 50\% in the triple negative subgroup (p = 0.10). The subgroup of HER2-positive breast cancer patients numerically increased in the course of disease; the HER2-negative overall cohort decreased. A loss of HER2 expression from primary BC to the first relapse correlated with a better OS (p = 0.018). No clinicopathological or therapeutic features could be identified as potential risk factors for HER2 conversion. Conclusion HER2 expression is rising during the progression of BC disease. In view of upcoming therapeutical options, the re-analysis of newly developed metastasis will become increasingly important.}, language = {en} } @article{LeonhardtWinklerKollikowskietal.2023, author = {Leonhardt, Jonas and Winkler, Marcela and Kollikowski, Anne and Schiffmann, Lisa and Quenzer, Anne and Einsele, Hermann and L{\"o}ffler, Claudia}, title = {Mind-body-medicine in oncology—from patient needs to tailored programs and interventions}, series = {Frontiers in Psychology}, volume = {14}, journal = {Frontiers in Psychology}, issn = {1664-1078}, doi = {10.3389/fpsyg.2023.1140693}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-321970}, year = {2023}, abstract = {Introduction: National and international guidelines recommend early integration of evidence-based multimodal interventions and programs, especially with a focus on relaxation techniques and other Mind-Body-based methods to maintain the quality of life of oncology patients, improve treatment tolerability, and promote healthy lifestyle behaviors. Consequently, we aim to understand what drives patients and how they navigate integrative medicine to best advise them. This study aimed to detect possible topics of particular interest to patients and identify the patient groups that could benefit most from further programs. Furthermore, we aimed to investigate if patients are open-minded toward integrative oncology concepts and learn about their motivational level to maintain or change behavior. Methods: Between August 2019 and October 2020 we surveyed patients undergoing oncological therapy in a university oncological outpatient center using a custom-developed questionnaire based on established Mind-Body Medicine concepts. Results: We included 294 patients with various cancers. More than half reported problems sleeping through (61\%) and 42\% felt stressed frequently, invariably rating this as detrimental to their health. Moreover, a slight majority (52\%) felt physically limited due to their disease and only 30\% performed defined exercise programs. Women were significantly more likely to feel stressed and reported with alarming frequency that they often feel "everything was up to them." The 40-65-year-olds reported significantly less restful sleep, more stress and were more dissatisfied with their situation. However, this group already used natural remedies most frequently and was most often motivated to use relaxation techniques in the next 6 months. The lower the perceived individual energy level (EL), the less frequently patients did sport, the more frequently they felt their disease impaired their activity, mostly feeling stressed and tense. We also found significant associations between negative emotions/thoughts and the variables "sleep," "use of relaxation techniques," "personal stress perception," and "successful lifestyle modification." Conclusion: Mind-Body programs that focus on patient's individual resources, with tools to explore impairing patterns of self-perception and cognitive biases, can be a valuable resource for oncology patients and should therefore be part of an integrative medical treatment concept.}, language = {en} } @article{KieselBeyersKaliszetal.2022, author = {Kiesel, Matthias and Beyers, Inga and Kalisz, Adam and W{\"o}ckel, Achim and Quenzer, Anne and Schlaiß, Tanja and Wulff, Christine and Diessner, Joachim}, title = {Evaluating the value of a 3D printed model for hands-on training of gynecological pelvic examination}, series = {3D Printing in Medicine}, volume = {8}, journal = {3D Printing in Medicine}, doi = {10.1186/s41205-022-00149-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-313365}, year = {2022}, abstract = {Background Simulation in the field of gynecological pelvic examination with educational purposes holds great potential. In the current manuscript we evaluate a 3D printed model of the female pelvis, which improves practical teaching of the gynecological pelvic examination for medical staff. Methods We evaluated the benefit of a 3D printed model of the female pelvis (Pelvisio®) as part of a seminar ("skills training") for teaching gynecological examination to medical students. Each student was randomly assigned to Group A or B by picking a ticket from a box. Group A underwent the skills training without the 3D printed model. Group B experienced the same seminar with integration of the model. Both groups evaluated the seminar by answering five questions on Likert scales (1-10, 1 = "very little" or "very poor", 10 equals "very much" or "very good"). Additionally, both groups answered three multiple-choice questions concerning pelvic anatomy (Question 6 to 8). Finally, Group B evaluated the 3D printed model with ten questions (Question 9 to 18, Likert scales, 1-10). Results Two of five questions concerning the students' satisfaction with the seminar and their gained knowledge showed statistically significant better ratings in Group B (6.7 vs. 8.2 points and 8.1 vs. 8.9 points (p < 0.001 and p < 0.009). The other three questions showed no statistically significant differences between the traditional teaching setting vs. the 3D printed model (p < 0.411, p < 0.344 and p < 0.215, respectively). The overall mean score of Question 1 to 5 showed 8.4 points for Group B and 7.8 points for Group A (p < 0.001). All three multiple-choice questions, asking about female pelvic anatomy, were answered more often correctly by Group B (p < 0.001, p < 0.008 and p < 0.001, respectively). The mean score from the answers to Questions 9 to 18, only answered by Group B, showed a mean of 8.6 points, indicating, that the students approved of the model. Conclusion The presented 3D printed model Pelvisio® improves the education of female pelvic anatomy and examination for medical students. Hence, training this pivotal examination can be supported by a custom designed anatomical model tailored for interactive and explorative learning.}, language = {en} } @phdthesis{Quenzer2018, author = {Quenzer, Anne}, title = {Der antiproliferative Effekt des Multidrug resistance-Protein 1 (MRP1)-Inhibitors Reversan und der Laktatdehydrogenase (LDH)-Inhibitoren Natriumoxamat und Galloflavin an kolorektalen Karzinomzellen bei tumorphysiologischen Sauerstoffkonzentrationen}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156051}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {Ziel der vorliegenden Arbeit waren pharmakologische Untersuchungen zum antiproliferativen Effekt der beiden Laktatdehydrogenase (LDH)-Inhibitoren Natriumoxamat und Galloflavin sowie des MRP1-Inhibitors Reversan einzeln und in Kombination bei verschiedenen Sauerstoffkonzentrationen in vitro zu untersuchen. Zus{\"a}tzlich wurde der antiproliferative Effekt der drei Inhibitoren mit dem antiproliferativen Effekt von 5-FU verglichen. Das Konzept zu dieser Arbeit basiert auf Gemeinsamkeiten zwischen LDH und MRP1 in malignen Zellen. Eine ist, dass beide Molek{\"u}le von zahlreichen Tumoren {\"u}berexprimiert werden. Weiter sind beide an der Ausbildung von Chemoresistenz beteiligt und beide werden auch in Hypoxie exprimiert. Zudem wird das f{\"u}r die Funktion von MRP1 notwendige ATP in malignen Zellen haupts{\"a}chlich mit der hyperaktiven Glykoloyse gebildet, deren Stoffumsatz auch von der LDH-Aktivit{\"a}t abh{\"a}ngig ist. Eine kombinierte Inhibition beider Zielstrukturen scheint somit geeignet zu sein, um die Proliferation maligner Zellen gezielt zu hemmen. Da in großen Teilen solider Tumoren hypoxische bzw. anoxische Bedingungen vorherrschen, wurde die Wirksamkeit der drei Inhibitoren auch bei 5 \% und 1 \% Sauerstoff, die als tumorphysiologisch gelten, untersucht. Die wichtigsten Ergebnisse aus dieser Arbeit sind, dass die beiden LDH-Inhibitoren Natriumoxamat und Galloflavin und der MRP1-Inhibitor Reversan einen antiproliferativen Effekt bei kolorektalen Karzinomzellen ausl{\"o}sen, der auch f{\"u}r tumorphysiologische Sauerstoffkonzentrationen nachzuweisen war. So verringerte sich durch Natriumoxamat bzw. Galloflavin der Anteil vitaler Zellen um bis zu 45 \% und durch Reversan um bis zu 60 \% bei 5 \% und 1 \% Sauerstoff im Vergleich zur unbehandelten Kontrolle. Auch unterschiedliche Kombination aus Natriumoxamat, Galloflavin und Reversan f{\"u}hrten zu einer Steigerung des antiproliferativen Effektes, der auch immer bei tumorphysiologischen Konzentrationen nachzuweisen war. Den st{\"a}rksten antiproli-ferativen Effekt wies die Dreifachkombination aus Galloflavin, Natriumoxamat und Reversan auf. So verringerte sich der Anteil vitaler Zellen bei 1 \% Sauerstoff durch diese Kombination auf bis zu 28 \% bei vier der f{\"u}nf kolorektalen Karzinomzelllinien. Die Dreifachkombination wies einen gleichstarken bzw. st{\"a}rkeren antiproliferativen Effekt auf als das Chemotherapeutikum 5-FU und zwar ebenfalls bei 5 \% und 1 \% Sauerstoff. Die Ergebnisse der vorliegenden Arbeit zum antiproliferativen Effekt von Natriumoxamat, Galloflavin (beides LDH-Inhibitoren) und Reversan (MRP1-Inhibitor) in vitro lassen den Schluss zu, dass das Konzept der Arbeit, einen antiproliferativen Effekt auch bei tumorphysiologischen Sauerstoffkonzentrationen zu induzieren, grunds{\"a}tzlich best{\"a}tigt wurde. Auch l{\"o}ste die gemeinsame Hemmung von LDH und MRP1 einen teilweise st{\"a}rkeren antiproliferativen Effekt aus als 5-FU. Weitere Untersuchungen sind aber ohne Frage n{\"o}tig, um die molekularen Interaktion zwischen LDH und MRP1 sowie ihrer Inhibition im Detail zu verstehen.}, subject = {Lactatdehydrogenase}, language = {de} } @article{WiegeringMatthesMuehlingetal.2017, author = {Wiegering, Armin and Matthes, Niels and M{\"u}hling, Bettina and Koospal, Monika and Quenzer, Anne and Peter, Stephanie and Germer, Christoph-Thomas and Linnebacher, Michael and Otto, Christoph}, title = {Reactivating p53 and Inducing Tumor Apoptosis (RITA) Enhances the Response of RITA-Sensitive Colorectal Cancer Cells to Chemotherapeutic Agents 5-Fluorouracil and Oxaliplatin}, series = {Neoplasia}, volume = {19}, journal = {Neoplasia}, number = {4}, doi = {10.1016/j.neo.2017.01.007}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-171067}, pages = {301-309}, year = {2017}, abstract = {Colorectal carcinoma (CRC) is the most common cancer of the gastrointestinal tract with frequently dysregulated intracellular signaling pathways, including p53 signaling. The mainstay of chemotherapy treatment of CRC is 5-fluorouracil (5FU) and oxaliplatin. The two anticancer drugs mediate their therapeutic effect via DNA damage-triggered signaling. The small molecule reactivating p53 and inducing tumor apoptosis (RITA) is described as an activator of wild-type and reactivator of mutant p53 function, resulting in elevated levels of p53 protein, cell growth arrest, and cell death. Additionally, it has been shown that RITA can induce DNA damage signaling. It is expected that the therapeutic benefits of 5FU and oxaliplatin can be increased by enhancing DNA damage signaling pathways. Therefore, we highlighted the antiproliferative response of RITA alone and in combination with 5FU or oxaliplatin in human CRC cells. A panel of long-term established CRC cell lines (n = 9) including p53 wild-type, p53 mutant, and p53 null and primary patient-derived, low-passage cell lines (n = 5) with different p53 protein status were used for this study. A substantial number of CRC cells with pronounced sensitivity to RITA (IC\(_{50}\)< 3.0 μmol/l) were identified within established (4/9) and primary patient-derived (2/5) CRC cell lines harboring wild-type or mutant p53 protein. Sensitivity to RITA appeared independent of p53 status and was associated with an increase in antiproliferative response to 5FU and oxaliplatin, a transcriptional increase of p53 targets p21 and NOXA, and a decrease in MYC mRNA. The effect of RITA as an inducer of DNA damage was shown by a strong elevation of phosphorylated histone variant H2A.X, which was restricted to RITA-sensitive cells. Our data underline the primary effect of RITA, inducing DNA damage, and demonstrate the differential antiproliferative effect of RITA to CRC cells independent of p53 protein status. We found a substantial number of RITA-sensitive CRC cells within both panels of established CRC cell lines and primary patient-derived CRC cell lines (6/14) that provide a rationale for combining RITA with 5FU or oxaliplatin to enhance the antiproliferative response to both chemotherapeutic agents.}, language = {en} }