@article{LapaSchrederSchirbeletal.2017, author = {Lapa, Constantin and Schreder, Martin and Schirbel, Andreas and Samnick, Samuel and Kort{\"u}m, Klaus Martin and Herrmann, Ken and Kropf, Saskia and Einsele, Herrmann and Buck, Andreas K. and Wester, Hans-J{\"u}rgen and Knop, Stefan and L{\"u}ckerath, Katharina}, title = {[\(^{68}\)Ga]Pentixafor-PET/CT for imaging of chemokine receptor CXCR4 expression in multiple myeloma - comparison to [\(^{18}\)F]FDG and laboratory values}, series = {Theranostics}, volume = {7}, journal = {Theranostics}, number = {1}, doi = {10.7150/thno.16576}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-172106}, pages = {205-212}, year = {2017}, abstract = {Chemokine (C-X-C motif) receptor 4 (CXCR4) is a key factor for tumor growth and metastasis in several types of human cancer including multiple myeloma (MM). Proof-of-concept of CXCR4-directed radionuclide therapy in MM has recently been reported. This study assessed the diagnostic performance of the CXCR4-directed radiotracer [\(^{68}\)Ga]Pentixafor in MM and a potential role for stratifying patients to CXCR4-directed therapies. Thirty-five patients with MM underwent [\(^{68}\)Ga]Pentixafor-PET/CT for evaluation of eligibility for endoradiotherapy. In 19/35 cases, [\(^{18}\)F]FDG-PET/CT for correlation was available. Scans were compared on a patient and on a lesion basis. Tracer uptake was correlated with standard clinical parameters of disease activity. [\(^{68}\)Ga]Pentixafor-PET detected CXCR4-positive disease in 23/35 subjects (66\%). CXCR4-positivity at PET was independent from myeloma subtypes, cytogenetics or any serological parameters and turned out as a negative prognostic factor. In the 19 patients in whom a comparison to [\(^{18}\)F]FDG was available, [\(^{68}\)Ga]Pentixafor-PET detected more lesions in 4/19 (21\%) subjects, [\(^{18}\)F]FDG proved superior in 7/19 (37\%). In the remaining 8/19 (42\%) patients, both tracers detected an equal number of lesions. [\(^{18}\)F]FDG-PET positivity correlated with [\(^{68}\)Ga]Pentixafor-PET positivity (p=0.018). [\(^{68}\)Ga]Pentixafor-PET provides further evidence that CXCR4 expression frequently occurs in advanced multiple myeloma, representing a negative prognostic factor and a potential target for myeloma specific treatment. However, selecting patients for CXCR4 directed therapies and prognostic stratification seem to be more relevant clinical applications for this novel imaging modality, rather than diagnostic imaging of myeloma.}, language = {en} } @article{LapaGarciaVellosoLueckerathetal.2017, author = {Lapa, Constantin and Garcia-Velloso, Maria J. and L{\"u}ckerath, Katharina and Samnick, Samuel and Schreder, Martin and Otero, Paula Rodriguez and Schmid, Jan-Stefan and Herrmann, Ken and Knop, Stefan and Buck, Andreas K. and Einsele, Hermann and San-Miguel, Jesus and Kort{\"u}m, Klaus Martin}, title = {\(^{11}\)C-methionine-PET in multiple myeloma: a combined study from two different institutions}, series = {Theranostics}, volume = {7}, journal = {Theranostics}, number = {11}, doi = {10.7150/thno.20491}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-172038}, pages = {2956-2964}, year = {2017}, abstract = {\(^{11}\)C-methionine (MET) has recently emerged as an accurate marker of tumor burden and disease activity in patients with multiple myeloma (MM). This dual-center study aimed at further corroboration of the superiority of MET as positron emission tomography (PET) tracer for staging and re-staging MM, as compared to \(^{18}\)F-2`-deoxy-2`-fluoro-D-glucose (FDG). 78 patients with a history of solitary plasmacytoma (n=4), smoldering MM (SMM, n=5), and symptomatic MM (n=69) underwent both MET- and FDG-PET/computed tomography (CT) at the University Centers of W{\"u}rzburg, Germany and Navarra, Spain. Scans were compared on a patient and on a lesion basis. Inter-reader agreement was also evaluated. In 2 patients, tumor biopsies for verification of discordant imaging results were available. MET-PET detected focal lesions (FL) in 59/78 subjects (75.6\%), whereas FDG-PET/CT showed lesions in only 47 patients (60.3\%; p<0.01), accordingly disease activity would have been missed in 12 patients. Directed biopsies of discordant results confirmed MET-PET/CT results in both cases. MET depicted more FL in 44 patients (56.4\%; p<0.01), whereas in two patients (2/78), FDG proved superior. In the remainder (41.0\%, 32/78), both tracers yielded comparable results. Inter-reader agreement for MET was higher than for FDG (κ = 0.82 vs κ = 0.72). This study demonstrates higher sensitivity of MET in comparison to standard FDG to detect intra- and extramedullary MM including histologic evidence of FDG-negative, viable disease exclusively detectable by MET-PET/CT. MET holds the potential to replace FDG as functional imaging standard for staging and re-staging of MM.}, language = {en} } @phdthesis{Kortuem2007, author = {Kort{\"u}m, Klaus Martin}, title = {Analyse der Behandlungssituation in der Rektumkarzinomchirurgie der Chirurgischen Universit{\"a}tsklinik W{\"u}rzburg - Aufbau und Auswertung einer Datenbank im Rahmen der Qualit{\"a}tssicherung}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-25499}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2007}, abstract = {In der vorliegenden Arbeit wurde eine Datenbank entwickelt,um die Behandlungssituation in der Rektumkarzinomchirurgie beurteilen zu k{\"o}nnen. Mit Hilfe dieser Datenbank wurden retrospektiv die Akten von 179 an einem Rekumkarzinom erkrankten Patienten an der Chirurgischen Universit{\"a}tsklinik W{\"u}rzburg ausgewertet. Anhand dieser Daten konnten die W{\"u}rzburger Behandlungsergebnisse mit denjenigen, welche in der internationalen Literatur zu finden sind, verglichen werden.}, subject = {Mastdarmchirurgie}, language = {de} } @article{HaertleBuenacheCuestaHernandezetal.2023, author = {Haertle, Larissa and Buenache, Natalia and Cuesta Hern{\´a}ndez, Hip{\´o}lito Nicol{\´a}s and Simicek, Michal and Snaurova, Renata and Rapado, Inmaculada and Martinez, Nerea and L{\´o}pez-Mu{\~n}oz, Nieves and S{\´a}nchez-Pina, Jos{\´e} Mar{\´i}a and Munawar, Umair and Han, Seungbin and Ruiz-Heredia, Yanira and Colmenares, Rafael and Gallardo, Miguel and Sanchez-Beato, Margarita and Piris, Miguel Angel and Samur, Mehmet Kemal and Munshi, Nikhil C. and Ayala, Rosa and Kort{\"u}m, Klaus Martin and Barrio, Santiago and Mart{\´i}nez-L{\´o}pez, Joaqu{\´i}n}, title = {Genetic alterations in members of the proteasome 26S subunit, AAA-ATPase (PSMC) gene family in the light of proteasome inhibitor resistance in multiple myeloma}, series = {Cancers}, volume = {15}, journal = {Cancers}, number = {2}, issn = {2072-6694}, doi = {10.3390/cancers15020532}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-305013}, year = {2023}, abstract = {For the treatment of Multiple Myeloma, proteasome inhibitors are highly efficient and widely used, but resistance is a major obstacle to successful therapy. Several underlying mechanisms have been proposed but were only reported for a minority of resistant patients. The proteasome is a large and complex machinery. Here, we focus on the AAA ATPases of the 19S proteasome regulator (PSMC1-6) and their implication in PI resistance. As an example of cancer evolution and the acquisition of resistance, we conducted an in-depth analysis of an index patient by applying FISH, WES, and immunoglobulin-rearrangement sequencing in serial samples, starting from MGUS to newly diagnosed Multiple Myeloma to a PI-resistant relapse. The WES analysis uncovered an acquired PSMC2 Y429S mutation at the relapse after intensive bortezomib-containing therapy, which was functionally confirmed to mediate PI resistance. A meta-analysis comprising 1499 newly diagnosed and 447 progressed patients revealed a total of 36 SNVs over all six PSMC genes that were structurally accumulated in regulatory sites for activity such as the ADP/ATP binding pocket. Other alterations impact the interaction between different PSMC subunits or the intrinsic conformation of an individual subunit, consequently affecting the folding and function of the complex. Interestingly, several mutations were clustered in the central channel of the ATPase ring, where the unfolded substrates enter the 20S core. Our results indicate that PSMC SNVs play a role in PI resistance in MM.}, language = {en} } @article{ZhouRuckdeschelPeteretal.2022, author = {Zhou, Xiang and Ruckdeschel, Anna and Peter, Jessica and B{\"o}ckle, David and Hornburger, Hannah and Danhof, Sophia and Steinhardt, Maximilian Johannes and Heimeshoff, Larissa and Einsele, Hermann and Kort{\"u}m, Klaus Martin and Rasche, Leo}, title = {Salvage therapy with "Dara-KDT-P(A)CE" in heavily pretreated, high-risk, proliferative, relapsed/refractory multiple myeloma}, series = {Hematological Oncology}, volume = {40}, journal = {Hematological Oncology}, number = {2}, doi = {10.1002/hon.2949}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-257495}, pages = {202-211}, year = {2022}, abstract = {The multi-agent therapy "VDT-PACE" represents an established regimen in relapsed/refractory multiple myeloma (RRMM). Here, we report on our experience with a "modified VDT-PACE" incorporating new generation anti-MM agents daratumumab and carfilzomib ("Dara-KDT-P(A)CE"). We retrospectively analyzed 38 patients with RRMM treated with "Dara-KDT-P(A)CE". The median age was 62 (range 45-82) years, and the patients were heavily pretreated with a median of 5 (range 2-12) prior lines of therapy. Twenty-one (55\%) patients suffered from penta-refractory MM. High-risk cytogenetics was present in 31 (81\%) patients. The patients received a median of 2 (range 1-10) cycles of this therapy, and the overall response rate (ORR) was 70\%. Patients with penta-refractory MM and high-risk cytogenetics showed similar ORR of 65\% and 79\%, respectively. The median progression-free survival (PFS) and overall survival were 4.1 (95\% CI 2.7-5.4) and 8.4 (95\% CI 6.7-10.0) months, respectively. Patients with lactate dehydrogenase >250 IU/L showed significantly shorter PFS in comparison with others patients (p = 0.006). We used this regimen as bridging therapy prior to chimeric antigen receptor T-cell infusion in four patients. In conclusion, "Dara-KDT-P(A)CE" is an effective salvage therapy for patients with heavily pretreated, multi-refractory, high-risk RRMM lacking alternative options.}, language = {en} } @article{SteinhardtZhouKrummenastetal.2020, author = {Steinhardt, Maximilian Johannes and Zhou, Xiang and Krummenast, Franziska and Meckel, Katharina and Nickel, Katharina and B{\"o}ckle, David and Messerschmidt, Janin and Knorz, Sebastian and Dierks, Alexander and Heidemeier, Anke and Lapa, Constantin and Einsele, Hermann and Rasche, Leo and Kort{\"u}m, Klaus Martin}, title = {Sequential CD38 monoclonal antibody retreatment leads to deep remission in a patient with relapsed/refractory multiple myeloma}, series = {International Journal of Immunopathology and Pharmacology}, volume = {34}, journal = {International Journal of Immunopathology and Pharmacology}, doi = {10.1177/2058738420980258}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236235}, pages = {1-5}, year = {2020}, abstract = {We report on a currently 76-year-old female patient with relapsed/refractory (RR) multiple myeloma (MM) treated at our institution. This patient had received six lines of therapy including tandem autologous stem cell transplant, proteasome inhibitor, immunomodulatory drugs and CD38 antibody MOR202. At the last relapse, she progressed during treatment with pomalidomide and MOR202. In an individualized therapy concept, we started a multi-agent salvage therapy with pomalidomide, bortezomib, doxorubicin, dexamethasone, and CD38 antibody daratumumab ("Pom-PAD-Dara"), which resulted in a stringent complete remission with minimal residual disease (MRD) negativity after nine cycles. So far, our patient shows a progression free survival of more than 12 months. Our case demonstrates the feasibility of successful CD38 antibody retreatment in a patient with heavily pretreated CD38 antibody resistant MM.}, language = {en} }