@article{KochPetzoldWesselyetal.2021, author = {Koch, Elias A. T. and Petzold, Anne and Wessely, Anja and Dippel, Edgar and Gesierich, Anja and Gutzmer, Ralf and Hassel, Jessica C. and Haferkamp, Sebastian and Hohberger, Bettina and K{\"a}hler, Katharina C. and Knorr, Harald and Kreuzberg, Nicole and Leiter, Ulrike and Loquai, Carmen and Meier, Friedegund and Meissner, Markus and Mohr, Peter and Pf{\"o}hler, Claudia and Rahimi, Farnaz and Schadendorf, Dirk and Schell, Beatrice and Schlaak, Max and Terheyden, Patrick and Thoms, Kai-Martin and Schuler-Thurner, Beatrice and Ugurel, Selma and Ulrich, Jens and Utikal, Jochen and Weichenthal, Michael and Ziller, Fabian and Berking, Carola and Heppt, Markus}, title = {Immune checkpoint blockade for metastatic uveal melanoma: patterns of response and survival according to the presence of hepatic and extrahepatic metastasis}, series = {Cancers}, volume = {13}, journal = {Cancers}, number = {13}, issn = {2072-6694}, doi = {10.3390/cancers13133359}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-242603}, year = {2021}, abstract = {Background: Since there is no standardized and effective treatment for advanced uveal melanoma (UM), the prognosis is dismal once metastases develop. Due to the availability of immune checkpoint blockade (ICB) in the real-world setting, the prognosis of metastatic UM has improved. However, it is unclear how the presence of hepatic and extrahepatic metastasis impacts the response and survival after ICB. Methods: A total of 178 patients with metastatic UM treated with ICB were included in this analysis. Patients were recruited from German skin cancer centers and the German national skin cancer registry (ADOReg). To investigate the impact of hepatic metastasis, two cohorts were compared: patients with liver metastasis only (cohort A, n = 55) versus those with both liver and extra-hepatic metastasis (cohort B, n = 123). Data were analyzed in both cohorts for response to treatment, progression-free survival (PFS), and overall survival (OS). The survival and progression probabilities were calculated with the Kaplan-Meier method. Log-rank tests, χ\(^2\) tests, and t-tests were performed to detect significant differences between both cohorts. Results: The median OS of the overall population was 16 months (95\% CI 13.4-23.7) and the median PFS, 2.8 months (95\% CI 2.5-3.0). The median OS was longer in cohort B than in cohort A (18.2 vs. 6.1 months; p = 0.071). The best objective response rate to dual ICB was 13.8\% and to anti-PD-1 monotherapy 8.9\% in the entire population. Patients with liver metastases only had a lower response to dual ICB, yet without significance (cohort A 8.7\% vs. cohort B 16.7\%; p = 0.45). Adverse events (AE) occurred in 41.6\%. Severe AE were observed in 26.3\% and evenly distributed between both cohorts. Conclusion: The survival of this large cohort of patients with advanced UM was more favorable than reported in previous benchmark studies. Patients with both hepatic and extrahepatic metastasis showed more favorable survival and higher response to dual ICB than those with hepatic metastasis only.}, language = {en} } @phdthesis{Schuler2005, author = {Schuler, Patrick}, title = {Lokalisation und Blockade der Serinprotease uPA im C6-Glioblastom-Modell der Ratte}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-18967}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2005}, abstract = {Gegenstand dieser Doktorarbeit war die Beschreibung des Urokinaseplaminaktivators uPA im C6-Sph{\"a}roidmodell der Ratte und dessen Lokalisation in Bezug auf den Prim{\"a}rtumor. Das hierbei verwendete Tiermodell basiert auf der C6-Tumorzellreihe, welche durch Transfektion von Rattengliomzellen mit dem Vaskularisierungsfaktor VEGF entwickelt wurde. Die gesteigerte Expression von VEGF resultiert in einer st{\"a}rkeren Vaskularisierung und einer erh{\"o}hten Wachstumsrate des Tumors. Im Vorfeld der Tumorimplantation konnte die Expression von uPA durch die C6-Tumorzellen mittels reverser RNA-Transkription und Polymerasekettenreaktion nachgewiesen werden. In vitro gelang der Nachweis von uPA im C6-Sph{\"a}roiden mittels Fluoreszenz-F{\"a}rbung. Im Rahmen des Tierversuches wurden aus den Tumorzellen ca. 300µm große Sph{\"a}roide hergestellt, welche den Ratten in den Kortex des linken Frontallappens implantiert wurden und dort solide Hirntumoren bildeten. Die Versuchstiere wurden anschließend in zwei Gruppen aufgeteilt. Der Positivgruppe wurde t{\"a}glich {\"u}ber einen Zeitraum von 19 bzw. 21 Tagen der Proteasehemmer WX-UK1 in die Bauchh{\"o}hle injiziert, die Kontrollgruppe erhielt ein Placebo. Nach Ablauf des Behandlungszeitraumes konnte an den explantierten Gehirnen mittels histochemischer Peroxidasef{\"a}rbung die Protease uPA im Tumorgewebe nachgewiesen werden. Die Konzentration von uPA war besonders im invasionsaktiven Bereich des Tumors erh{\"o}ht. Dieser entspricht der Randzone des soliden Tumors, sowie den distanzierten Zellnestern im gesunden Hirngewebe, welche als so genannte Invasionszone zusammengefasst werden. Die tragende Rolle von uPA bei der Invasion der Tumorzellen in das gesunde Hirngewebe konnte somit best{\"a}tigt werden. Die Messung von erh{\"o}hten uPA-Konzentrationen an der Basalmembran von Hirngef{\"a}ßen korreliert mit Beobachtungen, dass die Tumorzellen entlang von Gef{\"a}ßen und Plexus migrieren, aber nicht in der Lage sind, in das Gef{\"a}ßlumen einzudringen. Der Nachweis der erfolgreichen orthotopen Sph{\"a}roidimplantation mittels MRT-Bildgebung der Hirntumoren unterstreicht den Vorteil der offenen Implantationstechnik gegen{\"u}ber der Zellinjektion. Die peritoneale Verabreichung des Proteasehemmers WX-UK1 f{\"u}hrte im Rahmen dieser Untersuchungen zu keiner signifikanten Reduktion des Tumorwachstums, welches mittels Volumenmessung im MRT dokumentiert wurde. Des Weiteren konnte keine Minderung der uPA-Konzentration in den Tumoren der Positivgruppe gegen{\"u}ber der Kontrollgruppe gemessen werden. Neben der fehlenden Biodistribution des Wirkstoffes kommt hierf{\"u}r auch eine mangelnde Spezifit{\"a}t von WX-UK1 f{\"u}r uPA oder ein alternativer Aktivierungsweg der Proteolyse innerhalb der Tumorzellen in Betracht. Diese Arbeit f{\"u}hrt zur Weiterentwicklung des C6-Sph{\"a}roidmodells und unterst{\"u}tzt die zuk{\"u}nftige Entwicklung von Wirkstoffen gegen das Tumorwachstum auf Basis der anti-invasiven Therapie.}, language = {de} } @article{KochPetzoldWesselyetal.2022, author = {Koch, Elias A. T. and Petzold, Anne and Wessely, Anja and Dippel, Edgar and Gesierich, Anja and Gutzmer, Ralf and Hassel, Jessica C. and Haferkamp, Sebastian and K{\"a}hler, Katharina C. and Knorr, Harald and Kreuzberg, Nicole and Leiter, Ulrike and Loquai, Carmen and Meier, Friedegund and Meissner, Markus and Mohr, Peter and Pf{\"o}hler, Claudia and Rahimi, Farnaz and Schadendorf, Dirk and Schell, Beatrice and Schlaak, Max and Terheyden, Patrick and Thoms, Kai-Martin and Schuler-Thurner, Beatrice and Ugurel, Selma and Ulrich, Jens and Utikal, Jochen and Weichenthal, Michael and Ziller, Fabian and Berking, Carola and Heppt, Markus V.}, title = {Immune checkpoint blockade for metastatic uveal melanoma: re-induction following resistance or toxicity}, series = {Cancers}, volume = {14}, journal = {Cancers}, number = {3}, issn = {2072-6694}, doi = {10.3390/cancers14030518}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-254814}, year = {2022}, abstract = {Re-induction with immune checkpoint blockade (ICB) needs to be considered in many patients with uveal melanoma (UM) due to limited systemic treatment options. Here, we provide hitherto the first analysis of ICB re-induction in UM. A total of 177 patients with metastatic UM treated with ICB were included from German skin cancer centers and the German national skin cancer registry (ADOReg). To investigate the impact of ICB re-induction, two cohorts were compared: patients who received at least one ICB re-induction (cohort A, n = 52) versus those who received only one treatment line of ICB (cohort B, n = 125). In cohort A, a transient benefit of overall survival (OS) was observed at 6 and 12 months after the treatment start of ICB. There was no significant difference in OS between both groups (p = 0.1) with a median OS of 16.2 months (cohort A, 95\% CI: 11.1-23.8) versus 9.4 months (cohort B, 95\% CI: 6.1-14.9). Patients receiving re-induction of ICB (cohort A) had similar response rates compared to those receiving ICB once. Re-induction of ICB may yield a clinical benefit for a small subgroup of patients even after resistance or development of toxicities.}, language = {en} }