TY  - THES
A1  - Schuler, Simone
T1  - Verlaufsuntersuchung zu Knochendichteveränderungen bei juveniler Anorexia nervosa und Implikationen für ihre Therapie
T1  - Course of changes in bone density at juvenile anorexia nervosa and implications for therapy
N2  - In der vorliegenden Arbeit konnten 52 von 103 Patientinnen, die in der Zeit von 1989 bis 1995 aufgrund einer Anorexia nervosa an der Universitätsklinik für Kinder- und Jugendpsychiatrie Würzburg stationär behandelt worden waren, nach im Mittel 5,3 Jahren persönlich nachuntersucht werden. Schwerpunkte der Studie waren der Langzeitverlauf der Knochendichte nach einer Erkrankung an Anorexia nervosa und mögliche Einflussfaktoren auf die Knochendichteentwicklung. Es wurde untersucht, in wieweit sich Krankheitsverlauf, Heilungserfolg, Östrogensubstitution, Amenorrhoedauer sowie sportliche Betätigung auf die Entwicklung der Knochendichteparameter auswirkten. Im Gegensatz zu den meisten vorhergehenden Verlaufsstudien wurde eine relativ große Patientinnengruppe, die alle im Kindes- und Jugendalter erkrankt waren und über Ausgangsdaten bezüglich der Knochendichte verfügten, persönlich nachuntersucht. Neben verschiedenen klinischen Parametern wurde die Knochendichte mittels pQCT und DEXA bestimmt. Es zeigte sich, dass Knochendichteverluste noch veränderbar waren und die jungen Frauen teilweise eine günstige Knochendichteentwicklung aufwiesen. Positiv wirkte sich vor allem ein günstiger Heilungsverlauf aus. Im Gegensatz dazu fand sich bei Patientinnen mit chronischem Krankheitsverlauf eine sehr ungünstige Knochendichteentwicklung. Nicht ganz so positiv stellt sich die Restitution der Knochenarchitektur dar. Insgesamt ließ sich kein eindeutiger Einfluss einer Östrogensubstitution nachweisen. Positive Tendenzen waren bezüglich der Knochendichteentwicklung im Zusammenhang mit sportlicher Aktivität zu beobachten. Die Ergebnisse zeigen, dass eine zügige und anhaltende Gesundung der Patientinnen den einzig nachweislich positiven Einflussfaktor auf die Knochendichteentwicklung darstellt. In wieweit die Einflussgrößen sportliche Aktivität und Östrogensubstitution sich günstig auswirken, ließ sich nicht eindeutig klären. Aus diesem Grund bedarf es weiterführender prospektiver, randomisierter Studien, um die anorexieassoziierten Knochendichteveränderungen und damit verknüpfte Einflussfaktoren zu verstehen.
N2  - 52 of 103 women were personally examined after average 5.3 years. All of them were during 1989 and 1995 treated because of anorexia nerovsa as inpatients in the child and adolescent psychiatry Würzburg. Main emphasis of the study was the longterm-course of bone density after anorexia nervosa and possible influences on the development of bone density, outcome, estrogen-substitution, duration of ammenorrhea and sports on the development of the bone density. Beside different clinical parameters the bone density was measured with pQCT and DEXA. The result was that the loss of bone density was changeable and the young women had partielly a good progress of bone density. Positiv was a good outcome. In spite of the patients with a chronically outcome had a poor increase on bone density. The restitution of the bone architecture was not so positive. There was no clear influence of estrogensubsitution. Positiv trends were found for sports. The results show that a fast and long lasting good outcome of the patients is the only positiv influence on the development of bone density.
KW  - Anorexia nervosa
KW  - Knochendichte
KW  - Knochendichteverlauf
KW  - Östrogene
KW  - Anorexia nervosa
KW  - bone density
KW  - changes in bone density
KW  - Estrogene
Y1  - 2003
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-7511
ER  - 
TY  - JOUR
A1  - Peindl, Matthias
A1  - Göttlich, Claudia
A1  - Crouch, Samantha
A1  - Hoff, Niklas
A1  - Lüttgens, Tamara
A1  - Schmitt, Franziska
A1  - Pereira, Jesús Guillermo Nieves
A1  - May, Celina
A1  - Schliermann, Anna
A1  - Kronenthaler, Corinna
A1  - Cheufou, Danjouma
A1  - Reu-Hofer, Simone
A1  - Rosenwald, Andreas
A1  - Weigl, Elena
A1  - Walles, Thorsten
A1  - Schüler, Julia
A1  - Dandekar, Thomas
A1  - Nietzer, Sarah
A1  - Dandekar, Gudrun
T1  - EMT, stemness, and drug resistance in biological context: a 3D tumor tissue/in silico platform for analysis of combinatorial treatment in NSCLC with aggressive KRAS-biomarker signatures
JF  - Cancers
N2  - Epithelial-to-mesenchymal transition (EMT) is discussed to be centrally involved in invasion, stemness, and drug resistance. Experimental models to evaluate this process in its biological complexity are limited. To shed light on EMT impact and test drug response more reliably, we use a lung tumor test system based on a decellularized intestinal matrix showing more in vivo-like proliferation levels and enhanced expression of clinical markers and carcinogenesis-related genes. In our models, we found evidence for a correlation of EMT with drug resistance in primary and secondary resistant cells harboring KRAS\(^{G12C}\) or EGFR mutations, which was simulated in silico based on an optimized signaling network topology. Notably, drug resistance did not correlate with EMT status in KRAS-mutated patient-derived xenograft (PDX) cell lines, and drug efficacy was not affected by EMT induction via TGF-β. To investigate further determinants of drug response, we tested several drugs in combination with a KRAS\(^{G12C}\) inhibitor in KRAS\(^{G12C}\) mutant HCC44 models, which, besides EMT, display mutations in P53, LKB1, KEAP1, and high c-MYC expression. We identified an aurora-kinase A (AURKA) inhibitor as the most promising candidate. In our network, AURKA is a centrally linked hub to EMT, proliferation, apoptosis, LKB1, and c-MYC. This exemplifies our systemic analysis approach for clinical translation of biomarker signatures.
KW  - EMT
KW  - drug resistance
KW  - invasion
KW  - stemness
KW  - 3D lung tumor tissue models
KW  - KRAS biomarker signatures
KW  - boolean in silico models
KW  - targeted combination therapy
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-270744
SN  - 2072-6694
VL  - 14
IS  - 9
ER  - 
TY  - JOUR
A1  - Hecht, Markus
A1  - Meier, Friedegund
A1  - Zimmer, Lisa
A1  - Polat, Bülent
A1  - Loquai, Carmen
A1  - Weishaupt, Carsten
A1  - Forschner, Andrea
A1  - Gutzmer, Ralf
A1  - Utikal, Jochen S.
A1  - Goldinger, Simone M.
A1  - Geier, Michael
A1  - Hassel, Jessica C.
A1  - Balermpas, Panagiotis
A1  - Kiecker, Felix
A1  - Rauschenberg, Ricarda
A1  - Dietrich, Ursula
A1  - Clemens, Patrick
A1  - Berking, Carola
A1  - Grabenbauer, Gerhard
A1  - Schadendorf, Dirk
A1  - Grabbe, Stephan
A1  - Schuler, Gerold
A1  - Fietkau, Rainer
A1  - Distel, Luitpold V.
A1  - Heinzerling, Lucie
T1  - Clinical outcome of concomitant vs interrupted BRAF inhibitor therapy during radiotherapy in melanoma patients
JF  - British Journal of Cancer
N2  - Background:
Concomitant radiation with BRAF inhibitor (BRAFi) therapy may increase radiation-induced side effects but also potentially improve tumour control in melanoma patients.

Methods:
A total of 155 patients with BRAF-mutated melanoma from 17 European skin cancer centres were retrospectively analysed. Out of these, 87 patients received concomitant radiotherapy and BRAFi (59 vemurafenib, 28 dabrafenib), while in 68 patients BRAFi therapy was interrupted during radiation (51 vemurafenib, 17 dabrafenib). Overall survival was calculated from the first radiation (OSRT) and from start of BRAFi therapy (OSBRAFi).

Results:
The median duration of BRAFi treatment interruption prior to radiotherapy was 4 days and lasted for 17 days. Median OSRT and OSBRAFi in the entire cohort were 9.8 and 12.6 months in the interrupted group and 7.3 and 11.5 months in the concomitant group (P=0.075/P=0.217), respectively. Interrupted vemurafenib treatment with a median OSRT and OSBRAFi of 10.1 and 13.1 months, respectively, was superior to concomitant vemurafenib treatment with a median OSRT and OSBRAFi of 6.6 and 10.9 months (P=0.004/P=0.067). Interrupted dabrafenib treatment with a median OSRT and OSBRAFi of 7.7 and 9.8 months, respectively, did not differ from concomitant dabrafenib treatment with a median OSRT and OSBRAFi of 9.9 and 11.6 months (P=0.132/P=0.404). Median local control of the irradiated area did not differ in the interrupted and concomitant BRAFi treatment groups (P=0.619). Skin toxicity of grade ≥2 (CTCAE) was significantly increased in patients with concomitant vemurafenib compared to the group with treatment interruption (P=0.002).

Conclusions:
Interruption of vemurafenib treatment during radiation was associated with better survival and less toxicity compared to concomitant treatment. Due to lower number of patients, the relevance of treatment interruption in dabrafenib treated patients should be further investigated. The results of this analysis indicate that treatment with the BRAFi vemurafenib should be interrupted during radiotherapy. Prospective studies are desperately needed.
KW  - radiation
KW  - radiotherapy
KW  - BRAF
KW  - vemurafenib
KW  - dabrafenib
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227970
VL  - 118
ER  -