Refine
Is part of the Bibliography
- yes (139)
Year of publication
Document Type
- Journal article (72)
- Doctoral Thesis (66)
- Book (1)
Keywords
- breast cancer (19)
- Brustkrebs (11)
- ovarian cancer (10)
- Eierstockkrebs (6)
- pregnancy (6)
- Ovarialkarzinom (5)
- dendritic cells (5)
- 3D printing (4)
- Dendritische Zellen (4)
- Mammakarzinom (4)
- Schwangerschaft (4)
- expression (4)
- gynecology (4)
- Adenosin (3)
- Breast cancer (3)
- CD39 (3)
- CD73 (3)
- Embryo (3)
- HLA-G (3)
- IVF (3)
- Ketogene Kost (3)
- Lebensqualität (3)
- Reproduktionsmedizin (3)
- Sterilität (3)
- adenosine (3)
- education (3)
- immune escape (3)
- inflammation (3)
- ketogenic diet (3)
- survival (3)
- teaching (3)
- Adenosinrezeptor (2)
- Adipositas (2)
- Akt (2)
- BRENDA (2)
- Beta-Hydroxybutyrat (2)
- Blastozyste (2)
- Chemotherapie (2)
- Dendritische Zelle (2)
- ECMO-Therapie (2)
- Fortpflanzung (2)
- Gestationsdiabetes (2)
- Glykolyse (2)
- HERV-K (2)
- HLA-E (2)
- Halacha (2)
- Harninkontinenz (2)
- Hydroxybutyrat <3-> (2)
- ICSI (2)
- Ketogenic diet (2)
- Ketonkörper (2)
- Metastatic breast cancer (2)
- Rezeptorkonversion (2)
- Stressinkontinenz (2)
- T cells (2)
- Tumorzellen (2)
- VEGF (2)
- Zytokine (2)
- apoptosis (2)
- autophagy (2)
- blastocyst (2)
- blood-brain barrier (2)
- cancer (2)
- cancer detection and diagnosis (2)
- cytokines (2)
- disease (2)
- embryo (2)
- gene (2)
- gestational diabetes (2)
- glucose (2)
- hormones (2)
- immunotherapy (2)
- jüdisches Recht (2)
- lymph nodes (2)
- mammography (2)
- metabolism (2)
- obesity (2)
- ovarian carcinoma (2)
- pelvic examination (2)
- pelvic palpation (2)
- score (2)
- stress (2)
- trastuzumab (2)
- tumor immunology (2)
- tumor stem cells (2)
- visualization (2)
- 2,4 DNP (1)
- 2-APB (1)
- 3D tissue model (1)
- 3D-Ultraschall (1)
- 3D-ultrasound (1)
- 5-FU (1)
- ADCC (1)
- AKT-Signalweg (1)
- Acetessigester (1)
- Acetoacetat (1)
- Acid-base-state (1)
- Adenylatcyclaseassay (1)
- Adjuvante Therapie (1)
- Angiogenese (1)
- Anitkörpertherapie (1)
- Apoptosis (1)
- Astrocytic tumor (1)
- Atmungskette (1)
- Auswahl (1)
- Axonal degeneration (1)
- Azidose (1)
- B7-H1 (1)
- Basendefizit (1)
- Beckenbodenmuskulatur (1)
- Beckenbodensenkung (1)
- Bedürfnis (1)
- Bedürfnisse (1)
- Betahydroxybutyrat (1)
- Beurteilung (1)
- Bindungsassay (1)
- Bioimpedance (1)
- Bioimpedanzanalyse (1)
- Blockierende Faktoren (1)
- Blood–brain barrier (1)
- Blut (1)
- Blutgasstatus (1)
- BrdU (1)
- Breast Cancer (1)
- Brustkompression (1)
- Brustselbstuntersuchung (1)
- CD74 (1)
- COVID-19 (1)
- COVID-19-ARDS (1)
- COVID-19-Pademie (1)
- CX3CL1 (1)
- CXCL13 (1)
- Ca2+ release activated Ca2+ channel (1)
- CaCo-2 (1)
- Cancer stem cells (1)
- Capillary leak (1)
- Caspase (1)
- Cervical Carcinoma (1)
- Chemokine (1)
- Chemokinreceptor (1)
- Chemoresistenz (1)
- Chemosensititvität (1)
- Chirurgie (1)
- Colonkrebs (1)
- Coronavirus Disease 2019 (1)
- Cortison (1)
- Covid-19 (1)
- Cytokine (1)
- DC/T-Zell-Konjugate (1)
- DNA repair protraction (1)
- DNP (1)
- Dedifferenzierung (1)
- Dendritic cells (1)
- Dermoid (1)
- Dermoidzysten (1)
- Descensus (1)
- Descensus uteri (1)
- Descensus vaginalis (1)
- Descensuschirurgie (1)
- Diabetic polyneuropathy (1)
- Dignität (1)
- Dinitrophenol (1)
- Dinitrophenol <2,4-> (1)
- Dinitrophenole (1)
- Disorazol (1)
- Disorazole (1)
- Dranginkontinenz (1)
- ECMO therapy (1)
- Eierstocktumor (1)
- Eklampsie (1)
- Electric stimulation therapy (1)
- Elektrostimualtionstherapie (1)
- Embryonenqualität (1)
- Empfängnisverhütung (1)
- Endogene Retroviren (1)
- Endogenous Glucocorticoids (1)
- Endometriose (1)
- Endometriumkarzinom (1)
- Endometriumvolumen (1)
- Endothelzelle (1)
- Energiestoffwechsel (1)
- Entkoppler (1)
- Epidural Analgesia (1)
- Erythrocyte deformability in Healthy Women (1)
- Erythrozyten Verformbarkeit bei gesunden Frauen (1)
- Expression (1)
- FACS (1)
- FDM (1)
- FWGE (1)
- Fertilität (1)
- Fertilitätsprotektion (1)
- Fetomaternal (1)
- Fetomaternal immunology (1)
- Fetomaternale Immunologie (1)
- Fettgehalt (1)
- Fettsucht (1)
- Follikelflüssigkeit (1)
- GDF-15 (1)
- Geburtseinleitung (1)
- Geburtshilfe (1)
- Geburtshilfliche Intensivmedizin (1)
- Gebärmutterhalskrebs (1)
- Geb�rmutterschleimhautkrebs (1)
- Genetic causes of cancer (1)
- Glioblastoma cell line (1)
- Glioblastoma multiforme (1)
- Glucosestoffwechsel (1)
- GnRH (1)
- GnRH-Agonisten (1)
- Gonadotropin-Releasinghormon-Analoga (1)
- Gynäkologie (1)
- HCT-116 (1)
- HER2 (1)
- HER2 conversion (1)
- HER2 targeted therapy (1)
- HER2-Rezeptor (1)
- HER2-low (1)
- HERV (1)
- HLA class II (1)
- HLA peptidome (1)
- HLA-Antigene (1)
- HT-29 (1)
- Habitueller Abort (1)
- Health care service research (1)
- Healthcare Cost (1)
- Healthcare Economics (1)
- Hemmung (1)
- High fat diet (1)
- Hormone (1)
- Hormonrezeptor (1)
- Human Endogenous Retrovirus - K (1)
- Human endogenous retrovirus (1)
- Humane endogene Retroviren (1)
- Hyperthermie (1)
- IOM-Kriterien (1)
- IVF/ICSI (1)
- Immunhistochemie (1)
- Immunisierung (1)
- Immunmodulator (1)
- Immunohistochemistry (1)
- Immunologie (1)
- Immunsuppression (1)
- Implantationsversagen (1)
- In vitro models (1)
- In-vitro-Fertilisation (1)
- Induktion (1)
- Infektionswellen (1)
- Infertilität (1)
- Inhibition (1)
- Inhibitor (1)
- Interleukin-1 beta (1)
- Intratumorale Heterogenität (1)
- KET (1)
- Kachexie (1)
- Kaiserschnitt (1)
- Ketogene Diät (1)
- Kohlendioxidpartialdruck (1)
- Kolonkarzinom (1)
- Kombinationstherapie (1)
- Krebs <Medizin> (1)
- Krebskranker (1)
- Krebsvorsorge (1)
- Kulturmedium (1)
- L. reuteri (1)
- LIF (1)
- LPS (1)
- Labour Analgesia (1)
- Labour Pain (1)
- Lactatdehydrogenase (1)
- Large Granular Lymphocytes (1)
- Large loop excision of the transformation zone (LLETZ) (1)
- Leukaemia Inhibitory Factor (LIF) (1)
- Liganden (1)
- Loop electrosurgical excision procedure (LEEP) (1)
- M2-PK (1)
- M2PK (1)
- MIF (1)
- MMP (1)
- MRSA - methicillin-resistant Staphylococcus aureus (1)
- Makrosomie (1)
- Mammacarzinom (1)
- Mammographie (1)
- Mangelernährung (1)
- Matrix metalloproteinases (1)
- Medicine (1)
- Medizin (1)
- Mesh (1)
- Messenger-RNS (1)
- Metabolismus (1)
- Metastase (1)
- Metastasierung (1)
- Metastatic (1)
- Mikrokaloriemetrie (1)
- Molecular biology (1)
- Morphokinetik (1)
- Motor nerve biopsy (1)
- Multidrug-Resistance-Related Proteine (1)
- Muscarin (1)
- Muscarinrezeptor (1)
- Mutationen (1)
- Myometrium (1)
- NKG2D / DNAM-1 (1)
- NRG1 (1)
- NSG (1)
- NVP-BEZ235 (1)
- Nabelschnurblut (1)
- Nachsorge (1)
- Natürliche Killerzelle (1)
- Nectin‐2 (1)
- Needs (1)
- Nekroptose (1)
- Neuropathy (1)
- Neurotrophic factors (1)
- Non-coding RNAs (1)
- Novel PI3K (1)
- Ovar (1)
- Ovarian Cancer (1)
- Oxidative Phosphorylierung (1)
- PAP-Abstrich (1)
- PARP (1)
- PC-1 blockade (1)
- PCR analysis (1)
- PD-1 (1)
- PD-L1 (1)
- PI3K-Signalweg (1)
- PI3K/AKT Inhibitor (1)
- PI3K/AKT inhibitor (1)
- PROLIFT (1)
- Pap-Test (1)
- Parkinson’s disease (1)
- Patient Controlled Analgesia (1)
- Patient Satisfaction (1)
- Patient-centered registry (1)
- Patient’s needs (1)
- Pelvisio® (1)
- Placenta (1)
- Platin (1)
- Plazenta (1)
- Polypropylen-Netz (1)
- Prevalence (1)
- Prognosefakoren (1)
- Prognosefaktor (1)
- Prolaps (1)
- Prostaglandin E2 Vaginalgel (1)
- Protein p53 (1)
- Proteinkinase B (1)
- Präimplantationsembryo (1)
- Prävalenz (1)
- Pyruvatkinase (1)
- Quality of Life (1)
- Quality of life (1)
- RIP-1 (1)
- RT-qPCT (1)
- Radiosensitivität (1)
- Red cell deformability (1)
- Remifentanil (1)
- Resektion (1)
- Resistenz (1)
- Reverse Transkriptase-Polymerase-Kettenreaktion (1)
- Reverse transcriptase-polymerase chain reaction; Myometrium; Muscarin; Muscarinic Receptors; Messenger-RNA (1)
- Rezeptor (1)
- Rezidiv (1)
- S100 Protein (1)
- S100 protein (1)
- SH-6 (1)
- SLA (1)
- SOCE (1)
- Schmerz (1)
- Schwangerschaftshormone (1)
- Schwangerschaftsraten (1)
- Selbstabtastung (1)
- Selektion (1)
- Senkungsbeschwerden (1)
- Severe Acute Respiratory Syndrome Coronavirus 2 (1)
- Spermienqualität (1)
- Spermiogramme (1)
- Stammzelle (1)
- Stoffwechsel (1)
- Strahlensensibilität (1)
- Stressincontinence (1)
- Stuhlinkontinenz (1)
- Syncytin (1)
- Synergie (1)
- Säure-Basen-Haushalt (1)
- T-DM1 (1)
- T-Lymphozyt (1)
- T-Zelle (1)
- TGF-beta (1)
- TKTL1 (1)
- TNBC (1)
- TNF (1)
- TRAIL (1)
- TVT® (1)
- Therapie (1)
- Toll-like receptor signaling (1)
- Transforming Growth Factor beta (1)
- Triple-negativ (1)
- Tumor (1)
- Tumorimmunologie (1)
- Tumorkachexie (1)
- Tumormetabolismus (1)
- Tumorstammzellen (1)
- Tumorstoffwechsel (1)
- Tumorzelle (1)
- UME6 (1)
- Urgeincontinence (1)
- Urgeinkontinenz (1)
- Urinary incontinence (1)
- VE-cadherin (1)
- Vasectomy (1)
- Vasektomie (1)
- Verformbarkeit (1)
- Vorkerne (1)
- Warburg effect (1)
- Warburgeffekt (1)
- Weight Gain During Pregnancy (1)
- Wertigkeit (1)
- Zellkultur (1)
- Zervixkarzinom (1)
- Zytostatikatherapie (1)
- accessibility (1)
- acute respiratory distress syndrome (1)
- adenosine receptor (1)
- advanced breast cancer (1)
- age factors (1)
- aged (1)
- aged 80 and over (1)
- aging in men and semen (1)
- altersassoziierte Spermienschwankungen (1)
- animal models (1)
- anti-hormonal therapy (1)
- anti-tumor effects (1)
- argeted therapy (1)
- ascites (1)
- assistierte Reproduktion (1)
- astrocytic tumor (1)
- astrocytoma (1)
- axillary dissection (1)
- bacteria (1)
- bacterial infection model (1)
- base excess (1)
- benzoquinone (1)
- bioimpedance analysis (1)
- bioinformatics (1)
- biomarker (1)
- bioreactor culture (1)
- blocking factors (1)
- blood gases (1)
- blood lipids; fat loss; running performance (1)
- blood-brain barrier (BBB) model (1)
- bone metastases (1)
- brain metastases (1)
- brain metastasis (1)
- brain-metastasis (1)
- breast cancer imaging (1)
- breast cancer metastases (1)
- breast cancer subtypes (1)
- breast self-examination (1)
- cachexia (1)
- calprotectin (1)
- cancer cell lines (1)
- cancer cells (1)
- cancer chemotherapy (1)
- cancer dissemination (1)
- cancer microenvironment (1)
- cancer patients (1)
- cancer risk factors (1)
- cancer screening (1)
- cancer stem cell immunology (1)
- cancer stem cells (1)
- cancer treatment (1)
- cell death (1)
- cell lung cancer (1)
- cervical dysplasia (1)
- cesarean section (1)
- chemokine (1)
- chemokine recepteo (1)
- chemotherapy (1)
- chronic periodontitis (1)
- claudin 5 (1)
- co-culture (1)
- combinatorial drug predictions (1)
- common variable immunodeficiency (CVID) (1)
- contraception (1)
- conventional imaging (1)
- cord blood (1)
- cross-sectional imaging (1)
- culture medium (1)
- cytokine (1)
- cytonkines (1)
- cytostatic (1)
- cytotoxic antibodies (1)
- cytotoxicity (1)
- decidua basalis (1)
- delay of therapy (1)
- dendritische Zelle (1)
- dendritische Zellen (1)
- dignity (1)
- dinitrophenol (1)
- diseases of the nervous system (1)
- dysplasia (1)
- endocrine therapy (1)
- endometrial cancer (1)
- endometrial volume (1)
- energy metabolism (1)
- epidemiology (1)
- evidence‐based medicine (1)
- exercise (1)
- exosomes (1)
- expression pattern (1)
- failure of implantation (1)
- feasibility (1)
- fecal incontinence (1)
- fecal short-chain fatty acids (1)
- female (1)
- female urinary incontinence (1)
- fetal outcome (1)
- fiber intake (1)
- follicular fluid (1)
- follow up (1)
- follow-up (1)
- fused deposition modeling (FDM) (1)
- geburtshilfliches Ergebnis (1)
- gene expression (1)
- genetic testing (1)
- genital warts (1)
- geographic information science (1)
- glioblastoma (1)
- glioblastoma cell-lines (1)
- glioblastoma multiforme (1)
- glioblastoma stem cell (1)
- glioma (1)
- gliomas (1)
- glycolysis (1)
- growth (1)
- growth differentiation factor 15 (1)
- guideline adherent treatment (1)
- gynecologic surgical procedures/methods (1)
- health care providers (1)
- health care service research (1)
- her-2/neu (1)
- histology (1)
- histopathology (1)
- hla-sharing (1)
- hormona therapy (1)
- human genetics (1)
- human induced pluripotent stem cells (hiPSCs)human induced pluripotent stem cells (hiPSCs) (1)
- human papillomavirus (1)
- human semen quality (1)
- humanized mice (1)
- hyaluronan-related enzymes (1)
- hypoxia (1)
- immune modulator (1)
- immune response (1)
- immunohistochemistry (1)
- immunologische Synapse (1)
- immunoresistance (1)
- immunosurveillance (1)
- immunotherapies (1)
- impact (1)
- implementation (1)
- in-vitro fertilization (1)
- inborn errors of immunity (IEIs) (1)
- individual mind state (1)
- infertility (1)
- inflammatory cascades (1)
- insulin (1)
- insulin-like growth factor 1 (IGF1) (1)
- intestinal inflammation (1)
- intestinal permeability (1)
- intracytoplasmatic sperm injection (1)
- intracytoplasmatische Spermieninjektion (1)
- invasiveness (1)
- ionizing radiation (1)
- ivf-failure (1)
- jahreszeitliche Spermienschwankungen (1)
- ketogenic dients (1)
- ketone bodies (1)
- labor induction (1)
- laparoscopy/methods (1)
- large loop excision of the transformation zone (LLETZ) (1)
- latency (1)
- leukaemia inhibitory factor (LIF) (1)
- lifestyle habits (1)
- low carb diet (1)
- low carbohydrate diet (1)
- lung-cancer (1)
- m-Health (1)
- mTOR Inhibitor (1)
- macrosomia (1)
- male factor infertility (1)
- mammographic compression (1)
- matrix metalloproteinase (1)
- medicine (1)
- melanoma (1)
- metabolic profile (1)
- metastasis (1)
- miRNA (1)
- miRNAs (1)
- mice (1)
- microRNA (1)
- microarray (1)
- microbiota (1)
- microcalorimetry (1)
- microglia (1)
- microna profiles (1)
- middle Aged (1)
- modular tumor tissue models (1)
- monoclonal antibody (1)
- monocyte (1)
- monocyte subsets (1)
- monocytes (1)
- monoklonale Antikörper (1)
- morphogenesis (1)
- motivational level (1)
- mouse brain (1)
- multiple sclerosis (1)
- multipotent fetal neural stem cells (fNSCs) (1)
- mutations (1)
- männliche Subfertilität (1)
- neoadjuvant therapies (1)
- neonatal immunology (1)
- neural stem cell (1)
- neurodegeneration (1)
- neurogenesis (1)
- neuroimmunology (1)
- neuroinflammation (1)
- neurological disorders (1)
- neurovascular unit in vitro (1)
- number of (1)
- ovary (1)
- p53 (1)
- pAkt (1)
- pCO2 acidosis (1)
- pH (1)
- pain (1)
- pathways (1)
- patient safety (1)
- patient serum (1)
- pelvic floor (1)
- pelvic organ prolapse (1)
- pelvic organ prolapse/surgery (1)
- peripheral blood (1)
- peritoneal metastasis (1)
- pertuzumab (1)
- pi3k-signalweg (1)
- pilot study (1)
- plaque (1)
- polyvinylidene fluoride (PVDF) (1)
- positive nodal status (1)
- post-neoadjuvant therapies (1)
- postoperative complications/epidemiology (1)
- postpartum (1)
- prediction (1)
- pregnancy gingivitis (1)
- pregnancy hormones (1)
- pregnancy rates (1)
- preimplantation embryo (1)
- premalignant lesion (1)
- preterm infants (1)
- primary immunodeficiency (1)
- probiotic lozenges (1)
- prognosefaktor (1)
- prognosis (1)
- prognostic factor (1)
- prognostic factors (1)
- prognostic marker (1)
- prognsotic significance (1)
- prolonged second stage of labour (1)
- pronuclear (1)
- prospective (1)
- prospektiv (1)
- prostaglandin E2 vaginal gel (1)
- protrahierte Austreibungsperiode (1)
- psychische Belastung (1)
- psychological distress (1)
- quality of care (1)
- quality of life (1)
- radiosensibility (1)
- reactive oxygen species (1)
- receptor conversion (1)
- reconstructive surgical procedures/methods (1)
- recurrent (1)
- reduction in male fertility (1)
- regulator (1)
- rehabilitation (1)
- reproductive medicine (1)
- retrospective Studies (1)
- review (1)
- rheumatoid arthritis (1)
- risk (1)
- robotic complications (1)
- robotic hysterectomy (1)
- robotic sacrocolpopexy (1)
- safety (1)
- seahorse (1)
- seasonal trends in semen parameters (1)
- selection (1)
- sentinel (1)
- serum (1)
- signature (1)
- simulation (1)
- skeleton (1)
- sling suspension (1)
- sperm count (1)
- staib agar (1)
- staphylocccal infection/epidemiology (1)
- sterility (1)
- stressincontinence (1)
- stromal hyaluronan (1)
- subgingival (1)
- suburethrale Schlingeninsertion (1)
- subventricular zone (1)
- supportive care (1)
- surgical Mesh (1)
- survivors (1)
- symptom burden (1)
- temporal trends in sperm parameters (1)
- testing (1)
- therapy (1)
- transfer (1)
- transforming growth factor-beta-1 (1)
- trastuzumab deruxtecan (1)
- triple negatives Mamma Karzinom (1)
- triple-negative (1)
- tumor associated macrophages (1)
- tumor cells (1)
- tumor dormancy (1)
- tumor immune escape (1)
- tumor immunosurveillance (1)
- tumor infiltrating lymphocytes (1)
- tumor size (1)
- tumor-associated hyaluronan staining pattern (1)
- tumor-infiltrating lymphocytes (1)
- tumor-propagating cells (1)
- tumors (1)
- tumorspezifische Therapie (1)
- tumour (1)
- tumour immunology (1)
- ultrasound (1)
- umbilical cord blood (1)
- unmet needs (1)
- urgeincontinence (1)
- urinary incontinence (1)
- urinary incontinence/surgery (1)
- uterine prolapse/surgery (1)
- vagina/surgery (1)
- vaginal delivery (1)
- vaginale Geburt (1)
- vascular permeability (1)
- viral load (1)
- virtual (1)
- virulence (1)
- weibliche Harninkontinenz (1)
- zeitliche Spermienschwankungen (1)
- zonulin (1)
- zytotoxische Antikörper (1)
- β-Hydroxybutyrate (1)
Institute
- Frauenklinik und Poliklinik (139) (remove)
EU-Project number / Contract (GA) number
- 259867 (1)
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.
Immune checkpoint blockade therapy is beneficial and even curative for some cancer patients. However, the majority don’t respond to immune therapy. Across different tumor types, pre-existing T cell infiltrates predict response to checkpoint-based immunotherapy. Based on in vitro pharmacological studies, mouse models and analyses of human melanoma patients, we show that the cytokine GDF-15 impairs LFA-1/β2-integrin-mediated adhesion of T cells to activated endothelial cells, which is a pre-requisite of T cell extravasation. In melanoma patients, GDF-15 serum levels strongly correlate with failure of PD-1-based immune checkpoint blockade therapy. Neutralization of GDF-15 improves both T cell trafficking and therapy efficiency in murine tumor models. Thus GDF-15, beside its known role in cancer-related anorexia and cachexia, emerges as a regulator of T cell extravasation into the tumor microenvironment, which provides an even stronger rationale for therapeutic anti-GDF-15 antibody development.
Increased intestinal permeability and inflammation, both fueled by dysbiosis, appear to contribute to rheumatoid arthritis (RA) pathogenesis. This single-center pilot study aimed to investigate zonulin, a marker of intestinal permeability, and calprotectin, a marker of intestinal inflammation, measured in serum and fecal samples of RA patients using commercially available kits. We also analyzed plasma lipopolysaccharide (LPS) levels, a marker of intestinal permeability and inflammation. Furthermore, univariate, and multivariate regression analyses were carried out to determine whether or not there were associations of zonulin and calprotectin with LPS, BMI, gender, age, RA-specific parameters, fiber intake, and short-chain fatty acids in the gut. Serum zonulin levels were more likely to be abnormal with a longer disease duration and fecal zonulin levels were inversely associated with age. A strong association between fecal and serum calprotectin and between fecal calprotectin and LPS were found in males, but not in females, independent of other biomarkers, suggesting that fecal calprotectin may be a more specific biomarker than serum calprotectin is of intestinal inflammation in RA. Since this was a proof-of-principle study without a healthy control group, further research is needed to validate fecal and serum zonulin as valid biomarkers of RA in comparison with other promising biomarkers.
Die tumorbedingte Mangelernährung und Kachexie ist ein Syndrom mit sowohl medizinischer als auch gesundheitsökonomischer Relevanz. In den letzten Jahren wurde ein besseres Verständnis für die komplexe Pathophysiologie, bestehend aus Stoffwechselstörungen, verminderter Energiezufuhr und Entzündungsprozessen, die zum fortschreitenden Muskel- und Fettmassenverlust führen, erreicht. Dieses Verständnis dient bis heute der Entwicklung möglicher präventiver und therapeutischer Ansätze. Geeignete Screening-Tests tragen dazu bei, das Syndrom rechtzeitig zu erkennen und weitere Maßnahmen einzuleiten. Da der Muskel- und Fettmassenverlust nicht immer durch einen reinen Gewichtsverlust gekennzeichnet ist, ist die Erfassung der Körperzusammensetzung ein wesentlicher Bestandteil in der Betreuung onkologisch Erkrankter. Die BIA ist ein hierfür geeignetes Verfahren, welches leicht in den klinischen Alltag zu integrieren ist und besonders zur interindividuellen Verlaufskontrolle herangezogen werden könnte. Ernährungsmedizinische und bewegungstherapeutische Maßnahmen sind bereits fester Bestandteil internationaler Leitlinien. Für pharmakologische Therapiekonzepte besteht noch weiterer Forschungsbedarf, um eine Arzneimittelzulassung zu erreichen. Eine alleinige Intervention ist in der Behandlung der onkologischen Mangelernährung und Kachexie wenig effektiv. Deshalb müssen die Bedeutung und der potentielle Nutzen einer Kombination der einzelnen Behandlungsbausteine näher betrachtet werden, um eine bessere Evidenz zu erhalten. Der nachweisliche Mangel an Ernährungsstrukturen und ernährungsmedizinischer Fachkompetenz, Schwierigkeiten der Definitionsentwicklung und Gestaltung von Studien sowie finanzierungstechnische Fragen stellen ein zentrales Problem in der angemessenen Betreuung der Erkrankten dar. Jedoch bestehen klare Handlungsempfehlungen und Strategien, durch die entsprechende Herausforderungen reduziert oder beseitigt werden könnten. Dadurch profitieren sowohl Erkrankte als auch das Gesundheitssystem. Dies kann durch eine verbesserte Versorgung mittels Prävention, frühzeitiger Erfassung, Diagnose und Einleitung angebrachter Therapiemaßnahmen auf dem Gebiet der tumorbedingten Mangelernährung und Kachexie erreicht werden.
Abstract
Despite multidisciplinary local and systemic therapeutic approaches, the prognosis for most patients with brain metastases is still dismal. The role of adaptive and innate anti-tumor response including the Human Leukocyte Antigen (HLA) machinery of antigen presentation is still unclear. We present data on the HLA class II-chaperone molecule CD74 in brain metastases and its impact on the HLA peptidome complexity.
We analyzed CD74 and HLA class II expression on tumor cells in a subset of 236 human brain metastases, primary tumors and peripheral metastases of different entities in association with clinical data including overall survival. Additionally, we assessed whole DNA methylome profiles including CD74 promoter methylation and differential methylation in 21 brain metastases. We analyzed the effects of a siRNA mediated CD74 knockdown on HLA-expression and HLA peptidome composition in a brain metastatic melanoma cell line.
We observed that CD74 expression on tumor cells is a strong positive prognostic marker in brain metastasis patients and positively associated with tumor-infiltrating T-lymphocytes (TILs). Whole DNA methylome analysis suggested that CD74 tumor cell expression might be regulated epigenetically via CD74 promoter methylation. CD74\(^{high}\) and TIL\(^{high}\) tumors displayed a differential DNA methylation pattern with highest enrichment scores for antigen processing and presentation. Furthermore, CD74 knockdown in vitro lead to a reduction of HLA class II peptidome complexity, while HLA class I peptidome remained unaffected.
In summary, our results demonstrate that a functional HLA class II processing machinery in brain metastatic tumor cells, reflected by a high expression of CD74 and a complex tumor cell HLA peptidome, seems to be crucial for better patient prognosis.
Ziel dieser Arbeit war es, den Einfluss von Endometriose sowie den Einfluss einer vollständigen Endometriose-Resektion auf morphokinetische, mit dem Implantationserfolg korrelierende Aspekte der Embryonenqualität zu untersuchen.
Für die zugrundeliegende retrospektive Studie wurden 258 im Rahmen von IVF- und/oder ICSI-Zyklen befruchtete und kultivierte Embryonen von 44 Patientinnen mit histologisch gesicherter Endometriose und 43 Patientinnen mit laparoskopisch ausgeschlossener Endometriose ausgewertet. Sowohl Endometriose als auch die vollständige Endometriose-Resektion wurden als Einflussfaktor der frühen Embryonalentwicklung untersucht. Hierfür wurde unter Anwendung des KIDScore\(^{TM}\) D3 und D5 Implantationsdaten-Algorithmus die Morphokinetik der jeweiligen Embryonen verglichen.
Die Analyse ergab keine signifikanten Unterschiede bei den medianen KIDScores\(^{TM}\) D3 zwischen den drei Gruppen aus Patientinnen ohne Endometriose, Patientinnen mit vollständig resezierter Endometriose und Patientinnen ohne vollständige operative Entfernung ihrer Endometriose. Bei den KIDScores\(^{TM}\) D5 erreichten die Embryonen von Patientinnen mit Endometriose ohne vollständige Resektion einen Medianwert von 2,6 (auf einer Skala von 1 bis 9,9), während die Embryonen der Kontrollgruppe aus Patientinnen ohne Endometriose einen Wert von 6,8 erreichten (p = 0,003). Der Medianwert für Embryonen von Endometriose-Patientinnen mit vollständiger chirurgischer Entfernung ihrer Endometriose betrug 7,2, was einen signifikanten Anstieg im Vergleich zu Embryonen von Patientinnen ohne vollständige Resektion darstellt (p = 0,002). Die Umrechnung in die Effektstärke d (Cohens d) ergab einen mittleren Effekt (d = 0,639) für „keine Endometriose“ versus „Endometriose ohne Resektion“ sowie einen großen Effekt (d = 0,93) für „Endometriose-Komplettresektion“ versus „Endometriose ohne Resektion“. In einer Fallserie aus vier Patientinnen, die sich sowohl vor als auch nach vollständiger Resektion ihrer Endometriose IVF-/ICSI-Zyklen unterzogen hatten, zeigten drei von vier Patientinnen eine deutliche Verbesserung der KIDScores\(^{TM}\) nach vollständiger Resektion. Die Schwangerschafts- und Abortraten zwischen Frauen mit und ohne Endometriose(resektion) wichen nicht signifikant voneinander ab.
Zusammenfassend scheint die vollständige Resektion der Endometriose die ansonsten tendenziell verminderte Embryonenqualität von Patientinnen, die sich einer künstlichen Befruchtung unterziehen, zu verbessern. Die Daten sprechen daher dafür, Patientinnen mit Endometriose vor IVF oder ICSI zu einem chirurgischen Eingriff zu raten.
Das triple negative Mamma-Karzinom stellt eine Tumorart dar, welche besonders junge Frauen betrifft und eine schlechte Prognose aufweist. Unterstützende und pro- gnoseverbessernde Therapien sind deshalb Gegenstand aktueller Forschung. Eine mögliche unterstützende Therapie stellt hierbei die ketogene Diät dar. Diese Arbeit untersuchte die Fragestellung, ob β-Hydroxybutyrat (3OHB), welches als Hauptme- tabolit unter ketogener Diät oder beim Fasten erhöht ist, Einfluss auf das Zellwachs- tum triple-negativer Brustkrebszellen ausübt. Außerdem wurde eruiert, ob 3OHB die üblichen Behandlungsformen - Chemotherapie und Strahlentherapie - positiv oder negativ beeinflusst. In vitro wurden Versuche mit drei triple-negativen Brust- krebszellreihen unter möglichst physiologischen Bedingungen durchgeführt. Hierbei konnte durch 3OHB weder ein wachstumsfördernder noch ein wachstumshemmender Effekt beobachtet werden. Genauso zeigte sich bei den Chemo- oder Strahlenthera- pieversuchen keine durch 3OHB induzierte Wechselwirkung. In vivo durchgeführte Studien über den Einfluss einer ketogenen Diät finden sich nur vereinzelt. Um be- lastbare Daten zu erhalten werden deshalb weitere Studien in Zukunft vonnöten sein. Eine ketogene Diät könnte hierbei im Rahmen eines multimodalen Therapie- konzeptes eine unterstützende Rolle spielen, wofür erste Einzelfallstudien Hinweise geben
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.
Purpose
An increasing incidence of breast cancer can be observed worldwide. Since a delay of therapy can have a negative impact on prognosis, timely cancer care is an important quality indicator. By receiving treatment at a certified breast cancer center, the patient has the best chance of treatment in accordance with guidelines and the best prognosis. The identification of risk factors for a delay of therapy is of central importance and should be the basis for a continuous optimization of treatment at breast cancer centers.
Methods
This retrospective study included women with breast cancer (primary diagnosis, relapse, or secondary malignancy) at the University Hospital Würzburg in 2019 and 2020. Data were retrieved from patients’ records. Correlations and regression analyses were performed to detect potential risk factors for treatment delay.
Results
Patients who received the histological confirmation of breast cancer at an external institution experienced a later therapy start than those patients who received the histological confirmation at the University Hospital Würzburg itself. (35.7 vs. 32.2 days). The interval between histological confirmation and the first consultation at the University Hospital Würzburg correlated statistically significant with age, distress and distance to the hospital.
Conclusion
Patients with an in-house diagnosis of breast cancer are treated more quickly than those whose diagnosis was confirmed in an external institution. We identified factors such as increased age, greater distance to the hospital as well as increased distress to prolong the time until start of oncological treatment. Intensified patient care should be offered to these subgroups.