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4 results on '"P.A. Fasching"'

1. Adjuvant abemaciclib combined with endocrine therapy for high-risk early breast cancer: updated efficacy and Ki-67 analysis from the monarchE study

Author

N. Harbeck, P. Rastogi, M. Martin, S.M. Tolaney, Z.M. Shao, P.A. Fasching, C.S. Huang, G.G. Jaliffe, A. Tryakin, M.P. Goetz, H.S. Rugo, E. Senkus, L. Testa, M. Andersson, K. Tamura, L. Del Mastro, G.G. Steger, H. Kreipe, R. Hegg, J. Sohn, V. Guarneri, J. Cortés, E. Hamilton, V. André, R. Wei, S. Barriga, S. Sherwood, T. Forrester, M. Munoz, A. Shahir, B. San Antonio, S.C. Nabinger, M. Toi, S.R.D. Johnston, J. O’Shaughnessy, M.M. Jimenez, S. Johnston, F. Boyle, P. Neven, Z. Jiang, M. Campone, J. Huober, C. Shimizu, I. Cicin, A. Wardley, G.G. Abuin, J. Zarba, E. Lim, P. Sant, N. Liao, B. Christiansen, N. Eigeliene, J. Martin-Babau, J. Ettl, D. Mavroudis, J. Chiu, K. Boer, R. Nagarkar, S. Paluch-Shimon, L. Moscetti, Y. Sagara, S.-B. Kim, M.M. Maciel, V. Tjan-Heijnen, R. Broom, A. Lacko, M. Schenker, N. Volkov, Y. Sim Yap, M. Coccia-Portugal, J. Ángel García Sáenz, A. Andersson, T.-Y. Chao, E. Gokmen, H. Harputluoglu, O. Berzoy, D. Patt, H. McArthur, H. Chew, P. Chalasani, P. Kaufman, K. Tedesco, S.L. Graff, Institut Català de la Salut, [Harbeck N] Breast Center, Department of OB & GYN and CCC Munich, LMU University Hospital, Munich, Germany. [Rastogi P] University of Pittsburgh/UPMC, NSABP Foundation, Pittsburgh, USA. [Martin M] Hospital General Universitario Gregorio Marañon, Universidad Complutense, CIBERONC, GEICAM, Madrid, Spain. [Tolaney SM] Dana-Farber Cancer Institute, Boston, USA. [Shao ZM] Fudan University Shanghai Cancer Center, Shanghai, China. [Fasching PA] University Hospital Erlangen, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. [Cortés J] International Breast Cancer Center (IBCC), Madrid & Barcelona. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Oncology, Receptor, ErbB-2, abemaciclib, adjuvant, CDK4/6, early breast cancer, Ki-67, Aminopyridines, Antineoplastic Combined Chemotherapy Protocols, Benzimidazoles, Chemotherapy, Adjuvant, Disease-Free Survival, Female, Humans, Ki-67 Antigen, Neoplasm Recurrence, Local, Breast Neoplasms, medicine.medical_treatment, Neoplasms::Neoplasms by Site::Breast Neoplasms [DISEASES], Other subheadings::Other subheadings::/drug therapy [Other subheadings], chemistry.chemical_compound, Tratamiento médico, ErbB-2, Clinical endpoint, Other subheadings::/therapeutic use [Other subheadings], Abemaciclib, education.field_of_study, neoplasias::neoplasias por localización::neoplasias de la mama [ENFERMEDADES], biology, terapéutica::terapéutica::farmacoterapia::protocolos antineoplásicos::terapéutica::farmacoterapia::protocolos de quimioterapia antineoplásica combinada [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Hematology, Cáncer, medicine.anatomical_structure, Local, Cohort, Neoplasias de la mama, Adjuvant, Receptor, medicine.medical_specialty, Axillary lymph nodes, Mujer, Population, Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Quimioteràpia combinada, Internal medicine, Therapeutics::Therapeutics::Drug Therapy::Antineoplastic Protocols::Therapeutics::Drug Therapy::Antineoplastic Combined Chemotherapy Protocols [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], medicine, Chemotherapy, education, business.industry, Otros calificadores::/uso terapéutico [Otros calificadores], Interim analysis, Neoplasm Recurrence, chemistry, Mama - Càncer - Tractament, biology.protein, business
Abstract

Abemaciclib; Adjuvant; Early breast cancer Abemaciclib; Adjuvant; Càncer de mama precoç Abemaciclib; Adyuvante; Cáncer de mama precoz Background Adjuvant abemaciclib combined with endocrine therapy (ET) previously demonstrated clinically meaningful improvement in invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) in hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-positive, high-risk early breast cancer at the second interim analysis, however follow-up was limited. Here, we present results of the prespecified primary outcome analysis and an additional follow-up analysis. Patients and methods This global, phase III, open-label trial randomized (1 : 1) 5637 patients to adjuvant ET for ≥5 years ± abemaciclib for 2 years. Cohort 1 enrolled patients with ≥4 positive axillary lymph nodes (ALNs), or 1-3 positive ALNs and either grade 3 disease or tumor ≥5 cm. Cohort 2 enrolled patients with 1-3 positive ALNs and centrally determined high Ki-67 index (≥20%). The primary endpoint was IDFS in the intent-to-treat population (cohorts 1 and 2). Secondary endpoints were IDFS in patients with high Ki-67, DRFS, overall survival, and safety. Results At the primary outcome analysis, with 19 months median follow-up time, abemaciclib + ET resulted in a 29% reduction in the risk of developing an IDFS event [hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.58-0.87; nominal P = 0.0009]. At the additional follow-up analysis, with 27 months median follow-up and 90% of patients off treatment, IDFS (HR = 0.70, 95% CI 0.59-0.82; nominal P < 0.0001) and DRFS (HR = 0.69, 95% CI 0.57-0.83; nominal P < 0.0001) benefit was maintained. The absolute improvements in 3-year IDFS and DRFS rates were 5.4% and 4.2%, respectively. Whereas Ki-67 index was prognostic, abemaciclib benefit was consistent regardless of Ki-67 index. Safety data were consistent with the known abemaciclib risk profile. Conclusion Abemaciclib + ET significantly improved IDFS in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-positive, high-risk early breast cancer, with an acceptable safety profile. Ki-67 index was prognostic, but abemaciclib benefit was observed regardless of Ki-67 index. Overall, the robust treatment benefit of abemaciclib extended beyond the 2-year treatment period. This work was supported by the sponsor (Eli Lilly and Company) and designed together with the study Executive Committee (no grant number).

Published
2021

2. Körperliche Bewegung und Sport zur Prävention und Behandlung von Krebskrankheiten

Author

P.A. Fasching, J. Hübner, and U.R. Kleeberg

Subjects
Gynecology, medicine.medical_specialty, Oncology, business.industry, Medicine, Hematology, business
Abstract

Weltweit machen Lebensumstande ca. 50–75% des Krebsrisikos aus. Bei einer wachsenden Zahl von Malignomen ist Bewegungsmangel neben Adipositas und Fehlernahrung von kritischer Bedeutung. Insulinartige Wachstumsfaktoren (IGF) stellen das Bindeglied zwischen Adipositas, Bewegungsmangel und Krebs dar. Gegebenenfalls sind sie mitverantwortlich fur die Entwicklung einer endokrinen Therapieresistenz. Die Beeinflussung des Glukose- und Insulinstoffwechsels entwickelt sich als neue und erganzende Strategie gegen malignes Zellwachstum. Das Zusammenwirken von korperlicher Aktivitat und Ernahrungsweise wird fur den klinischen Einsatz im Sinne von EBM mit dem Evidenzgrad IA bewertet. Der gunstige Effekt einer solchen Lebensfuhrung, ist, wie prospektive, randomisierte Phase-III-Studien zeigen, dem einer adjuvanten endokrinen oder zytostatischen Therapie moglicherweise gleichwertig. Dem Wunsch des Patienten, selbst zum Therapieerfolg beizutragen, kann fundiert entsprochen werden, und es besteht die Chance, ihn so mit einer nachhaltigen Anleitung zu taglicher korperlicher Aktivitat und einem optimalen Korpermassenindex (Body-Mass-Index, BMI) vor einem irrealen Einsatz ungeprufter sog. komplementarer und alternativer Medizin (KAM) zu bewahren.

Published
2009

3. Survival after neoadjuvant chemotherapy with or without bevacizumab or everolimus for HER2-negative primary breast cancer (GBG 44-GeparQuinto)

Author

G. von Minckwitz, S. Loibl, M. Untch, H. Eidtmann, M. Rezai, P.A. Fasching, H. Tesch, H. Eggemann, I. Schrader, K. Kittel, C. Hanusch, J. Huober, C. Solbach, C. Jackisch, G. Kunz, J.U. Blohmer, M. Hauschild, T. Fehm, V. Nekljudova, B. Gerber, K. Gnauert, B. Heinrich, T. Prätz, U. Groh, H. Tanzer, C. Villena, A. Tulusan, B. Liedtke, J.-U. Blohmer, C. Mau, J. Potenberg, J. Schilling, M. Just, E. Weiss, U. Bückner, M. Wolfgarten, R. Lorenz, G. Doering, S. Feidicker, P. Krabisch, U. Deichert, D. Augustin, K. Kast, C. Nestle-Krämling, C. Höß, J. Terhaag, P. Fasching, P. Staib, B. Aktas, T. Kühn, F. Khandan, V. Möbus, E. Stickeler, G. Heinrich, H. Wagner, A. Abdallah, T. Dewitz, G. Emons, A. Belau, V. Rethwisch, T. Lantzsch, C. Thomssen, U. Mattner, A. Nugent, V. Müller, T. Noesselt, F. Holms, T. Müller, J.-U. Deuker, D. Strumberg, C. Uleer, E. Solomayer, I. Runnebaum, H. Link, O. Tomé, H.-U. Ulmer, B. Conrad, G. Feisel-Schwickardi, C. Schumacher, T. Steinmetz, I. Bauerfeind, S. Kremers, D. Langanke, U. Kullmer, A. Ober, D. Fischer, A. Kohls, W. Weikel, J. Bischoff, K. Freese, M. Schmidt, W. Wiest, M. Sütterlin, M. Dietrich, M. Grießhammer, D.-M. Burgmann, B. Rack, C. Salat, D. Sattler, J. Tio, E. von Abel, B. Christensen, U. Burkamp, C.-H. Köhne, W. Meinerz, S.-T. Graßhoff, T. Decker, F. Overkamp, I. Thalmann, A. Sallmann, T. Beck, T. Reimer, G. Bartzke, M. Deryal, M. Weigel, P. Weder, C.-C. Steffens, S. Lemster, A. Stefek, F. Ruhland, M. Hofmann, J. Schuster, W. Simon, U. Kronawitter, M. Clemens, W. Janni, K. Latos, W. Bauer, A. Roßmann, L. Bauer, D. Lampe, V. Heyl, G. Hoffmann, F. Lorenz-Salehi, J. Hackmann, and R. Schlag

Subjects
Adult, Oncology, medicine.medical_specialty, Bevacizumab, Receptor, ErbB-2, medicine.medical_treatment, Medizin, Angiogenesis Inhibitors, Breast Neoplasms, Antibodies, Monoclonal, Humanized, Breast cancer, Internal medicine, medicine, Humans, Everolimus, Neoadjuvant therapy, Sirolimus, Chemotherapy, business.industry, Hematology, Middle Aged, medicine.disease, Survival Analysis, Chemotherapy regimen, Docetaxel, Chemotherapy, Adjuvant, Drug Therapy, Combination, Female, business, medicine.drug, Epirubicin
Abstract

Background The GeparQuinto study showed that adding bevacizumab to 24 weeks of anthracycline–taxane–based neoadjuvant chemotherapy increases pathological complete response (pCR) rates overall and specifically in patients with triple-negative breast cancer (TNBC). No difference in pCR rate was observed for adding everolimus to paclitaxel in nonearly responding patients. Here, we present disease-free (DFS) and overall survival (OS) analyses. Patients and methods Patients (n = 1948) with HER2-negative tumors of a median tumor size of 4 cm were randomly assigned to neoadjuvant treatment with epirubicin/cyclophosphamide followed by docetaxel (EC-T) with or without eight infusions of bevacizumab every 3 weeks before surgery. Patients without clinical response to EC ± Bevacizumab were randomized to 12 weekly cycles paclitaxel with or without everolimus 5 mg/day. To detect a hazard ratio (HR) of 0.75 (α = 0.05, β = 0.8) 379 events had to be observed in the bevacizumab arms. Results With a median follow-up of 3.8 years, 3-year DFS was 80.8% and 3-year OS was 89.7%. Outcome was not different for patients receiving bevacizumab (HR 1.03; P = 0.784 for DFS and HR 0.974; P = 0.842 for OS) compared with patients receiving chemotherapy alone. Patients with TNBC similarly showed no improvement in DFS (HR = 0.99; P = 0.941) and OS (HR = 1.02; P = 0.891) when treated with bevacizumab. No other predefined subgroup (HR+/HER2-; locally advanced (cT4 or cN3) or not; cT1–3 or cT4; pCR or not) showed a significant benefit. No difference in DFS (HR 0.997; P = 0.987) and OS (HR 1.11; P = 0.658) was observed for nonearly responding patients receiving paclitaxel with or without everolimus overall as well as in subgroups. Conclusions Long-term results, in opposite to the results of pCR, do not support the neoadjuvant use of bevacizumab in addition to an anthracycline–taxane-based chemotherapy or everolimus in addition to paclitaxel for nonearly responding patients. Clinical trial number NCT 00567554, www.clinicaltrials.gov .

Published
2014

4. Cancer detection in gynecology

Author

D. Jap, B. Kuschel, P.A. Fasching, S. P. Renner, M. W. Beckmann, and Y. Werner

Subjects
Gynecology, medicine.medical_specialty, business.industry, Obstetrics and Gynecology, Medicine, business
Abstract

Die Durchfuhrung der Krebsfruherkennung orientiert sich an den 1971 festgelegten Richtlinien des gesetzlichen Krebsfruherkennungsprogramms (GKFP). Untersuchte Organe sind das ausere und innere Genitale, die Mammae, die Haut sowie das Rektum und das Kolon. Die Methoden umfassen die gezielte Anamnese, die korperliche Untersuchung, die Anleitung zur Selbstuntersuchung der Mammae, den zytologischen Zervixabstrich und die Testung auf Blut im Stuhl. Die Durchfuhrung der Mammographie ist beschrankt auf Indikationen wie Zugehorigkeit zu anamnestischen Risikogruppen und manifesten Brustveranderungen. Im Jahr 2000 hat sich das Wissen im Bereich der Onkologie gewandelt. Die Ausrichtung und die Anspruche an das GKFP verandern sich durch diesen neuen Wissensstand. Gleichzeitig muss dies auch unter dem Gesichtspunkt reduzierter finanzieller Ressourcen im Gesundheitssystem mit Fokussierung auf eine maximale Effektivitat der eingesetzten Methoden, der erfassten Risikogruppen und auch der grosten Compliance der Frauen aus diesen Gruppen erfolgen. Ein Screening aller Bevolkerungsgruppen erscheint unter diesen Aspekten nicht durchfuhrbar. Durch die Integration von Risikoberechnungen, Information und Aufklarung uber Pravention und Prophylaxe und Motivation zur Teilnahme konnte das Fruherkennungsprogramm in ein umfassenderes, individualisiertes Vorsorgeprogramm gewandelt werden.

Published
2000

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