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Publications (5)23.19 Total impact

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    ABSTRACT: In January 2007, the �AGO Kommission Mamma� for the 5th time updated the �AGO Recommendations for the Diagnostic and Therapy of Breast Cancer� that were established and published for the first time in 2002. The most important statements and modifications are described here. With regard to adjuvant therapy, the definition of the recommended regimens could be established more precisely. The increasing knowledge about the clinical value of sentinel lymph node excision is taken into consideration. For the pathological work-up, the needs and standards of additional markers and prognostic factors were better defined and adjusted to the guidelines of the German pathologists. The routine use of gene arrays for therapy decision is still rejected. Detailed recommendations were established for acute and long-term side effects of therapy. In the chapter �specific situations�, CUP (carcinoma of unknown primary) syndrome and phyllodes tumor were included. Taking into account the improved prognosis of breast cancer, specific advice for survivors and information about complementary therapy, hormone therapies, and contraception was prepared in detail. The treatment principles of metastastic disease have not changed substantially, thus pronouncing the significance of guiding therapy by defining the goal and estimating the therapeutic index for each situation.
    Breast Care 01/2007; 2(4):244-250. · 0.68 Impact Factor
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    ABSTRACT: To evaluate the predictive value of HER-2 in a population of advanced breast cancer patients randomly treated either with single-agent doxorubicin (A) or with single-agent docetaxel (T). Patients from this study participated in a phase III clinical trial in which doxorubicin or docetaxel was administered for advanced disease. HER-2 was evaluated by IHC. In all positive cases, FISH was used to confirm the HER-2 positive status. The different cohorts of patients identified by HER-2 were examined to assess a possible relationship between HER-2 status and treatment effect. Tumor samples were available for 176 of the 326 patients entered in the clinical trial (54%). HER-2 positivity was observed in 20% of the study population. A statistically significant interaction was found between response rates to the study drugs and HER-2 status, with HER-2 positive patients deriving the highest benefit from the use of T (odds ratio for HER-2 positive patients treated with T = 3.12 (95% CI 1.11-8.80), p = 0.03). The interaction between HER-2 and response rates to A and T was also confirmed by a multivariate analysis. No statistically significant interaction was found between HER-2 and drugs efficacy evaluated in terms of time to progression and overall survival, although in the HER-2 negative cohort A was at least as effective as T in term of overall survival. These results suggest that in HER-2 positive breast cancer patients docetaxel might be more active than doxorubicin, while in HER-2 negative patients doxorubicin might be at least as effective as docetaxel. Although the present results cannot have an impact on current practice, they allow us to formulate the hypothesis that HER-2 positive breast cancer is a heterogeneous disease with regard to sensitivity to anthracyclines and taxanes, and that this might be dependent upon other molecular markers including the p-53 and topoisomerase II alpha genes. This hypothesis is currently being tested prospectively in two different 'bench to bed-side' clinical trials.
    Breast Cancer Research and Treatment 09/2004; 86(3):197-206. · 4.47 Impact Factor
  • Zentralblatt für Gynäkologie 06/2002; 124(5):293-303.
  • Zentralblatt für Gynäkologie 06/2002; 124(5):284-92.
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    ABSTRACT: This phase III study compared docetaxel and doxorubicin in patients with metastatic breast cancer who had received previous alkylating agent-containing chemotherapy. Patients were randomized to receive an intravenous infusion of docetaxel 100 mg/m(2) or doxorubicin 75 mg/m(2) every 3 weeks for a maximum of seven treatment cycles. A total of 326 patients were randomized, 165 to receive doxorubicin and 161 to receive docetaxel. Overall, docetaxel produced a significantly higher rate of objective response than did doxorubicin (47.8% v 33.3%; P =.008). Docetaxel was also significantly more active than doxorubicin in patients with negative prognostic factors, such as visceral metastases (objective response, 46% v 29%) and resistance to prior chemotherapy (47% v 25%). Median time to progression was longer in the docetaxel group (26 weeks v 21 weeks; difference not significant). Median overall survival was similar in the two groups (docetaxel, 15 months; doxorubicin, 14 months). There was one death due to infection in each group, and an additional four deaths due to cardiotoxicity in the doxorubicin group. Although neutropenia was similar in both groups, febrile neutropenia and severe infection occurred more frequently in the doxorubicin group. For severe nonhematologic toxicity, the incidences of cardiac toxicity, nausea, vomiting, and stomatitis were higher among patients receiving doxorubicin, whereas diarrhea, neuropathy, fluid retention, and skin and nail changes were higher among patients receiving docetaxel. The observed differences in activity and toxicity profiles provide a basis for therapy choice and confirms the rationale for combination studies in early breast cancer.
    Journal of Clinical Oncology 09/1999; 17(8):2341-54. · 18.04 Impact Factor