Thomas Kühr's research while affiliated with Klinikum Wels-Grieskirchen and other places

Publications (59)

Article
Background Elotuzumab plus lenalidomide and dexamethasone has shown improved progression-free and overall survival versus lenalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma. We aimed to assess these regimens in patients with newly diagnosed multiple myeloma who are ineligible for haematopoietic stem-cell transpl...
Article
Background Increasing use of antibodies targeting CD38 in first line (1L) for multiple myeloma (MM) has created a need for treatments for patients who are refractory to anti-CD38. This analysis describes the use of carfilzomib (K) with lenalidomide and dexamethasone (KRd) or with dexamethasone alone (Kd) in anti-CD38 refractory patients. Methods P...
Article
Background: With approvals of lenalidomide (Len) based therapy for the treatment of transplant ineligible patients (pts) with newly diagnosed multiple myeloma, and for pts receiving maintenance following transplant, there is an increasing use of Len as induction and maintenance therapy. As a result, treatment options for pts who become Len-refracto...
Article
Background: To understand carfilzomib (K) usage, effectiveness and safety in patients (pts) with relapsed or refractory multiple myeloma (RRMM) in real-life, we describe the results of an interim analysis by K-based regimens from a large prospective observational study (NCT03091127). Methods: Adult pts who received ≥1 prior line of therapy and ≥1 K...
Article
The goal of current management of patients with chronic phase chronic myeloid leukemia (CML) is to reach treatment free remission (TFR) with sustained deep molecular remission (DMR) being the prerequisite therefor. Second generation tyrosine kinase inhibitors (TKIs) can induce deeper and faster remission than imatinib, but are often associated with...
Article
Background Olaratumab is a humanized monoclonal antiplatelet-derived growth factor receptor alpha antibody that has been approved in combination with doxorubicin for the treatment of patients with metastatic soft tissue sarcoma (STS). The purpose of this retrospective study was to assess the clinical efficacy in STS patients treated with olaratumab...
Article
Full-text available
Despite recent advances in the treatment of gastric cancer, mortality related to this disease is still substantial. Surgery and chemotherapy represent the cornerstones of patient management. Targeted treatments that include anti-angiogenic agents and the advent of immunotherapies can contribute to improved patient prognosis. Herein, we present an A...
Article
Abstract BACKGROUND: Patients who are immunocompromised because of malignancy have an increased risk of herpes zoster and herpes zoster-related complications. We aimed to investigate the efficacy and safety of an inactivated varicella zoster virus (VZV) vaccine for herpes zoster prevention in patients with solid tumour or haematological malignancie...
Article
Full-text available
According to former classification systems chronic myelomonocytic leukemia (CMML) is listed within myelodysplastic syndromes (MDS). Therefore data regarding treatment of CMML is largely derived from MDS trials. Two published studies suggest efficacy of lenalidomide in a proportion of patients with CMML, but the number of patients included was very...
Article
Introduction Ixazomib, a second generation proteasome inhibitor provides the advantage of combining oral administration with pronounced activity and a favorable toxicity profile. Phase II studies employing ixazomib-dexamethasone established a once weekly dosing regimen and showed substantial activity in RRMM yielding response rates of up to 58% whe...
Article
Background: Acute renal failure (ARF) is a frequent complication of multiple myeloma (MM) and most frequently due to clonotypic light chains (LC) causing cast nephropathy, which is associated with fast deterioration of renal function, increased risk for infections and shortened survival. Here we present the final results of a phase II study employi...
Article
Introduction Chronic myelomonocytic leukaemia (CMML) is a clonal disorder of a haematopoietic stem cell characterized by the presence of an absolute monocytosis in peripheral blood. CMML is a rare disease with an incidence of 0.5 to 3 per 100 000 per year with median survival of 12 to 20 months. Coexistence of myelodysplastic and myeloproliferative...
Article
Full-text available
We prospectively evaluated the activity and tolerance of lenalidomide-dexamethasone in 35 patients with acute light chain-induced renal failure. The lenalidomide dose was adapted to the estimated glomerular filtration rate and dexamethasone was given at high dose at cycle one and at low dose thereafter. Four patients died within the first 2 cycles,...
Article
Therapeutic options for patients with advanced pretreated soft tissue sarcomas are limited. However, in this setting, sorafenib has shown promising results. We reviewed the data of 33 patients with soft tissue sarcoma treated with sorafenib within a named patient program in Austria. Twelve physicians from eight different hospitals provided records...
Article
Purpose: The purpose of this retrospective analysis was to assess efficacy and tolerability of trabectedin in soft tissue sarcoma (STS) in the routine clinical setting. Patients and methods: Efficacy and safety data of trabectedin were retrospectively evaluated in patients with advanced STS who had started treatment with trabectedin at six insti...
Article
Current literature provides conflicting evidence regarding the efficacy of lenalidomide in patients with myelofibrosis (MF). The aim of this work was to evaluate the efficacy of lenalidomide in patients with MF treated within a named patient program in Austria. A total of 22 patients with MF were treated with lenalidomide in 7 different centres thr...
Article
Optimal treatment for patients suffering from gastrointestinal stromal tumors (GIST) is based on an interdisciplinary treatment approach. Austrian representatives of Medical and Surgical Oncology, Pathology, Radiology, Nuclear Medicine, Gastroenterology, and Laboratory Medicine issued this manuscript on a consensual base within the context of curre...
Article
Background: Enteropathy-associated T-cell lymphoma (EATCL) is an intraepithelial lymphocyte derived small intestinal lymphoma frequently associated with celiac disease. A variant of EATCL composed of CD56+ cells apparently does not arise against the genetic background of celiac disease, but shows the same poor outcome with most patients dying withi...
Article
Adequate treatment of gastrointestinal stromal tumors (GISTs) is linked to an interdisciplinary treatment approach. Austrian representatives of medical oncology, surgery, pathology, radiology and gastroenterology have issued this consensus manuscript within the context of currently available and published literature. The paper contains guidelines a...
Article
HEIBL C., TROMMET V., BURGSTALLER S., MAYRBAEURL B., BALDINGER C., KOPLMÜLLER R., KÜHR T., WIMMER L. & THALER J. (2010) European Journal of Cancer Care19, 676–681 Complications associated with the use of Port-a-Caths in patients with malignant or haematological disease: a single-centre prospective analysis Totally implantable central venous cathete...
Article
Die Diagnose und Behandlung von GIST bedarf eines interdisziplinären Ansatzes. Dieser Gedanken wiederspiegelt den Inhalt dieser Publikation. Österreichische Vertreter von für Diagnose und Behandlung von GIST Patienten relevanten Fachdisziplinen verfassten dieses Manuskript konsensuell. Die vorliegende Arbeit soll als Leitfaden für die in 'GIST invo...
Article
Die adjuvante Behandlung von GIST-Patienten mit 400 mg Imatinib/Tag verlängert das rezidivfreie Überleben signifikant. Das Rezidivrisiko wurde in den meisten der präsentierten Studien nach Fletcher [8] beurteilt. Eine Klassifizierung nach Miettinen [9] und Joensuu [10] und eine zusätzliche Berücksichtigung des Mutationsstatus könnten in Zukunft aus...
Article
Diagnosis and treatment of gastrointestinal stromal tumors (GIST) requires an interdisciplinary treatment approach. This strategy should be reflected by the content of this article. Austrian representatives of 'GIST relevant' specialties authored this publication on a consensual base. This manuscript should be regarded as a guideline for 'GIST invo...
Article
Adjuvant treatment of gastrointestinal stromal tumor (GIST) patients with Imatinib (400 mg/d) is associated with a statistically significant improvement of relapse-free survival. Risk of relapse has been determined according to Fletcher [8] in the majority of the mentioned trials. However, classification according to Miettinen [9] and Joensuu [10]...
Article
Full-text available
The aim of the study was to evaluate the feasibility and efficacy of an outpatient oxaliplatin/irinotecan chemotherapy in chemonaive patients suffering from unresectable gastric cancer. Biweekly oxaliplatin (85 mg/m2) and irinotecan (125 mg/m2) was chosen since it has been shown previously in colorectal cancer that oxaliplatin (85 mg/m2) is superio...
Article
7077 Background: Imatinib (IM) is widely used to treat CML. The Unmet Needs in CML study assessed real-life treatment of CML. Methods: This cross-sectional study, with retrospective chart review of patients currently treated for CML/Ph+ALL in 8 European countries (enrolled Sept 06-Mar 07), assessed proportions of IM-treated patients and those with...
Article
Imatinib is widely used for the treatment of chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL), and is associated with improved response rates in these patients. However, the management of patients who show resistance or intolerance to imatinib has been identified as an unmet need. The UNIC st...
Article
Current recommendations for patients with CML (Baccarani M, et al. Blood2006;108:1809–20) advocate regular treatment response monitoring, including evaluation of: cytogenetic response (CyR) at least every 6 months until complete CyR is achieved, then every 12 months; molecular response (MolR) every 3 months; mutational analysis in cases of failure/...
Article
4070 Background: There are only limited treatment options for advanced gastric cancer. Development of new treatment options is therefore warranted. The aim of this study was to evaluate the safety, feasibility and efficacy of an outpatient Oxaliplatin/Irinotecan combination in patients suffering from unresectable, locally advanced and/or metastatic...
Article
Full-text available
We describe the fusion of TP53BP1 to PDGFRB in a patient with a chronic myeloid leukemia-like disorder associated with eosinophilia and a t(5;15)(q33;q22). TP53BP1 encodes 53BP1, a p53-binding protein that plays a role in cellular responses to DNA damage. The 53BP1-PDGFRbeta fusion protein is predicted to retain the kinetochore-binding domain of 53...
Article
Full-text available
This multicentre phase I/II study was designed to determine the maximum tolerated dose of irinotecan when combined with 5-fluorouracil and folinic acid according to the Mayo Clinic schedule and to evaluate the activity of this combination as first-line therapy in patients with advanced colorectal cancer. Sixty-three patients received irinotecan (25...
Article
A real-time PCR technique with automated computerized analysis (TaqMan ) was tested to detect K-ras mutations in 66 patients suffering from NSCLC. This technology is characterized by high reproducibility of data and a time-saving analysis procedure. In 11% (7/66) of the tumour specimens and 2% (1/58) of adjacent tumour-free lung specimens a K-ras c...
Article
This multicenter randomized phase III study was designed to compare the efficacy and toxicity of IFN alpha-2c (3.5 MU/d) in combination with either araC (10 mg/m(2) d1-10) or hydroxyurea (HU: 25 mg/kg per day) in newly diagnosed CML patients. A total of 114 patients were randomized. Following a median observation period of 36 (range 1-73) months th...
Article
Expression of the catalytic subunit of the telomerase enzyme hTERT is essential for prolonging the replicative lifespan and is the rate-limiting step in cellular immortalization and carcinogenesis. Because hTERT expression is positively correlated with telomerase activity, its regulation is suggested as the major determinant of enzymatic activity....
Article
The present analysis was performed to evaluate the impact of cytosine arabinoside (ara-C) dose escalation on hematological and cytogenetic responses in patients with chronic myelogenous leukemia (CML) who failed to respond to low-dose ara-C (LD ara-C) at a dose of 10 mg/m2/d over 10 days per month and interferon-alpha (IFNalpha, 3.5 MU/d). Followin...
Article
The purpose of this study was to investigate the effects of interleukin-2 (IL-2) gene-transduced hematopoietic progenitor cells or cytotoxic function and systemic toxicity following syngeneic bone marrow transplantation. Marrow of 5-fluorouracil pretreated donor mice were transfected with a retroviral vector containing the murine IL-2 gene and tran...
Article
The efficacy of continuous oral cytarabine ocfosfate (YNK01) (300 mg/day) in combination with interferon alpha (IFNalpha, 5x10(6) IU/day) was evaluated in patients with advanced chronic myelogenous leukemia, who previously failed to respond to IFNalpha-based therapies. Dose escalations up to 900 mg YNK01 were allowed in patients who failed to respo...
Article
In a retrospective immunohistochemical study based on 27 patients with stage IV follicle center lymphoma (FCL) the expression of CD44standard (CD44s), LFA-1 (CD11a, CD18), VLA-4 (CD49d, CD29) and ICAM-1 (CD54) was analysed on lymphoma cells in bone marrow infiltrates. The results were correlated to clinical data and overall survival. Our data demon...
Article
Preclinical models and methods aimed at detecting and quantitating minimal residual disease (MRD) after autologous bone marrow transplantation (BMT) for acute myeloid leukemia (AML) could facilitate assessment of innovative therapeutic strategies for their antileukemic potential. Among the various techniques exploited to identify MRD, polymerase ch...
Article
Described here are 2 patients who developed thrombotic microangiopathy of the kidneys after receiving high cumulative doses of the new anticancer drug gemcitabine. The first patient, who received gemcitabine for treatment of a carcinoma of the pancreas, required hemodialysis for 6 months. In the second case, a woman suffering from a cholangiocellul...
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Full-text available
The telomere-telomerase hypothesis states that the vast majority of human tumors have a prolonged replicative life span throughout expressing telomerase, which compensates the cell division-associated loss of telomere DNA. The use of telomere length and telomerase expression as new biological markers in cancer patients requires their correlation wi...
Article
Despite advances in the development of myeloablative treatment strategies, relapse remains a major challenge after autologous bone marrow transplantation (ABMT) for acute leukemia, which can mainly be ascribed to the inadvertent reinfusion of occult residual tumor cells and absence of a graft versus leukemia effect. In an attempt to compensate for...
Article
In a prospective multicenter phase-II trial 80 patients with Philadelphia (Ph)-positive chronic myelogenous leukemia (CML) were treated with recombinant interferon (IFN) alpha-2c, administered subcutaneously at an absolute dose of 3.5 megaunits (MU)/day. Complete hematological remission was achieved in 29 (39%) and partial hematological remission i...
Article
 In a prospective multicenter phase-II trial 80 patients with Philadelphia (Ph)-positive chronic myelogenous leukemia (CML) were treated with recombinant interferon (IFN)α-2c, administered subcutaneously at an absolute dose of 3.5 megaunits (MU)/day. Complete hematological remission was achieved in 29 (39%) and partial hematological remission in 26...
Article
Considerable controversy exists concerning the role of aberrant MHC-class II antigen expression in the pathogenesis of organ-specific auto-immune disease. Since Obese strain (OS) chickens are afflicted with a spontaneously occurring autoimmune thyroiditis (SAT), we have readdressed this pivotal question by investigating the chronical appearance of...
Article
In a Phase II study, 82 patients with Philadelphia chromosome(Ph)-positive chronic myelogenous leukaemia were treated with 3.5 million I.U./d of recombinant interferon alpha-2c (rIFN). 73 patients have so far been evaluated (42 male, 31 female, mean age 50 [12-87] years). At the start of therapy, 10 were in the accelerated phase (group 1) and 63 in...
Article
Im Rahmen einer Phase-II-Studie wurden 82 Patienten mit Philadelphia-Chromosom (Ph)-positiver chronischer myeloischer Leukämie (CML) mit rekombinantem Interferon α-2c (rIFN) in einer Dosis von 3,5 Mio. I.E./d behandelt. Von bisher 73 Patienten mit auswertbaren Daten (42 Männer, 31 Frauen, mittleres Alter 50 [12-87] Jahre) befanden sich zu Therapieb...
Article
A variety of immunological, endocrinological, and virological abnormalities have been implicated in the etiopathogenesis of spontaneous autoimmune thyroiditis (SAT) of Obese strain (OS) chickens, e.g., a general T cell hyperreactivity, an increased uptake of iodine into the thyroid gland, a diminution of the glucocorticoid tonus, and an OS-specific...
Article
Development of organ-specific autoimmune diseases depends on both an abnormal immune regulation and a genetically determined primary susceptibility of the target organ to the autoimmune attack. In addition to the essential genetically determined prerequisites there are also facultative, modulating factors that influence the outcome of an autoimmune...

Citations

... These rates were particularly low compared to those observed in the registration trials, considering that around 50% and 60% of patients respectively treated with KRd and Kd had a prior history of cardiovascular conditions. Serious AE (SAEs) occurred in around 33% of patients in both groups, and 3% and 8% of them were fatal in the KRd and Kd groups, respectively (56). The occurrence of SAEs was lower than that observed in the ASPIRE (65%) and ENDEAVOR (60%) trials and was likely biased due to a lower frequency of SAEs in the observational trial than in the interventional trials, despite the similar rates of fatal events (ASPIRE not available; ENDEAVOR 7%). ...
... IFN-α was used for many years to treat hairy cell leukemia, 40 CML and myelofibrosis 41 ; it may still be resorted to alone or as adjunct therapy for CML patients resistant to multiple TKIs. 1 A recent paper reported deep molecular remission in four of nine CML patients treated with Imatinib plus Ropeginterferon-α2b, with few AE. 42 IFNs have also been suggested to enhance treatment with temozolomide by inhibiting the MGMT repair enzyme. 43 However, chromosome instability in AML has been shown to directly upregulate IFNstimulated genes, 44 suggesting that IFN itself will not be helpful in treatment. ...
... 88 A 2007 survey of American and European physicians who had treated at least 4 patients with CML reported that 60% of US-based respondents were unfamiliar with mutational testing or had never requested a test. 93 This underuse of mutational analysis in the management of patients with CML in clinical practice was also highlighted by Morra et al., 94 who found that 57% of patients with imatinib-resistant disease had not been assessed for mutations. ...
... A French phase II trial (17) showed superiority of the FOLFIRI-regimen (continuous 5-FU, leucovorin, irinotecan, originally developed for colorectal cancer) over leucovorin/5-FU with or without cisplatin. Also, for an irinotecan/ oxaliplatin combination, an Austrian phase II trial (18) showed a median survival of more than 9 months at low toxicity rates. However, these combinations have not been tested in randomized trials. ...
... In this cohort, only 11.4% of the patients experienced some response, with a reported median PFS of 2.6 months of and a median OS of 11.4 months. 17 In the most recently published real-word experience from multiple centers in England and Northern Ireland, the retrospective analysis of outcomes from 172 patients treated with Olaratumab and Doxorubicin revealed that only 21% of the patients had complete or partial response, whereas 33.7% had disease progression. The median PFS in this retrospective cohort was 6.8 months. ...
... Clinical experiences propose that dose-reduced lenalidomide can be safely and efficiently managed in the adjustment of renal failure [95]. The compound of lenalidomide and high-dose dexamethasone results in a quick decrease of pathogenic light chains [152]. Lenalidomide is also a probable choice in patients with mild-to-moderate renal failure and should be used at decreased doses based on renal function [148]. ...
... Ixazomib is also being investigated in combination with thalidomide-dexamethasone (Td) and pomalidomidedexamethasone (Pd). Preliminary findings from an ongoing phase II study of ixazomib-Td have shown an ORR of 61%, CBR of 68% and a PFS of 9.3 months [85]. Initial results of the ongoing studies utilizing ixazomib in combination with Pd also demonstrated good tolerability and a promising clinical activity. ...
... In both these combination studies, the lenalidomide starting dose was 10 mg by mouth daily and dose delays and modifications were not uncommon, suggesting that lenalidomide may be too toxic for some patients without marrow reserve. A contemporaneous phase 1 study of single-agent lenalidomide specifically in CMML patients was reported at the ASH annual meeting in 2014 and identified the maximum tolerated dose of lenalidomide as 5 mg by mouth daily [66]. Further studies are necessary in a focused CMML population to confirm the tolerability and efficacy of combination regimens with a reduced lenalidomide dose. ...
... The Austrian Consensus on systemic therapy in patients with gastric adenocarcinoma recommends more frequent assessment of MSI and PD-L1 status, as biomarker-selected patients benefit from checkpoint inhibition in a palliative setting [16,17]. ...
... For example, in patients with cancer, two doses of vaccine against seasonal influenza leads to higher immuno genicity than a single dose 89,90 . Similarly, two doses of vaccine against hepatitis B or herpes zoster 91 , three doses of vaccine against pneumococcal infection 92 , three doses of a recombinant subunit zoster vaccine 93 and four doses of an inactivated herpes zoster vaccine 85,94,95 lead to high seropositivity rates and acceptable levels of protection. This experience supports the idea that patients who are either immunocompromised or immunosuppressed might require more vaccine doses than those who are immunocompetent. ...