HIV-assoziierte Malignome

Kaposi's sarcoma (KS), Non-Hodgkin's lymphma (NHL) and invasive cervical cancer are considered AIDS-defining malignancies. The incidence of Kaposi's sarcoma has recently been increased as a secondary manifestation of AIDS. The pathogenesis is not completely understood. Human herpesvirus 8 could be identified as an infectious cofactor. Therapeutic strategies should be based on prognostic factors and tailored to the patient's individual situation. Local treatments widely used are cryotherapy or radiotherapy. Systemic therapies such as interferon-alpha. or single and multiagent chemotherapy are also well established. Based on their high response rates and favorable toxicity profile, liposome-encapsulated anthracyclines may be considered first-line therapy for advanced AIDS-related KS. HIV-associated NHL may increase in frequency as HIV-infected individuals survive longer with improved antiretroviral therapy. There is no advantage for intensive as compared with standard or less intensive chemotherapeutic regimens of the CHOP type. Complete remissions can be achieved in approximately 50% of the patients, but the recurrence rate is high. The therapeutic strategy should include an optimal supportive care and antiretroviral treatment because chemotherapy significantly increases the risk of opportunistic infection. In urban populations at risk, cervical cancer is a common AIDS-related malignancy in women. Patients with cervical carcinoma usually have a more aggressive and more advanced disease. Various malignant diseases, such as Hodgkin's lymphoma, anal cancer or seminoma in patients with AIDS occur at higher frequency in HIV infection

Immunoblotting for the serodiagnosis of alveolar echinococcosis in alive and dead Eurasian beavers (Castor fiber)

A novel species-specific anti-beaver-IgG-alkaline-phosphatase conjugate was synthesized for the development of a new serological test for echinococcosis in beavers. Two different ELISAs conventionally used for human Echinococcus multilocularis serology (Em18-ELISA and Em2-ELISA) yielded diagnostic sensitivities of 0% and 46%, respectively. In contrast, the subsequently developed immunoblotting assay gave an 85% diagnostic sensitivity (11 out of 13 beavers with alveolar echinococcosis were immunoblotting-positive, i.e. showed reactivity with a specific 21 Mr band), and maximal specificity. In conclusion, this immunoblotting assay should be the method of choice for use in serological studies on E. multilocularis in Eurasian beavers, and the test proved suitable to investigate both animals alive and post-mortem

Prime movers : mechanochemistry of mitotic kinesins

Mitotic spindles are self-organizing protein machines that harness teams of multiple force generators to drive chromosome segregation. Kinesins are key members of these force-generating teams. Different kinesins walk directionally along dynamic microtubules, anchor, crosslink, align and sort microtubules into polarized bundles, and influence microtubule dynamics by interacting with microtubule tips. The mechanochemical mechanisms of these kinesins are specialized to enable each type to make a specific contribution to spindle self-organization and chromosome segregation

Solve-RD: systematic pan-European data sharing and collaborative analysis to solve rare diseases

For the first time in Europe hundreds of rare disease (RD) experts team up to actively share and jointly analyse existing patient’s data. Solve-RD is a Horizon 2020-supported EU flagship project bringing together >300 clinicians, scientists, and patient representatives of 51 sites from 15 countries. Solve-RD is built upon a core group of four European Reference Networks (ERNs; ERN-ITHACA, ERN-RND, ERN-Euro NMD, ERN-GENTURIS) which annually see more than 270,000 RD patients with respective pathologies. The main ambition is to solve unsolved rare diseases for which a molecular cause is not yet known. This is achieved through an innovative clinical research environment that introduces novel ways to organise expertise and data. Two major approaches are being pursued (i) massive data re-analysis of >19,000 unsolved rare disease patients and (ii) novel combined -omics approaches. The minimum requirement to be eligible for the analysis activities is an inconclusive exome that can be shared with controlled access. The first preliminary data re-analysis has already diagnosed 255 cases form 8393 exomes/genome datasets. This unprecedented degree of collaboration focused on sharing of data and expertise shall identify many new disease genes and enable diagnosis of many so far undiagnosed patients from all over Europe

Predicting Outcomes in Men With Metastatic Nonseminomatous Germ Cell Tumors (NSGCT): Results From the IGCCCG Update Consortium

Purpose: The classification of the International Germ Cell Cancer Collaborative Group (IGCCCG) plays a pivotal role in the management of metastatic germ cell tumors but relies on data of patients treated between 1975 and 1990. Materials and methods: Data on 9,728 men with metastatic nonseminomatous germ cell tumors treated with cisplatin- and etoposide-based first-line chemotherapy between 1990 and 2013 were collected from 30 institutions or collaborative groups in Europe, North America, and Australia. Clinical trial and registry data were included. Primary end points were progression-free survival (PFS) and overall survival (OS). The survival estimates were updated for the current era. Additionally, a novel prognostic model for PFS was developed in 3,543 patients with complete information on potentially relevant variables. The results were validated in an independent data set. Results: Compared with the original IGCCCG publication, 5-year PFS remained similar in patients with good prognosis with 89% (87%-91%) versus 90% (95% CI, 89 to 91), but the 5-year OS increased from 92% (90%-94%) to 96% (95%-96%). In patients with intermediate prognosis, PFS remained similar with 75% (71%-79%) versus 78% (76%-80%) and the OS increased from 80% (76%-84%) to 89% (88%-91%). In patients with poor prognosis, the PFS increased from 41% (95% CI, 35 to 47) to 54% (95% CI, 52 to 56) and the OS from 48% (95% CI, 42 to 54) to 67% (95% CI, 65 to 69). A more granular prognostic model was developed and independently validated. This model identified a new cutoff of lactate dehydrogenase at a 2.5 upper limit of normal and increasing age and presence of lung metastases as additional adverse prognostic factors. An online calculator is provided (https://www.eortc.org/IGCCCG-Update). Conclusion: The IGCCCG Update model improves individual prognostication in metastatic nonseminomatous germ cell tumors. Increasing age and lung metastases add granularity to the original IGCCCG classification as adverse prognostic factors

Phase II study of weekly oxaliplatin plus infusional fluorouracil and folinic acid (FUFOX regimen) as first-line treatment in metastatic gastric cancer

Oxaliplatin plus fluorouracil/folinic acid (5-FU/FA) every 2 weeks has shown promising activity in advanced gastric cancer. This study assessed the efficacy and safety of weekly oxaliplatin plus 5-FU/FA (FUFOX regimen) in the metastatic setting. Patients with previously untreated metastatic gastric cancer received oxaliplatin (50 mg m−2) plus FA (500 mg m−2, 2-h infusion) followed by 5-FU (2000 mg m−2, 24-h infusion) given on days 1, 8, 15 and 22 of a 5-week cycle. The primary end point of this multicentre phase II study was the response rate according to RECIST criteria. A total of 48 patients were enrolled. Median age was 62 years and all patients had metastatic disease, with a median number of three involved organs. The most common treatment-related grade 3/4 adverse events were diarrhoea (17%), deep vein thrombosis (15%), neutropenia (8%), nausea (6%), febrile neutropenia (4%), fatigue (4%), anaemia (4%), tumour bleeding (4%), emesis (2%), cardiac ischaemia (2%) and pneumonia (2%). Grade 1/2 sensory neuropathy occurred in 67% of patients but there were no episodes of grade 3 neuropathy. Intent-to-treat analysis showed a response rate of 54% (95% CI, 39–69%), including two complete responses. At a median follow-up of 18.1 months (range 11.2–26.2 months), median survival is 11.4 months (95% CI, 8.0–14.9 months) and the median time to progression is 6.5 months (95% CI, 3.9–9.2 months). The weekly FUFOX regimen is well tolerated and shows notable activity as first-line treatment in metastatic gastric cancer

Majorana quantization and half-integer thermal quantum Hall effect in a Kitaev spin liquid

The quantum Hall effect (QHE) in two-dimensional (2D) electron gases, which is one of the most striking phenomena in condensed matter physics, involves the topologically protected dissipationless charge current flow along the edges of the sample. Integer or fractional electrical conductance are measured in units of $e^2/2\pi\hbar$, which is associated with edge currents of electrons or quasiparticles with fractional charges, respectively. Here we discover a novel type of quantization of the Hall effect in an insulating 2D quantum magnet. In $\alpha$-RuCl$_3$ with dominant Kitaev interaction on 2D honeycomb lattice, the application of a parallel magnetic field destroys the long-range magnetic order, leading to a field-induced quantum spin liquid (QSL) ground state with massive entanglement of local spins. In the low-temperature regime of the QSL state, we report that the 2D thermal Hall conductance $\kappa_{xy}^{2D}$ reaches a quantum plateau as a function of applied magnetic field. $\kappa_{xy}^{2D}/T$ attains a quantization value of $(\pi/12)(k_B^2/\hbar)$, which is exactly half of $\kappa_{xy}^{2D}/T$ in the integer QHE. This half-integer thermal Hall conductance observed in a bulk material is a direct signature of topologically protected chiral edge currents of charge neutral Majorana fermions, particles that are their own antiparticles, which possess half degrees of freedom of conventional fermions. These signatures demonstrate the fractionalization of spins into itinerant Majorana fermions and $Z_2$ fluxes predicted in a Kitaev QSL. Above a critical magnetic field, the quantization disappears and $\kappa_{xy}^{2D}/T$ goes to zero rapidly, indicating a topological quantum phase transition between the states with and without chiral Majorana edge modes. Emergent Majorana fermions in a quantum magnet are expected to have a major impact on strongly correlated topological quantum matter.Comment: 7 pages, 8 figures. Submitted versio