Measurement of e⁺e⁻-->e⁺e⁻ and e⁺e⁻-->gammagamma at energies up to 36.7 GeV

e+e- +- +- ... + e e und e e + yy wurden bel Energlen zwischen 33.0 und 36.7 GeV gemessen. Die Ergebnisse stimmen mit den Vorhersagen der Quantenelektrodynamik überein. Ein Vergleich mit dem Standardmodell der elektroschwachen Wechselwirkung liefert sin 20w= 0.25 ± 0.13

Detection of circulating tumor cells using manually performed immunocytochemistry (MICC) does not correlate with outcome in patients with early breast cancer – Results of the German SUCCESS-A- trial

Background: Recently, the prognostic significance of circulating tumor cells (CTCs) in primary breast cancer as assessed using the Food-and-Drug-Administration-approved CellSearch® system has been demonstrated. Here, we evaluated the prognostic relevance of CTCs, as determined using manually performed immunocytochemistry (MICC) in peripheral blood at primary diagnosis, in patients from the prospectively randomized multicenter SUCCESS-A trial (EudraCT2005000490-21). Methods: We analyzed 23 ml of blood from 1221 patients with node-positive or high risk node-negative breast cancer before adjuvant taxane-based chemotherapy. Cells were separated using a density gradient followed by epithelial cell labeling with the anti-cytokeratin-antibody A45-B/B3, immunohistochemical staining with new fuchsin, and cytospin preparation. All cytospins were screened for CTCs, and the cutoff for positivity was at least one CTC. The prognostic value of CTCs with regard to disease-free survival (DFS), distant disease-free survival (DDFS), breast-cancer-specific survival (BCSS), and overall survival (OS) was assessed using both univariate analyses applying the Kaplan–Meier method and log-rank tests, and using multivariate Cox regressions adjusted for other predictive factors. Results: In 20.6% of all patients (n = 251) a median of 1 (range, 1–256) CTC was detected, while 79.4% of the patients (n = 970) were negative for CTCs before adjuvant chemotherapy. A pT1 tumor was present in 40.% of patients, 4.8% had G1 grading and 34.6% were node-negative. There was no association between CTC positivity and tumor stage, nodal status, grading, histological type, hormone receptor status, Her2 status, menopausal status or treatment. Univariate survival analyses based on a median follow-up of 64 months revealed no significant differences between CTC-positive and CTC-negative patients with regard to DFS, DDFS, BCSS, or OS. This was confirmed by fully adjusted multivariate Cox regressions, showing that the presence of CTCs (yes/no) as assessed by MICC did not predict DFS, DDFS, BCSS or OS. Conclusions: We could not demonstrate prognostic relevance regarding CTCs that were quantified using the MICC method at the time of primary diagnosis in our cohort of early breast cancer patients. Further studies are necessary to evaluate if the presence of CTCs assessed using MICC has prognostic relevance, or can be used for risk stratification and treatment monitoring in adjuvant breast cancer. Trial registration The ClinicalTrial.gov registration ID of this prospectively randomized trial is NCT02181101; the (retrospective) registration date was June 2014 (study start date September 2005)

Tumor Characteristics and Prognostic Factors in Nodal Positive Early Stage Breast Cancer of Obese Patients - Sub Analysis of the German ADEBAR Study

Abstract Background: Obesity is often associated with an increased risk of dying from breast cancer and poor outcomes of therapy. There are several possible explanations for this phenomenon. The aim of this analysis was to examine the correlation and potential causality between overweight, obesity and breast cancer. Tumor size, tumor histology, tumor grading and tumor localisation, number of positive lymph nodes, patients age, menopausal status, hormone receptor and HER-2 status are relevant characteristics in prognosis and treatment of breast cancer and at the same time potentially strongly associated with the body mass index. Patients and Methods: The ADEBAR study is a german multicenter phase III trial (n=1502). Study-goal was to evaluate whether breast cancer (BC) pts with &amp;gt; 3 axillarylymph node metastases benefit from a sequential anthracycline-docetaxel regimen (E90C-D: 4 cycles epirubicin [E] 90 mg/m2 plus cyclophosphamide [C] 600 mg/m2 q21 days followed by 4 cycles docetaxel [D] 100mg/m2 q21 days) compared to dose-intensive anthracycline-containing polychemotherapy (FE120C: 6 cycles E 60 mg/m2 d 1+8, 5-FU 500mg/m2 d 1+8 and C 75 mg/m2 d 1-14, q4 weeks). For our evaluation at hand Adebar-Patients were grouped according the WHO global database on body mass index (BMI) into normal range (18,50 - 24,99 kg/sqm) and obese (≤30,00 kg/sqm) high risk patients. Results: There is a strong correlation between body mass index, age and menopausal status at clinical diagnosis of breast cancer. Obese patients (n=300) at diagnosis in median are 55 years old (range 27-71 year) and already postmenopausal (52%, n=209). This analysis shows no connection of tumor localisation (unilateral left or right and bilateral breast cancer) and BMI.The tumor size at clinical diagnosis was strongly associated to the patient's weight (&amp;lt;0.0001). Breast tumors in obese patients have shown a size &amp;gt;3cm in 61 % (n=184) and a size &amp;gt;5cm in 16% (n=47). In normal weight and obese patients there was no sign for a significant difference in the number of positive lymph nodes (p=0.0440), tumor histology (p=0.8028) and grading (p=0.7353). Breast Cancer positivity for ER and PR hormone receptors (ER p=0.7364, PR p=0.4405) and the expression of HER-2 at the tumor surface (p=0.1560) were not significant associated to obesity in study patients. Conclusion: Our sub analysis between normal weight and obese patients shows a highly significant coherence between body mass index and tumor size in patients with early stage node positive breast cancer.This finding is in line with current publications which show that overweight and obese woman have often been diagnosed at a more advanced stage of disease and the treatment in this patients being less effective as a consequence. Weight reduction and tumor prevention in this high risk collective might be an additional approach on breast cancer therapy. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-11-06.</jats:p

Gemcitabine as adjuvant chemotherapy in patients with high-risk early breast cancer—results from the randomized phase III SUCCESS-A trial

Background!#!When chemotherapy is indicated in patients with early breast cancer, regimens that contain anthracyclines and taxanes are established standard treatments. Gemcitabine has shown promising effects on the response and prognosis in patients with metastatic breast cancer. The SUCCESS-A trial (NCT02181101) examined the addition of gemcitabine to a standard chemotherapy regimen in high-risk early breast cancer patients.!##!Methods!#!A total of 3754 patients with at least one of the following characteristics were randomly assigned to one of the two treatment arms: nodal positivity, tumor grade 3, age ≤ 35 years, tumor larger than 2 cm, or negative hormone receptor status. The treatment arms received either three cycles of 5-fluorouracil, epirubicin, and cyclophosphamide, followed by three cycles of docetaxel (FEC → Doc); or three cycles of FEC followed by three cycles of docetaxel and gemcitabine (FEC → Doc/Gem). The primary study aim was disease-free survival (DFS), and the main secondary objectives were overall survival (OS) and safety.!##!Results!#!No differences were observed in the 5-year DFS or OS between FEC → Doc and FEC → Doc/Gem. The hazard ratio was 0.93 (95% CI, 0.78 to 1.12; P = 0.47) for DFS and 0.94 (95% CI, 0.74 to 1.19; P = 0.60) for OS. For patients treated with FEC → Doc and FEC → Doc/Gem, the 5-year probabilities of DFS were 86.6% and 87.2%, and the 5-year probabilities of OS were 92.8% and 92.5%, respectively.!##!Conclusion!#!Adding gemcitabine to a standard chemotherapy does not improve the outcomes in patients with high-risk early breast cancer and should therefore not be included in the adjuvant treatment setting.!##!Trial registration!#!Clinicaltrials.gov NCT02181101 and EU Clinical Trials Register EudraCT 2005-000490-21. Registered September 2005