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Background: We analyzed whether co-occurring mutations influence the outcome of systemic therapy in ALK-rearranged non-small-cell lung cancer (NSCLC).
Patients and methods: ALK-rearranged stage IIIB/IV NSCLC patients were analyzed with next-generation sequencing and fluorescence in situ hybridization analyses on a centralized diagnostic platform. Median progression-free survival (PFS) and overall survival (OS) were determined in the total cohort and in treatment-related sub-cohorts. Cox regression analyses were carried out to exclude confounders.
Results: Among 216 patients with ALK-rearranged NSCLC, the frequency of pathogenic TP53 mutations was 23.8%, while other co-occurring mutations were rare events. In ALK/TP53 co-mutated patients, median PFS and OS were significantly lower compared with TP53 wildtype patients [PFS 3.9 months (95% CI: 2.4–5.6) versus 10.3 months (95% CI: 8.6–12.0), P < 0.001; OS 15.0 months (95% CI: 5.0–24.9) versus 50.0 months (95% CI: 22.9–77.1), P = 0.002]. This difference was confirmed in all treatment-related subgroups including chemotherapy only [PFS first-line chemotherapy 2.6 months (95% CI: 1.3–4.1) versus 6.2 months (95% CI: 1.8–10.5), P = 0.021; OS 2.0 months (95% CI: 0.0–4.6) versus 9.0 months (95% CI: 6.1–11.9), P = 0.035], crizotinib plus chemotherapy [PFS crizotinib 5.0 months (95% CI: 2.9–7.2) versus 14.0 months (95% CI: 8.0–20.1), P < 0.001; OS 17.0 months (95% CI: 6.7–27.3) versus not reached, P = 0.049] and crizotinib followed by next-generation ALK-inhibitor [PFS next-generation inhibitor 5.4 months (95% CI: 0.1–10.7) versus 9.9 months (95% CI: 6.4–13.5), P = 0.039; OS 7.0 months versus 50.0 months (95% CI: not reached), P = 0.001).
Conclusions: In ALK-rearranged NSCLC co-occurring TP53 mutations predict an unfavorable outcome of systemic therapy. Our observations encourage future research to understand the underlying molecular mechanisms and to improve treatment outcome of the ALK/TP53 co-mutated subgroup.
Internationale sprachwissenschaftliche Konferenz "Korpuslinguistik Deutsch-Tschechisch kontrastiv" in Sambachshof und Würzburg, 06.-08. Oktober 2009 (Iva Kratochvílová, Norbert Richard Wolf)
"Tschechen und Deutsche im 20. und 21. Jahrhundert. Neue Sichtweisen auf alte Probleme." Deutsch-tschechisches Seminar in Sankelmark, 09.-11. Oktober 2009 (Jarmila Jehličková)
Von der Grenze zum Dazwischen. Ein tschechisch-österreichisches Projekt zur Grenze und der Veränderung ihrer Wahrnehmung in Wien, 9.-11. November 2009 und Brünn 7.-10. Dezember 2009 (Michaela Kropik, Katharina Wessely)
Bericht über den V. Germanisten-Kongress in Sevilla, 16.-18. Dezember 2009 (Fernando Magallanes)
Bericht über die Linguistik-Tage in Freiburg im Breisgau, 02.-04. März 2010 (Martin Lachout)
Sprachliches Wissen zwischen Lexikon und Grammatik. Bericht über die 46. Jahrestagung des Instituts für Deutsche Sprache in Mannheim, 09.-11. März 2010 (Veronika Kotůlková)
"Mittlerin aus Europas Mitte" – 3. MGV-Kongress in Wien, 08.-10. April 2010 (Manfred Glauniger)
"Gedichte und Geschichte – Zur poetischen und politischen Rede in Österreich". Tagung der Franz Werfel-Stipendiaten und –Stipendiatinnen in Wien, 16.–17. April 2010 (Roman Kopřiva)
Binationales Kolloquium zur Problematik der Migrationsformen im 20. und 21. Jahrhundert in Geschichte und Kunst in Ústí nad Labem, 22.-24. März 2010 und Linz 04.-07. Mai 2010 (Jarmila Jehličková)
Ein "hinternationaler" Schriftsteller aus Böhmen: Dritte internationale Johannes-Urzidil-Konferenz in Ústí nad Labem, 05.-08. Mai 2010 (Vera Schneider)
"Wir sind Tschechinnen, wir schreiben Deutsch!" – Öffentliche Gesprächsrunde mit deutschsprachigen Autorinnen in Prag, 13. Mai 2010 (Jenifer Johanna Becker)
"Überkreuzungen. Verhandlungen kultureller, ethnischer, religiöser und geschlechtlicher Identitäten in österreichischer Literatur und Kultur." MALCA-Tagung in Wien, 22.-25. Mai 2010 (Daniela Drobna, Katharina Haderer, Natalie Lamprecht, Friedrich Teutsch, Esther Wratschko)
Pathogenic variants in PRRT2, encoding the proline-rich transmembrane protein 2, have been associated with an evolving spectrum of paroxysmal neurologic disorders. Based on a cohort of children with PRRT2-related infantile epilepsy, this study aimed at delineating the broad clinical spectrum of PRRT2-associated phenotypes in these children and their relatives. Only a few recent larger cohort studies are on record and findings from single reports were not confirmed so far. We collected detailed genetic and phenotypic data of 40 previously unreported patients from 36 families. All patients had benign infantile epilepsy and harbored pathogenic variants in PRRT2 (core cohort). Clinical data of 62 family members were included, comprising a cohort of 102 individuals (extended cohort) with PRRT2-associated neurological disease. Additional phenotypes in the cohort of patients with benign sporadic and familial infantile epilepsy consist of movement disorders with paroxysmal kinesigenic dyskinesia in six patients, infantile-onset movement disorders in 2 of 40 individuals, and episodic ataxia after mild head trauma in one girl with bi-allelic variants in PRRT2. The same girl displayed a focal cortical dysplasia upon brain imaging. Familial hemiplegic migraine and migraine with aura were reported in nine families. A single individual developed epilepsy with continuous spikes and waves during sleep. In addition to known variants, we report the novel variant c.843G>T, p.(Trp281Cys) that co-segregated with benign infantile epilepsy and migraine in one family. Our study highlights the variability of clinical presentations of patients harboring pathogenic PRRT2 variants and expands the associated phenotypic spectrum.
Objective: Nationwide data on the epidemiology, treatment characteristics, and long-term outcome of severe traumatic brain injury (TBI) in Germany is not yet existing. Neurosurgeons from the German Neurosurgery Society (DGNC) and traumatologists from the German Trauma Society (DGU), therefore, joined forces in 2016 to conceptualize a TBI module for the well-established Trauma Register of the DGU (TR-DGU). Here, we report how this “German National TBI registry (GNTR)” has been developed, implemented, and tested in a recently completed pilot period.
Methods: The conception and implementation process of the GNTR from August 2016 to February 2019 is described, and results of its 23-months long pilot period from February 2019 to December 2020 are presented. For the pilot period, TBI patients were prospectively enrolled at nine neurosurgical and traumatological hospitals across Germany. Inclusion criteria were treatment on the ICU ≥ 24h, or an ISS score ≥ 16. A variety of clinical, imaging, and laboratory parameters were collected, and the GOSE score was used to assess the outcome at discharge and 6- and 12 months follow-up.
Results: Details on the structure and dataset of the GNTR as well as milestones and pitfalls during its conception and implementation, are outlined. During the pilot period, a total of 264 TBI patients were enrolled. Their demographic characteristics, clinical, imaging, and radiological findings, and their early mortality and functional outcome are described. Furthermore, factors associated with an unfavorable outcome (GOSE 1-4) are assessed using uni- and multivariate regression analyses. Finally, problems and future directions of the GNTR are discussed.
Conclusion: The pilot period of the GNTR offers a first glance at the current epidemiology and treatment characteristics of TBI patients in Germany. More importantly, they show how a national TBI registry yielding high-quality prospective data can be developed, implemented, and tested within four years