@article{HempelVelosodeOliveiraGaumannetal.2021, author = {Hempel, Louisa and Veloso de Oliveira, Julia and Gaumann, Andreas and Milani, Valeria and Schweneker, Katrin and Schenck, Kristina and Fleischmann, Bastian and Philipp, Patrick and Mederle, Stefanie and Garg, Arun and Piehler, Armin and Gandorfer, Beate and Schick, Cordula and Kleespies, Axel and Sellmann, Ludger and Bartels, Marius and Goetze, Thorsten O. and Stein, Alexander and Goekkurt, Eray and Pfitzner, Lucia and Robert, Sebastian and Hempel, Dirk}, title = {Landscape of Biomarkers and Actionable Gene Alterations in Adenocarcinoma of GEJ and Stomach - A Real World Data Analysis}, series = {Cancers}, volume = {13}, journal = {Cancers}, number = {17}, pages = {4453}, year = {2021}, abstract = {After several years of negative phase III trials in gastric and esophageal cancer, a significant breakthrough in the treatment of metastatic adenocarcinomas of the gastroesophageal junction (GEJ) and stomach (GC) is now becoming evident with the emerging of precision oncology and implementation of molecular targets in tumor treatment. In addition, new generation studies such as umbrella and basket trials are focused on these molecular targets, which makes an early molecular diagnosis based on IHC/ISH and NGS necessary. The required companion diagnostics of Her2neu overamplification or PD-L1 expression is based on immunohistochemistry (IHC) or additionally in situ hybridization (ISH) in case of an IHC Her2neu score of 2+. However, there are investigator-dependent differences in the assessment of Her2neu amplification and different PD-L1 scoring systems obtained by IHC/ISH. The use of high-throughput technologies such as next-generation sequencing (NGS) holds the potential to standardize the analysis and thus make them more comparable. In the presented study, real-world multigene sequencing data of 72 Caucasian patients diagnosed with metastatic adenocarcinomas of GEJ and stomach were analyzed. In the clinical companion diagnostics, we found ESCAT level I molecular targets in one-third of our patients, which directly determined the therapy. In addition, we found potential targets in 14/72 patients (19.4\%) who potentially qualify for precision therapies in corresponding molecular studies. The study highlights the importance of comprehensive molecular profiling for precision treatment of GEJ/GC and indicates that a biomarker evaluation should be performed for all patients with metastatic adenocarcinomas before the initiation of first-line treatment and during second-line or subsequent treatment.}, language = {en} } @article{HempelPiehlerPfaffletal.2020, author = {Hempel, Louisa and Piehler, Armin and Pfaffl, Michael W. and Molnar, Jakob and Kirchner, Benedikt and Robert, Sebastian and Veloso, Julia and Gandorfer, Beate and Trepotec, Zeljka and Mederle, Stefanie and Keim, Sabine and Milani, Valeria and Ebner, Florian and Schweneker, Katrin and Fleischmann, Bastian and Kleespies, Axel and Scheiber, Josef and Hempel, Dirk and Zehn, Dietmar}, title = {SARS-CoV-2 infections in cancer outpatients—Most infected patients are asymptomatic carriers without impact on chemotherapy}, series = {Cancer Medicine}, volume = {9}, journal = {Cancer Medicine}, number = {21}, pages = {8020 -- 8028}, year = {2020}, abstract = {Oncologic patients are regarded as the population most at risk of developing a severe course of COVID-19 due to the fact that malignant diseases and chemotherapy often weaken the immune system. In the face of the ongoing SARS-CoV-2 pandemic, how particular patients deal with this infection remains an important question. In the period between the 15 and 26 April 2020, a total of 1227 patients were tested in one of seven oncologic outpatient clinics for SARS-CoV-2, regardless of symptoms, employing RT-qPCR. Of 1227 patients, 78 (6.4\%) were tested positive of SARS-CoV-2. Only one of the patients who tested positive developed a severe form of COVID-19 with pneumonia (CURB-65 score of 2), and two patients showed mild symptoms. Fourteen of 75 asymptomatic but positively tested patients received chemotherapy or chemo-immunotherapy according to their regular therapy algorithm (±4 weeks of SARS-CoV-2 test), and 48 of 78 (61.5\%) positive-tested patients received glucocorticoids as co-medication. None of the asymptomatic infected patients showed unexpected complications due to the SARS-CoV-2 infection during the cancer treatment. These data clearly contrast the view that patients with an oncologic disease are particularly vulnerable to SARS-CoV-2 and suggest that compromising therapies could be continued or started despite the ongoing pandemic. Moreover the relatively low appearance of symptoms due to COVID-19 among patients on chemotherapy and other immunosuppressive co-medication like glucocorticoids indicate that suppressing the response capacity of the immune system reduces disease severity.}, language = {en} }