Trastuzumab treatment of patients with early, HER2-positive breast cancer in 17 certified German breast cancer centers.

PURPOSE: Since 2008, guidelines recommend that patients with HER2-positive early breast cancer (BC) should receive adjuvant chemotherapy in combination with trastuzumab in Germany. However, recent studies highlight that a substantial share of patients do not receive trastuzumab. We investigate which patient characteristics are associated with a tumor board recommendation for trastuzumab in Breast Cancer Centers (BCC) certified by the German Cancer Society (DKG) and the German Society for Senology, and if the recommendation differs between BCCs. MATERIALS AND METHODS: Multi-level modeling was performed using quality assurance data based on 3052 HER2-positive, operated patients with a first diagnosis of early BC treated between 2006 and 2019 in 17 BCCs in Germany to investigate whether trastuzumab recommendation varies with patient sex, age, and disease characteristics, as well as over time and across BCCs. RESULTS: Tumor board recommendations for trastuzumab differ substantially between BCCs (intraclass correlation coefficient [ICC] null model: 0.11). Our final model (ICC 0.17, Akaike Information Criterion [AIC], 1328.0, R2 0.69) shows that physicians in BCCs more often recommend trastuzumab to patients who are younger than 60 years and those with a recommendation for any additional therapy (chemotherapy, radiation or endocrine therapy) (all p < 0.05). Furthermore, there is a significant time-dependent increase of trastuzumab recommendations (odds ratio [OR] = 1.38, 95% confidence interval [CI] = 1.31-1.46, p < 0.05). CONCLUSION: In certified BCCs in Germany, guideline concordant trastuzumab recommendation is increasing since 2006 (positive cohort effect). Recommendation of trastuzumab for HER2-positive BC patients in BCCs is significantly associated with patients' age and the recommendations for other additional therapy strategies, apart from surgery. The quality assurance data analyzed do not include potentially relevant confounders, such as socioeconomic status or comorbidities.

Electronic excitation of transition metal nitrides by light ions with keV energies.

We investigated the specific electronic energy deposition by protons and He ions with keV energies in different transition metal nitrides of technological interest. Data were obtained from two different time-of-flight ion scattering setups and show excellent agreement. For protons interacting with light nitrides, i.e. TiN, VN and CrN, very similar stopping cross sections per atom were found, which coincide with literature data of N2 gas for primary energies ⩽25 keV. In case of the chemically rather similar nitrides with metal constituents from the 5th and 6th period, i.e. ZrN and HfN, the electronic stopping cross sections were measured to exceed what has been observed for molecular N2 gas. For He ions, electronic energy loss in all nitrides was found to be significantly higher compared to the equivalent data of N2 gas. Additionally, deviations from velocity proportionality of the observed specific electronic energy loss are observed. A comparison with predictions from density functional theory for protons and He ions yields a high apparent efficiency of electronic excitations of the target for the latter projectile. These findings are considered to indicate the contributions of additional mechanisms besides electron hole pair excitations, such as electron capture and loss processes of the projectile or promotion of target electrons in atomic collisions.

Aggregation of Au(i)-complexes on amorphous substrates governed by aurophilicity.

In single crystals of 2-naphthylisonitrile-gold(i)-halide (halide = Cl, Br, I) complexes, AuAu distances are found to be significantly shorter than twice the van der Waals radius, indicating attractive interactions between gold atoms in adjacent molecules. In the particular case of the studied 2-naphthylisonitrile-gold(i) complexes, homodimers are the common structural motifs, in which the linearly coordinated gold exhibits a crossed swords arrangement with the Au atoms of two molecules being at the intersection point. The crossed swords motif is preserved upon physical vapour deposition of both the chlorine and bromine derivatives on amorphous substrates like glass and glassy carbon. The determined activation energies of desorption for the chlorine (0.9 eV) and the bromine (1.2 eV) derivative are comparable to that of unsubstituted naphthalene. Using X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and ion scattering (RBS), we confirmed the chemical integrity of the molecules in thin films and revealed the orientation of the crossed swords dimers with respect to the substrate surface.

On the Z1-dependence of electronic stopping in TiN.

We present a thorough experimental study of electronic stopping of H, He, B, N, Ne and Al ions in TiN with the aim to learn about the energy loss mechanisms of slow ions. The energy loss was measured by means of time-of-flight medium-energy ion scattering. Thin films of TiN on silicon with a δ-layer of W at the TiN/Si interface were used as targets. We compare our results to non-linear density functional theory calculations, examining electron-hole pair excitations by screened ions in a free electron gas in the static limit, with a density equivalent to the expected value for TiN. These calculations predict oscillations in the electronic stopping power for increasing atomic number Z1 of the projectile. An increasing discrepancy between our experimental results and predictions by theory for increasing Z1 was observed. This observation can be attributed to contributions from energy loss channels different from electron-hole pair excitation in binary Coulomb collisions.

The effects of short-term fasting on quality of life and tolerance to chemotherapy in patients with breast and ovarian cancer: a randomized cross-over pilot study.

BACKGROUND: This pilot trial aimed to study the feasibility and effects on quality of life (QOL) and well-being of short-term fasting (STF) during chemotherapy in patients with gynecological cancer. METHODS: In an individually-randomized cross-over trial patients with gynecological cancer, 4 to 6 planned chemotherapy cycles were included. Thirty-four patients were randomized to STF in the first half of chemotherapies followed by normocaloric diet (group A;n = 18) or vice versa (group B;n = 16). Fasting started 36 h before and ended 24 h after chemotherapy (60 h-fasting period). QOL was assessed by the FACIT-measurement system. RESULTS: The chemotherapy-induced reduction of QOL was less than the Minimally Important Difference (MID; FACT-G = 5) with STF but greater than the MID for non-fasted periods. The mean chemotherapy-induced deterioration of total FACIT-F was 10.4 ± 5.3 for fasted and 27.0 ± 6.3 for non-fasted cycles in group A and 14.1 ± 5.6 for non-fasted and 11.0 ± 5.6 for fasted cycles in group B. There were no serious adverse effects. CONCLUSION: STF during chemotherapy is well tolerated and appears to improve QOL and fatigue during chemotherapy. Larger studies should prove the effect of STF as an adjunct to chemotherapy. TRIAL REGISTRATION: This trial was registered at clinicaltrials.gov: NCT01954836 .