ABC3 Consensus Commented from the Perspective of the German Guidelines: Third International Consensus Conference for Advanced Breast Cancer (ABC3), Lisbon, 07. 11. 2015.

The Third International Consensus Conference for Advanced Breast Cancer ABC3 on the diagnosis and treatment of advanced breast cancer was held in Lisbon from 5 to 7 November 2015. This year the focus was the treatment of metastatic breast cancer (stage IV) - including the patient perspectives. Important topics were questions relating to quality of life, the care for long-term survivors as well as the management of disease-related symptoms and treatment-based side effects. The use of standardised tools to assess individual treatment success and the benefits of new substances were important points for discussion. The diagnosis and treatment of inoperable locally advanced breast cancer were discussed two years ago during the ABC2 consensus 1. A working group of German breast cancer experts commented on the results of the ABC panellists, paying particular attention to the German guidelines (AGO, S3, DGHO) on the diagnosis and treatment of breast cancer 2, 3, 4, 5 in Germany.

Discontinuation and non-adherence to endocrine therapy in breast cancer patients: is lack of communication the decisive factor?

INTRODUCTION: Non-adherence to anti-hormonal therapy is a major problem in gynecologic oncology. Reasons reported are side effects and lack of support. The aim of our study was an analysis of influence of experiences of patients with endocrine therapy and communication and information on this topic and their influence on adherence. METHODS: We developed a structured questionnaire which was tested in a pilot version and then programmed as online questionnaire and presented to patient members of self-help and breast cancer organizations. RESULTS: Patients only had received scarce information on endocrine therapy. Only 12.8% stated that their questions were answered in detail, 43.2% got no answers or only non-detailed answers. 76% had side effects limiting functions of daily life. 60% of physicians did not react on these side effects. There is a significant correlation between number and intensity of side effects and non-adherence or disruption of therapy (p = 0.029 and p < 0.01, respectively). Women who reported having received detailed answers to their questions also reported better adherence (p = 0.014). CONCLUSION: In order to improve adherence, detailed information on side effects and answers in case of symptoms are most important. Physicians should not rely on presenting written information but should mainly engage in direct communication.

CEOP-IMVP-Dexa in the treatment of aggressive lymphomas: an Austrian multicenter trial.

PURPOSE: This trial evaluated the efficacy, toxicity, and practicability of a new intensive chemotherapy regimen in a multicenter setting of university and community hospitals. PATIENTS AND METHODS: We tested a hybrid protocol of two non-cross-resistant regimens, cyclophosphamide, epirubicin, vincristine, and prednisolone (CEOP) and ifosfamide, etoposide (VP-16), methotrexate, and dexamethasone (IMVP-Dexa) given every fourth week, three to six times according to response, in patients with untreated intermediate- and high-grade non-Hodgkin's lymphoma. Ten Austrian centers entered 81 patients onto this multicenter trial. Eleven patients were excluded. The median age was 55 years. Twenty-six of 70 patients had stage III or IV disease. The distribution among international risk categories low, intermediate-low, intermediate-high, and high was 20%, 34%, 23%, and 23%, respectively. RESULTS: Of 70 eligible patients, 56 (80%) had a complete remission and seven (10%) a partial remission. After a median observation time of 36 months, the estimated time to relapse and overall survival rates are 67% and 72%, respectively. Age and Karnofsky index were the only independent risk factors for survival. Toxicity was primarily hematologic, with a median granulocyte nadir of 0.56 x 10(9)/L. Sixty-seven percent of patients had infections; 25.7% were severe World Health Organization (WHO) grade III or IV. There were three treatment-related deaths. CONCLUSION: CEOP-IMVP-Dexa chemotherapy is safe and feasible on a groupwide basis even when used in community hospitals. Neutropenic infections are the major complications. A 72% 3-year survival rate in patients with intermediate- and high-grade non-Hodgkin's lymphoma warrants further studies. These data are the basis for a randomized trial to compare cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) with CEOP/IMVP-Dexa.

[Predictive value of latex agglutination on Helicobacter pylori in children with recurrent abdominal pain]. / Praediktiver Wert einer Latex-Agglutination auf Helicobacter pylori bei Kindern mit rezidivierenden abdominellen Beschwerden.

In a prospective investigation, a rapid latex test for Helicobacter pylori in the serum (Pyloriset) was carried out in 39 patients with recurrent abdominal pain aged from six to 15 years. The test was positive in 19 patients. All of these children were subjected to gastroduodenoscopy. Seven cases showed a Helicobacter-associated chronic active antrum gastritis, whereas in the remaining 12 children gastritis not induced by Helicobacter or normal mucosa was found. Of the 20 Pyloriset-negative patients, only five could be biopsied. One of these showed a Helicobacter pylori-induced antrum gastritis. The latex test investigated had a positive predictive value which was too low (37%) to make it helpful in deciding for or against gastroduodenoscopy and the general anesthesia mostly associated with this.

Toxicity and preliminary results with a new eight-drug regimen (CEOP-IMVP-DEXA) in the treatment of aggressive lymphomas.

A combination of two non-cross-resistant regimens, CEOP and IMVP-Dexa given every 4 weeks, three to six times according to response was tested in patients with untreated histological proven high and intermediate grade non-Hodgkin's lymphoma. To date eight Austrian centres entered 37 patients in this multicentre trial. Data are available from 33 patients, three were excluded, two because of pretreatment, one because of wrong histology. Twenty-five patients are evaluable for response, 21 had a complete and three a partial remission, two of them entered a complete remission after radiotherapy to residual disease, resulting in a complete remission rate of 92 per cent. Only one patient progressed during therapy. Until now three patients relapsed after achieving a remission. Observation time is 0.4-23.8 months, median 8.8 months. Toxicity was primarily hematologic with 53.3 per cent of patients having granulocyte nadirs below 0.5 x 10(9)/L and 3.3 per cent below 0.1 x 10(9)/L. Although 60 per cent of patients had infections, there was only one life-threatening infection in an AIDS patient. CEOP-IMVP-Dexa can be safely given even in smaller hematologic centres and is able to achieve a high rate of complete responses in patients with high and intermediate grade malignant non-Hodgkin's lymphomas.