Lessons learned after one year of COVID-19 from a urologist and radiotherapist view: A German survey on prostate cancer diagnosis and treatment.

INTRODUCTION: Since the beginning of the pandemic in 2020, COVID-19 has changed the medical landscape. International recommendations for localized prostate cancer (PCa) include deferred treatment and adjusted therapeutic routines. MATERIALS AND METHODS: To longitudinally evaluate changes in PCa treatment strategies in urological and radiotherapy departments in Germany, a link to a survey was sent to 134 institutions covering two representative baseline weeks prior to the pandemic and 13 weeks from March 2020 to February 2021. The questionnaire captured the numbers of radical prostatectomies, prostate biopsies and case numbers for conventional and hypofractionation radiotherapy. The results were evaluated using descriptive analyses. RESULTS: A total of 35% of the questionnaires were completed. PCa therapy increased by 6% in 2020 compared to 2019. At baseline, a total of 69 radiotherapy series and 164 radical prostatectomies (RPs) were documented. The decrease to 60% during the first wave of COVID-19 particularly affected low-risk PCa. The recovery throughout the summer months was followed by a renewed reduction to 58% at the end of 2020. After a gradual decline to 61% until July 2020, the number of prostate biopsies remained stable (89% to 98%) during the second wave. The use of RP fluctuated after an initial decrease without apparent prioritization of risk groups. Conventional fractionation was used in 66% of patients, followed by moderate hypofractionation (30%) and ultrahypofractionation (4%). One limitation was a potential selection bias of the selected weeks and the low response rate. CONCLUSION: While the diagnosis and therapy of PCa were affected in both waves of the pandemic, the interim increase between the peaks led to a higher total number of patients in 2020 than in 2019. Recommendations regarding prioritization and fractionation routines were implemented heterogeneously, leaving unexplored potential for future pandemic challenges.

Association of occupational sitting with cardiovascular outcomes and cardiometabolic risk factors: a systematic review with a sex-sensitive/gender-sensitive perspective.

OBJECTIVES: Sedentary behaviour is a modifiable risk factor for cardiovascular health. Although long periods of sedentary behaviour take place at work, evidence of the relationship between such occupational sitting and cardiometabolic health risks remains limited. This systematic review aimed to update the evidence on the associations of occupational sitting with cardiovascular outcomes and cardiometabolic risk factors based on longitudinal studies. DESIGN: Systematic review. SETTING: Workplace. POPULATION: Employees aged 18-65 years. PRIMARY AND SECONDARY OUTCOMES: Primary outcomes were cardiovascular diseases and cardiometabolic risk markers. The secondary outcome was all-cause mortality. DATA SOURCES: Ten databases, including PubMed, Web of Science and CINAHL (search January 2018, updated February 2019). DATA EXTRACTION AND SYNTHESIS: Data were screened, extracted and appraised by three independent reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Studies were markedly heterogeneous in terms of measurement of occupational sitting, cardiometabolic risk factors and cardiovascular morbidity and mortality, so that standards were hardly identifiable and limiting the value of the evidence. The review included 27 high or acceptable quality publications. Of the eight high-quality publications from seven cohorts, three cohort studies found significant associations of occupational sitting with primary outcomes. Additionally, one study described an association with the secondary outcome. Another high-quality publication found an association between occupational sitting and ischaemic heart disease in a subgroup already at risk due to hypertension. For sex/gender analysis, 11 of the 27 high and acceptable quality publications reported sex-stratified results. Five of these found sex differences. CONCLUSIONS: Evidence regarding the association of occupational sitting with cardiometabolic health risks was limited because of the lack of standardised measurements for occupational sitting. Occupational sitting combined with an overall sedentary lifestyle was associated with an elevated relative risk for several cardiometabolic outcomes. There is an urgent need for standardised measurements of occupational sitting to facilitate meta-analysis. Sex/gender aspects of this relationship require further investigation.

How Are Techno-Stressors Associated with Mental Health and Work Outcomes? A Systematic Review of Occupational Exposure to Information and Communication Technologies within the Technostress Model.

The technostress model has introduced different factors to consider when assessing how information and communication technologies impact individuals in different work settings. This systematic review gathers evidence regarding associations between occupational exposure to technostress and health or work outcomes. In addition, we highlight typical methodological constraints of the technostress model. We conducted electronic literature searches in June 2020 (PubMed, PubMed Central, Web of Science, Scopus, PsycInfo, PsycArticles) and independently screened 321 articles. We report on 21 articles meeting eligibility criteria (working population, technostress exposure, health or work outcome, quantitative design). The most frequently examined techno-stressors, i.e., factors of technostress, were techno-overload and techno-invasion. Techno-stressors were consistently associated with adverse health and work outcomes, apart from a positive impact on work engagement. However, studies may be subject to considerable conceptual overlap between exposure and outcome measures. Future technostress research would benefit from reducing heterogeneity in technostress measures, assessing their external validity and focussing on specific techno-stressors.

Is There a Sampling Bias in Research on Work-Related Technostress? A Systematic Review of Occupational Exposure to Technostress and the Role of Socioeconomic Position.

Technostress is a widespread model used to study negative effects of using information communication technologies at work. The aim of this review is to assess the role of socioeconomic position (SEP) in research on work-related technostress. We conducted systematic searches in multidisciplinary databases (PubMed, PubMed Central, Web of Science, Scopus, PsycInfo, PsycArticles) in June 2020 and independently screened 321 articles against eligibility criteria (working population, technostress exposure, health or work outcome, quantitative design). Of the 21 studies included in the narrative synthesis, three studies did not collect data on SEP, while 18 studies operationalised SEP as education (eight), job position (five), SEP itself (two) or both education as well as job position (three). Findings regarding differences by SEP are inconclusive, with evidence of high SEP reporting more frequent exposure to overall technostress. In a subsample of 11 studies reporting data on educational attainment, we compared the percentage of university graduates to World Bank national statistics and found that workers with high SEP are overrepresented in nine of 11 studies. The resulting socioeconomic sampling bias limits the scope of the technostress model to high SEP occupations. The lack of findings regarding differences by SEP in technostress can partly be attributed to limitations in study designs. Studies should aim to reduce the heterogeneity of technostress and SEP measures to improve external validity and generalisability across socioeconomic groups. Future research on technostress would benefit from developing context-sensitive SEP measures and quality appraisal tools that identify socioeconomic sampling biases by comparing data to national statistics.

[Workshop on Health Risks of Sedentary Behavior at Workplace - Solutions Part II]. / Workshop Gesundheitsgefährdung durch langes Sitzen am Arbeitsplatz ­ Teil II Betriebliche Lösungsansätze.

AIM: Health risks of prolonged periods of sitting at work are a matter of concern. Solutions are needed based on interdisciplinary collaborations of research experts and practitioners in occupational safety and health areas. METHODS: In February 2019, at a workshop in Berlin of experts from different fields, issues of scientific evidence on the health risks of sedentary behaviour at work were presented in 6 lectures and solutions for the workplace were discussed. The workshop is documented here in 2 parts. Gender relevant aspects are distinguished where possible. RESULTS: Part II describes solution approaches for practice in the workplace. The results of a recent evaluation of dynamic workplaces are presented. Two examples provide insight into ongoing workplace health promotion measures addressing sedentary behavior in Germany which currently mainly target measures to increase physical activity rather than measures to interrupt long sedentary bouts. The documentation of the plenary discussion summarizes how interventions addressing sedentary behaviour at the workplace can be successful. CONCLUSIONS: Decision makers increasingly realize that there is a trend in the 21st century towards low physical demands due to increasingly sedentary tasks in the workplace. Despite research gaps, there is a need for evidence-based decisions in policy and workplace practices. Germany can learn from the experiences of other countries.

Results from extended lymphadenectomies with [111In]PSMA-617 for intraoperative detection of PSMA-PET/CT-positive nodal metastatic prostate cancer.

PURPOSE: Identification of suspicious PSMA-PET/CT-positive lymph node (LN) metastases (LNM) from prostate cancer (PCa) during lymphadenectomy (LA) is challenging. We evaluated an 111In-labelled PSMA ligand (DKFZ-617, referred to as [111In]PSMA-617) as a γ-emitting tracer for intraoperative γ-probe application for resected tissue samples in PCa patients. Forty-eight hours prior to LA, [111In]PSMA-617 was administered intravenously in 23 patients with suspected LNM on PSMA-PET/CT (n = 21 with biochemical relapse, n = 2 at primary therapy). Resected tissue samples (LN, LNM and fibrofatty tissue) were measured ex situ by a γ-probe expressed as counts per second (CPSnorm). [111In]PSMA-617 tissue sample uptake was measured by a germanium detector for verification and calculated as %IAlbm (percent injected activity per kilogram lean body mass at time of surgery). Based on a clinical requirement for a specificity > 95%, thresholds for both ex situ measurements were chosen accordingly. Correlation of the results from PET/CT, γ-probe and germanium detector with histopathology was done. RESULTS: Eight hundred sixty-four LNs (197 LNM) were removed from 275 subregions in 23 patients, on average 8.6 ± 14.9 LNM per patient. One hundred four of 275 tissue samples showed cancer. Median γ-probe and germanium detector results were significantly different between tumour-affected (33.5 CPSnorm, 0.71 %IAlbm) and tumour-free subregions (3.0 CPSnorm, 0.03 %IAlbm) (each p value < 0.0001). For the chosen γ-probe cut-off (CPSnorm > 23) and germanium detector cut-off (%IAlbm > 0.27), 64 and 74 true-positive and 158 true-negative samples for both measurements were identified. Thirty-nine and 30 false-negative and 6 and 5 false-positive tissue samples were identified by γ-probe and germanium detector measurements. CONCLUSION: [111In]PSMA-617 application for LA is feasible in terms of an intraoperative real-time measurement with a γ-probe for detection of tumour-affected tissue samples. γ-probe results can be confirmed by precise germanium detector measurements and were significantly different between tumour-affected and tumour-free samples.

Validation of different PSMA-PET/CT-based contouring techniques for intraprostatic tumor definition using histopathology as standard of reference.

PURPOSE: Accurate definition of the intraprostatic gross tumor volume (GTV) is crucial for diagnostic and therapeutic approaches in patients with primary prostate cancer (PCa). The optimal methodology for contouring of GTV using Prostate specific membrane antigen positron emission tomography (PSMA-PET) information has not yet been defined. METHODS AND MATERIALS: PCa patients who underwent a [68Ga]PSMA-11-PET/CT followed by radical prostatectomy were prospectively enrolled (n = 20). Six observer teams with different levels of experience and using different PET image scaling techniques performed manual contouring of GTV. Additionally, semi-automatic segmentation of GTVs was performed using SUVmax thresholds of 20-50%. Coregistered histopathological gross tumor volume (GTV-Histo) served as reference. Inter-observer agreement was assessed by calculating the Dice similarity coefficient (DSC). RESULTS: Most contouring methods provided high sensitivity and specificity. For manual delineation, scaling the PET images from SUVmin-max: 0-5 resulted in high sensitivity (>86%). The highest specificity (100%) was obtained by scaling the PET images from SUVmin-max: 0-SUVmax. High interobserver agreement (median DSC 0.8) was observed when using the same PET image scaling technique (PET images SUVmin-max: 0-5). For semi-automatic segmentation, a low SUVmax threshold of 20% optimized sensitivity (SUVmax threshold 20%, 100% sensitivity, 32% of prostatic volume), whereas a higher threshold optimized specificity (SUVmax threshold 40%-50%, 100% specificity). CONCLUSIONS: Contouring of regions with high tracer-uptake resulted in very high specificities and should be used for biopsy guidance. Both manual and semi-automatic approaches using validated SUV scaling (SUVmin-max: 0-5) or thresholding (20%) may provide high sensitivity, and should be considered for PSMA-PET-based focal therapy approaches.

Heterogeneous learning cultures in interprofessional education: a teacher training.

Aim: Due to the political demand for the integration of interprofessional (IP) learning into the undergraduate education of health professionals, teachers now have to create and perform IP courses. The IP and thus heterogeneous learning groups pose a special challenge. The presented project aimed at designing a workshop training to support teachers to reflect on heterogeneous learning cultures and to prepare for IP teaching. Methods: The workshop concept was developed in using the Plan-Do-Check-Act (PDCA) cycle and included planning, several rounds of testing and the evaluation of the concept. All planning steps in the development of the workshop concept followed the principles of cooperative learning. The concept evolved in an iterative process based on participants' feedback and facilitators' self-reflection. Results: The resulting workshop concept includes theoretical input as well as discussion, teamwork and participants' self-reflection. The workshop's core element is the work assignment to develop an IP teaching session considering different learning cultures. Work results and experiences are discussed with the entire group and required skills of IP teachers are identified. Conclusion: The subjective feedback of participants regarding their satisfaction and knowledge gained indicates that the workshop concept is well received. The joint planning of an IP teaching session highlights particularities resulting from heterogeneous learning cultures. These should be utilized in IP education to better prepare learners for IP cooperation in the workplace.

Radiomic features from PSMA PET for non-invasive intraprostatic tumor discrimination and characterization in patients with intermediate- and high-risk prostate cancer - a comparison study with histology reference.

Purpose: To evaluate the performance of radiomic features (RF) derived from PSMA PET for intraprostatic tumor discrimination and non-invasive characterization of Gleason score (GS) and pelvic lymph node status. Patients and methods: Patients with prostate cancer (PCa) who underwent [68Ga]-PSMA-11 PET/CT followed by radical prostatectomy and pelvic lymph node dissection were prospectively enrolled (n=20). Coregistered histopathological gross tumor volume (GTV-Histo) in the prostate served as reference. 133 RF were derived from GTV-Histo and from manually created segmentations of the intraprostatic tumor volume (GTV-Exp). Spearman´s correlation coefficients (ρ) were assessed between RF derived from the different GTVs. We additionally analyzed the differences in RF values for PCa and non-PCa tissues. Furthermore, areas under receiver-operating characteristics curves (AUC) were calculated and uni- and multivariate analyses were performed to evaluate the RF based discrimination of GS 7 and ≥8 disease and of patients with nodal spread (pN1) and non-nodal spread (pN0) in surgical specimen. The results found in the latter analyses were validated by a retrospective cohort of 40 patients. Results: Most RF from GTV-Exp showed strong correlations with RF from GTV-Histo (86% with ρ>0.7). 81% and 76% of RF from GTV-Exp and GTV-Histo significantly discriminated between PCa and non-PCa tissue. The texture feature QSZHGE discriminated between GS 7 and ≥8 considering GTV-Histo (AUC=0.93) and GTV-Exp (prospective cohort: AUC=0.91 / validation cohort: AUC=0.84). QSZHGE also discriminated between pN1 and pN0 disease considering GTV-Histo (AUC=0.85) and GTV-Exp (prospective cohort: AUC=0.87 / validation cohort: AUC=0.85). In uni- and multivariate analyses including patients of both cohorts QSZHGE was a statistically significant (p<0.01) predictor for PCa patients with GS ≥8 tumors and pN1 status. Conclusion: RF derived from PSMA PET discriminated between PCa and non-PCa tissue within the prostate. Additionally, the texture feature QSZHGE discriminated between GS 7 and GS ≥8 tumors and between patients with pN1 and pN0 disease. Our results support the role of RF in PSMA PET as a new tool for non-invasive PCa discrimination and characterization of its biological properties.

Detection Rate of 18F-Choline PET/CT and 68Ga-PSMA-HBED-CC PET/CT for Prostate Cancer Lymph Node Metastases with Direct Link from PET to Histopathology: Dependence on the Size of Tumor Deposits in Lymph Nodes.

Accurate detection of prostate cancer lymph node metastases (LNM) through PET/CT before lymphadenectomy is crucial for successful therapy. PET/CT with choline derivatives used to be the standard tool for imaging metastases, whereas 68Ga-PSMA (prostate-specific membrane antigen) PET/CT was introduced recently. Both PET techniques were investigated with respect to what extent the detection rate of LNM depends on the size of tumor deposits (TDs) within LNM. Methods: Documenting the switch from the use of 18F-choline to 68Ga-PSMA in 2014, we used 2 patient cohorts undergoing a template lymphadenectomy because of a PET/CT indicating LNM. Forty-four and 40 patients underwent PET/CT with 18F-choline or 68Ga-PSMA ligand, respectively. In total, 226 LNM (125 18F-choline, 101 68Ga-PSMA) originated from 73 salvage lymphadenectomies at biochemical recurrence and from 11 primary lymphadenectomies at radical prostatectomy. LNM eligible for direct correlation of PET/CT to histopathology were identified from lymphadenectomies conducted in small anatomic subregions, with 1 LNM (condition 1) or 1-2 LNM (condition 2). Longitudinal and short diameters of TD within LNM were determined by histopathology, allowing linking of the size of TD in LNM to the detection threshold of PET/CT. Diameters associated with a detection rate of 50% and 90% (d50%, d90%) were calculated on the basis of logistic growth curve models fitted. Results: Gleason score, number of removed LNs, and subregions for lymphadenectomy per patient did not differ significantly between the 18F-choline and 68Ga-PSMA groups. The median prostate-specific antigen level at imaging and number of LNM per patient were significantly higher in the 18F-choline group (3.4 ng/mL, n = 34) than in the 68Ga-PSMA group (2.2 ng/mL, n = 28; both P < 0.05). Longitudinal and short diameters of TD in LNM to reach d90% were 11.2 and 7.4 mm, respectively, for 18F-choline PET/CT and 6.3 and 4.9 mm, respectively, for 68Ga-PSMA PET/CT. Corresponding diameters to reach d50% were 5.5 and 3.3 mm, respectively, for 18F-choline PET/CT and 3.7 and 2.3 mm, respectively, for 68Ga-PSMA PET/CT. Detection rates were significantly higher under 68Ga-PSMA (P = 0.005 and 0.04 for longitudinal and short diameter). Conclusion: 68Ga-PSMA PET/CT is superior to 18F-choline PET/CT in the detection of LNM. Whether those results will lead to an improved patient outcome after 68Ga-PSMA PET-guided therapy needs to be investigated by further studies.

Performance of 111In-labelled PSMA ligand in patients with nodal metastatic prostate cancer: correlation between tracer uptake and histopathology from lymphadenectomy.

PURPOSE: Intraoperative identification of lymph node (LN) metastases (LNM) detected on preoperative PSMA PET/CT may be facilitated by PSMA radioguided surgery with the use of a gamma probe. We evaluated the uptake of 111In-labelled PSMA ligand DKFZ-617 (referred to as 111In-PSMA-617) in unaffected LN and LNM at the level of single LN. METHODS: Six patients with prostate cancer (PCa) with suspicion of LNM on preoperative PSMA PET/CT underwent 111In-PSMA-617-guided lymphadenectomy (LA; four salvage LA and two primary LA). 111In-PSMA-617 (109 ± 5 MBq). was injected Intravenously 48 h prior to surgery Template LAs were performed in small subregions: common, external, obturator and internal iliac vessels, and presacral and retroperitoneal subregions (n = 4). Samples from each subregion were isolated aiming at the level of single LN. Uptake was measured ex situ using a germanium detector. Receiver operating characteristic (ROC) analysis was performed based on 111In-PSMA-617 uptake expressed as standardized uptake values normalized to lean body mass (SUL). RESULTS: Overall 310 LN (mean 52 ± 19.7) were removed from 74 subregions (mean 12 ± 3.7). Of the 310 LN, 35 turned out to be LNM on histopathology. Separation of the samples from all subregions resulted in 318 single specimens: 182 PCa-negative LN samples with 275 LN, 35 single LNM samples, 3 non-nodal PCa tissue samples and 98 fibrofatty tissue samples. The median SULs of nonaffected LN (0.16) and affected LN (13.2) were significantly different (p < 0.0001). Based on 38 tumour-containing and 182 tumour-free specimens, ROC analysis revealed an area under the curve of 0.976 (95% CI 0.95-1.00, p < 0.0001). Using a SUL cut-off value of 1.136, sensitivity, specificity, positive predictive value, negative predictive value and accuracy in discriminating affected from nonaffected LN were 92.1% (35/38), 98.9% (180/182), 94.6% (35/37), 98.4% (180/183) and 97.7% (215/220), respectively. CONCLUSION: Ex situ analysis at the level of single LN showed that 111In-PSMA-617 had excellent ability to discriminate between affected and nonaffected LN in our patients with PCa. This tracer characteristic is a prerequisite for in vivo real-time measurements during surgery.

Focal dose escalation for prostate cancer using 68Ga-HBED-CC PSMA PET/CT and MRI: a planning study based on histology reference.

BACKGROUND: Focal radiation therapy has gained of interest in treatment of patients with primary prostate cancer (PCa). The question of how to define the intraprostatic boost volume is still open. Previous studies showed that multiparametric MRI (mpMRI) or PSMA PET alone could be used for boost volume definition. However, other studies proposed that the combined usage of both has the highest sensitivity in detection of intraprostatic lesions. The aim of this study was to demonstrate the feasibility and to evaluate the tumour control probability (TCP) and normal tissue complication probability (NTCP) of radiation therapy dose painting using 68Ga-HBED-CC PSMA PET/CT, mpMRI or the combination of both in primary PCa. METHODS: Ten patients underwent PSMA PET/CT and mpMRI followed by prostatectomy. Three gross tumour volumes (GTVs) were created based on PET (GTV-PET), mpMRI (GTV-MRI) and the union of both (GTV-union). Two plans were generated for each GTV. Plan95 consisted of whole-prostate IMRT to 77 Gy in 35 fractions and a simultaneous boost to 95 Gy (Plan95PET/Plan95MRI/Plan95union). Plan80 consisted of whole-prostate IMRT to 76 Gy in 38 fractions and a simultaneous boost to 80 Gy (Plan80PET/Plan80MRI/Plan80union). TCPs were calculated for GTV-histo (TCP-histo), which was delineated based on PCa distribution in co-registered histology slices. NTCPs were assessed for bladder and rectum. RESULTS: Dose constraints of published protocols were reached in every treatment plan. Mean TCP-histo were 99.7% (range: 97%-100%) and 75.5% (range: 33%-95%) for Plan95union and Plan80union, respectively. Plan95union had significantly higher TCP-histo values than Plan95MRI (p = 0.008) and Plan95PET (p = 0.008). Plan80union had significantly higher TCP-histo values than Plan80MRI (p = 0.012), but not than Plan80PET (p = 0.472). Plan95MRI had significantly lower NTCP-rectum than Plan95union (p = 0.012). No significant differences in NTCP-rectum and NTCP-bladder were observed for all other plans (p > 0.05). CONCLUSIONS: IMRT dose escalation on GTVs based on mpMRI, PSMA PET/CT and the combination of both was feasible. Boosting GTV-union resulted in significantly higher TCP-histo with no or minimal increase of NTCPs compared to the other plans.

Loss of PSMA Expression in Non-neuroendocrine Dedifferentiated Acinar Prostate Cancer.

The introduction of tracers targeting the prostate-specific membrane antigen (PSMA) has revolutionized PET imaging of acinar prostate adenocarcinoma. In general, an increasing PSMA expression is assumed with increasing dedifferentiation. Whereas loss of PSMA expression has been reported in case of neuroendocrine dedifferentiation, we present a patient with acinar prostate adenocarcinoma with a loss of PSMA expression after chemotherapy on PET/CT and in histological and immunohistochemical analyses. All tissue samples indicated the retention of acinar features but no expression of neuroendocrine markers (NSE, synaptophysin, chromogranin, and CD56), corresponding to nonelevated serum NSE.

Multimodal imaging for radiation therapy planning in patients with primary prostate cancer.

Implementation of advanced imaging techniques like multiparametric magnetic resonance imaging (mpMRI) or Positron Emission Tomography (PET) in radiation therapy (RT) planning of patients with primary prostate cancer demands several preconditions: accurate staging of the extraprostatic and intraprostatic tumor mass, robust delineation of the intraprostatic gross tumor volume (GTV) and a reproducible characterization of the prostate cancer's biological properties. In the current review we searched for the currently available imaging techniques and we discussed their ability to fulfill these preconditions. We found that current pretreatment imaging was mainly performed with mpMRI and/or Prostate-specific membrane antigen PET imaging. Both techniques offered an accurate detection of the extraprostatic and intraprostatic tumor burden and had a major impact on RT concepts. However, some studies postulated that mpMRI and PSMA PET had complementary information for intraprostatic GTV detection. Moreover, interobserver differences for intraprostatic tumor delineation based on mpMRI were observed. It is currently unclear whether PET based GTV delineation underlies also interobserver heterogeneity. Further research is warranted to answer whether multimodal imaging is able to visualize biological processes related to prostate cancer pathophysiology and radiation resistance.

Interprofessional peer-assisted learning as a low-threshold course for joint learning: Evaluation results of the interTUT Project.

BACKGROUND AND OBJECTIVE: The delivery of needs-based health care services requires a team-based and collaborative approach of different health professionals, which is not yet sufficienctliy implemented on a day to day basis. Interprofessional learning activities aim to respond to this in future. The cross-university pilot project interTUT used peer-assisted learning approaches and extracurricular tutorials in order address this issue. METHODOLOGY: During the pilot phase, eight students and trainees have been acquired. Together, they prepared and led four extracurricular tutorials on core topics of interprofessional cooperation and documented them in procedure manuals. The course was evaluated using a standardized participant survey (n=72) and two focus groups (n=3, n=5) in which participants were asked to reflect on their individual learning experiences. Descriptive statistics were used to analyze the survey data and the focus group material was interpreted using qualitative content analysis. RESULTS: The results indicated a high level of satisfaction, acceptance of and further demand for peer-supported learning activities. The students and trainees reported changed attitudes and subjective knowledge growth regarding the other professional groups. The constructive learning atmosphere as well as having access to a forum for interprofessional exchange were equally valued. CONCLUSIONS: Extracurricular tutorials offer a low-threshold and very promising point of contact for the facilitation of interprofessional teaching and learning. However, this should be viewed against the background that, as part of the pilot project, only a small number of students and trainees who were already interested in the topic could be reached by this optional course. A comprehensive, long-term trial of this teaching and learning format, its linkage to curricular courses, and further research on its education-specific and practice-related effects are, therefore, necessary.