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Article ; Online: Extending the conversation over the immune-related hepatotoxicity: author response to Dr. Gauci

Ziogas, Dimitrios C / Gogas, Helen

2021 Volume 9, Issue 3

Abstract: Immune-related hepatotoxicity (IRH) remains the subject of many immune-oncology debates due to its challenging diagnosis and management. Although it is currently defined by the restrictive Common Terminology Criteria for Adverse Events (CTCAE), the term ... ...

Abstract	Immune-related hepatotoxicity (IRH) remains the subject of many immune-oncology debates due to its challenging diagnosis and management. Although it is currently defined by the restrictive Common Terminology Criteria for Adverse Events (CTCAE), the term of IRH covers a wide range of liver pathologies, including hepatitic, cholangitic, mixed, steatotic and nonspecific patterns of injury. Even when liver biopsy is performed, the recognized histopathological findings cannot predict the response to steroids or the need for secondary immunosuppression, and usually do not significantly modify the suggested empirical treatment of IRH. Beyond the CTCAE grading, a more comprehensive assessment of IRH severity, including laboratory biomarkers and clinical features, should be developed and a more patient-oriented management should be established by additional randomized evidence, incorporating hepatology and immune-oncology experience.
MeSH term(s)	Biopsy ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Medical Oncology
Language	English
Publishing date	2021-03-15
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	2719863-7
ISSN	2051-1426 ; 2051-1426
ISSN (online)	2051-1426
ISSN	2051-1426
DOI	10.1136/jitc-2021-002391
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Article ; Online: Preoperative plasmapheresis in patients with Graves' disease intolerant to antithyroid drugs.

Apaydin, Tugce / Gogas Yavuz, Dilek

Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy

2021 Volume 25, Issue 6, Page(s) 877–883

Abstract: ... into consideration in patients who were scheduled for surgery within 24 h after TPE. In terms of reducing ... intraoperative bleeding, patients can be referred to surgery 24-48 h after TPE, or fresh frozen plasma ...

Abstract	Antithyroid drugs (ATDs) are the mainstay of treatment for Graves' disease with possible detrimental adverse effects. Surgery or radioactive iodine (RAI) ablation is the second choice among the treatment options in cases of non-remission. Normalization of serum thyroid hormone levels as much as possible is required before surgery or RAI to prevent thyrotoxic crisis in patients with uncontrolled Graves' disease. In recent decades, therapeutic plasma exchange (TPE) has been used in the treatment of thyroid storm, drug-induced hepatotoxicity and agranulocytosis, or patients with hyperthyroidism scheduled for emergency surgery. TPE is an effective method to reduce serum FT3, FT4, and TRAB levels in severe hyperthyroid conditions. Although TPE-related complications are rare, the risk of bleeding needs to be taken into consideration in patients who were scheduled for surgery within 24 h after TPE. In terms of reducing intraoperative bleeding, patients can be referred to surgery 24-48 h after TPE, or fresh frozen plasma transfusion can be the preferred treatment for emergency cases.
MeSH term(s)	Antithyroid Agents/administration & dosage ; Graves Disease/surgery ; Graves Disease/therapy ; Humans ; Plasmapheresis/methods ; Preoperative Care/methods
Chemical Substances	Antithyroid Agents
Language	English
Publishing date	2021-03-19
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	2119809-3
ISSN	1744-9987 ; 1091-6660 ; 1744-9979
ISSN (online)	1744-9987
ISSN	1091-6660 ; 1744-9979
DOI	10.1111/1744-9987.13639
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Zs.A 5208: Show issues

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Article: A feasibility study of 1-h paclitaxel infusion in patients with solid tumors.

Tsavaris, N / Polyzos, A / Kosmas, C / Giannikos, L / Gogas, J

Cancer chemotherapy and pharmacology

1997 Volume 40, Issue 4, Page(s) 353–357

Abstract: ... study was carried out to evaluate the safety of paclitaxel administration by 1-h infusion ... in a single dose by 1-h i.v. infusion. This protocol was repeated every 21 days. All patients were ... all premedication being carried out 1 h before the paclitaxel infusion. In a total of 156 cycles, only 1 patient ...

Abstract	The optimal schedule for paclitaxel administration has not yet been determined. This phase I/II study was carried out to evaluate the safety of paclitaxel administration by 1-h infusion in the outpatient setting. A total of 43 patients with advanced pretreated malignancies (18 breast, 18 ovarian, and 7 non-small-cell lung cancers) received at least 2 cycles of paclitaxel given at 175 mg/ m2 in a single dose by 1-h i.v. infusion. This protocol was repeated every 21 days. All patients were premedicated as follows: promethazine given i.m. at 50 mg, dexamethasone given at 16 mg in 250 ml normal saline by i.v. infusion for 20 min and ranitidine given i.v. at 50 mg in 250 ml normal saline over 15 min, all premedication being carried out 1 h before the paclitaxel infusion. In a total of 156 cycles, only 1 patient presented with a hypersensitivity reaction (grade 2 urticaria in 1 cycle) and another patient developed transient facial flushing (in 1 cycle: this was resolved by slowing of the infusion rate) on this schedule of paclitaxel administration. Other adverse side effects were usually mild and well tolerated. Alopecia was universal; myelosuppression was uncommon because our patients were supported with granulocyte colony-stimulating factor (G-CSF, lenograstim) given at 34 IU/day in the presence of a neutrophil count of < 500 microliters; neutropenia was seen in 50/156 (32%) cycles and was mild. Neurotoxicity was the most serious adverse effect, and all patients experienced mild to severe neuro-muscular toxicity, mainly in the form of peripheral sensorimotor neuropathy and myalgias. In conclusion, 1-h paclitaxel administration is safe and reduces the duration of treatment, making its use more convenient and easy in the outpatient setting. A prospective comparison of 1-h versus 3-h paclitaxel infusion in terms of efficacy and toxicity is the subject of our current randomized study.
MeSH term(s)	Aged ; Antineoplastic Agents, Phytogenic/administration & dosage ; Antineoplastic Agents, Phytogenic/adverse effects ; Bone Marrow/drug effects ; Breast Neoplasms/drug therapy ; Breast Neoplasms/pathology ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/pathology ; Central Nervous System/drug effects ; Dexamethasone/administration & dosage ; Feasibility Studies ; Female ; Humans ; Infusions, Intravenous ; Lung Neoplasms/drug therapy ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/pathology ; Paclitaxel/administration & dosage ; Paclitaxel/adverse effects ; Premedication ; Promethazine/administration & dosage ; Ranitidine/administration & dosage ; Safety
Chemical Substances	Antineoplastic Agents, Phytogenic ; Dexamethasone (7S5I7G3JQL) ; Ranitidine (884KT10YB7) ; Promethazine (FF28EJQ494) ; Paclitaxel (P88XT4IS4D)
Language	English
Publishing date	1997
Publishing country	Germany
Document type	Clinical Trial ; Clinical Trial, Phase I ; Clinical Trial, Phase II ; Journal Article
ZDB-ID	6820-2
ISSN	1432-0843 ; 0344-5704 ; 0943-9404
ISSN (online)	1432-0843
ISSN	0344-5704 ; 0943-9404
DOI	10.1007/s002800050669
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Article ; Online: Intensification of Insulin Treatment With Insulin Degludec/Aspart in Type 2 Diabetic Patients: A 2-Year Real-World Experience.

Oner, Hatice / Gunhan, Hatice Gizem / Gogas Yavuz, Dilek

Frontiers in clinical diabetes and healthcare

2022 Volume 3, Page(s) 783277

Abstract: Aim: To evaluate the effects of insulin degludec/insulin aspart (IDegAsp) coformulation as an intensification of insulin treatment for glycemic control in patients with type 2 diabetes (T2D) in a long term real-world clinical setting.: Materials and ... ...

Abstract	Aim: To evaluate the effects of insulin degludec/insulin aspart (IDegAsp) coformulation as an intensification of insulin treatment for glycemic control in patients with type 2 diabetes (T2D) in a long term real-world clinical setting. Materials and methods: This retrospective non-interventional study, included 210 patients with T2D who to IDegAsp coformulation from prior insulin treatment in a tertiary endocrinology center between September 2017 and December 2019. The baseline data was taken as the index date and defined as the first IDegAsp prescription claim. Previous insulin treatment modalities, hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and body weight were recorded, respectively at the 3 Results: Out of the total 210 patients, 166 patients under insulin treatment switched to twice-daily IDegAsp treatment, 35 patients switched to once daily IDegAsp and twice premeal short-acting insulin regimen as a modified basal-bolus (BB) treatment, and nine patients commenced with once-daily IDegAsp treatment. HbA1c decreased from 9.2% ± 1.9% to 8.2% ± 1.6% in 6 months, 8.2% ± 1.7% in the first year, and 8.1% ± 1.6% in the second year of the therapy ( Conclusion: Intensification of insulin treatment with IDegAsp coformulation improved glycemic control in patients with T2D. The total daily insulin requirement increased but the IDegAsp requirement lightly increased at the two-year follow-up. Patients under BB treatment required de-escalation of insulin treatment.
Language	English
Publishing date	2022-07-26
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-6616
ISSN (online)	2673-6616
DOI	10.3389/fcdhc.2022.783277
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Article: New Emerging Targets in Cancer Immunotherapy: The Role of B7-H3.

Koumprentziotis, Ioannis-Alexios / Theocharopoulos, Charalampos / Foteinou, Dimitra / Angeli, Erasmia / Anastasopoulou, Amalia / Gogas, Helen / Ziogas, Dimitrios C

Vaccines

2024 Volume 12, Issue 1

Abstract: Immune checkpoints (ICs) are molecules implicated in the fine-tuning of immune response via co-inhibitory or co-stimulatory signals, and serve to secure minimized host damage. Targeting ICs with various therapeutic modalities, including checkpoint ... ...

Abstract	Immune checkpoints (ICs) are molecules implicated in the fine-tuning of immune response via co-inhibitory or co-stimulatory signals, and serve to secure minimized host damage. Targeting ICs with various therapeutic modalities, including checkpoint inhibitors/monoclonal antibodies (mAbs), antibody-drug conjugates (ADCs), and CAR-T cells has produced remarkable results, especially in immunogenic tumors, setting a paradigm shift in cancer therapeutics through the incorporation of these IC-targeted treatments. However, the large proportion of subjects who experience primary or secondary resistance to available IC-targeted options necessitates further advancements that render immunotherapy beneficial for a larger patient pool with longer duration of response. B7-H3 (B7 Homolog 3 Protein, CD276) is a member of the B7 family of IC proteins that exerts pleiotropic immunomodulatory effects both in physiologic and pathologic contexts. Mounting evidence has demonstrated an aberrant expression of B7-H3 in various solid malignancies, including tumors less sensitive to current immunotherapeutic options, and has associated its expression with advanced disease, worse patient survival and impaired response to IC-based regimens. Anti-B7-H3 agents, including novel mAbs, bispecific antibodies, ADCs, CAR-T cells, and radioimmunotherapy agents, have exhibited encouraging antitumor activity in preclinical models and have recently entered clinical testing for several cancer types. In the present review, we concisely present the functional implications of B7-H3 and discuss the latest evidence regarding its prognostic significance and therapeutic potential in solid malignancies, with emphasis on anti-B7-H3 modalities that are currently evaluated in clinical trial settings. Better understanding of B7-H3 intricate interactions in the tumor microenvironment will expand the oncological utility of anti-B7-H3 agents and further shape their role in cancer therapeutics.
Language	English
Publishing date	2024-01-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines12010054
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Article: Reaching the Diagnosis of Checkpoint Inhibitor-Induced Diabetes Mellitus in Different Clinical Scenarios: A Real-World Application of Updated Diagnostic Criteria.

Angelousi, Anna / Ziogas, Dimitrios C / Siampanopoulou, Vasiliki / Mytareli, Chrysoula / Anastasopoulou, Amalia / Lyrarakis, George / Gogas, Helen

Diseases (Basel, Switzerland)

2024 Volume 12, Issue 2

Abstract: Background: Checkpoint inhibitor (CPI)-associated diabetes mellitus (CPI-DM) is a rare immune-related adverse event (irAE) that presents with variable clinical manifestations. Data about its pathogenesis have not yet been adequately studied.: Methods!# ...

Abstract	Background: Checkpoint inhibitor (CPI)-associated diabetes mellitus (CPI-DM) is a rare immune-related adverse event (irAE) that presents with variable clinical manifestations. Data about its pathogenesis have not yet been adequately studied. Methods: Applying the recently updated diagnostic criteria from the American Diabetes Association, we retrospectively reviewed the medical records of all CPI-treated patients referred to our endocrinological unit for managing their endocrine irAEs and analyzed the incidence of CPI-DM, its clinical characteristics, and its management. Results: Among the 326 CPI-treated patients with endocrine irAEs, 4 patients met the updated criteria for the diagnosis of CPI-DM, representing 1.22% of all endocrine irAEs in our cohort. These four patients presented with distinct clinical scenarios regarding the irAE onset, the underlying malignancy, the administered CPI regimen, and the type of circulating autoantibodies. Conclusion: The variable presentation of CPI-DM and the non-standard sensitivity of the presence of the type 1 DM traditional autoantibodies highlight the need for distinct guidelines and increased awareness of its diagnosis and management.
Language	English
Publishing date	2024-02-14
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2720869-2
ISSN	2079-9721
ISSN	2079-9721
DOI	10.3390/diseases12020040
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Article: Challenges in the treatment of melanoma with BRAF and MEK inhibitors in patients with sickle cell disease: case report and review of the literature.

Diamantopoulos, Panagiotis T / Anastasopoulou, Amalia / Dimopoulou, Maria / Samarkos, Michalis / Gogas, Helen

Therapeutic advances in hematology

2023 Volume 14, Page(s) 20406207231155991

Abstract: Patients with sickle cell disease (SCD) suffer from complications due to anemia, inflammation, and vaso-occlusion. Factors that trigger sickling and/or inflammation may initiate such complications, while treatment with hydroxyurea (HU) reduces their ... ...

Abstract	Patients with sickle cell disease (SCD) suffer from complications due to anemia, inflammation, and vaso-occlusion. Factors that trigger sickling and/or inflammation may initiate such complications, while treatment with hydroxyurea (HU) reduces their emergence and prolongs survival. On the contrary, inhibition of the BRAF-MEK-ERK pathway with BRAF and MEK inhibitors (BRAF/MEKi) has revolutionized treatment of melanoma but their use has been correlated with inflammatory adverse events. Thus, treatment of patients with SCD with BRAF/MEKi may be quite challenging and pyrexia in those patients should be managed as a medical emergency. In this article, intrigued by the case of a 36-year-old female patient with S/β-thal under HU who was treated with dabrafenib and trametinib for melanoma, we analyze the mechanisms underlying inflammation and vaso-occlusion in SCD, the mechanisms of pyrexia and inflammation induced by BRAF/MEKi, their potential interconnections, the shared role of the inflammasome in these two entities, and the protective effect of HU in SCD. Since SCD is the most common inheritable blood disorder, the administration of BRAF/MEKi for melanoma in patients with SCD may be a rather common challenge. Thus, proper treatment with HU may pave the way for an uneventful management of such patients.
Language	English
Publishing date	2023-03-15
Publishing country	England
Document type	Case Reports
ZDB-ID	2585183-4
ISSN	2040-6215 ; 2040-6207
ISSN (online)	2040-6215
ISSN	2040-6207
DOI	10.1177/20406207231155991
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Article ; Online: Histone deacetylase inhibitors as a novel therapeutic approach for pheochromocytomas and paragangliomas.

Manta, Aspasia / Kazanas, Spyridon / Karamaroudis, Stefanos / Gogas, Helen / Ziogas, Dimitrios C

Oncology research

2023 Volume 30, Issue 5, Page(s) 211–219

Abstract: Epigenetic mechanisms, such as DNA methylation and histone modifications (e.g., acetylation and deacetylation), are strongly implicated in the carcinogenesis of various malignancies. During transcription, the expression and functionality of coding gene ... ...

Abstract	Epigenetic mechanisms, such as DNA methylation and histone modifications (e.g., acetylation and deacetylation), are strongly implicated in the carcinogenesis of various malignancies. During transcription, the expression and functionality of coding gene products are altered following the histone acetylation and deacetylation. These processes are regulated by histone acetyltransferases (HATs) and histone deacetylases (HDACs), respectively. HDAC inhibitors (HDACis) have been developed as promising therapeutic agents, to limit exposure to traditional and toxic chemotherapies and offer more alternatives for some specific malignant diseases with limited options. Mechanistically, these agents affect many intracellular pathways, including cell cycle arrest, apoptosis and differentiation, and their mechanism of action mainly depends on the type of cancer. Currently, five HDACis have been approved for the treatment of several hematological malignancies (e.g., T-cell lymphoma subtypes and multiple myeloma); while, many of them are tested for further therapeutic indications in solid tumors (e.g., colorectal, thyroid, breast, lung and pancreatic cancer). Herein, we review the literature and gather all available evidence, from
MeSH term(s)	Humans ; Pheochromocytoma/drug therapy ; Histone Deacetylase Inhibitors/pharmacology ; Histone Deacetylase Inhibitors/therapeutic use ; Paraganglioma/drug therapy ; Paraganglioma/genetics ; Pancreatic Neoplasms ; Adrenal Gland Neoplasms/drug therapy ; Adrenal Gland Neoplasms/genetics
Chemical Substances	Histone Deacetylase Inhibitors
Language	English
Publishing date	2023-02-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1114699-0
ISSN	1555-3906 ; 0965-0407
ISSN (online)	1555-3906
ISSN	0965-0407
DOI	10.32604/or.2022.026913
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Zs.A 3087: Show issues

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Article ; Online: Inhibition of the Hedgehog pathway in lung cancer.

Dimou, A / Bamias, A / Gogas, H / Syrigos, K

Lung cancer (Amsterdam, Netherlands)

2019 Volume 133, Page(s) 56–61

Abstract: Inhibitors of the hedgehog pathway are effective in patients with basal cell carcinoma and a subgroup of patients with medulloblastoma with active hedgehog signaling. Despite preclinical work suggesting otherwise, clinical trials in solid tumors of ... ...

Abstract	Inhibitors of the hedgehog pathway are effective in patients with basal cell carcinoma and a subgroup of patients with medulloblastoma with active hedgehog signaling. Despite preclinical work suggesting otherwise, clinical trials in solid tumors of epithelial origin have not shown added benefit with these drugs. Here, we review the preclinical and clinical data of hedgehog pathway inhibition in the most common histologic types of lung cancer. We focus on highlighting areas of uncertainty, where further research might define a niche for hedgehog pathway inhibition in patients with lung cancer.
MeSH term(s)	Animals ; Antineoplastic Agents/pharmacology ; Antineoplastic Agents/therapeutic use ; Carcinoma, Basal Cell/drug therapy ; Clinical Trials as Topic ; Drug Evaluation, Preclinical ; Hedgehog Proteins/antagonists & inhibitors ; Hedgehog Proteins/metabolism ; Humans ; Lung Neoplasms/drug therapy ; Lung Neoplasms/metabolism ; Medulloblastoma/drug therapy ; Signal Transduction
Chemical Substances	Antineoplastic Agents ; Hedgehog Proteins
Language	English
Publishing date	2019-05-06
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	632771-0
ISSN	1872-8332 ; 0169-5002
ISSN (online)	1872-8332
ISSN	0169-5002
DOI	10.1016/j.lungcan.2019.05.004
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Zs.A 2135: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Neoadjuvant treatment in ovarian cancer: New perspectives, new challenges.

Nikolaidi, Adamantia / Fountzilas, Elena / Fostira, Florentia / Psyrri, Amanda / Gogas, Helen / Papadimitriou, Christos

Frontiers in oncology

2022 Volume 12, Page(s) 820128

Abstract: Ovarian cancer remains the leading cause of death from gynecological cancer. Survival is significantly related to the stage of the disease at diagnosis. Of quite importance is primary cytoreductive surgery, having as a goal to remove all visible tumor ... ...

Abstract	Ovarian cancer remains the leading cause of death from gynecological cancer. Survival is significantly related to the stage of the disease at diagnosis. Of quite importance is primary cytoreductive surgery, having as a goal to remove all visible tumor tissue, and is the standard primary treatment in combination with platinum-based chemotherapy for patients with advanced ovarian carcinoma. Neo-adjuvant chemotherapy (NACT) has been implemented mostly in treating advanced disease, with studies performed having numerous limitations. Data extrapolated from these studies have not shown inferiority survival of NACT, compared to primary debulking surgery. The role of NACT is of particular interest because of the intrinsic mechanisms that are involved in the process, which can be proven as therapeutic approaches with enormous potential. NACT increases immune infiltration and programmed death ligand-1 (PDL-1) expression, induces local immune activation, and can potentiate the immunogenicity of immune-exclude high grade serous ovarian tumors, while the combination of NACT with bevacizumab, PARP inhibitors or immunotherapy remains to be evaluated. This article summarizes all available data on studies implementing NACT in the treatment of ovarian cancer, focusing on clinical outcomes and study limitations. High mortality rates observed among ovarian cancer patients necessitates the identification of more effective treatments, along with biomarkers that will aid treatment individualization.
Language	English
Publishing date	2022-07-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.820128
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