Clinical trial NCT03034473: Translational Validation Study to Examine KFO179-1 Biomarker Scores for the Prediction and Prognosis of Advanced Primary Resectable Rectal Cancer Stages UICC-II-IV, With a 5-Fluorouracil-based Standard Radiochemotherapy Followed by Total Mesorectal Excision.
Official title: Translational Validation Study to Examine KFO179-1 Biomarker Scores for the Prediction and Prognosis of Advanced Primary Resectable Rectal Cancer Stages UICC II-IV, With a 5-FU-based Standard Radiochemotherapy Followed by Total Mesorectal Excision.
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Locally Advanced Rectal Cancer
Keywords: locally advanced rectal cancer
translational research
Biomarker
Lead sponsor: University Medical Center Goettingen
Sponsor class: OTHER
Collaborators: name: German Research Foundation
First posted: 2017-01-27
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: DIAGNOSTIC

Brief summary: The objective of the TransValid-KFO179/GRCSG-Trial-A is the validation of potential biomarkers. These are predictive (Prediction of probability of response to a certain therapy) / prognostic (predicting long-term outcome) microarray-based gene expression signatures and immunohistochemically evaluated biomarkers. The evaluation was done within the KFO179 (www.kfo179.de) - the validation is implemented in this trial.

Therefore tumor material of patients undergoing standard radiochemotherapy will be analyzed from pretreatment biopsies an residual tissue from the resection specimen after surgery. This validation and the biomaterial asservation will be incorporated into clinical routine in all participating centers as a model for the treatment of solid tumors. The obtained biomarkers with a predictive and prognostic power will be used to develop an algorithm to predict patients at high risk of local and distant cancer recurrence.

Detailed description: The objective of the TransValid-KFO179/GRCSG-Trial-A is to validate the predictive/prognostic microarray-based gene expression signatures and single gene biomarkers (including 5-Fluorouracil (FU) metabolism, apoptosis, Kirsten Rat Sarcoma (KRAS), CpGCpG island methylation phenotype (CIMP) and TGF-beta pathway), which have been established in patients treated with standard 5-FU based RCT in the GRCSG trials (e.g. the CAO/ARO/AIO-94-, CAO/ARO/AIO-04-phase III trials). This validation will be incorporated into clinical routine in all participating centers as a model for the treatment of solid tumors. If the KFO179 biomarkers are predictive at a satisfactory level in the validation set, we will propose a prediction algorithm to stratify the patient population into a "high"-risk and "low"-risk population to develop local and distant cancer recurrence.

Eligibility criteria: Inclusion Criteria:

* Aged 18 to 85 years, inclusive
* Histologically confirmed advanced primary rectal cancer localized up to 12 cm above the anocutaneous line (determined with a rigid rectoscope), classified as T3/T4 or N+ carcinomas or with evidence for synchronous, but resectable distant metastases (liver or lung metastases)
* No specific tumor treatment except colostomy due to tumor stenosis with ileus
* World Health Organization (WHO)/Eastern Cooperative Oncology Group (ECOG) status ≤2
* Adequate bone marrow function (WBC \>3.0x10\^9/L, neutrophils \>1.5x10\^9/L, thrombocytes \>100x10\^9/L, hemoglobin ≥10 g/dl)
* Adequate liver function (bilirubin ≤2.0 mg/dl, SGOT, SGPT, AP, gamma-GT \< three point five fold of upper level of normal range
* serum creatinine \< 1.5 mg/dl
* Written and signed informed consent indicating the understanding of the investigational nature and the study protocol.

Exclusion Criteria:

* Pregnant or lactating women
* Men and women unwilling or unable to use highly effective methods of contraception (per institutional standard) during treatment and for 6 months (male or female) after the end of treatment
* Prolonged drug, medication or alcohol abuse
* Previous chemotherapy (up to 2 years before diagnosis of rectal cancer)
* Previous radiotherapy to the pelvic area
* Simultaneous therapy with other anti-cancer drugs
* Participation in a clinical trial in the period 30 days prior to inclusion
* Patients (man and woman) who are not able or willing to accept treatment and follow-up care according to trial protocol
* Patients (man and woman) with uncontrolled, serious physical or mental diseases, e.g.: instable cardiac disease in spite of medical treatment, myocardial infarction during the last 3 months prior to start of trial participation

  * neurological or psychiatric dysfunction including dementia or seizure disorder
  * Disseminated infection or sepsis
  * Disseminated intravascular coagulopathy
  * Symptomatic neuropathy (NCI CTC ≥2)
* Patients with secondary malignancies except basal cell carcinoma of the skin or carcinoma in situ of the cervix, which have been successfully treated. (The inclusion of patients with other tumors that were successfully treated and no recurrence within the last 3-5 years should be discussed before registration in the trial)
* Chronic diarrhea (\>grade 1 according NCI CTCAE)
* Allergic reaction to platin-derivates or study medication
* Simultaneous treatment with sorivudine and analogous
* Known Dihydropyrimidine dehydrogenase deficiency

Primary outcomes:
measure: Number of patients with histopathologically confirmed complete remission (pCR) (ypT0N0 R0) after preoperative RCTx related to pretherapeutically determined gene expression signature predicting tumor response to RCTx.
timeFrame: 1 year after surgery
Secondary outcomes:
measure: R0-rate of resection
timeFrame: 30 days after surgery based on histopathological findings and reports
measure: post-operative 30-day mortality
timeFrame: 30 days after surgery
measure: post-operative morbidity (esp. rate of anastomotic insufficiencies)
timeFrame: 30 days after surgery
measure: post-operative late complications (defecation problems, anastomotic, stenoses, loss of sphincter function)
timeFrame: up to 5 years after surgery
measure: Quality of TME-surgery according to M.E.R.C.U.R.Y classification
timeFrame: 30 days after surgery based on surgical and histopathological findings/reports
measure: acute and late toxicity of the chemotherapy according to the CommonToxicity Criteria of the National Cancer Institute (CTC) (vs 4.0)
timeFrame: up to 5 years after therapy
measure: Disease free survival (DSF) after 2 and 3 years (local and/or distant recurrences)
timeFrame: up to 3 years after surgery
measure: Cumulative incidence of local relapses and distant metastases
timeFrame: up to 5 years after surgery
measure: Overall cancer specific survival (CSS) after 3 and 5 years
timeFrame: up to 5 years after surgery
measure: Quality of life (QL) according to the EORTC-Questionnaire QLQ-30 (3.0)
timeFrame: up to 5 years after surgery
measure: Wexner-Score-Questionnaire
timeFrame: up to 5 years after surgery
Other outcomes:
Locations:
city: Gottingen
country: Germany
facility: University Medical Center Goettingen
state: Lower Saxony
Study officials:
affiliation: University Medical Center Goettingen
name: Torsten Liersch, MD, Prof.
role: PRINCIPAL_INVESTIGATOR
affiliation: University Medical Center Goettingen
name: Michael Ghadimi, MD, Prof.
role: STUDY_DIRECTOR
References:
citation: Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, Martus P, Tschmelitsch J, Hager E, Hess CF, Karstens JH, Liersch T, Schmidberger H, Raab R; German Rectal Cancer Study Group. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004 Oct 21;351(17):1731-40. doi: 10.1056/NEJMoa040694.
citation: Jakob C, Aust DE, Meyer W, Baretton GB, Schwabe W, Hausler P, Becker H, Liersch T. Thymidylate synthase, thymidine phosphorylase, dihydropyrimidine dehydrogenase expression, and histological tumour regression after 5-FU-based neo-adjuvant chemoradiotherapy in rectal cancer. J Pathol. 2004 Dec;204(5):562-8. doi: 10.1002/path.1663.
citation: Ghadimi BM, Grade M, Difilippantonio MJ, Varma S, Simon R, Montagna C, Fuzesi L, Langer C, Becker H, Liersch T, Ried T. Effectiveness of gene expression profiling for response prediction of rectal adenocarcinomas to preoperative chemoradiotherapy. J Clin Oncol. 2005 Mar 20;23(9):1826-38. doi: 10.1200/JCO.2005.00.406.
citation: Jakob C, Liersch T, Meyer W, Baretton GB, Hausler P, Schwabe W, Becker H, Aust DE. Immunohistochemical analysis of thymidylate synthase, thymidine phosphorylase, and dihydropyrimidine dehydrogenase in rectal cancer (cUICC II/III): correlation with histopathologic tumor regression after 5-fluorouracil-based long-term neoadjuvant chemoradiotherapy. Am J Surg Pathol. 2005 Oct;29(10):1304-9. doi: 10.1097/01.pas.0000170346.55304.88.
citation: Liersch T, Meller J, Kulle B, Behr TM, Markus P, Langer C, Ghadimi BM, Wegener WA, Kovacs J, Horak ID, Becker H, Goldenberg DM. Phase II trial of carcinoembryonic antigen radioimmunotherapy with 131I-labetuzumab after salvage resection of colorectal metastases in the liver: five-year safety and efficacy results. J Clin Oncol. 2005 Sep 20;23(27):6763-70. doi: 10.1200/JCO.2005.18.622.
citation: Rodel C, Martus P, Papadoupolos T, Fuzesi L, Klimpfinger M, Fietkau R, Liersch T, Hohenberger W, Raab R, Sauer R, Wittekind C. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer. J Clin Oncol. 2005 Dec 1;23(34):8688-96. doi: 10.1200/JCO.2005.02.1329. Epub 2005 Oct 24.
citation: Grade M, Ghadimi BM, Varma S, Simon R, Wangsa D, Barenboim-Stapleton L, Liersch T, Becker H, Ried T, Difilippantonio MJ. Aneuploidy-dependent massive deregulation of the cellular transcriptome and apparent divergence of the Wnt/beta-catenin signaling pathway in human rectal carcinomas. Cancer Res. 2006 Jan 1;66(1):267-82. doi: 10.1158/0008-5472.CAN-05-2533.
citation: Grade M, Becker H, Liersch T, Ried T, Ghadimi BM. Molecular cytogenetics: genomic imbalances in colorectal cancer and their clinical impact. Cell Oncol. 2006;28(3):71-84. doi: 10.1155/2006/173815.
citation: Jakob C, Liersch T, Meyer W, Baretton GB, Schwabe W, Hausler P, Kulle B, Becker H, Aust DE. Prognostic value of histologic tumor regression, thymidylate synthase, thymidine phosphorylase, and dihydropyrimidine dehydrogenase in rectal cancer UICC Stage II/III after neoadjuvant chemoradiotherapy. Am J Surg Pathol. 2006 Sep;30(9):1169-74. doi: 10.1097/01.pas.0000213302.13435.6e.
citation: Liersch T, Langer C, Ghadimi BM, Kulle B, Aust DE, Baretton GB, Schwabe W, Hausler P, Becker H, Jakob C. Lymph node status and TS gene expression are prognostic markers in stage II/III rectal cancer after neoadjuvant fluorouracil-based chemoradiotherapy. J Clin Oncol. 2006 Sep 1;24(25):4062-8. doi: 10.1200/JCO.2005.04.2739.
citation: Ghadimi BM, Grade M, Monkemeyer C, Kulle B, Gaedcke J, Gunawan B, Langer C, Liersch T, Becker H. Distinct chromosomal profiles in metastasizing and non-metastasizing colorectal carcinomas. Cell Oncol. 2006;28(5-6):273-81. doi: 10.1155/2006/529190.
citation: Rodel C, Liersch T, Hermann RM, Arnold D, Reese T, Hipp M, Furst A, Schwella N, Bieker M, Hellmich G, Ewald H, Haier J, Lordick F, Flentje M, Sulberg H, Hohenberger W, Sauer R. Multicenter phase II trial of chemoradiation with oxaliplatin for rectal cancer. J Clin Oncol. 2007 Jan 1;25(1):110-7. doi: 10.1200/JCO.2006.08.3675.
citation: Fietkau R, Rodel C, Hohenberger W, Raab R, Hess C, Liersch T, Becker H, Wittekind C, Hutter M, Hager E, Karstens J, Ewald H, Christen N, Jagoditsch M, Martus P, Sauer R; German Rectal Cancer Study Group. Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: results of study CAO/ARO/AIO-94. Int J Radiat Oncol Biol Phys. 2007 Mar 15;67(4):1008-19. doi: 10.1016/j.ijrobp.2006.10.020. Epub 2006 Dec 29.
citation: Grade M, Hormann P, Becker S, Hummon AB, Wangsa D, Varma S, Simon R, Liersch T, Becker H, Difilippantonio MJ, Ghadimi BM, Ried T. Gene expression profiling reveals a massive, aneuploidy-dependent transcriptional deregulation and distinct differences between lymph node-negative and lymph node-positive colon carcinomas. Cancer Res. 2007 Jan 1;67(1):41-56. doi: 10.1158/0008-5472.CAN-06-1514.
citation: Liersch T, Meller J, Bittrich M, Kulle B, Becker H, Goldenberg DM. Update of carcinoembryonic antigen radioimmunotherapy with (131)I-labetuzumab after salvage resection of colorectal liver metastases: comparison of outcome to a contemporaneous control group. Ann Surg Oncol. 2007 Sep;14(9):2577-90. doi: 10.1245/s10434-006-9328-x. Epub 2007 Jun 15.
citation: Vorwerk H, Hermann RM, Christiansen H, Liersch T, Hess CF, Weiss E. A special device (double-hole belly board) and optimal radiation technique to reduce testicular radiation exposure in radiotherapy of rectal cancer. Radiother Oncol. 2007 Sep;84(3):320-7. doi: 10.1016/j.radonc.2007.06.017. Epub 2007 Aug 13.
citation: Rodel C, Arnold D, Hipp M, Liersch T, Dellas K, Iesalnieks I, Hermann RM, Lordick F, Hinke A, Hohenberger W, Sauer R. Phase I-II trial of cetuximab, capecitabine, oxaliplatin, and radiotherapy as preoperative treatment in rectal cancer. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1081-6. doi: 10.1016/j.ijrobp.2007.07.2356. Epub 2007 Sep 19.
citation: Jakob C, Liersch T, Meyer W, Becker H, Baretton GB, Aust DE. Predictive value of Ki67 and p53 in locally advanced rectal cancer: correlation with thymidylate synthase and histopathological tumor regression after neoadjuvant 5-FU-based chemoradiotherapy. World J Gastroenterol. 2008 Feb 21;14(7):1060-6. doi: 10.3748/wjg.14.1060.
citation: Stoehlmacher J, Goekkurt E, Mogck U, Aust DE, Kramer M, Baretton GB, Liersch T, Ehninger G, Jakob C. Thymidylate synthase genotypes and tumour regression in stage II/III rectal cancer patients after neoadjuvant fluorouracil-based chemoradiation. Cancer Lett. 2008 Dec 18;272(2):221-5. doi: 10.1016/j.canlet.2008.07.008. Epub 2008 Aug 21.
citation: Kalata P, Martus P, Zettl H, Rodel C, Hohenberger W, Raab R, Becker H, Liersch T, Wittekind C, Sauer R, Fietkau R; German Rectal Cancer Study Group. Differences between clinical trial participants and patients in a population-based registry: the German Rectal Cancer Study vs. the Rostock Cancer Registry. Dis Colon Rectum. 2009 Mar;52(3):425-37. doi: 10.1007/DCR.0b013e318197d13c.
citation: Liersch T, Rothe H, Ghadimi BM, Becker H. [Individualizing treatment for locally advanced rectal cancer]. Chirurg. 2009 Apr;80(4):281-93. doi: 10.1007/s00104-008-1617-4. German.
citation: Liersch T, Grade M, Gaedcke J, Varma S, Difilippantonio MJ, Langer C, Hess CF, Becker H, Ried T, Ghadimi BM. Preoperative chemoradiotherapy in locally advanced rectal cancer: correlation of a gene expression-based response signature with recurrence. Cancer Genet Cytogenet. 2009 Apr 15;190(2):57-65. doi: 10.1016/j.cancergencyto.2008.11.011.
citation: Sprenger T, Rothe H, Langer C, Becker H, Liersch T. Comment on "lymph nodes after preoperative chemoradiotherapy for rectal carcinoma: number, status, and impact on survival". Am J Surg Pathol. 2009 Jul;33(7):1107; author reply 1108. doi: 10.1097/PAS.0b013e31819ca2a4. No abstract available.
citation: Grade M, Gaedcke J, Wangsa D, Varma S, Beckmann J, Liersch T, Hess C, Becker H, Difilippantonio MJ, Ried T, Ghadimi BM. Chromosomal copy number changes of locally advanced rectal cancers treated with preoperative chemoradiotherapy. Cancer Genet Cytogenet. 2009 Aug;193(1):19-28. doi: 10.1016/j.cancergencyto.2009.03.016.
citation: Sprenger T, Rothe H, Homayounfar K, Beissbarth T, Ghadimi BM, Becker H, Liersch T. Preoperative chemoradiotherapy does not necessarily reduce lymph node retrieval in rectal cancer specimens--results from a prospective evaluation with extensive pathological work-up. J Gastrointest Surg. 2010 Jan;14(1):96-103. doi: 10.1007/s11605-009-1057-6. Epub 2009 Oct 15.
citation: Folprecht G, Gruenberger T, Bechstein WO, Raab HR, Lordick F, Hartmann JT, Lang H, Frilling A, Stoehlmacher J, Weitz J, Konopke R, Stroszczynski C, Liersch T, Ockert D, Herrmann T, Goekkurt E, Parisi F, Kohne CH. Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. Lancet Oncol. 2010 Jan;11(1):38-47. doi: 10.1016/S1470-2045(09)70330-4. Epub 2009 Nov 26.
citation: Wolff HA, Gaedcke J, Jung K, Hermann RM, Rothe H, Schirmer M, Liersch T, Herrmann MKA, Hennies S, Rave-Frank M, Hess CF, Christiansen H. High-grade acute organ toxicity during preoperative radiochemotherapy as positive predictor for complete histopathologic tumor regression in multimodal treatment of locally advanced rectal cancer. Strahlenther Onkol. 2010 Jan;186(1):30-35. doi: 10.1007/s00066-009-2037-1. Epub 2009 Dec 28.
citation: Weiss C, Arnold D, Dellas K, Liersch T, Hipp M, Fietkau R, Sauer R, Hinke A, Rodel C. Preoperative radiotherapy of advanced rectal cancer with capecitabine and oxaliplatin with or without cetuximab: A pooled analysis of three prospective phase I-II trials. Int J Radiat Oncol Biol Phys. 2010 Oct 1;78(2):472-8. doi: 10.1016/j.ijrobp.2009.07.1718. Epub 2010 Feb 3.
citation: Gutenberg A, Gerdes JS, Jung K, Sander B, Gunawan B, Bock HC, Liersch T, Bruck W, Rohde V, Fuzesi L. High chromosomal instability in brain metastases of colorectal carcinoma. Cancer Genet Cytogenet. 2010 Apr 1;198(1):47-51. doi: 10.1016/j.cancergencyto.2009.12.006.
citation: Sprenger T, Rothe H, Jung K, Christiansen H, Conradi LC, Ghadimi BM, Becker H, Liersch T. Stage II/III rectal cancer with intermediate response to preoperative radiochemotherapy: do we have indications for individual risk stratification? World J Surg Oncol. 2010 Apr 13;8:27. doi: 10.1186/1477-7819-8-27.
citation: Rodel F, Reichert S, Sprenger T, Gaipl US, Mirsch J, Liersch T, Fulda S, Rodel C. The role of survivin for radiation oncology: moving beyond apoptosis inhibition. Curr Med Chem. 2011;18(2):191-9. doi: 10.2174/092986711794088362.
citation: Sprenger T, Rodel F, Beissbarth T, Conradi LC, Rothe H, Homayounfar K, Wolff HA, Ghadimi BM, Yildirim M, Becker H, Rodel C, Liersch T. Failure of downregulation of survivin following neoadjuvant radiochemotherapy in rectal cancer is associated with distant metastases and shortened survival. Clin Cancer Res. 2011 Mar 15;17(6):1623-31. doi: 10.1158/1078-0432.CCR-10-2592. Epub 2010 Nov 30.
citation: Rodel C, Arnold D, Becker H, Fietkau R, Ghadimi M, Graeven U, Hess C, Hofheinz R, Hohenberger W, Post S, Raab R, Sauer R, Wenz F, Liersch T. Induction chemotherapy before chemoradiotherapy and surgery for locally advanced rectal cancer : is it time for a randomized phase III trial? Strahlenther Onkol. 2010 Dec;186(12):658-64. doi: 10.1007/s00066-010-2194-2. Epub 2010 Nov 30.
citation: Meller J, Liersch T, Oezerden MM, Sahlmann CO, Meller B. Targeting NCA-95 and other granulocyte antigens and receptors with radiolabeled monoclonal antibodies (Mabs). Q J Nucl Med Mol Imaging. 2010 Dec;54(6):582-98.
citation: Meller B, Rave-Franck M, Breunig C, Schirmer M, Baehre M, Nadrowitz R, Liersch T, Meller J. Novel Carcinoembryonic-Antigen-(CEA)-Specific Pretargeting System to Assess Tumor Cell Viability after Irradiation of Colorectal Cancer Cells. Strahlenther Onkol. 2011 Feb;187(2):120-6. doi: 10.1007/s00066-010-2191-5. Epub 2011 Jan 24.
citation: Danner BC, Gerdes JS, Jung K, Sander B, Enders C, Liersch T, Seipelt R, Gutenberg A, Gunawan B, Schondube FA, Fuzesi L. Comparison of chromosomal aberrations in primary colorectal carcinomas to their pulmonary metastases. Cancer Genet. 2011 Mar;204(3):122-8. doi: 10.1016/j.cancergen.2010.12.003.
citation: Wolff HA, Conradi LC, Schirmer M, Beissbarth T, Sprenger T, Rave-Frank M, Hennies S, Hess CF, Becker H, Christiansen H, Liersch T. Gender-specific acute organ toxicity during intensified preoperative radiochemotherapy for rectal cancer. Oncologist. 2011;16(5):621-31. doi: 10.1634/theoncologist.2010-0414. Epub 2011 May 9.
citation: Gaedcke J, Liersch T, Hess C, Becker H, Rodel C, Ghadimi BM. [Rectal cancer: current status of multimodal therapy--when and how?]. Zentralbl Chir. 2011 Aug;136(4):334-42. doi: 10.1055/s-0031-1271581. Epub 2011 Aug 23. German.
citation: Gehoff A, Basten O, Sprenger T, Conradi LC, Bismarck C, Bandorski D, Merkelbach-Bruse S, Schneider-Stock R, Stoehr R, Wirtz RM, Kitz J, Muller A, Hartmann A, Becker H, Ghadimi BM, Liersch T, Ruschoff J. Optimal lymph node harvest in rectal cancer (UICC stages II and III) after preoperative 5-FU-based radiochemotherapy. Acetone compression is a new and highly efficient method. Am J Surg Pathol. 2012 Feb;36(2):202-13. doi: 10.1097/PAS.0b013e31823fa35b.
citation: Rodel C, Hofheinz R, Liersch T. Rectal cancer: state of the art in 2012. Curr Opin Oncol. 2012 Jul;24(4):441-7. doi: 10.1097/CCO.0b013e328352ea02.
citation: Sauer R, Liersch T, Merkel S, Fietkau R, Hohenberger W, Hess C, Becker H, Raab HR, Villanueva MT, Witzigmann H, Wittekind C, Beissbarth T, Rodel C. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol. 2012 Jun 1;30(16):1926-33. doi: 10.1200/JCO.2011.40.1836. Epub 2012 Apr 23.
citation: Rodel C, Liersch T, Becker H, Fietkau R, Hohenberger W, Hothorn T, Graeven U, Arnold D, Lang-Welzenbach M, Raab HR, Sulberg H, Wittekind C, Potapov S, Staib L, Hess C, Weigang-Kohler K, Grabenbauer GG, Hoffmanns H, Lindemann F, Schlenska-Lange A, Folprecht G, Sauer R; German Rectal Cancer Study Group. Preoperative chemoradiotherapy and postoperative chemotherapy with fluorouracil and oxaliplatin versus fluorouracil alone in locally advanced rectal cancer: initial results of the German CAO/ARO/AIO-04 randomised phase 3 trial. Lancet Oncol. 2012 Jul;13(7):679-87. doi: 10.1016/S1470-2045(12)70187-0. Epub 2012 May 23.
citation: Rodel F, Sprenger T, Kaina B, Liersch T, Rodel C, Fulda S, Hehlgans S. Survivin as a prognostic/predictive marker and molecular target in cancer therapy. Curr Med Chem. 2012;19(22):3679-88. doi: 10.2174/092986712801661040.
citation: Sprenger T, Conradi LC, Beissbarth T, Ermert H, Homayounfar K, Middel P, Ruschoff J, Wolff HA, Schuler P, Ghadimi BM, Rodel C, Becker H, Rodel F, Liersch T. Enrichment of CD133-expressing cells in rectal cancers treated with preoperative radiochemotherapy is an independent marker for metastasis and survival. Cancer. 2013 Jan 1;119(1):26-35. doi: 10.1002/cncr.27703. Epub 2012 Jun 26.
citation: Conradi LC, Styczen H, Sprenger T, Wolff HA, Rodel C, Nietert M, Homayounfar K, Gaedcke J, Kitz J, Talaulicar R, Becker H, Ghadimi M, Middel P, Beissbarth T, Ruschoff J, Liersch T. Frequency of HER-2 positivity in rectal cancer and prognosis. Am J Surg Pathol. 2013 Apr;37(4):522-31. doi: 10.1097/PAS.0b013e318272ff4d.
citation: Wolff HA, Conradi LC, Beissbarth T, Leha A, Hohenberger W, Merkel S, Fietkau R, Raab HR, Tschmelitsch J, Hess CF, Becker H, Wittekind C, Sauer R, Rodel C, Liersch T; German Rectal Cancer Study Group. Gender affects acute organ toxicity during radiochemotherapy for rectal cancer: long-term results of the German CAO/ARO/AIO-94 phase III trial. Radiother Oncol. 2013 Jul;108(1):48-54. doi: 10.1016/j.radonc.2013.05.009. Epub 2013 Jun 11.
citation: Sprenger T, Rothe H, Becker H, Beissbarth T, Homayounfar K, Gauss K, Kitz J, Wolff H, Scheel AH, Ghadimi M, Rodel C, Conradi LC, Liersch T. Lymph node metastases in rectal cancer after preoperative radiochemotherapy: impact of intramesorectal distribution and residual micrometastatic involvement. Am J Surg Pathol. 2013 Aug;37(8):1283-9. doi: 10.1097/PAS.0b013e3182886ced.
citation: Fokas E, Conradi L, Weiss C, Sprenger T, Middel P, Rau T, Dellas K, Kitz J, Rodel F, Sauer R, Ruschoff J, Beissbarth T, Arnold D, Ghadimi BM, Rodel C, Liersch T. Preoperative chemoradiation therapy with capecitabine/oxaliplatin and cetuximab in rectal cancer: long-term results of a prospective phase 1/2 study. Int J Radiat Oncol Biol Phys. 2013 Dec 1;87(5):992-9. doi: 10.1016/j.ijrobp.2013.09.011. Epub 2013 Oct 24.
citation: Quack H, Erpenbeck L, Wolff HA, Sprenger T, Seitz CS, Schon MP, Neumann S, Stanek K, Ghadimi BM, Michels B, Middel P, Schaefer IM, Liersch T, Conradi LC. Oxaliplatin-Induced Leukocytoclastic Vasculitis under Adjuvant Chemotherapy for Colorectal Cancer: Two Cases of a Rare Adverse Event. Case Rep Oncol. 2013 Dec 11;6(3):609-15. doi: 10.1159/000357166. eCollection 2013 Sep.
citation: Folprecht G, Gruenberger T, Bechstein W, Raab HR, Weitz J, Lordick F, Hartmann JT, Stoehlmacher-Williams J, Lang H, Trarbach T, Liersch T, Ockert D, Jaeger D, Steger U, Suedhoff T, Rentsch A, Kohne CH. Survival of patients with initially unresectable colorectal liver metastases treated with FOLFOX/cetuximab or FOLFIRI/cetuximab in a multidisciplinary concept (CELIM study). Ann Oncol. 2014 May;25(5):1018-25. doi: 10.1093/annonc/mdu088. Epub 2014 Feb 27.
citation: Fokas E, Liersch T, Fietkau R, Hohenberger W, Beissbarth T, Hess C, Becker H, Ghadimi M, Mrak K, Merkel S, Raab HR, Sauer R, Wittekind C, Rodel C. Tumor regression grading after preoperative chemoradiotherapy for locally advanced rectal carcinoma revisited: updated results of the CAO/ARO/AIO-94 trial. J Clin Oncol. 2014 May 20;32(15):1554-62. doi: 10.1200/JCO.2013.54.3769. Epub 2014 Apr 21.
citation: Homayounfar K, Bleckmann A, Helms HJ, Lordick F, Ruschoff J, Conradi LC, Sprenger T, Ghadimi M, Liersch T. Discrepancies between medical oncologists and surgeons in assessment of resectability and indication for chemotherapy in patients with colorectal liver metastases. Br J Surg. 2014 Apr;101(5):550-7. doi: 10.1002/bjs.9436. Epub 2014 Feb 20.
citation: Ilgen P, Stoldt S, Conradi LC, Wurm CA, Ruschoff J, Ghadimi BM, Liersch T, Jakobs S. STED super-resolution microscopy of clinical paraffin-embedded human rectal cancer tissue. PLoS One. 2014 Jul 15;9(7):e101563. doi: 10.1371/journal.pone.0101563. eCollection 2014.
citation: Fokas E, Liersch T, Fietkau R, Hohenberger W, Hess C, Becker H, Sauer R, Wittekind C, Rodel C. Downstage migration after neoadjuvant chemoradiotherapy for rectal cancer: the reverse of the Will Rogers phenomenon? Cancer. 2015 Jun 1;121(11):1724-7. doi: 10.1002/cncr.29260. Epub 2015 Jan 21.
citation: Scheel AH, Reineke RA, Sprenger T, Lokka S, Kitz J, Ghadimi BM, Ruschoff J, Liersch T, Middel P. Comprehensive lymph node morphometry in rectal cancer using acetone compression. J Clin Pathol. 2015 Jun;68(6):458-64. doi: 10.1136/jclinpath-2014-202555. Epub 2015 Mar 16.
citation: Styczen H, Nagelmeier I, Beissbarth T, Nietert M, Homayounfar K, Sprenger T, Boczek U, Stanek K, Kitz J, Wolff HA, Ghadimi BM, Middel P, Liersch T, Ruschoff J, Conradi LC. HER-2 and HER-3 expression in liver metastases of patients with colorectal cancer. Oncotarget. 2015 Jun 20;6(17):15065-76. doi: 10.18632/oncotarget.3527.
citation: Poschau M, Dickreuter E, Singh-Muller J, Zscheppang K, Eke I, Liersch T, Cordes N. EGFR and beta1-integrin targeting differentially affect colorectal carcinoma cell radiosensitivity and invasion. Radiother Oncol. 2015 Sep;116(3):510-6. doi: 10.1016/j.radonc.2015.06.005. Epub 2015 Jun 18.
citation: Rodel C, Graeven U, Fietkau R, Hohenberger W, Hothorn T, Arnold D, Hofheinz RD, Ghadimi M, Wolff HA, Lang-Welzenbach M, Raab HR, Wittekind C, Strobel P, Staib L, Wilhelm M, Grabenbauer GG, Hoffmanns H, Lindemann F, Schlenska-Lange A, Folprecht G, Sauer R, Liersch T; German Rectal Cancer Study Group. Oxaliplatin added to fluorouracil-based preoperative chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO-04 study): final results of the multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2015 Aug;16(8):979-89. doi: 10.1016/S1470-2045(15)00159-X. Epub 2015 Jul 15.
citation: Bleckmann A, Conradi LC, Menck K, Schmick NA, Schubert A, Rietkotter E, Arackal J, Middel P, Schambony A, Liersch T, Homayounfar K, Beissbarth T, Klemm F, Binder C, Pukrop T. beta-catenin-independent WNT signaling and Ki67 in contrast to the estrogen receptor status are prognostic and associated with poor prognosis in breast cancer liver metastases. Clin Exp Metastasis. 2016 Apr;33(4):309-23. doi: 10.1007/s10585-016-9780-3. Epub 2016 Feb 9.
citation: Sprenger T, Rothe H, Conradi LC, Beissbarth T, Kauffels A, Kitz J, Homayounfar K, Wolff H, Strobel P, Ghadimi M, Wittekind C, Sauer R, Rodel C, Liersch T. Stage-Dependent Frequency of Lymph Node Metastases in Patients With Rectal Carcinoma After Preoperative Chemoradiation: Results from the CAO/ARO/AIO-94 Trial and From a Comparative Prospective Evaluation With Extensive Pathological Workup. Dis Colon Rectum. 2016 May;59(5):377-85. doi: 10.1097/DCR.0000000000000570.
citation: Jo P, Nietert M, Gusky L, Kitz J, Conradi LC, Muller-Dornieden A, Schuler P, Wolff HA, Ruschoff J, Strobel P, Grade M, Liersch T, Beissbarth T, Ghadimi MB, Sax U, Gaedcke J. Neoadjuvant Therapy in Rectal Cancer - Biobanking of Preoperative Tumor Biopsies. Sci Rep. 2016 Oct 18;6:35589. doi: 10.1038/srep35589.
citation: Sahlmann CO, Homayounfar K, Niessner M, Dyczkowski J, Conradi LC, Braulke F, Meller B, Beissbarth T, Ghadimi BM, Meller J, Goldenberg DM, Liersch T. Repeated adjuvant anti-CEA radioimmunotherapy after resection of colorectal liver metastases: Safety, feasibility, and long-term efficacy results of a prospective phase 2 study. Cancer. 2017 Feb 15;123(4):638-649. doi: 10.1002/cncr.30390. Epub 2016 Oct 20.