Skip to main content
Erschienen in: International Journal of Colorectal Disease 2/2009

01.02.2009 | Original Article

Evaluation of novel histone deacetylase inhibitors as therapeutic agents for colorectal adenocarcinomas compared to established regimens with the histoculture drug response assay

verfasst von: Jin C. Kim, Dae D. Kim, Yoo M. Lee, Tae W. Kim, Dong H. Cho, Moon B. Kim, Seong G. Ro, Seon Y. Kim, Yong S. Kim, Jung S. Lee

Erschienen in: International Journal of Colorectal Disease | Ausgabe 2/2009

Einloggen, um Zugang zu erhalten

Abstract

Background and aims

This study was to evaluate the efficacy of histone deacetylase (HDAC) inhibitors in colorectal cancer together with other established regimens.

Materials and methods

Chemosensitivities of 114 colorectal cancer patients to established regimens (fluorouracil (5-FU with leucovorin (FL), capecitabine, FL with irinotecan (FLIRI), and FL with oxaliplatin (FLOX)) as well as five hydroxamic acid derivatives (suberoylanilide hydroxamic acid, PXD101, and three novel candidates of CG-1, CG-2, and CG-3) were comparatively evaluated using the histoculture drug response assay.

Results

The chemosensitivity with established regimens was between 34.2% and 52.6%, when the cutoff value of the inhibition ratio was set at 30%, and between 54.5% and 84.1% with HDAC inhibitors. All HDAC inhibitors displayed synergistic effects in combination with established regimens of FLOX and FLIRI (P ≤ 0.0001–0.002). Advanced T- and N-category tumors and patients with synchronous adenoma displayed higher chemosensitivity to CG-3, CG-2, and CG-1, respectively, on a multivariate analysis (P = 0.023, 0.044, and 0.045, respectively). Tumors with mismatch repair defects were closely correlated with chemosensitivities to combined regimens of PDX101 with FLOX and FLIRI (P = 0.044 and 0.048, respectively).

Conclusions

Our findings firstly demonstrated the chemo-responsiveness of colorectal cancers to HDAC inhibitors with therapeutic efficacy comparable to the established regimens. Additionally, tumor growth and heredity were significantly associated with specific regimens, supporting their possible role as chemosensitive predictors.
Literatur
1.
Zurück zum Zitat Kelly C, Cassidy J (2007) Chemotherapy in metastatic colorectal cancer. Surg Oncol 16:65–70PubMedCrossRef Kelly C, Cassidy J (2007) Chemotherapy in metastatic colorectal cancer. Surg Oncol 16:65–70PubMedCrossRef
2.
Zurück zum Zitat de Gramont A, Buyse M, Abrahantes JC, Burzykowski T, Quinaux E, Cervantes A, Figer A, Lledo G, Flesch M, Mineur L, Carola E, Etienne PL, Rivera F, Chirivella I, Perez-Staub N, Louvet C, André T, Tabah-Fisch I, Tournigand C (2007) Reintroduction of oxaliplatin is associated with improved survival in advanced colorectal cancer. J Clin Oncol 25:3224–3229PubMedCrossRef de Gramont A, Buyse M, Abrahantes JC, Burzykowski T, Quinaux E, Cervantes A, Figer A, Lledo G, Flesch M, Mineur L, Carola E, Etienne PL, Rivera F, Chirivella I, Perez-Staub N, Louvet C, André T, Tabah-Fisch I, Tournigand C (2007) Reintroduction of oxaliplatin is associated with improved survival in advanced colorectal cancer. J Clin Oncol 25:3224–3229PubMedCrossRef
3.
Zurück zum Zitat Douillard JY, Cunningham D, Roth AD, Navarro M, James RD, Karasek P, Jandik P, Iveson T, Carmichael J, Alakl M, Gruia G, Awad L, Rougier P (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355:1041–1047PubMedCrossRef Douillard JY, Cunningham D, Roth AD, Navarro M, James RD, Karasek P, Jandik P, Iveson T, Carmichael J, Alakl M, Gruia G, Awad L, Rougier P (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355:1041–1047PubMedCrossRef
4.
Zurück zum Zitat Sabharwal A, Kerr D (2007) Chemotherapy for colorectal cancer in the metastatic and adjuvant setting: past, present and future. Expert Rev Anticancer Ther 7:477–487PubMedCrossRef Sabharwal A, Kerr D (2007) Chemotherapy for colorectal cancer in the metastatic and adjuvant setting: past, present and future. Expert Rev Anticancer Ther 7:477–487PubMedCrossRef
5.
Zurück zum Zitat Marchion D, Munster P (2007) Development of histone deacetylase inhibitors for cancer treatment. Expert Rev Anticancer Ther 7:583–598PubMedCrossRef Marchion D, Munster P (2007) Development of histone deacetylase inhibitors for cancer treatment. Expert Rev Anticancer Ther 7:583–598PubMedCrossRef
6.
Zurück zum Zitat Burgess A, Ruefli A, Beamish H, Warrener R, Saunders N, Johnstone R, Gabrielli B (2004) Histone deacetylase inhibitors specifically kill nonproliferating tumour cells. Oncogene 23:6693–6701PubMedCrossRef Burgess A, Ruefli A, Beamish H, Warrener R, Saunders N, Johnstone R, Gabrielli B (2004) Histone deacetylase inhibitors specifically kill nonproliferating tumour cells. Oncogene 23:6693–6701PubMedCrossRef
7.
Zurück zum Zitat Glaser KB (2007) HDAC inhibitors: clinical update and mechanism-based potential. Biochem Pharmacol 74:659–671PubMedCrossRef Glaser KB (2007) HDAC inhibitors: clinical update and mechanism-based potential. Biochem Pharmacol 74:659–671PubMedCrossRef
8.
Zurück zum Zitat Waldenmaier DS, Babarina A, Kischkel FC (2003) Rapid in vitro chemosensitivity analysis of human colon tumor cell lines. Toxicol Appl Pharmacol 192:237–245PubMedCrossRef Waldenmaier DS, Babarina A, Kischkel FC (2003) Rapid in vitro chemosensitivity analysis of human colon tumor cell lines. Toxicol Appl Pharmacol 192:237–245PubMedCrossRef
9.
Zurück zum Zitat Moon YW, Choi SH, Kim YT, Sohn JH, Chang J, Kim SK, Park MS, Chung KY, Lee HJ, Kim JH (2007) Adenosine triphosphate-based chemotherapy response assay (ATP-CRA)-guided platinum-based 2-drug chemotherapy for unresectable nonsmall-cell lung cancer. Cancer 109:1829–1835PubMedCrossRef Moon YW, Choi SH, Kim YT, Sohn JH, Chang J, Kim SK, Park MS, Chung KY, Lee HJ, Kim JH (2007) Adenosine triphosphate-based chemotherapy response assay (ATP-CRA)-guided platinum-based 2-drug chemotherapy for unresectable nonsmall-cell lung cancer. Cancer 109:1829–1835PubMedCrossRef
10.
Zurück zum Zitat Nakada S, Aoki D, Ohie S, Horiuchi M, Suzuki N, Kanasugi M, Susumu N, Udagawa Y, Nozawa S (2005) Chemosensitivity testing of ovarian cancer using the histoculture drug response assay: sensitivity to cisplatin and clinical response. Int J Gynecol Cancer 15:445–452PubMedCrossRef Nakada S, Aoki D, Ohie S, Horiuchi M, Suzuki N, Kanasugi M, Susumu N, Udagawa Y, Nozawa S (2005) Chemosensitivity testing of ovarian cancer using the histoculture drug response assay: sensitivity to cisplatin and clinical response. Int J Gynecol Cancer 15:445–452PubMedCrossRef
11.
Zurück zum Zitat Furukawa T, Kubota T, Hoffman RM (1995) Clinical applications of the histoculture drug response assay. Clin Cancer Res 1:305–311PubMed Furukawa T, Kubota T, Hoffman RM (1995) Clinical applications of the histoculture drug response assay. Clin Cancer Res 1:305–311PubMed
12.
Zurück zum Zitat Ohie S, Udagawa Y, Aoki D, Nozawa S (2005) Histoculture drug response assay to monitor chemoresponse. Methods Mol Med 110:79–86PubMed Ohie S, Udagawa Y, Aoki D, Nozawa S (2005) Histoculture drug response assay to monitor chemoresponse. Methods Mol Med 110:79–86PubMed
13.
Zurück zum Zitat Vescio RA, Redfern CH, Nelson TJ, Ugoretz S, Stern PH, Hoffman RM (1987) In vivo-like drug responses of human tumors growing in three-dimensional gel-supported primary culture. Proc Natl Acad Sci USA 84:5029–5033PubMedCrossRef Vescio RA, Redfern CH, Nelson TJ, Ugoretz S, Stern PH, Hoffman RM (1987) In vivo-like drug responses of human tumors growing in three-dimensional gel-supported primary culture. Proc Natl Acad Sci USA 84:5029–5033PubMedCrossRef
14.
Zurück zum Zitat Kubota T, Sasano N, Abe O, Nakao I, Kawamura E, Saito T, Endo M, Kimura K, Demura H, Sasano H, Nagura H, Ogawa N, Hoffman RM (1995) Potential of the histoculture drug-response assay to contribute to cancer patient survival. Clin Cancer Res 1:1537–1543PubMed Kubota T, Sasano N, Abe O, Nakao I, Kawamura E, Saito T, Endo M, Kimura K, Demura H, Sasano H, Nagura H, Ogawa N, Hoffman RM (1995) Potential of the histoculture drug-response assay to contribute to cancer patient survival. Clin Cancer Res 1:1537–1543PubMed
15.
Zurück zum Zitat Singh B, Li R, Xu L, Poluri A, Patel S, Shaha AR, Pfister D, Sherman E, Goberdhan A, Hoffman RM, Shah J (2002) Prediction of survival in patients with head and neck cancer using the histoculture drug response assay. Head Neck 24:437–442PubMedCrossRef Singh B, Li R, Xu L, Poluri A, Patel S, Shaha AR, Pfister D, Sherman E, Goberdhan A, Hoffman RM, Shah J (2002) Prediction of survival in patients with head and neck cancer using the histoculture drug response assay. Head Neck 24:437–442PubMedCrossRef
16.
Zurück zum Zitat Andreotti PE, Cree IA, Kurbacher CM, Hartmann DM, Linder D, Harel G, Gleiberman I, Caruso PA, Ricks SH, Untch M, Sartori C, Bruckner HW (1995) Chemosensitivity testing of human tumors using a microplate adenosine triphosphate luminescence assay: clinical correlation for cisplatin resistance of ovarian carcinoma. Cancer Res 55:5276–5282PubMed Andreotti PE, Cree IA, Kurbacher CM, Hartmann DM, Linder D, Harel G, Gleiberman I, Caruso PA, Ricks SH, Untch M, Sartori C, Bruckner HW (1995) Chemosensitivity testing of human tumors using a microplate adenosine triphosphate luminescence assay: clinical correlation for cisplatin resistance of ovarian carcinoma. Cancer Res 55:5276–5282PubMed
17.
Zurück zum Zitat Yamashita K, Urakami A, Kubozoe T, Ikeda M, Hirabayashi Y, Yamamura M, Iki K, Akiyama T, Matsumoto H, Hirai T, Sadahira Y, Tsunoda T (2005) In vitro detection of cross-resistant and non-cross-resistant agents with fluorouracil for patients with colorectal cancer. Int J Clin Oncol 10:328–332PubMedCrossRef Yamashita K, Urakami A, Kubozoe T, Ikeda M, Hirabayashi Y, Yamamura M, Iki K, Akiyama T, Matsumoto H, Hirai T, Sadahira Y, Tsunoda T (2005) In vitro detection of cross-resistant and non-cross-resistant agents with fluorouracil for patients with colorectal cancer. Int J Clin Oncol 10:328–332PubMedCrossRef
18.
Zurück zum Zitat Kim JC, Han MS, Lee HK, Kim WS, Park SK, Park KC, Bodmer WF, Rowan AJ, Kim OJ (1999) Distribution of carcinoembryonic antigen and biologic behavior in colorectal carcinoma. Dis Colon Rectum 42:640–648PubMedCrossRef Kim JC, Han MS, Lee HK, Kim WS, Park SK, Park KC, Bodmer WF, Rowan AJ, Kim OJ (1999) Distribution of carcinoembryonic antigen and biologic behavior in colorectal carcinoma. Dis Colon Rectum 42:640–648PubMedCrossRef
19.
Zurück zum Zitat Marks PA, Breslow R (2007) Dimethyl sulfoxide to vorinostat: development of this histone deacetylase inhibitor as an anticancer drug. Nat Biotechnol 25:84–90PubMedCrossRef Marks PA, Breslow R (2007) Dimethyl sulfoxide to vorinostat: development of this histone deacetylase inhibitor as an anticancer drug. Nat Biotechnol 25:84–90PubMedCrossRef
20.
Zurück zum Zitat Hayon T, Dvilansky A, Shpilberg O, Nathan I (2003) Appraisal of the MTT-based assay as a useful tool for predicting drug chemosensitivity in leukemia. Leuk Lymphoma 44:1957–1962PubMedCrossRef Hayon T, Dvilansky A, Shpilberg O, Nathan I (2003) Appraisal of the MTT-based assay as a useful tool for predicting drug chemosensitivity in leukemia. Leuk Lymphoma 44:1957–1962PubMedCrossRef
21.
Zurück zum Zitat Andreotti PE, Linder D, Hartmann DM, Cree IA, Pazzagli M, Bruckner HW (1994) TCA-100 tumour chemosensitivity assay: differences in sensitivity between cultured tumour cell lines and clinical studies. J Biolumin Chemilumin 9:373–378PubMedCrossRef Andreotti PE, Linder D, Hartmann DM, Cree IA, Pazzagli M, Bruckner HW (1994) TCA-100 tumour chemosensitivity assay: differences in sensitivity between cultured tumour cell lines and clinical studies. J Biolumin Chemilumin 9:373–378PubMedCrossRef
22.
Zurück zum Zitat Fakhrejahani E, Miyamoto A, Tanigawa N (2007) Correlation between thymidylate synthase and dihydropyrimidine dehydrogenase mRNA level and in vitro chemosensitivity to 5-fluorouracil, in relation to differentiation in gastric cancer. Cancer Chemother Pharmacol 60:437–446PubMedCrossRef Fakhrejahani E, Miyamoto A, Tanigawa N (2007) Correlation between thymidylate synthase and dihydropyrimidine dehydrogenase mRNA level and in vitro chemosensitivity to 5-fluorouracil, in relation to differentiation in gastric cancer. Cancer Chemother Pharmacol 60:437–446PubMedCrossRef
23.
Zurück zum Zitat Whitehouse PA, Knight LA, Di Nicolantonio F, Mercer SJ, Sharma S, Cree IA (2003) Heterogeneity of chemosensitivity of colorectal adenocarcinoma determined by a modified ex vivo ATP-tumor chemosensitivity assay (ATP-TCA). Anticancer Drugs 14:369–375PubMedCrossRef Whitehouse PA, Knight LA, Di Nicolantonio F, Mercer SJ, Sharma S, Cree IA (2003) Heterogeneity of chemosensitivity of colorectal adenocarcinoma determined by a modified ex vivo ATP-tumor chemosensitivity assay (ATP-TCA). Anticancer Drugs 14:369–375PubMedCrossRef
24.
Zurück zum Zitat Hsi LC, Xi X, Lotan R, Shureiqi I, Lippman SM (2004) The histone deacetylase inhibitor suberoylanilide hydroxamic acid induces apoptosis via induction of 15-lipoxygenase-1 in colorectal cancer cells. Cancer Res 64:8778–8781PubMedCrossRef Hsi LC, Xi X, Lotan R, Shureiqi I, Lippman SM (2004) The histone deacetylase inhibitor suberoylanilide hydroxamic acid induces apoptosis via induction of 15-lipoxygenase-1 in colorectal cancer cells. Cancer Res 64:8778–8781PubMedCrossRef
25.
Zurück zum Zitat Archer SY, Johnson J, Kim HJ, Ma Q, Mou H, Daesety V, Meng S, Hodin RA (2005) The histone deacetylase inhibitor butyrate downregulates cyclin B1 gene expression via a p21/WAF-1-dependent mechanism in human colon cancer cells. Am J Physiol Gastrointest Liver Physiol 289:G696–G703PubMed Archer SY, Johnson J, Kim HJ, Ma Q, Mou H, Daesety V, Meng S, Hodin RA (2005) The histone deacetylase inhibitor butyrate downregulates cyclin B1 gene expression via a p21/WAF-1-dependent mechanism in human colon cancer cells. Am J Physiol Gastrointest Liver Physiol 289:G696–G703PubMed
26.
Zurück zum Zitat Tumber A, Collins LS, Petersen KD, Thougaard A, Christiansen SJ, Dejligbjerg M, Jensen PB, Sehested M, Ritchie JW (2007) The histone deacetylase inhibitor PXD101 synergises with 5-fluorouracil to inhibit colon cancer cell growth in vitro and in vivo. Cancer Chemother Pharmacol 60:275–283PubMedCrossRef Tumber A, Collins LS, Petersen KD, Thougaard A, Christiansen SJ, Dejligbjerg M, Jensen PB, Sehested M, Ritchie JW (2007) The histone deacetylase inhibitor PXD101 synergises with 5-fluorouracil to inhibit colon cancer cell growth in vitro and in vivo. Cancer Chemother Pharmacol 60:275–283PubMedCrossRef
27.
Zurück zum Zitat Ocker M, Alajati A, Ganslmayer M, Zopf S, Lüders M, Neureiter D, Hahn EG, Schuppan D, Herold C (2005) The histone-deacetylase inhibitor SAHA potentiates proapoptotic effects of 5-fluorouracil and irinotecan in hepatoma cells. J Cancer Res Clin Oncol 131:385–394PubMedCrossRef Ocker M, Alajati A, Ganslmayer M, Zopf S, Lüders M, Neureiter D, Hahn EG, Schuppan D, Herold C (2005) The histone-deacetylase inhibitor SAHA potentiates proapoptotic effects of 5-fluorouracil and irinotecan in hepatoma cells. J Cancer Res Clin Oncol 131:385–394PubMedCrossRef
28.
Zurück zum Zitat Yonekura K, Basaki Y, Chikahisa L, Okabe S, Hashimoto A, Miyadera K, Wierzba K, Yamada Y (1999) UFT and its metabolites inhibit the angiogenesis induced by murine renal cell carcinoma, as determined by a dorsal air sac assay in mice. Clin Cancer Res 5:2185–2191PubMed Yonekura K, Basaki Y, Chikahisa L, Okabe S, Hashimoto A, Miyadera K, Wierzba K, Yamada Y (1999) UFT and its metabolites inhibit the angiogenesis induced by murine renal cell carcinoma, as determined by a dorsal air sac assay in mice. Clin Cancer Res 5:2185–2191PubMed
29.
Zurück zum Zitat Zhu P, Martin E, Mengwasser J, Schlag P, Janssen KP, Göttlicher M (2004) Induction of HDAC2 expression upon loss of APC in colorectal tumorigenesis. Cancer Cell 5:455–463PubMedCrossRef Zhu P, Martin E, Mengwasser J, Schlag P, Janssen KP, Göttlicher M (2004) Induction of HDAC2 expression upon loss of APC in colorectal tumorigenesis. Cancer Cell 5:455–463PubMedCrossRef
30.
Zurück zum Zitat Bendardaf R, Lamlum H, Ristamäki R, Algars A, Collan Y, Pyrhönen S (2004) Response to chemotherapy (irinotecan plus 5-fluorouracil) in colorectal carcinoma can be predicted by tumour DNA content. Oncology 66:46–52PubMedCrossRef Bendardaf R, Lamlum H, Ristamäki R, Algars A, Collan Y, Pyrhönen S (2004) Response to chemotherapy (irinotecan plus 5-fluorouracil) in colorectal carcinoma can be predicted by tumour DNA content. Oncology 66:46–52PubMedCrossRef
31.
Zurück zum Zitat Hanks S, Rahman N (2005) Aneuploidy-cancer predisposition syndromes: a new link between the mitotic spindle checkpoint and cancer. Cell Cycle 4:225–227PubMed Hanks S, Rahman N (2005) Aneuploidy-cancer predisposition syndromes: a new link between the mitotic spindle checkpoint and cancer. Cell Cycle 4:225–227PubMed
32.
Zurück zum Zitat Braun MS, Quirke P, Seymour MT (2007) Molecular markers of chemotherapeutic response and toxicity in colorectal cancer. Expert Rev Anticancer Ther 7:489–501PubMedCrossRef Braun MS, Quirke P, Seymour MT (2007) Molecular markers of chemotherapeutic response and toxicity in colorectal cancer. Expert Rev Anticancer Ther 7:489–501PubMedCrossRef
33.
Zurück zum Zitat Plumb J, Steele N, Finn P, Brown R (2004) Epigenetic approaches to cancer therapy. Biochem Soc Trans 32:1095–1097PubMedCrossRef Plumb J, Steele N, Finn P, Brown R (2004) Epigenetic approaches to cancer therapy. Biochem Soc Trans 32:1095–1097PubMedCrossRef
34.
Zurück zum Zitat Williams EA, Coxhead JM, Mathers JC (2003) Anti-cancer effects of butyrate: use of micro-array technology to investigate mechanisms. Proc Nutr Soc 62:107–115PubMed Williams EA, Coxhead JM, Mathers JC (2003) Anti-cancer effects of butyrate: use of micro-array technology to investigate mechanisms. Proc Nutr Soc 62:107–115PubMed
Metadaten
Titel
Evaluation of novel histone deacetylase inhibitors as therapeutic agents for colorectal adenocarcinomas compared to established regimens with the histoculture drug response assay
verfasst von
Jin C. Kim
Dae D. Kim
Yoo M. Lee
Tae W. Kim
Dong H. Cho
Moon B. Kim
Seong G. Ro
Seon Y. Kim
Yong S. Kim
Jung S. Lee
Publikationsdatum
01.02.2009
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 2/2009
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-008-0590-1

Weitere Artikel der Ausgabe 2/2009

International Journal of Colorectal Disease 2/2009 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.