Skip to main content
Erschienen in: Investigational New Drugs 4/2008

01.08.2008 | PHASE I STUDIES

Phase I trial of docetaxel and thalidomide: a regimen based on metronomic therapeutic principles

verfasst von: Sharon L. Sanborn, Matthew M. Cooney, Afshin Dowlati, Joanna M. Brell, Smitha Krishnamurthi, Joseph Gibbons, Joseph A. Bokar, Charles Nock, Anne Ness, Scot C. Remick

Erschienen in: Investigational New Drugs | Ausgabe 4/2008

Einloggen, um Zugang zu erhalten

Summary

Purpose: Pre-clinical models have demonstrated the benefit of metronomic schedules of cytotoxic chemotherapy combined with anti-angiogenic compounds. This trial was undertaken to determine the toxicity of a low dose regimen using docetaxel and thalidomide. Patients and Methods: Patients with advanced solid tumors were enrolled. Thalidomide 100mg twice daily was given with escalating doses of docetaxel from 10 to 30mg/m2/week. One cycle consisted of 12 consecutive weeks of therapy. The maximal tolerated dose (MTD) was defined as the dose of thalidomide along with docetaxel that caused ≤grade 1 non-hematologic or ≤grade 2 hematologic toxicity for cycle one. Results: Twenty-six patients were enrolled. Dose-limiting toxicities (DLTs) were bradycardia, fatigue, fever, hyperbilirubinemia, leukopenia, myocardial infarction, and neutropenia. Prolonged freedom from disease progression was observed in 44.4% of the evaluable patients. Conclusions: This anti-angiogenic regimen was well tolerated and demonstrated clinical benefit. The recommended phase II dosing schedule is thalidomide 100mg twice daily with docetaxel 25mg/m2/week.
Literatur
1.
Zurück zum Zitat Folkman J (1971) Tumor angiogenesis: therapeutic implications. N Engl J Med 285:1182–1186PubMed Folkman J (1971) Tumor angiogenesis: therapeutic implications. N Engl J Med 285:1182–1186PubMed
2.
Zurück zum Zitat Harris AL (1997) Antiangiogenesis for cancer therapy. Lancet 349:13–15CrossRef Harris AL (1997) Antiangiogenesis for cancer therapy. Lancet 349:13–15CrossRef
3.
Zurück zum Zitat Jain RK (2005) Antiangiogenic therapy for cancer: current and emerging concepts. Oncology (Williston Park) 19:7–16 Jain RK (2005) Antiangiogenic therapy for cancer: current and emerging concepts. Oncology (Williston Park) 19:7–16
4.
Zurück zum Zitat Kerbel RS (1991) Inhibition of tumor angiogenesis as a strategy to circumvent acquired resistance to anti-cancer therapeutic agents. Bioessays 13:31–36PubMedCrossRef Kerbel RS (1991) Inhibition of tumor angiogenesis as a strategy to circumvent acquired resistance to anti-cancer therapeutic agents. Bioessays 13:31–36PubMedCrossRef
5.
Zurück zum Zitat Kerbel RS (2000) Tumor angiogenesis: past, present and the near future. Carcinogenesis 21:505–515PubMedCrossRef Kerbel RS (2000) Tumor angiogenesis: past, present and the near future. Carcinogenesis 21:505–515PubMedCrossRef
6.
Zurück zum Zitat Scappaticci FA (2002) Mechanisms and future directions for angiogenesis-based cancer therapies. J Clin Oncol 20:3906–3927PubMedCrossRef Scappaticci FA (2002) Mechanisms and future directions for angiogenesis-based cancer therapies. J Clin Oncol 20:3906–3927PubMedCrossRef
7.
Zurück zum Zitat Hudis CA (2005) Clinical implications of antiangiogenic therapies. Oncology (Williston Park) 19:26–31 Hudis CA (2005) Clinical implications of antiangiogenic therapies. Oncology (Williston Park) 19:26–31
8.
Zurück zum Zitat Teicher BA (1999) Combination of antiangiogenic agents with standard cytotoxic therapies in therapeutic regimens. Clin Cancer Res 5:3878s–3879s Teicher BA (1999) Combination of antiangiogenic agents with standard cytotoxic therapies in therapeutic regimens. Clin Cancer Res 5:3878s–3879s
9.
Zurück zum Zitat Denekamp J (1993) Review article: angiogenesis, neovascular proliferation and vascular pathophysiolgy as targets for cancer therapy. Br J Radiol 66:181–196PubMedCrossRef Denekamp J (1993) Review article: angiogenesis, neovascular proliferation and vascular pathophysiolgy as targets for cancer therapy. Br J Radiol 66:181–196PubMedCrossRef
10.
Zurück zum Zitat Hanahan D, Bergers G, Bergsland E (2000) Less is more, regularly: metronomic dosing of cytotoxic drugs can target tumor angiogenesis in mice. J Clin Invest 105:1045–1047PubMedCrossRef Hanahan D, Bergers G, Bergsland E (2000) Less is more, regularly: metronomic dosing of cytotoxic drugs can target tumor angiogenesis in mice. J Clin Invest 105:1045–1047PubMedCrossRef
11.
Zurück zum Zitat Klement G, Baruchel S, Rak J et al (2000) Continuous low-dose therapy with vinblastine and VEGF receptor-2 antibody induces sustained tumor regression without overt toxicity. J Clin Invest 105:R15–R24PubMedCrossRef Klement G, Baruchel S, Rak J et al (2000) Continuous low-dose therapy with vinblastine and VEGF receptor-2 antibody induces sustained tumor regression without overt toxicity. J Clin Invest 105:R15–R24PubMedCrossRef
12.
Zurück zum Zitat Browder T, Butterfield CE, Kraling BM et al (2000) Antiangiogenic scheduling of chemotherapy improves efficacy against experimental drug-resistant cancer. Cancer Res 60:1878–1886PubMed Browder T, Butterfield CE, Kraling BM et al (2000) Antiangiogenic scheduling of chemotherapy improves efficacy against experimental drug-resistant cancer. Cancer Res 60:1878–1886PubMed
13.
Zurück zum Zitat Belotti D, Vergani V, Drudis T et al (1996) The microtubule-affecting drug paclitaxel has antiangiogenic activity. Clin Cancer Res 2:1843–1849PubMed Belotti D, Vergani V, Drudis T et al (1996) The microtubule-affecting drug paclitaxel has antiangiogenic activity. Clin Cancer Res 2:1843–1849PubMed
14.
Zurück zum Zitat Hotchkiss KA, Ashton AW, Sparano J et al (2000) Inhibition of endothelial cell function by docetaxel (Taxotere). Proc Am Assoc Cancer Res 41:647 Hotchkiss KA, Ashton AW, Sparano J et al (2000) Inhibition of endothelial cell function by docetaxel (Taxotere). Proc Am Assoc Cancer Res 41:647
15.
Zurück zum Zitat Hainsworth JD, Burris HA III, Greco FA (1999) Weekly administration of docetaxel (Taxotere): summary of clinical data. Semin Oncol 26:19–24PubMed Hainsworth JD, Burris HA III, Greco FA (1999) Weekly administration of docetaxel (Taxotere): summary of clinical data. Semin Oncol 26:19–24PubMed
16.
Zurück zum Zitat Sweeney CJ, Miller KD, Sissons SE et al (2001) The antiangiogenic property of docetaxel is synergistic with a recombinant humanized monoclonal antibody against vascular endothelial growth factor or 2-methoxyestradiol but antagonized by endothelial growth factors. Cancer Res 61:3369–3372PubMed Sweeney CJ, Miller KD, Sissons SE et al (2001) The antiangiogenic property of docetaxel is synergistic with a recombinant humanized monoclonal antibody against vascular endothelial growth factor or 2-methoxyestradiol but antagonized by endothelial growth factors. Cancer Res 61:3369–3372PubMed
17.
Zurück zum Zitat Sweeney CJ, Sissions SE, Nozaki S et al (2000) Overcoming resistance to the anti-angiogenic properties of docetaxel induced by endothelial cell stimulation. Proc Am Assoc Cancer Res 41:647 Sweeney CJ, Sissions SE, Nozaki S et al (2000) Overcoming resistance to the anti-angiogenic properties of docetaxel induced by endothelial cell stimulation. Proc Am Assoc Cancer Res 41:647
18.
Zurück zum Zitat D’Amato RJ, Loughnan MS, Flynn E et al (1994) Thalidomide in an inhibitor of angiogenesis. Proc Natl Acad Sci U S A 91:4082–4085PubMedCrossRef D’Amato RJ, Loughnan MS, Flynn E et al (1994) Thalidomide in an inhibitor of angiogenesis. Proc Natl Acad Sci U S A 91:4082–4085PubMedCrossRef
19.
Zurück zum Zitat Sampaio EP, Sarno EN, Galilly R et al (1991) Thalidomide selectively inhibits tumor necrosis factor alpha production by stimulated human monocytes. J Exp Med 173:699–703PubMedCrossRef Sampaio EP, Sarno EN, Galilly R et al (1991) Thalidomide selectively inhibits tumor necrosis factor alpha production by stimulated human monocytes. J Exp Med 173:699–703PubMedCrossRef
20.
Zurück zum Zitat Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef
21.
23.
Zurück zum Zitat Abraham D, Abri S, Hofmann M et al (2003) Low dose carboplatin combined with angiostatic agents prevents metastasis in human testicular germ cell tumor xenografts. J Urol 170:1388–1393PubMedCrossRef Abraham D, Abri S, Hofmann M et al (2003) Low dose carboplatin combined with angiostatic agents prevents metastasis in human testicular germ cell tumor xenografts. J Urol 170:1388–1393PubMedCrossRef
24.
Zurück zum Zitat Bello L, Carrabba G, Giussani C et al (2001) Low-dose chemotherapy combined with an antiangiogenic drug reduces human glioma growth in vivo. Cancer Res 61:7501–7506PubMed Bello L, Carrabba G, Giussani C et al (2001) Low-dose chemotherapy combined with an antiangiogenic drug reduces human glioma growth in vivo. Cancer Res 61:7501–7506PubMed
25.
Zurück zum Zitat Klement G, Huang P, Mayer B et al (2002) Differences in therapeutic indexes of combination metronomic chemotherapy and an anti-VEGFR-2 antibody in multidrug-resistant human breast cancer xenografts. Clin Cancer Res 8:221–232PubMed Klement G, Huang P, Mayer B et al (2002) Differences in therapeutic indexes of combination metronomic chemotherapy and an anti-VEGFR-2 antibody in multidrug-resistant human breast cancer xenografts. Clin Cancer Res 8:221–232PubMed
26.
Zurück zum Zitat Man S, Bocci G, Francia G et al (2002) Antitumor effects in mice of low-dose (metronomic) cyclophosphamide administered continuously through the drinking water. Cancer Res 62:2731–2735PubMed Man S, Bocci G, Francia G et al (2002) Antitumor effects in mice of low-dose (metronomic) cyclophosphamide administered continuously through the drinking water. Cancer Res 62:2731–2735PubMed
27.
Zurück zum Zitat Mauceri HJ, Seetharam S, Beckett MA et al (2002) Angiostatin potentiates cyclophosphamide treatment of metastatic disease. Cancer Chemother Pharmacol 50:412–418PubMedCrossRef Mauceri HJ, Seetharam S, Beckett MA et al (2002) Angiostatin potentiates cyclophosphamide treatment of metastatic disease. Cancer Chemother Pharmacol 50:412–418PubMedCrossRef
28.
Zurück zum Zitat Pietras K, Hanahan D (2005) A multitargeted, metronomic, and maximum-tolerated dose “chemo-switch” regimen is antiangiogenic, producing objective responses and survival benefit in a mouse model of cancer. J Clin Oncol 23:939–952PubMedCrossRef Pietras K, Hanahan D (2005) A multitargeted, metronomic, and maximum-tolerated dose “chemo-switch” regimen is antiangiogenic, producing objective responses and survival benefit in a mouse model of cancer. J Clin Oncol 23:939–952PubMedCrossRef
29.
Zurück zum Zitat Takahashi N, Haba A, Matsuno F et al (2001) Antiangiogenic therapy of established tumors in human skin/severe combined immunodeficiency mouse chimeras by anti-endoglin (CD105) monoclonal antibodies, and synergy between anti-endoglin antibody and cyclophosphamide. Cancer Res 61:7846–7854PubMed Takahashi N, Haba A, Matsuno F et al (2001) Antiangiogenic therapy of established tumors in human skin/severe combined immunodeficiency mouse chimeras by anti-endoglin (CD105) monoclonal antibodies, and synergy between anti-endoglin antibody and cyclophosphamide. Cancer Res 61:7846–7854PubMed
30.
Zurück zum Zitat Teicher BA, Holden SA, Ara G et al (1994) Potentiation of cytotoxic cancer therapies by TNP-470 alone and with other anti-angiogenic agents. Int J Cancer 57:920–925PubMedCrossRef Teicher BA, Holden SA, Ara G et al (1994) Potentiation of cytotoxic cancer therapies by TNP-470 alone and with other anti-angiogenic agents. Int J Cancer 57:920–925PubMedCrossRef
31.
Zurück zum Zitat Teicher BA, Sotomayor EA, Huang ZD (1992) Antiangiogenic agents potentiate cytotoxic cancer therapies against primary and metastatic disease. Cancer Res 52:6702–6704PubMed Teicher BA, Sotomayor EA, Huang ZD (1992) Antiangiogenic agents potentiate cytotoxic cancer therapies against primary and metastatic disease. Cancer Res 52:6702–6704PubMed
32.
Zurück zum Zitat Vogt T, Hafner C, Bross K et al (2003) Antiangiogenetic therapy with pioglitazone, rofecoxib, and metronomic trofosfamide in patients with advanced malignant vascular tumors. Cancer 98:2251–2256PubMedCrossRef Vogt T, Hafner C, Bross K et al (2003) Antiangiogenetic therapy with pioglitazone, rofecoxib, and metronomic trofosfamide in patients with advanced malignant vascular tumors. Cancer 98:2251–2256PubMedCrossRef
33.
Zurück zum Zitat Spieth K, Kaufmann R, Gille J (2003) Metronomic oral low-dose treosulfan chemotherapy combined with cyclooxygenase-2 inhibitor in pretreated advanced melanoma: a pilot study. Cancer Chemother Pharmacol 52:377–382PubMedCrossRef Spieth K, Kaufmann R, Gille J (2003) Metronomic oral low-dose treosulfan chemotherapy combined with cyclooxygenase-2 inhibitor in pretreated advanced melanoma: a pilot study. Cancer Chemother Pharmacol 52:377–382PubMedCrossRef
34.
Zurück zum Zitat Gille J, Spieth K, Kaufmann R (2005) Metronomic low-dose chemotherapy as antiangiogenic therapeutic strategy for cancer. J Dtsch Dermatol Ges 3:26–32PubMedCrossRef Gille J, Spieth K, Kaufmann R (2005) Metronomic low-dose chemotherapy as antiangiogenic therapeutic strategy for cancer. J Dtsch Dermatol Ges 3:26–32PubMedCrossRef
35.
Zurück zum Zitat Hafner C, Reichle A, Vogt T (2005) New indications for established drugs: combined tumor-stroma-targeted cancer therapy with PPARg agonists, COX-2 inhibitors, mTOR antagonists and metronomic chemotherapy. Curr Cancer Drug Targets 5:393–419PubMedCrossRef Hafner C, Reichle A, Vogt T (2005) New indications for established drugs: combined tumor-stroma-targeted cancer therapy with PPARg agonists, COX-2 inhibitors, mTOR antagonists and metronomic chemotherapy. Curr Cancer Drug Targets 5:393–419PubMedCrossRef
36.
Zurück zum Zitat McDermott DF, Cho DC, Merchan JR et al (2006) A phase II pilot trial of low dose, continuous infusion, or “metronomic”, paclitaxel and oral celecoxib in patients with metastatic melanoma. Proc Am Assoc Cancer Res 24:8010 McDermott DF, Cho DC, Merchan JR et al (2006) A phase II pilot trial of low dose, continuous infusion, or “metronomic”, paclitaxel and oral celecoxib in patients with metastatic melanoma. Proc Am Assoc Cancer Res 24:8010
37.
Zurück zum Zitat Orlando L, Cardillo A, Ghisini R et al (2006) Trastuzumab in combination with metronomic cyclophosphamide and methotrexate in patients with HER-2 positive metastatic breast cancer. BMC Cancer 6:225PubMedCrossRef Orlando L, Cardillo A, Ghisini R et al (2006) Trastuzumab in combination with metronomic cyclophosphamide and methotrexate in patients with HER-2 positive metastatic breast cancer. BMC Cancer 6:225PubMedCrossRef
38.
Zurück zum Zitat Sterba J, Valik D, Mudry P et al (2006) Combined biodifferentiating and antiangiogenic oral metronomic therapy is feasible and effective in relapsed solid tumors in children: single-center pilot study. Onkologie 29:308–313PubMedCrossRef Sterba J, Valik D, Mudry P et al (2006) Combined biodifferentiating and antiangiogenic oral metronomic therapy is feasible and effective in relapsed solid tumors in children: single-center pilot study. Onkologie 29:308–313PubMedCrossRef
39.
Zurück zum Zitat Young SD, Whissell M, Noble JC et al (2006) Phase II clinical trial results involving treatment with low-dose daily oral cyclophosphamide, weekly vinblastine, and rofecoxib in patients with advanced solid tumors. Clin Cancer Res 12:3092–3098PubMedCrossRef Young SD, Whissell M, Noble JC et al (2006) Phase II clinical trial results involving treatment with low-dose daily oral cyclophosphamide, weekly vinblastine, and rofecoxib in patients with advanced solid tumors. Clin Cancer Res 12:3092–3098PubMedCrossRef
40.
Zurück zum Zitat Colleoni M, Orlando L, Sanna G et al (2006) Metronomic low-dose oral cyclophosphamide and methotrexate plus or minus thalidomide in metastatic breast cancer: antitumor activity and biological effects. Ann Oncol 17:232–238PubMedCrossRef Colleoni M, Orlando L, Sanna G et al (2006) Metronomic low-dose oral cyclophosphamide and methotrexate plus or minus thalidomide in metastatic breast cancer: antitumor activity and biological effects. Ann Oncol 17:232–238PubMedCrossRef
41.
Zurück zum Zitat Kesari S, Schiff D, Doherty L et al (2006) Phase II study of antiangiogenic (metronomic) chemotherapy for recurrent malignant gliomas. Proc Am Assoc Cancer Res 24:1569 Kesari S, Schiff D, Doherty L et al (2006) Phase II study of antiangiogenic (metronomic) chemotherapy for recurrent malignant gliomas. Proc Am Assoc Cancer Res 24:1569
42.
Zurück zum Zitat Kieran MW, Turner CD, Rubin JB et al (2005) A feasibility trial of antiangiogenic (metronomic) chemotherapy in pediatric patients with recurrent or progressive cancer. J Pediatr Hematol Oncol 27:573–581PubMedCrossRef Kieran MW, Turner CD, Rubin JB et al (2005) A feasibility trial of antiangiogenic (metronomic) chemotherapy in pediatric patients with recurrent or progressive cancer. J Pediatr Hematol Oncol 27:573–581PubMedCrossRef
43.
Zurück zum Zitat Suvannasankha A, Fausel C, Juliar BE et al (2007) Final report of toxicity and efficacy of a phase II study of oral cyclophosphamide, thalidomide, and prednisone for patients with relapsed or refractory multiple myeloma: a Hoosier Oncology Group Trial, HEM01-21. Oncologist 12:99–106PubMedCrossRef Suvannasankha A, Fausel C, Juliar BE et al (2007) Final report of toxicity and efficacy of a phase II study of oral cyclophosphamide, thalidomide, and prednisone for patients with relapsed or refractory multiple myeloma: a Hoosier Oncology Group Trial, HEM01-21. Oncologist 12:99–106PubMedCrossRef
44.
Zurück zum Zitat Dahut WL, Gulley JL, Arlen PM et al (2004) Randomized phase II trial of docetaxel plus thalidomide in androgen-independent prostate cancer. J Clin Oncol 22:2532–2539PubMedCrossRef Dahut WL, Gulley JL, Arlen PM et al (2004) Randomized phase II trial of docetaxel plus thalidomide in androgen-independent prostate cancer. J Clin Oncol 22:2532–2539PubMedCrossRef
45.
Zurück zum Zitat Figg WD, Retter A, Steinberg SM et al (2005) Inhibition of angiogenesis: thalidomide or low-molecular weight heparin? J Clin Oncol 23:2113–2114CrossRef Figg WD, Retter A, Steinberg SM et al (2005) Inhibition of angiogenesis: thalidomide or low-molecular weight heparin? J Clin Oncol 23:2113–2114CrossRef
46.
Zurück zum Zitat Horne MK III, Figg WD, Arlen P et al (2003) Increased frequency of venous thromboembolism with the combination of docetaxel and thalidomide in patients with metastatic androgen-independent prostate cancer. Pharmacotherapy 23:315–318PubMedCrossRef Horne MK III, Figg WD, Arlen P et al (2003) Increased frequency of venous thromboembolism with the combination of docetaxel and thalidomide in patients with metastatic androgen-independent prostate cancer. Pharmacotherapy 23:315–318PubMedCrossRef
47.
Zurück zum Zitat Behrens RJ, Gulley JL, Dahut WL (2003) Pulmonary toxicity during prostate cancer treatment with docetaxel and thalidomide. Am J Ther 10:228–232PubMedCrossRef Behrens RJ, Gulley JL, Dahut WL (2003) Pulmonary toxicity during prostate cancer treatment with docetaxel and thalidomide. Am J Ther 10:228–232PubMedCrossRef
48.
Zurück zum Zitat Zangari M, Anaissie E, Barlogie B et al (2001) Increased risk of deep-vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy. Blood 98:1614–1615PubMedCrossRef Zangari M, Anaissie E, Barlogie B et al (2001) Increased risk of deep-vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy. Blood 98:1614–1615PubMedCrossRef
49.
Zurück zum Zitat Horstmann E, McCabe MS, Grochow L et al (2005) Risks and benefits of phase 1 oncology trials, 1991 through 2002. N Engl J Med 352:895–904PubMedCrossRef Horstmann E, McCabe MS, Grochow L et al (2005) Risks and benefits of phase 1 oncology trials, 1991 through 2002. N Engl J Med 352:895–904PubMedCrossRef
Metadaten
Titel
Phase I trial of docetaxel and thalidomide: a regimen based on metronomic therapeutic principles
verfasst von
Sharon L. Sanborn
Matthew M. Cooney
Afshin Dowlati
Joanna M. Brell
Smitha Krishnamurthi
Joseph Gibbons
Joseph A. Bokar
Charles Nock
Anne Ness
Scot C. Remick
Publikationsdatum
01.08.2008
Verlag
Springer US
Erschienen in
Investigational New Drugs / Ausgabe 4/2008
Print ISSN: 0167-6997
Elektronische ISSN: 1573-0646
DOI
https://doi.org/10.1007/s10637-008-9137-0

Weitere Artikel der Ausgabe 4/2008

Investigational New Drugs 4/2008 Zur Ausgabe

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

13.05.2024 Pankreaskarzinom Nachrichten

Gerade bei aggressiven Malignomen wie dem duktalen Adenokarzinom des Pankreas könnte Früherkennung die Therapiechancen verbessern. Noch jedoch klafft hier eine Lücke. Ein Studienteam hat einen Weg gesucht, sie zu schließen.

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

12.05.2024 Prostatakarzinom Nachrichten

Ein hoher Anteil pflanzlicher Nahrung trägt möglicherweise dazu bei, das Progressionsrisiko von Männern mit Prostatakarzinomen zu senken. In einer US-Studie war das Risiko bei ausgeprägter pflanzlicher Ernährung in etwa halbiert.

Alter verschlechtert Prognose bei Endometriumkarzinom

11.05.2024 Endometriumkarzinom Nachrichten

Ein höheres Alter bei der Diagnose eines Endometriumkarzinoms ist mit aggressiveren Tumorcharakteristika assoziiert, scheint aber auch unabhängig von bekannten Risikofaktoren die Prognose der Erkrankung zu verschlimmern.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Onkologie

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