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Maruzzo M, Basso U, Diminutto A, Roma A, Brunello A, Aliberti C, Banzato A, Guglieri I, Opocher G, Zattoni F, Zagonel V. Survival analysis of patients with metastatic renal cell carcinoma treated with sunitinib: a single centre, real-word experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv341.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mustacchi G, Puglisi F, Molino AM, Crivellari D, Ghiotto C, Ferro A, Brunello A, Saracchini S, Turazza M, Cretella E, Iop A, Malagoli M, Stefani M. Observational study on adjuvant trastuzumab in HER2-positive early breast cancer patients. Future Oncol 2015; 11:1493-500. [DOI: 10.2217/fon.15.34] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Aim: This observational study investigates the use of adjuvant trastuzumab (AT) in HER2-positive breast cancer patients in a real-life setting, focusing on relapse and discontinuation rates. Patients & methods: Data on a group of HER2-positive patients collected from 13 oncology centers of northeast Italy were analyzed. Results: In total, 1245 patients were analyzed. 13.1% of patients were excluded from AT because of comorbidities, age, tumor stage, refusal or other reasons; 8.2% of patients who received AT interrupted the therapy, mainly for toxicity. Overall the relapse rate was 10.9% in the AT-treated population versus 22.6% in nontreated patients (follow-up: 37.4 and 62.1 months, respectively). Disease-free survival (DFS) was lower in AT-relapsed patients than in not-relapsed. Statistical analysis showed a correlation between DFS and estrogen receptor status in AT-treated patients. Conclusion: Relapse rates are lower in clinical setting compared to clinical trials. Overall, AT is effective in HER2-positive early-stage breast cancer patients.
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Gambaro G, Bertaglia G, Brunello A, Vincenti M, Nassuato MA, Baggio B. Renal tubular function in the elderly. CONTRIBUTIONS TO NEPHROLOGY 2015; 105:81-4. [PMID: 8252876 DOI: 10.1159/000422474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Rumiato E, Brunello A, Ahcene-Djaballah S, Borgato L, Gusella M, Pasini F, Fiduccia P, Amadori A, Zagonel V, Saggioro D. 651: An array-based pharmacogenetic study on elderly patients with advanced breast cancer treated with aromatase inhibitors. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50571-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lumachi F, Brunello A, Maruzzo M, Basso U, Basso SMM. Treatment of estrogen receptor-positive breast cancer. Curr Med Chem 2014; 20:596-604. [PMID: 23278394 DOI: 10.2174/092986713804999303] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 11/15/2012] [Accepted: 12/01/2012] [Indexed: 12/12/2022]
Abstract
Estrogen receptor (ER) expression is the main indicator of potential responses to endocrine therapy (ET), and approximately 70% of human breast cancers (BCs) are hormone-dependent and ER-positive. The introduction of adjuvant systemic therapy led to a significant improvement in post-surgical survival and a reduction in disease relapse, especially in women with early BC and those with ER+ tumors, who may receive ET alone or in combination with cytotoxic therapy. Adjuvant ET currently consists of (i) ovarian suppression, (ii) selective estrogen receptor modulators (SERMs) and down-regulators, and (iii) aromatase inhibitors (AIs). In patients with ER+ tumors pharmacologic ovary suppression with gonadotropin-releasing hormone agonists in combination with standard adjuvant therapy is generally more effective than adjuvant chemotherapy alone. Tamoxifen is the best established SERM, has favorable effects on BC control and bone metabolism, but also has adverse effects due to its estrogenic activity in other tissues. For these reasons, other SERMs have been developed. Fulvestrant is an ER down-regulator with several potential advantages over SERMs, including a 100-fold increase in its affinity for ER compared with tamoxifen and no estrogen-like activity in the uterus. The inhibition of the aromatase system with third-generation AIs is associated with improved survival in patients with advanced BC compared with SERMs. In postmenopausal patients with ER+ BC adjuvant treatment with AIs should be performed, either as sequential treatment after tamoxifen or as upfront therapy. Studies evaluating the role of AIs as first-line therapy are ongoing and the results are encouraging.
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Brunello A, Basso U, Sacco C, Sava T, De Vivo R, Camerini A, Barile C, Roma A, Maruzzo M, Falci C, Zagonel V. Safety and activity of sunitinib in elderly patients (≥ 70 years) with metastatic renal cell carcinoma: a multicenter study. Ann Oncol 2013; 24:336-342. [PMID: 23051952 DOI: 10.1093/annonc/mds431] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Actual tolerability of sunitinib is still poorly documented in elderly patients with metastatic renal cell carcinoma (mRCC). PATIENTS AND METHODS Charts of elderly patients treated with sunitinib for mRCC were reviewed in six Italian centers to assess safety (primary objective), efficacy and correlation of toxicity with comprehensive geriatric assessment (CGA) (secondary objectives). RESULTS Sixty-eight patients were eligible, and the median age was 74 years. CGA was carried out in 34 patients (41% fit, 41% vulnerable and 18.5% frail). The dose reduction to 37.5 mg was made upfront or soon after the first cycle in 69.1%. More frequent toxic effects were fatigue (80.9%), mucositis (61.8%) and hypertension (58.8%). Cardiac events occurred in nine patients. In 10 patients, therapy was interrupted early due to rapidly progressive disease (10.3%) or severe toxicity (4.4%: 1 cardiac failure, 1 fatigue, 1 febrile neutropenia). At a median follow-up of 27.1 months, the median OS was 18.3 months and the median PFS was 13.6 months. Correlation was not found between frailty at CGA with severe toxicity nor with response. CONCLUSIONS Treatment with sunitinib is effective in elderly patients; yet early interruptions were frequent. Starting treatment at reduced dose and escalating in the absence of severe toxicity could be suggested.
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Brunello A, Borgato L, Basso U, Lumachi F, Zagonel V. Targeted Approaches to Triple-Negative Breast Cancer: Current Practice and Future Directions. Curr Med Chem 2013; 20:605-12. [DOI: 10.2174/092986713804999321] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 11/20/2012] [Accepted: 12/01/2012] [Indexed: 11/22/2022]
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Lumachi F, Luisetto G, Basso SMM, Basso U, Brunello A, Camozzi V. Endocrine therapy of breast cancer. Curr Med Chem 2011; 18:513-22. [PMID: 21143113 DOI: 10.2174/092986711794480177] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 12/18/2010] [Indexed: 12/29/2022]
Abstract
Breast cancer remains one of the first leading causes of death in women, and currently endocrine treatment is of major therapeutic value in patients with estrogen-receptor positive tumors. Selective estrogen-receptor modulators (SERMs), such as tamoxifen and raloxifene, aromatase inhibitors, and GnRH agonists are the drugs of choice. Tamoxifen, a partial nonsteroidal estrogen agonist, is a type II competitive inhibitor of estradiol at its receptor, and the prototype of SERMs. Aromatase inhibitors significantly lower serum estradiol concentration in postmenopausal patients, having no detectable effects on adrenocortical steroids formation, while GnRH agonists suppress ovarian function, inducing a menopause-like condition in premenopausal women. Endocrine therapy has generally a relatively low morbidity, leading to a significant reduction of mortality for breast cancer. The aim of chemoprevention is to interfere early with the process of carcinogenesis, reducing the risk of cancer development. As preventive agents, raloxifene and tamoxifene are equivalent, while raloxifene has more potent antiresorptive effects in postmenopausal osteoporosis. Endocrine treatment is usually considered a standard choice for patients with estrogen-receptor positive cancers and non-life-threatening advanced disease, or for older patients unfit for aggressive chemotherapy regimens. Several therapeutic protocols used in patients with breast cancer are associated with bone loss, which may lead to an increased risk of fracture. Bisphosphonates are the drugs of choice to treat such a drug-induced bone disease. The aim of this review is to outline current understanding on endocrine therapy of breast cancer.
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Basso U, Falci C, Brunello A, Zafferri V, Fiduccia P, Sergi G, Lonardi S, Lamberti E, Castegnaro E, Solda' C, Cossutta F, Chiarion-Sileni V, Monfardini S, Zagonel V. Prognostic value of multidimensional geriatric assessment (MGA) on survival of a prospective cohort of 880 elderly cancer patients (ECP). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Roma A, Basso U, Brunello A, Maruzzo M, Zagonel V, Nardin M, Bezzon E, Zovato S, Opocher G. First-line sunitinib in patients with renal cell carcinoma (RCC) and von Hippel-Lindau syndrome (VHL). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
373 Background: VHL is a rare hereditary condition caused by germline alteration of VHL gene predisposing to multiple renal and other tumors. Since acquired dysregulation of VHL-dependent pathways is often present in patients with sporadic RCC treated with first-line sunitinib (SUN), there is a strong rationale to use the same drug in VHL patients with progressive disease in the kidneys or other sites. Methods: We performed a retrospective analysis of SUN therapy in genetically confirmed VHL patients treated at our Institution for multifocal or advanced RCC. Results: From February 2007 to October 2010, 9 VHL patients were proposed first-line SUN for RCC, mean age 44 yrs (26-60), F:M ratio 2:1. SUN was administered for a mean of 9 cycles (1-20). Eight of 9 pts received at least two cycles and were considered for response evaluation: all 8 were stable according to RECIST criteria, but decrease in radiological density of lesions was observed in 7 of 8 pts (87.5%). Density decrease was noted not only in renal and hepatic lesions but also in some pancreatic nodules; all CNS haemangioblastoma lesions remained stable (see table). Preliminary median PFS is > 13 months (8 censored, 1 deceased). Conclusions: SUN treatment in VHL patients appears to achieve good disease control not only in renal tumors but also in synchronous VHL-related lesions, especially pancreatic solid nodules whose exact nature (metastatic RCC or neuroendocrine tumor) cannot be ruled out without invasive biopsies. [Table: see text] No significant financial relationships to disclose.
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Monfardini S, Basso U, Fiduccia P, Brunello A, Baretta Z, Soldàa C, Lamberti E, Bozza F, Jirillo A, Falci C. Can the short screening test Vulnerable Elders Survey 13 (VES-13) substitute for the time-consuming comprehensive geriatric assessment (CGA) to identify vulnerable/frail elderly breast cancer patients? J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Basso U, Roma A, Falci C, Brunello A, Fiduccia P, Vamvakas L, Bononi A, Gusella M, Banzato A, Monfardini S. Biweekly liposomal pegylated doxorubicin in elderly women with advanced breast cancer: A prospective multicenter trial focusing on tolerability and cardiotoxicity. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Begnini A, Tessari G, Turco A, Malerba G, Naldi L, Gotti E, Boschiero L, Forni A, Rugiu C, Piaserico S, Fortina A, Brunello A, Cascone C, Girolomoni G, Gomez Lira M. PTCH1
gene haplotype association with basal cell carcinoma after transplantation. Br J Dermatol 2010; 163:364-70. [DOI: 10.1111/j.1365-2133.2010.09776.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Monfardini S, Falci C, Crivellari D, Molino A, De Matteis A, Brunello A, Lonardi S, Massa I, Fiduccia P, Basso U. P33 Increasing age and vulnerability/frailty are associated with a delayed diagnosis made more by self examination than screening mammography in older breast cancer women: results of a prospective observational trial in 5 Italian centres. Crit Rev Oncol Hematol 2009. [DOI: 10.1016/s1040-8428(09)70071-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Brunello A, Maruzzo M, Ghiotto C, Koussis H, Basso U, Monfardini S, Jirillo A. 4010 Role of adjuvant chemotherapy in elderly (≥70 years) women with high-risk early breast cancer. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70744-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Basso U, Rossi E, Indraccolo S, Barile C, Sava T, Aieta M, Brunello A, Jirillo A, Amadori A, Zamarchi R. 7117 Do circulating tumor cells (CTCs) correlate with response to first-line sunitinib in metastatic renal carcinoma? EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71450-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Falci C, Basso U, Crivellari D, Molino A, De Matteis A, Brunello A, Lonardi S, Massa I, Fiduccia P, Monfardini S. 4007 Advanced age, vulnerability/frailty and presence of comorbidities are associated with a delayed diagnosis made more by self examination than screening mammography in older breast cancer women: results of a prospective observational trial in 5 Italian centers. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70741-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Monfardini S, Falci C, Crivellari D, Molino A, De Matteis A, Brunello A, Lonardi S, Massa I, Fiduccia P, Basso U. 4015 Early breast cancer in elderly women undergoing multidimensional geriatric assessment (MGA): does the consultation with Adjuvant!online change the choice of postoperative therapy? EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70749-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Basso U, Brunello A, Bertuzzi A, Santoro A. Sorafenib is active on lung metastases from synovial sarcoma. Ann Oncol 2009; 20:386-7. [PMID: 19211500 DOI: 10.1093/annonc/mdn685] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Z'Graggen WJ, Brander L, Tuchscherer D, Brunello A, Passath C, Takala J, Jakob SM, Bostock H. Assessment of muscle membrane properties using muscle velocity recovery cycles in patients with critical illness polyneuromyopathy. Crit Care 2009. [PMCID: PMC4083997 DOI: 10.1186/cc7275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Tuchscherer D, Z'Graggen W, Brunello A, Passath C, Sinderby C, Takala J, Jakob SM, Brander L. Neurally adjusted ventilatory assistance in patients with critical illness polyneuromyopathy. Crit Care 2009. [PMCID: PMC4083996 DOI: 10.1186/cc7274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Monfardini S, Brunello A, Crivellari D, Puglisi F, Paccagnella A, Molino A, Mustacchi G, Beda M, Luciani A, Simoncini E, Pogliani C, Basso U. Activity and safety of trastuzumab in advanced breast cancer in elderly women (≥ 70 years) in italy. Crit Rev Oncol Hematol 2008. [DOI: 10.1016/s1040-8428(08)70104-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Falci C, Monfardini S, Pasetto L, Basso U, Lonardi S, Brunello A, Lamberti E, Sinigaglia G, Jirillo A. A phase II study of adapted chemotherapy for first-line treatment of metastatic colo-rectal cancer (mCRC) in patients aged 70 years or over, systematically evaluated through Comprehensive Geriatric Assessment. Crit Rev Oncol Hematol 2008. [DOI: 10.1016/s1040-8428(08)70097-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Brunello A, Monfardini S, Crivellari D, Puglisi F, Nascimben O, Scattolin G, Molino A, Mustacchi G, Beda M, Basso U. Multicenter analysis of activity and safety of trastuzumab plus chemotherapy in advanced breast cancer in elderly women (≥ 70 years). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1096] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Popa M, Wallace K, Brunello A, Extermann M. The impact of polypharmacy on toxicity from chemotherapy in elderly patients: Focus on cytochrome P-450 inhibition and protein binding effects. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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