1
|
Musacchio L, Palluzzi E, Lauria R, Di Napoli M, Corrado G, Bergamini A, Salutari V, Marchetti C, Angioli R, Cassani C, Gori S, Palaia I, Savarese A, Raspagliesi F, Mosconi A, Zafarana E, De Angelis C, Ferrandina G, Scambia G, Lorusso D. 52P Real-world data of niraparib in platinum sensitive relapsed ovarian cancer: A multicenter experience of the MITO group. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
|
2
|
Palluzzi E, Marchetti C, Cappuccio S, Avesani G, Nardangeli A, Scambia G, Fagotti A. 752P PARP-inhibitors beyond progression: A new way to manage oligometastatic ovarian cancer recurrence. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
3
|
Marchetti C, Rosati A, De Felice F, Boccia SM, Vertechy L, Pavone M, Palluzzi E, Scambia G, Fagotti A. Optimizing the number of cycles of neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma: A propensity-score matching analysis. Gynecol Oncol 2021; 163:29-35. [PMID: 34312003 DOI: 10.1016/j.ygyno.2021.07.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/04/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Neoadjuvant chemotherapy and interval debulking surgery are now widely offered in ovarian cancer patients unsuitable for surgery; the number of preoperative NACT cycles to be given is still an issue. Our aim was to compare survival outcomes of patients with advanced ovarian cancer treated with ≤4 or more NACT cycles. METHODS A cohort of AEOC patients with stage III-IV epithelial OC who underwent NACT followed by IDS was identified. Patients were classified in group A (≤4 cycles) and group B (>4 cycles). Selection bias from the heterogeneity of demographic and clinical characteristics was avoided using propensity score matching (2:1 ratio). RESULTS 140 (group A) and 70 (group B) patients were included. After the propensity score matching, there were no imbalances in baseline characteristics. BRCA status was associated to improved OS (HR = 0.41; 95%CI 0.18.0.92, p = 0.032) and residual tumor to decreased OS (HR = 1.93; 95%CI 1.08-3.46, p = 0.026). Statistically significant differences were not observed in OS (2-year OS 82.4% for group A versus 77.1% for group B, p = 0.109) and PFS (2-year PFS 29.7% for group A versus 20.0% for group A, p = 0.875). In group B, the administration of >4 cycles was related to an additional chance of achieving complete (12.9%) and partial (34.3%) responses compared to responses after 3-4 cycles. CONCLUSIONS Receiving more than 4 cycles of NACT is no detrimental in terms of OS and PFS in advanced ovarian cancer. Response rates can increase following further cycles administration. APPROACH
Collapse
Affiliation(s)
- C Marchetti
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Rosati
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F De Felice
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - S M Boccia
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - L Vertechy
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Pavone
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E Palluzzi
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Scambia
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy.
| | - A Fagotti
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
4
|
Marchetti C, Rosati A, Scaletta G, Pietragalla A, Arcieri M, Ergasti R, Palluzzi E, Scambia G, Fagotti A. Secondary cytoreductive surgery in platinum-sensitive recurrent ovarian cancer before olaparib maintenance: Still getting any benefit? A case-control study. Gynecol Oncol 2019; 155:400-405. [PMID: 31606285 DOI: 10.1016/j.ygyno.2019.09.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/17/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The role of secondary cytoreductive surgery (SCS) in platinum-sensitive recurrent ovarian cancer (PSROC) is still controversial. We investigated the role of SCS in PSROC patients with BRCA1/2 mutation (BRCAmut) who received platinum-based chemotherapy followed by olaparib maintenance. METHODS This is a case-control study. Patients with first PSROC admitted to our Gynecologic Oncology Unit between 2014 and 2018 were identified. Main eligibility criteria: positive BRCA1/2 germline or somatic mutation status and olaparib maintenance at primary recurrence after response to platinum-based chemotherapy. Cases were those who received SCS followed by medical treatment (SCS-CT-OLA, group 1), controls were those who received medical treatment alone (CT-OLA, group 2). RESULTS Overall, 46 patients were identified; 23 (50%) BRCAmut women undergoing SCS followed by platinum-based chemotherapy and olaparib maintenance were matched with 23 (50%) BRCAmut women who only received medical treatment. Groups were well balanced: no statistical differences were found with regard of age, mutational status, treatment's approach at diagnosis, timing and patterns of disease presentation at recurrence. Median time to first subsequent therapy (TFST) was significantly longer in the SCS-CT-OLA than in the CT-OLA group (42 months vs 16 months; p = 0.05). Also, SCS-CT-OLA patients had the best post-recurrence survival (PRS), with a 3-year PRS of 79% in SCS-CT-OLA group versus 42% in CT-OLA group (p = 0.02). CONCLUSIONS SCS increases TFST and PRS in PSROC patients with BRCAmut candidate for olaparib maintenance after platinum-based chemotherapy. Prospective studies are needed. In the era of personalized medicine, indication to SCS should be individualized.
Collapse
Affiliation(s)
- C Marchetti
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - A Rosati
- Catholic University Sacred Heart, Rome, Italy
| | - G Scaletta
- Catholic University Sacred Heart, Rome, Italy
| | - A Pietragalla
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - M Arcieri
- Catholic University Sacred Heart, Rome, Italy
| | - R Ergasti
- Catholic University Sacred Heart, Rome, Italy
| | - E Palluzzi
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University Sacred Heart, Rome, Italy.
| | - A Fagotti
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Catholic University Sacred Heart, Rome, Italy
| |
Collapse
|
5
|
Irelli A, Bruera G, Cannita K, Palluzzi E, Gravina GL, Festuccia C, Ficorella C, Ricevuto E. Bioclinical parameters driving decision-making of subsequent lines of treatment in metastatic castration-resistant prostate cancer. Biomed Res Int 2014; 2014:909623. [PMID: 24971356 PMCID: PMC4058260 DOI: 10.1155/2014/909623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 04/30/2014] [Indexed: 11/17/2022]
Abstract
Different options are available as second-line treatment of metastatic castrate-resistant prostate cancer: cabazitaxel, abiraterone, and enzalutamide. Phase III studies evaluating cabazitaxel and the two hormonal agents have been shown to significantly prolong overall survival compared to mitoxantrone and placebo, respectively. Several studies have also demonstrated feasibility and activity of docetaxel rechallenge in case of a sufficient progression-free interval (3-6 months), good performance status, and previous acceptable safety profile, thus providing an additional treatment option in clinical practice. Clinical and biological parameters should be considered to tailor II line treatment. In clinical practice, we can primarily evaluate patients' fitness according to age, performance status, symptomatic disease, comorbidities, and expected safety profile of each drug. Different prognostic/predictive factors may be considered, such as presence of bone-limited or visceral metastases, length of androgen deprivation therapy (ADT) before chemotherapy, time to progression after docetaxel, Gleason score, PSA doubling time, and serum testosterone, even if their clinical relevance is still debated. This review will discuss current options of innovative drugs sequencing and selection according to bioclinical parameters.
Collapse
Affiliation(s)
- A. Irelli
- Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - G. Bruera
- Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - K. Cannita
- Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy
| | - E. Palluzzi
- Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - G. L. Gravina
- Radiotherapy, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy
| | - C. Festuccia
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - C. Ficorella
- Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - E. Ricevuto
- Medical Oncology, S. Salvatore Hospital, University of L'Aquila, 67100 L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| |
Collapse
|