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Grassi E, Zingaretti C, Petracci E, Corbelli J, Papiani G, Banchelli I, Valli I, Frassineti GL, Passardi A, Di Bartolomeo M, Pietrantonio F, Gelsomino F, Carandina I, Banzi M, Martella L, Bonetti AV, Boccaccino A, Molinari C, Marisi G, Ugolini G, Nanni O, Tamberi S. Phase II study of capecitabine-based concomitant chemoradiation followed by durvalumab as a neoadjuvant strategy in locally advanced rectal cancer: the PANDORA trial. ESMO Open 2023; 8:101824. [PMID: 37774508 PMCID: PMC10594026 DOI: 10.1016/j.esmoop.2023.101824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND This study investigated the efficacy of chemoradiotherapy (CRT) followed by durvalumab as neoadjuvant therapy of locally advanced rectal cancer. PATIENTS AND METHODS The PANDORA trial is a prospective, phase II, open-label, single-arm, multicenter study aimed at evaluating the efficacy and safety of preoperative treatment with durvalumab (1500 mg every 4 weeks for three administrations) following long-course radiotherapy (RT) plus concomitant capecitabine (5040 cGy RT in 25-28 fractions over 5 weeks and capecitabine administered at 825 mg/m2 twice daily). The primary endpoint was the pathological complete response (pCR) rate; secondary endpoints were the proportion of clinical complete remissions and safety. The sample size was estimated assuming a null pCR proportion of 0.15 and an alternative pCR proportion of 0.30 (α = 0.05, power = 0.80). The proposed treatment could be considered promising if ≥13 pCRs were observed in 55 patients (EudraCT: 2018-004758-39; NCT04083365). RESULTS Between November 2019 and August 2021, 60 patients were accrued, of which 55 were assessable for the study's objectives. Two patients experienced disease progression during treatment. Nineteen out of 55 eligible patients achieved a pCR (34.5%, 95% confidence interval 22.2% to 48.6%). Regarding toxicity related to durvalumab, grade 3 adverse events (AEs) occurred in four patients (7.3%) (diarrhea, skin toxicity, transaminase increase, lipase increase, and pancolitis). Grade 4 toxicity was not observed. In 20 patients (36.4%), grade 1-2 AEs related to durvalumab were observed. The most common were endocrine toxicity (hyper/hypothyroidism), dermatologic toxicity (skin rash), and gastrointestinal toxicity (transaminase increase, nausea, diarrhea, constipation). CONCLUSION This study met its primary endpoint showing that CRT followed by durvalumab could increase pCR with a safe toxicity profile. This combination is a promising, feasible strategy worthy of further investigation.
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Affiliation(s)
- E Grassi
- Medical Oncology Unit, "Degli Infermi" Hospital, AUSL della Romagna, Faenza
| | - C Zingaretti
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - E Petracci
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - J Corbelli
- Medical Oncology Unit, "Degli Infermi" Hospital, AUSL della Romagna, Faenza
| | - G Papiani
- Medical Oncology Unit, "Santa Maria delle Croci" Hospital, AUSL della Romagna, Ravenna
| | - I Banchelli
- Pathology Unit, "Santa Maria delle Croci" Hospital, AUSL della Romagna, Ravenna
| | - I Valli
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - G L Frassineti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - A Passardi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - M Di Bartolomeo
- Gastroenterological Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - F Pietrantonio
- Gastroenterological Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - F Gelsomino
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, Modena
| | - I Carandina
- Department of Medical Oncology, "Sant'Anna" University Hospital of Ferrara, Ferrara
| | - M Banzi
- Medical Oncology Unit, "Santa Maria Nuova" Hospital, AUSL-IRCCS di Reggio Emilia, Reggio Emilia
| | - L Martella
- Department of Medical Oncology, "Sant'Anna" University Hospital of Ferrara, Ferrara
| | - A V Bonetti
- Department of Medical Oncology, "Mater Salutis" Hospital, Legnago
| | - A Boccaccino
- Medical Oncology Unit, "Santa Maria delle Croci" Hospital, AUSL della Romagna, Ravenna
| | - C Molinari
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - G Marisi
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - G Ugolini
- General Surgery Unit, "Santa Maria delle Croci" Hospital, AUSL della Romagna, Ravenna, Italy
| | - O Nanni
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola
| | - S Tamberi
- Medical Oncology Unit, "Degli Infermi" Hospital, AUSL della Romagna, Faenza; Medical Oncology Unit, "Santa Maria delle Croci" Hospital, AUSL della Romagna, Ravenna.
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Farolfi A, Petracci E, Gurioli G, Tedaldi G, Casanova C, Arcangeli V, Rosati M, Burgio S, Cursano M, Lolli C, Schepisi G, De Giorgi U. 53P Impact of the time interval between primary or interval surgery and adjuvant chemotherapy in ovarian cancer patients. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100833] [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
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Ulivi P, Pasini L, Petracci E, Urbini M, Felip E, Stella F, Davoli F, Salvi M, Beau-Faller M, Tebaldi M, Azzali I, Solli P, Lai G, Amat R, Carbonell C, Martinez-Marti A, Pencreach E, Delmonte A, Crinò L. 21P Circulating free and extracellular vesicles-derived microRNA as prognostic biomarkers in resected early-stage non-small cell lung cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.049] [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: 11/15/2022] Open
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Ridolfi L, Bulgarelli J, Petracci E, Pancisi E, Piccinini C, Granato A, Petrini M, Tazzari M, Ancarani V, Turci L, Gentili G, Valmorri L, Romeo A, De Giorgi U, Burgio S, Casadei C, Cortesi P, Lolli C, De Rosa F, Guidoboni M. Radiotherapy as an Immunological Booster in Patients with Metastatic Melanoma or Renal Cell Carcinoma Treated with High-Dose Interleukin-2: Final Data. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz451.029] [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: 11/14/2022] Open
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Canale M, De Luigi N, Petracci E, Delmonte A, Ludovini V, Dubini A, Baglivo S, Minenza E, Chiadini E, Landi L, Papi M, Bronte G, Crinò L, Ulivi P. TP53 mutations predicts worse prognosis in EGFR-mutated NSCLC patients receiving TKIs in first- or further line of treatment. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.056] [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: 11/13/2022] Open
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Canale M, Petracci E, Crino L, De Luigi N, Ludovini V, Dubini A, Baglivo S, Minenza E, Chiadini E, Landi L, Papi M, Delmonte A, Bronte G, Ulivi P. P1.14-05 TP53 Exon 8 Mutation and Prognosis in EGFR-Mutated NSCLC Patients Treated with First-And-Second-Generation TKIs. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1156] [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: 10/25/2022]
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Ulivi P, Petracci E, Ludovini V, Marisi G, Baglivo S, Chiari R, Delmonte A, De Luigi N, Crinò L, Amadori D, Grignani F. P3.02-007 Circulating miRNAs as Prognostic Biomarkers in Resected Early-Stages Non-Small-Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1536] [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: 10/18/2022]
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Ulivi P, Petracci E, Ludovini V, Marisi G, Delmonte A, De Luigi N, Calistri D, Crinò L, Amadori D, Chiari R, Baglivo S, Grignani F. Role of circulating miRNAs as prognostic biomarkers in resected early-stage non-small cell lung cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.040] [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: 11/13/2022] Open
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Rudnas B, Montanari E, Dall'Agata M, Petracci E, Serra P, Piancastelli A, Vertogen B, Zumaglini F, Venturini B, Testoni S, Gallà V, Monti M, Andreis D, Pagan F, Ragazzini A, Fabbri F, Gentili G, Affatato A, Nanni O. The patients' understanding of clinical research. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.27] [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: 11/14/2022] Open
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Capelli L, Petracci E, Quagliuolo V, Saragoni L, Colombo P, Morgagni P, Calistri D, Tomezzoli A, Di Cosmo M, Roviello F, Vindigni C, Coniglio A, Villanacci V, Catarci M, Coppola L, Alfieri S, Ricci R, Capella C, Rausei S, Gulino D, Amadori D, Ulivi P. Gastric GISTs: Analysis of c-Kit, PDGFRA and BRAF mutations in relation to prognosis and clinical pathological characteristics of patients – A GIRCG study. Eur J Surg Oncol 2016; 42:1206-14. [DOI: 10.1016/j.ejso.2016.05.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/28/2016] [Accepted: 05/20/2016] [Indexed: 12/14/2022] Open
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Cutti AG, Parel I, Raggi M, Petracci E, Pellegrini A, Accardo AP, Sacchetti R, Porcellini G. Prediction bands and intervals for the scapulo-humeral coordination based on the Bootstrap and two Gaussian methods. J Biomech 2014; 47:1035-44. [PMID: 24485513 DOI: 10.1016/j.jbiomech.2013.12.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 12/20/2013] [Accepted: 12/30/2013] [Indexed: 11/26/2022]
Abstract
Quantitative motion analysis protocols have been developed to assess the coordination between scapula and humerus. However, the application of these protocols to test whether a subject's scapula resting position or pattern of coordination is "normal", is precluded by the unavailability of reference prediction intervals and bands, respectively. The aim of this study was to present such references for the "ISEO" protocol, by using the non-parametric Bootstrap approach and two parametric Gaussian methods (based on Student's T and Normal distributions). One hundred and eleven asymptomatic subjects were divided into three groups based on their age (18-30, 31-50, and 51-70). For each group, "monolateral" prediction bands and intervals were computed for the scapulo-humeral patterns and the scapula resting orientation, respectively. A fourth group included the 36 subjects (42 ± 13 year-old) for whom the scapulo-humeral coordination was measured bilaterally, and "differential" prediction bands and intervals were computed, which describe right-to-left side differences. Bootstrap and Gaussian methods were compared using cross-validation analyses, by evaluating the coverage probability in comparison to a 90% target. Results showed a mean coverage for Bootstrap from 86% to 90%, compared to 67-70% for parametric bands and 87-88% for parametric intervals. Bootstrap prediction bands showed a distinctive change in amplitude and mean pattern related to age, with an increase toward scapula retraction, lateral rotation and posterior tilt. In conclusion, Bootstrap ensures an optimal coverage and should be preferred over parametric methods. Moreover, the stratification of "monolateral" prediction bands and intervals by age appears relevant for the correct classification of patients.
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Affiliation(s)
- A G Cutti
- I.N.A.I.L. Centro Protesi - Vigorso di Budrio, Italy.
| | - I Parel
- I.N.A.I.L. Centro Protesi - Vigorso di Budrio, Italy; DI3, University of Trieste, Italy
| | - M Raggi
- I.N.A.I.L. Centro Protesi - Vigorso di Budrio, Italy
| | - E Petracci
- I.N.A.I.L. Centro Protesi - Vigorso di Budrio, Italy; Department of Statistics, University of Bologna, Italy
| | - A Pellegrini
- Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Cattolica, Italy
| | | | - R Sacchetti
- I.N.A.I.L. Centro Protesi - Vigorso di Budrio, Italy
| | - G Porcellini
- Department of Statistics, University of Bologna, Italy
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Abstract
We present a simple influence function based approach to compute the variances of estimates of absolute risk and functions of absolute risk. We apply this approach to criteria that assess the impact of changes in the risk factor distribution on absolute risk for an individual and at the population level. As an illustration we use an absolute risk prediction model for breast cancer that includes modifiable risk factors in addition to standard breast cancer risk factors. Influence function based variance estimates for absolute risk and the criteria are compared to bootstrap variance estimates.
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Affiliation(s)
- R M Pfeiffer
- Biostatistics Branch, DCEG, National Cancer Institute, 6120 Executive Blvd, EPS/8030, Bethesda, MD 20892-7244, USA
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Plasmati R, Pastorelli F, Cavo M, Petracci E, Zamagni E, Tosi P, Cangini D, Tacchetti P, Salvi F, Bartolomei I, Michelucci R, Tassinari CA. Neuropathy in multiple myeloma treated with thalidomide: a prospective study. Neurology 2007; 69:573-81. [PMID: 17679676 DOI: 10.1212/01.wnl.0000267271.18475.fe] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Thalidomide is effective as a first-line therapy for the treatment of multiple myeloma (MM), but its use is limited by peripheral neurotoxicity. OBJECTIVE To study the occurrence of both myeloma-related neuropathy and thalidomide-induced neuropathy in 31 patients with newly diagnosed MM. METHODS Clinical and electrophysiologic examinations were performed in 31 patients with newly diagnosed MM before and after 4 months of therapy with thalidomide (200 mg/day, total dose: 21 g) aimed at debulking MM, before autologous transplantation. After transplantation, the patients took thalidomide, 200 mg/day for another 3 months (total dose over three months: 18 g) and then underwent a final clinical and electrophysiologic checkup. RESULTS At baseline, four patients presented a mild sensorimotor peripheral neuropathy related to MM, which tended to worsen slightly during treatment with thalidomide. At the end of treatment, 83% of the patients had clinical and electrophysiologic evidence of a mild sensory rather than motor, axonal, length-dependent polyneuropathy, whereas 100% of the patients showed improvement to the basic pathology (>or=partial response). CONCLUSIONS Peripheral neuropathy, sometimes subclinical, and mild in our patients, is a common, early side effect of thalidomide therapy. The high doses (21 g) used in all patients for a relatively short time (4 months) rule out any correlations between neuropathy, total dose, and duration of treatment.
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Affiliation(s)
- R Plasmati
- Dipartimento di Neuroscienze, Unità Operativa di Neurologia, Ospedale Bellaria, Bologna, Italy.
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Di Martino M, Veronesi C, Degli Esposti L, Scarpa F, Buda S, Didoni G, Petracci E, Valpiani G, Degli Esposti E. Adherence to antihypertensive drug treatment and blood pressure control: a real practice analysis in Italy. J Hum Hypertens 2007; 22:51-3. [PMID: 17611549 DOI: 10.1038/sj.jhh.1002253] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M Di Martino
- Health Economics and Outcomes Research, CliCon S.r.l., Ravenna, Italy.
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