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Rizzo A, Schipilliti FM, Di Costanzo F, Acquafredda S, Arpino G, Puglisi F, Del Mastro L, Montemurro F, De Laurentiis M, Giuliano M. Discontinuation rate and serious adverse events of chemoimmunotherapy as neoadjuvant treatment for triple-negative breast cancer: a systematic review and meta-analysis. ESMO Open 2023; 8:102198. [PMID: 38100933 PMCID: PMC10774952 DOI: 10.1016/j.esmoop.2023.102198] [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: 06/21/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The use of combination of chemotherapy with immune checkpoint inhibitors (ICIs) has shown efficacy in triple-negative breast cancer (TNBC), and chemoimmunotherapy has been introduced in clinical practice. However, limited data are available on the discontinuation rate and serious adverse events of these treatments, particularly in the neoadjuvant setting. Herein, we carried out a comprehensive systematic review and meta-analysis to assess discontinuation rate and serious adverse events of chemoimmunotherapy compared to chemotherapy alone in phase II and III neoadjuvant clinical trials in TNBC. MATERIALS AND METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, EMBASE, Cochrane Library, and PubMed/Medline were searched for articles published from June 2008 to May 2023. The outcomes of interest were the discontinuation rate, serious adverse events, and grade 3-4 adverse events. RESULTS Four studies were included in the analysis. The pooled odds ratios (ORs) for discontinuation rate and serious adverse events were 1.26 [95% confidence interval (CI) 0.78-2.06] and 1.79 (95% CI 1.4-2.28), respectively, in patients receiving chemoimmunotherapy compared to chemotherapy alone as neoadjuvant treatment for TNBC. The chemoimmunotherapy group had a higher risk of grade 3-4 adverse events (OR 1.30, 95% CI 1.07-1.59). The analysis showed substantial heterogeneity, and the risk of discontinuation rate was heavily influenced by the KEYNOTE-522 trial. CONCLUSIONS Our findings highlight the need for clinical trials specifically focused on safety, quality of life, and treatment adherence in TNBC patients receiving neoadjuvant treatment. Close monitoring of tolerability remains crucial in this clinical setting.
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Affiliation(s)
- A Rizzo
- IRCCS Istituto Tumori "Giovanni Paolo II", Bari
| | - F M Schipilliti
- Oncological Department, Sant'Andrea Hospital, University Sapienza in Rome, Rome
| | - F Di Costanzo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples
| | | | - G Arpino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples
| | - F Puglisi
- Department of Medicine, University of Udine, Udine; Department of Medical Oncology-CRO Aviano, National Cancer Institute, IRCCS, Aviano
| | - L Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova; Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova
| | | | - M De Laurentiis
- Istituto Nazionale Tumori IRCCS "Fondazione Pascale", Napoli, Italy
| | - M Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples.
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Presotto EM, Rastrelli G, Desideri I, Scotti V, Gunnella S, Pimpinelli N, Vaccher E, Bearz A, Di Costanzo F, Bruggia M, Mini E, Maggi M, Peri A. Endocrine toxicity in cancer patients treated with nivolumab or pembrolizumab: results of a large multicentre study. J Endocrinol Invest 2020; 43:337-345. [PMID: 31542865 DOI: 10.1007/s40618-019-01112-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/03/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The immune checkpoint inhibitors (ICPIs) agents anti-T lymphocytes-associated antigen 4 (CTLA-4) and anti-programmed cell death protein-1 (PD-1) and its ligands (PD-L1/PD-L2) have opened a new scenario in the treatment of cancer. These agents can induce immuno-related adverse events (irAEs), which may affect the endocrine system. PURPOSE The aim of this study was to analyze the occurrence and the course of endocrine irAEs in cancer patients treated with anti-PD-1 immunotherapy. METHODS This was a retrospective, multicentre study, involving cancer patients treated with the PD-1 inhibitors nivolumab or pembrolizumab at reference Oncology Centres. One hundred and seventy-nine consecutive patients with different types of cancer (mostly non-small cell lung cancer, melanoma, kidney cancer) were included in the study. Patients had received nivolumab (70.9%) or pembrolizumab (29.1%) for 2-33 months. The study evaluated clinical data records until the established date of July 15, 2018. The primary end point was the assessment of endocrine toxicity and possible predictive factors. RESULTS Endocrine toxicity occurred in 54 out of 179 patients (30.2%) and was related to thyroid dysfunction, with the exception of one case of diabetes mellitus. Thyroid toxicity occurred mostly within 2 months from the initiation of immunotherapy (83% of cases). A pre-existing thyroid dysfunction was a significant predictor of disease flare. CONCLUSIONS Thyroid alterations are frequently associated with anti PD-1 treatment in cancer patients. Regular thyroid assessment should be performed, particularly in the first months of treatment and in patients with a pre-existing thyroid disease.
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Affiliation(s)
- E M Presotto
- Endocrinology, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, AOU Careggi, Viale Pieraccini, 6, 50139, Florence, Italy
| | - G Rastrelli
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, AOU Careggi, 50139, Florence, Italy
| | - I Desideri
- Radiation Oncology Unit, Department of Oncology and Experimental Clinical and Biomedical Sciences "Mario Serio", AOU Careggi, University of Florence, Florence, Italy
| | - V Scotti
- Radiation Oncology Unit, Department of Oncology and Experimental Clinical and Biomedical Sciences "Mario Serio", AOU Careggi, University of Florence, Florence, Italy
| | - S Gunnella
- Melanoma and Skin Cancer Unit, Tuscany Central District, Department of Health Sciences, Dermatology Unit, University of Florence, Florence, Italy
| | - N Pimpinelli
- Melanoma and Skin Cancer Unit, Tuscany Central District, Department of Health Sciences, Dermatology Unit, University of Florence, Florence, Italy
| | - E Vaccher
- Medical Oncology and Immuno-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - A Bearz
- Medical Oncology and Immuno-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - M Bruggia
- Unit of Translational Oncology, AOU Careggi, Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - E Mini
- Unit of Translational Oncology, AOU Careggi, Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - M Maggi
- Endocrinology, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, AOU Careggi, Viale Pieraccini, 6, 50139, Florence, Italy
| | - A Peri
- Endocrinology, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, AOU Careggi, Viale Pieraccini, 6, 50139, Florence, Italy.
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Capelletto E, Morabito A, Grossi F, Costanzo FD, Osman G, Chiari R, Bordi P, Scotti V, Romano G, Delmonte A, Galetta D, Ciuffreda L, Manzo A, Genova C, Mazzoni F, Morelli A, Critelli R, Stura I, Migliaretti G, Novello S. Post progression survival for patients treated with docetaxel/nintedanib in the SENECA trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.090] [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: 11/12/2022] Open
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Capelletto E, Osman G, Morabito A, Chiari R, Grossi F, Tiseo M, Di Costanzo F, Delmonte A, Romano G, Misino A, Scotti V, Gregorc V, Pisconti S, Bonomi M, Del Conte A, Ciuffreda L, Colantonio I, Bria E, Ricciardi S, Manzo A, Metro G, Morelli A, Critelli R, Stura I, Migliaretti G, Novello S. P2.04-84 NSCLC Survival Expectancy for Patients Treated with Docetaxel/Nintedanib in the SENECA Trial and Previous Immunotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1589] [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: 11/29/2022]
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Fratello A, Caivano R, Di Costanzo F, Mazzoccoli C, Cammarota A, Gallo C, Piccoli C. 295. A 3T MRS in the analysis of cell differentiation induced in human Neuroblastoma cells treated with l-Acetylaspartate and electro stimulation. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.304] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Morelli A, Migliorino M, Morabito A, Chiari R, Grossi F, Bordi P, Di Costanzo F, Delmonte A, Romano G, Misino A, Scotti V, Gregorc V, Pisconti S, Ceresoli G, Del Conte A, Colantonio I, Ciuffreda L, Capelletto E, Stura I, Novello S. Safety of nintedanib plus docetaxel in advanced non-squamous NSCLC (nsNSCLC) patients: The preliminary results of the SENECA (second-line nintedanib in non-small cell lung cancer) trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.026] [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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7
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Di Costanzo F, Caccialanza R, Santoro A, Gavazzi C, Pedrazzoli P. Current use of clinical nutrition in oncology patients: Real world evidence from big data in Italy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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8
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Liberati AM, Di Costanzo F, Buzzi F, Fatati G, Biscottini B, Ballatori E, Falchi R, Grignani F. 5-Fluorouracil, Vincristine and Hydroxyurea Combination Chemotherapy in Metastatic Colorectal Cancer. Tumori 2018; 69:485-7. [PMID: 6649073 DOI: 10.1177/030089168306900519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Twenty consecutive patients who had biopsy proven metastatic colorectal cancer were treated with combination chemotherapy. The drug regimen (FVH), in a 4 week cycle, consisted of 5-fluorouracil (600 mg/m2 i.v. on days 1, 8, 15 and 22), vincristine (1.4 mg/m2 i.v. on day 4), and hydroxyurea (2400 mg/m2 p.o. on days 3, 10, 17 and 24). Three of the 18 evaluable patients achieved an objective tumor remission (2 CR and 1 PR) and 15 patients had stable disease. The overall response rate to FVH was therefore not superior to that achieved in patients who received 5-fluorouracil alone, and the overall survival in this study was comparable to that of other studies involving patients with metastatic colorectal cancer.
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Passalacqua R, Bisagni G, Bertusi M, Donati D, Buzzi F, Di Costanzo F, Basurto C, Gori S. Lonidamine in Advanced Colorectal Cancer: A Phase II Study of the Italian Oncology Group for Clinical Research (Goirc). Tumori 2018; 75:277-9. [PMID: 2672481 DOI: 10.1177/030089168907500318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Twenty-one patients with metastatic colorectal adenocarcinoma, all previously treated with chemotherapy for metastatic disease, were treated with lonidamine (LDN). The major toxicity encountered was muscular (myalgias in 48%) and gastrointestinal (nausea and/or vomiting in 52%). Other toxicities included abdominal pain, somnolence, fever, arthralgia and ototoxicity. In the 14 patients evaluable for response we observed no complete or partial remission, 8 stable disease and 6 progressive disease. LND has no clinically worthwhile activity against colorectal carcinoma refractory to conventional chemotherapy.
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Affiliation(s)
- R Passalacqua
- Medical Oncology Service, Ospedale Maggiore, Parma, Italy
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10
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Alexanian A, Apolone G, Roberto Grilli RF, Mosconi P, Nicolucci A, Liberati A, Di Biagio G, Testore F, Michetti G, Beltrami V, Iarussi T, Bonati P, Rossetti A, Buccheri G, Manichetti C, Indelli M, Malacarne P, Ghiringhelli P, Olivadoti O, Cella C, Lepore S, Isa L, Scapaticci R, Sargenti A, Sevieri G, Lanzetti V, Nascimben O, Soresi E, Mezzetti M, Confalonieri C, Pavia G, Rizzi A, Di Costanzo F, Tagliaventi M, Trotti AB, Fracchia F, Rovea P, Verna V, Bian AR. Diagnosis and First-Line Treatment of Patients with Lung Cancer in Italian General Hospitals. Tumori 2018; 75:163-7. [PMID: 2741224 DOI: 10.1177/030089168907500217] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The quality of diagnostic and therapeutic care was examined in a series of 380 consecutive newly diagnosed cases of primary lung cancer seen in 20 Italian general hospitals between January and June 1987. At diagnosis most patients (78%) had one or more symptoms related to the tumor, and in an additional 9 % symptoms were related to the presence of distant metastases. The median diagnostic time lag between first symptoms and final diagnosis was 50 days with a significantly longer delay in patients first seen by their general practitioner compared with those who sought first care in hospital outpatient departments. The diagnostic process was satisfactorily carried out in fewer than two-thirds of the patients leading to complete ascertainment of disease stage and histology in 58% cases with significantly better performance in more specialized institutions. Analysis of the first-line treatment profile indicated a rather aggressive therapeutic attitude In the case of patients with non-small cell lung cancer – 28% of them had chemotherapy despite the lack of any proof of efficacy in controlled clinical trials – and a failure to identify among the patients with small cell disease those amenable to more aggressive treatment. The lack of progress in the treatment of lung cancer over the last decades seems to have resulted in widely varying practice patterns where a mixture of aggressive and laissez-faire attitudes does not take into account that in the absence of effective therapies a more conservative attitude would at least have some advantage in terms of quality of remaining life for many patients.
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Antonuzzo L, Del Re M, Barucca V, Spada F, Meoni G, Restante G, Danesi R, Di Costanzo F, Fazio N. Critical focus on mechanisms of resistance and toxicity of m-TOR inhibitors in pancreatic neuroendocrine tumors. Cancer Treat Rev 2017; 57:28-35. [PMID: 28535439 DOI: 10.1016/j.ctrv.2017.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 01/09/2017] [Revised: 05/01/2017] [Accepted: 05/03/2017] [Indexed: 10/19/2022]
Abstract
Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms representing less than 2% of all pancreatic malignancies. The PI3K-AKT-mTOR pathway is often deregulated in pNETs and seems to play a key role in tumorigenesis. Everolimus, an inhibitor of the mTOR pathway, has demonstrated efficacy in the treatment of pNETs. Nevertheless de novo or acquired drug resistance is responsible for disease progression and represents a major obstacle to overcome by clinicians. Blocking the PI3K/AKT/mTOR pathway may cover the supposed main mechanisms of resistance to everolimus. Therefore, BEZ-235, a potent oral dual PI3K/mTOR inhibitor was investigated in clinical trials. Globally more than 250 patients with different types of solid tumors were treated. Two studies were conducted in pNETs with BEZ-235 as single agent. The former was a phase 2 trial conducted in pNETs resistant to everolimus while the latter a randomized trial comparing everolimus and BEZ-235. Unfortunately, both the studies disappointed the expectations and were prematurely halted mainly due to severe toxicity. On this basis we reviewed m-TOR inhibitors in pNETs, focusing on their mechanisms of resistance and toxicity.
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Affiliation(s)
- L Antonuzzo
- S.C. Oncologia Medica 1, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Medical Genetics, University of Siena, Siena, Italy.
| | - M Del Re
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - V Barucca
- Division of Medical Oncology, Misericordia General Hospital, Grosseto, Italy
| | - F Spada
- Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, Milan, Italy
| | - G Meoni
- S.C. Oncologia Medica 1, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - G Restante
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - R Danesi
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - F Di Costanzo
- S.C. Oncologia Medica 1, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - N Fazio
- Unit of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, Milan, Italy
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Savarese I, Grazzini M, Gori A, D'Errico A, Doni L, Scarfì F, Covarelli P, Di Costanzo F, De Giorgi V. Trichilemmal cystis in metastatic melanoma: a case report. Exp Oncol 2017; 39:86-87. [PMID: 28361863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The malignant melanoma is a neoplasm associated with a wide variety of cutaneous paraneoplastic syndromes, as dermatomyositis, systemic sclerosis, paraneoplastic pemphigus. We describe a case of four multiple trichilemmal cystis arising on frontal region in the same patient with brain metastasis and unknown primary melanoma and discuss their relationship.
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Affiliation(s)
- I Savarese
- Department of Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Firenze 50121, 50132, Italy
| | - M Grazzini
- Department of Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Firenze 50121, 50132, Italy
| | - A Gori
- Cancer Research "Attilia Pofferi" Foundation, Pistoia 51100, Italy
| | - A D'Errico
- Department of Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Firenze 50121, 50132, Italy
| | - L Doni
- Oncology Unit, Department of Critical Care Medicine and Surgery, University of Florence, Firenze 50121, 50132, Italy
| | - F Scarfì
- Department of Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Firenze 50121, 50132, Italy
| | - P Covarelli
- Department of Surgery, University of Perugia, Perugia 06121, Italy
| | - F Di Costanzo
- Oncology Unit, Department of Critical Care Medicine and Surgery, University of Florence, Firenze 50121, 50132, Italy
| | - V De Giorgi
- Department of Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Firenze 50121, 50132, Italy
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Grossi F, Crinò L, Misino A, Bidoli P, Delmonte A, Gelsomino F, Proto C, Mancini M, Landi L, Turci D, Quadrini S, Antonelli P, Marchetti P, Toschi L, Giusti S, Di Costanzo F, Rastelli F, Sandri P, Scotti V, de Marinis F. Efficacy and safety of nivolumab in elderly patients (pts) with advanced squamous non small cell lung cancer (Sq-NSCLC) participating in the expanded access programme (EAP) in Italy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Berardi R, Torniai M, Pusceddu S, Spada F, Ibrahim T, Zichi C, Antonuzzo L, Ferolla P, Rinzivillo M, Silvestris N, Partelli S, Ferretti B, Bongiovanni A, Giustini L, Di Costanzo F, Delle Fave G, Fazio N, De Braud F, Falconi M, Cascinu S. Prognostic impact of the cumulative dose and dose intensity of everolimus in patients with pancreatic neuroendocrine tumors (PNETs). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw369.28] [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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Giommoni E, Maiello E, Tortora G, Vaccaro V, Rondini E, Toppo L, Giordano G, Latiano T, Calvetti L, Antonuzzo L, Lamperini C, Boni L, Di Costanzo F. Nab-paclitaxel in substitution of oxaliplatin and irinotecan in folfirinox schedule as first-line therapy in patients with metastatic pancreatic cancer: results of phase I dose finding of NabucCO study by GOIRC. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.74] [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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Berardi R, Pusceddu S, Spada F, Ibrahim T, Brizzi M, Antonuzzo L, Ferolla P, Rinzivillo M, Silvestris N, Freddari F, Testa E, Bongiovanni A, Zichi C, Di Costanzo F, Delle Fave G, Fazio N, de Braud F, Falconi M, Cascinu S. Prognostic impact of the cumulative dose and dose intensity of everolimus in patients with pancreatic neuroendocrine tumors (PNETs). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.17] [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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17
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Ciardiello F, Salvatore L, Cascinu S, Sobrero A, Banzi C, Barone C, Spallanzani A, Latiano T, Siena S, Bergamo F, Cartenì G, Di Costanzo F, Di Bartolomeo M, Santoro A, Russo A, Russo A, Moscovici M, Van Cutsem E, Grothey A, Zaniboni A. Regorafenib in previously treated metastatic colorectal cancer (mCRC): Analysis of age subgroups in the open-label phase 3b CONSIGN trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.17] [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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Salvatore L, Ciardiello F, Cascinu S, Sobrero A, Banzi C, Barone C, Gelsomino F, Maiello E, Siena S, Bergamo F, Cartenì G, Di Costanzo F, Di Bartolomeo M, Rimassa L, Russo A, Moscovici M, Van Cutsem E, Grothey A, Zaniboni A. Subgroup analysis of patients with metastatic colorectal cancer (mCRC) treated with regorafenib (REG) in the phase 3b CONSIGN trial who had progression-free survival (PFS) >4 months (m). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Bartoli F, Bruni C, Tesei G, Denaro V, Nacci F, Antonuzzo L, Di Costanzo F, Matucci-Cerinic M, Fiori G. SAT0582 Incidence of Malignancies in Patients with Inflammatory Rheumatic Diseases and Biological Drugs: Experience from One Center in Italy. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5769] [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: 11/03/2022]
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Ciardiello F, Salvatore L, Cascinu S, Sobrero A, Banzi M, Barone C, Spallanzani A, Latiano T, Amatu A, Zagonel V, Biglietto M, Di Costanzo F, Di Bartolomeo M, Santoro A, Russo A, Moscovici M, Van Cutsem E, Zaniboni A. Regorafenib for previously treated metastatic colorectal cancer (mCRC): results from 683 Italian patients treated in the open-label phase IIIB CONSIGN study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.04] [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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Mazzoni F, Petreni P, Lunghi A, Vannini A, Brugia M, Mela M, Stefani L, Mascherini G, Galanti G, Di Costanzo F. Physical exercise and eating habits in cancer survivors. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.41] [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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Petreni P, Lunghi A, Mazzoni F, Vannini A, Rispoli A, Brugia M, Stefani L, Petri C, Galanti G, Di Costanzo F. Fast Walking And Resistance Exercise Program In Breast Cancer Survivors. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.64] [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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Lastraioli E, Perrone G, Sette A, Fiore A, Crociani O, Manoli S, D'Amico M, Masselli M, Iorio J, Callea M, Borzomati D, Nappo G, Bartolozzi F, Santini D, Bencini L, Farsi M, Boni L, Di Costanzo F, Schwab A, Onetti Muda A, Coppola R, Arcangeli A. hERG1 channels drive tumour malignancy and may serve as prognostic factor in pancreatic ductal adenocarcinoma. Br J Cancer 2015; 112:1076-87. [PMID: 25719829 PMCID: PMC4366888 DOI: 10.1038/bjc.2015.28] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 01/02/2015] [Accepted: 01/12/2015] [Indexed: 12/15/2022] Open
Abstract
Background: hERG1 channels are aberrantly expressed in human cancers. The expression, functional role and clinical significance of hERG1 channels in pancreatic ductal adenocarcinoma (PDAC) is lacking. Methods: hERG1 expression was tested in PDAC primary samples assembled as tissue microarray by immunohistochemistry using an anti-hERG1 monoclonal antibody (α-hERG1-MoAb). The functional role of hERG1 was studied in PDAC cell lines and primary cultures. ERG1 expression during PDAC progression was studied in Pdx-1-Cre,LSL-KrasG12D/+,LSL-Trp53R175H/+ transgenic (KPC) mice. ERG1 expression in vivo was determined by optical imaging using Alexa-680-labelled α-hERG1-MoAb. Results: (i) hERG1 was expressed at high levels in 59% of primary PDAC; (ii) hERG1 blockade decreased PDAC cell growth and migration; (iii) hERG1 was physically and functionally linked to the Epidermal Growth Factor-Receptor pathway; (iv) in transgenic mice, ERG1 was expressed in PanIN lesions, reaching high expression levels in PDAC; (v) PDAC patients whose primary tumour showed high hERG1 expression had a worse prognosis; (vi) the α-hERG1-MoAb could detect PDAC in vivo. Conclusions: hERG1 regulates PDAC malignancy and its expression, once validated in a larger cohort also comprising of late-stage, non-surgically resected cases, may be exploited for diagnostic and prognostic purposes in PDAC either ex vivo or in vivo.
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Affiliation(s)
- E Lastraioli
- Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy
| | - G Perrone
- Department of Pathology, Pathology Unit, Campus Bio-Medico University, via del Portillo 200, Rome 00128, Italy
| | - A Sette
- Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy
| | - A Fiore
- Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy
| | - O Crociani
- Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy
| | - S Manoli
- Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy
| | - M D'Amico
- 1] Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy [2] DI.V.A.L Toscana Srl, Via Madonna del Piano 6, Sesto Fiorentino 50019, Italy
| | - M Masselli
- Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy
| | - J Iorio
- Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy
| | - M Callea
- Department of Pathology, Pathology Unit, Campus Bio-Medico University, via del Portillo 200, Rome 00128, Italy
| | - D Borzomati
- Department of General Surgery, Campus Bio-Medico University, via del Portillo 200, Rome 00128, Italy
| | - G Nappo
- Department of General Surgery, Campus Bio-Medico University, via del Portillo 200, Rome 00128, Italy
| | - F Bartolozzi
- Casa di Cura Villa Margherita, Viale di Villa Massimo 48, Rome 00161, Italy
| | - D Santini
- Department of Medical Oncology, Campus Bio-Medico University, via del Portillo 200, Rome 00128, Italy
| | - L Bencini
- Department of General Surgery and Surgical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy
| | - M Farsi
- Department of General Surgery and Surgical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy
| | - L Boni
- Clinical Trials Coordinating Center, Azienda Ospedaliero-Universitaria Careggi/Istituto Toscano Tumori, Largo Brambilla 3, Florence 50134, Italy
| | - F Di Costanzo
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, Florence 50134, Italy
| | - A Schwab
- Physiologisches Institut II, University of Münster, Robert-Koch-Str. 27b, Münster D-48149, Germany
| | - A Onetti Muda
- Department of Pathology, Pathology Unit, Campus Bio-Medico University, via del Portillo 200, Rome 00128, Italy
| | - R Coppola
- Department of General Surgery, Campus Bio-Medico University, via del Portillo 200, Rome 00128, Italy
| | - A Arcangeli
- Department of Experimental and Clinical Medicine, University of Florence, Viale GB Morgagni 50, Florence 50134, Italy
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Taieb J, Bordonaro R, Bencardino K, Ciuffreda L, Di Costanzo F, Di Bartolomeo M, Thomas A, Kröning H, Alfonso PG, Borg C, Moore Y, Brette S, Zilocchi C, Joulain F, Naoshy S, Garreau-Laporte P, Dochy E, Lledo G, Sobrero A. Quality of Life (Qol) on the Aflibercept/Folfiri Regimen: 4Th Interim Analysis of the Global Aflibercept Safety and Health-Related Qol Program. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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25
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Spada F, Fazio N, Marconcini R, Antonuzzo A, Ricci S, Fontana A, Luppi G, Antonuzzo L, Di Costanzo F, Nobili E, Radice D, Galdy S, Sonzogni M, Pisa E, Barberis M. Real-World Study on Oxaliplatin-Based Chemotherapy in Patients with Advanced Neuroendocrine Neoplasms : Clinical Outcomes and Preliminary Correlation with Biological Factors. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu345.19] [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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26
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Bajetta E, Floriani I, Di Bartolomeo M, Labianca R, Falcone A, Di Costanzo F, Comella G, Amadori D, Pinto C, Carlomagno C, Nitti D, Daniele B, Mini E, Poli D, Santoro A, Mosconi S, Casaretti R, Boni C, Pinotti G, Bidoli P, Landi L, Rosati G, Ravaioli A, Cantore M, Di Fabio F, Aitini E, Marchet A. Randomized trial on adjuvant treatment with FOLFIRI followed by docetaxel and cisplatin versus 5-fluorouracil and folinic acid for radically resected gastric cancer. Ann Oncol 2014; 25:1373-1378. [PMID: 24728035 DOI: 10.1093/annonc/mdu146] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [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] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Some trial have demonstrated a benefit of adjuvant fluoropirimidine with or without platinum compounds compared with surgery alone. ITACA-S study was designed to evaluate whether a sequential treatment of FOLFIRI [irinotecan plus 5-fluorouracil/folinic acid (5-FU/LV)] followed by docetaxel plus cisplatin improves disease-free survival in comparison with 5-FU/LV in patients with radically resected gastric cancer. PATIENTS AND METHODS Patients with resectable adenocarcinoma of the stomach or gastroesophageal junction were randomly assigned to either FOLFIRI (irinotecan 180 mg/m(2) day 1, LV 100 mg/m(2) as 2 h infusion and 5-FU 400 mg/m(2) as bolus, days 1 and 2 followed by 600 mg/m(2)/day as 22 h continuous infusion, q14 for four cycles) followed by docetaxel 75 mg/m(2) day 1, cisplatin 75 mg/m(2) day 1, q21 for three cycles (sequential arm) or De Gramont regimen (5-FU/LV arm). RESULTS From February 2005 to August 2009, 1106 patients were enrolled, and 1100 included in the analysis: 562 in the sequential arm and 538 in the 5-FU/LV arm. With a median follow-up of 57.4 months, 581 patients recurred or died (297 sequential arm and 284 5-FU/LV arm), and 483 died (243 and 240, respectively). No statistically significant difference was detected for both disease-free [hazard ratio (HR) 1.00; 95% confidence interval (CI): 0.85-1.17; P = 0.974] and overall survival (OS) (HR 0.98; 95% CI: 0.82-1.18; P = 0.865). Five-year disease-free and OS rates were 44.6% and 44.6%, 51.0% and 50.6% in the sequential and 5-FU/LV arm, respectively. CONCLUSIONS A more intensive regimen failed to show any benefit in disease-free and OS versus monotherapy. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01640782.
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Affiliation(s)
- E Bajetta
- Istituto di Oncologia, Policlinico di Monza, Monza
| | - I Floriani
- Laboratory of Clinical Research, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milano.
| | - M Di Bartolomeo
- Struttura Complessa di Medicina Oncologica 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - R Labianca
- Unità di Oncologia Medica, Ospedale Papa Giovanni XXIII, Bergamo
| | - A Falcone
- Dipartimento di Ricerca Traslazionale, Università di Pisa, Istituto Toscano Tumori, Pisa
| | - F Di Costanzo
- S.C. Oncologia Medica, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - G Comella
- Oncologia Medica A, Fondazione Pascale, Istituto Nazionale dei Tumori, Napoli
| | - D Amadori
- I.R.C.C.S. Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola
| | - C Pinto
- U.O. di Oncologia Medica, Policlinico S.Orsola Malpighi, Bologna
| | - C Carlomagno
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, Napoli
| | - D Nitti
- Clinica Chiurgica 1, Dipartimento di Scienze Chirurgiche Oncologiche e Gastroenterologiche, Padova
| | - B Daniele
- Dipartimento di Oncologia, A.O.G. Rummo, Benevento
| | - E Mini
- Dipartimento di Scienze Della Salute, Sezione di Farmacologia Clinica e Oncologia, Università degli Studi di Firenze, Firenze
| | - D Poli
- Laboratory of Clinical Research, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milano
| | - A Santoro
- U.O. Oncologia e Ematologia, Humanitas Cancer Center, Istituto Clinico Humanitas-I.R.C.C.S., Rozzano
| | - S Mosconi
- Unità di Oncologia Medica, Ospedale Papa Giovanni XXIII, Bergamo
| | - R Casaretti
- S.C. di Oncologia Medica Addominale, dell'Istituto Tumori di Napoli, Napoli
| | - C Boni
- Oncologia, Arcispedale Santa Maria Nuova-I.R.C.C.S., Reggio Emilia, Reggio Emilia
| | - G Pinotti
- Divisione di Oncologia Medica, A.O. Ospedale di Circolo, Varese
| | - P Bidoli
- S.C. Oncologia Medica, A.O.S. Gerardo, Monza
| | - L Landi
- U.O. Oncologia Medica, Azienda USL6 di Livorno, Istituto Toscano Tumori, Livorno
| | - G Rosati
- Unità Oncologia Medica, Ospedale S. Carlo, Potenza
| | - A Ravaioli
- U.O. di Oncologia, Ospedale Infermi Rimini, Ospedale Cervesi, Azienda USL di Rimini, Rimini, Cattolica
| | - M Cantore
- Oncologia Medica, USL 1, Massa Carrara
| | - F Di Fabio
- U.O. di Oncologia Medica, Policlinico S.Orsola Malpighi, Bologna
| | - E Aitini
- Ospedale Carlo Poma, Mantova, Italy
| | - A Marchet
- Clinica Chiurgica 1, Dipartimento di Scienze Chirurgiche Oncologiche e Gastroenterologiche, Padova
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Lastraioli E, Boni L, Romoli MR, Crescioli S, Taddei A, Beghelli S, Tomezzoli A, Vindigni C, Saragoni L, Messerini L, Bernini M, Bencini L, Giommoni E, Freschi G, Di Costanzo F, Scarpa A, Morgagni P, Farsi M, Roviello F, De Manzoni G, Bechi P, Arcangeli A. VEGF-A clinical significance in gastric cancers: immunohistochemical analysis of a wide Italian cohort. Eur J Surg Oncol 2014; 40:1291-8. [PMID: 24784776 DOI: 10.1016/j.ejso.2014.03.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/29/2014] [Accepted: 03/31/2014] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The clinical significance of VEGF-A expression in gastric cancer (GC) has been reported with contradicting results. We analyzed the expression and clinical significance of VEGF-A in a wide Italian cohort of GC specimens. METHODS VEGF-A expression was tested by immunohistochemistry in 507 patients with GC of all clinical stages. The impact of VEGF-A on overall survival (OS) was evaluated in conjunction with clinical and pathological parameters. RESULTS In the Italian cohort we studied VEGF-A was not an independent prognostic factor neither at the univariate nor at multivariate analysis. CONCLUSIONS Although frequently expressed, in our study VEGF-A was not able to discriminate between groups of patients with different risk.
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Affiliation(s)
- E Lastraioli
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - L Boni
- Clinical Trials Coordinating Center, Azienda Ospedaliero-Universitaria Careggi/Istituto Toscano Tumori, Largo GA Brambilla 3, 50134 Florence, Italy
| | - M R Romoli
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - S Crescioli
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - A Taddei
- Surgery and Translational Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - S Beghelli
- Department of Pathology and Diagnostics, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy
| | - A Tomezzoli
- Pathology Division, Borgo Trento Hospital, Piazzale A Stefani 1, 37134 Verona, Italy
| | - C Vindigni
- Pathology Division, Azienda Ospedaliero-Universitaria Senese, Viale M Bracci 16, 53100 Siena, Italy
| | - L Saragoni
- Pathology Division, Morgagni-Pierantoni Hospital, Via C Forlanini 34, 47121 Forlì, Italy
| | - L Messerini
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - M Bernini
- General Surgery and Surgical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - L Bencini
- General Surgery and Surgical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - E Giommoni
- Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - G Freschi
- Surgery and Translational Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - F Di Costanzo
- Medical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - A Scarpa
- Department of Pathology and Diagnostics, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy
| | - P Morgagni
- General Surgery, Morgagni-Pierantoni Hospital, Via C Forlanini 34, 47121 Forlì, Italy
| | - M Farsi
- General Surgery and Surgical Oncology, Azienda Ospedaliero-Universitaria Careggi, Largo GA Brambilla 3, 50134 Florence, Florence, Italy
| | - F Roviello
- Department of General Surgery and Oncology, University of Siena, Viale M Bracci 16, 53100 Siena, Italy
| | - G De Manzoni
- Division of Surgery, University of Verona, Piazzale LA Scuro 10, 37134 Verona, Italy
| | - P Bechi
- Surgery and Translational Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy
| | - A Arcangeli
- Department of Clinical and Experimental Medicine, University of Florence, Largo GA Brambilla 3, 50134 Florence, Italy.
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Cavalli T, Boni L, Di Costanzo F, Meoni G, Bencini L, Tonelli F. Observational study in metastatic colorectal cancer: Survival and complications in three different subgroups divided according to the first treatment performed. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.07.021] [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: 10/27/2022] Open
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Barni S, Borgonovo K, Di Costanzo F, Cognetti F, Bernardo G, Boni C, Agostara B, Pronzato P, Colucci G, Mammucari M. Pain Management in Eight Italian Oncological Care Centres. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33994-6] [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] Open
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Caldarella A, Amunni G, Angiolini C, Crocetti E, Di Costanzo F, Di Leo A, Giusti F, Pegna AL, Mantellini P, Luzzatto L, Paci E. Feasibility of evaluating quality cancer care using registry data and electronic health records: a population-based study. Int J Qual Health Care 2012; 24:411-8. [DOI: 10.1093/intqhc/mzs020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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31
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Pastorelli D, Latiano T, Antonuzzo L, Pavese I, Aieta M, Algeri R, Azzarello D, Bertolini A, Di Fabio F, Di Costanzo F. 6114 POSTER Clinical Outcomes of Bevacizumab (BV) + XELOX Combination for the First-line Treatment of Patients (pts) With Advanced Cancer of the Colon or Rectum (ACRC) – Preliminary Results of the OBELIX Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71759-2] [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: 10/17/2022]
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32
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Ardizzoni A, Boni L, Tiseo M, Vincent A, Passalacqua R, Camerini A, Labianca R, Genestreti G, Zanelli F, Ciuffreda L, Di Costanzo F, De Marinis F, Crinò L, Santo A, Pazzola A, Barbieri F, Zilembo N, Colantonio I, Tibaldi C, Smit EF. Pemetrexed versus pemetrexed plus carboplatin in pretreated patients with advanced non-small cell lung cancer (NSCLC): Pooled analysis of two randomized trials. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7555] [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: 11/20/2022] Open
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33
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Nuti M, Zizzari I, Napoletano C, Rughetti A, Rahimi H, Antonilli M, Bellati F, Di Costanzo F, Irimura T, Wandall H, Clausen H, Benedetti Panici P. Macrophage galactose-type C-type lectin receptor for DC targeting of antitumor glycopeptide vaccines. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e13528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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34
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Ruggeri EM, Cecere FL, Moscetti L, Doni L, Padalino D, Di Costanzo F. Severe rhabdomyolysis during sunitinib treatment of metastatic renal cell carcinoma. A report of two cases. Ann Oncol 2010; 21:1926-1927. [PMID: 20729535 DOI: 10.1093/annonc/mdq395] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E M Ruggeri
- Department of Medical Oncology, Ospedale Belcolle, Viterbo.
| | - F L Cecere
- Department of Medical Oncology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - L Moscetti
- Department of Medical Oncology, Ospedale Belcolle, Viterbo
| | - L Doni
- Department of Medical Oncology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - D Padalino
- Department of Medical Oncology, Ospedale Belcolle, Viterbo
| | - F Di Costanzo
- Department of Medical Oncology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
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Pronzato P, Mustacchi G, De Matteis A, Di Costanzo F, Rulli E, Floriani I, Cazzaniga ME. Biological characteristics and medical treatment of breast cancer in young women-a featured population: results from the NORA study. Int J Breast Cancer 2010; 2011:534256. [PMID: 22332011 PMCID: PMC3275934 DOI: 10.4061/2011/534256] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 08/16/2010] [Indexed: 11/20/2022] Open
Abstract
Background. The present paper described the biological characteristics and clinical behavior of young women in the cohort NORA study Patients and Methods. From 2000–2002, patients (N > 3500) were enrolled at 77 Italian hospitals. Women aged ≤50 years (N = 1013) were stratified into age groups (≤35, 36–40, 41–45, and 46–50 years). The relationship between age and patient characteristics, cancer presentation, and treatment was analyzed. Results. Younger women more frequently had tumors with ER/PgR-negative(χ2 = 7.07; P = .008), HER2 amplification (χ2 = 5.76; P = .01), and high (≥10%) Ki67 labelling index (χ2 = 9.53; P = .002). Positive nodal status, large tumors, and elevated Ki67 all associated with the choice for chemotherapy followed by endocrine therapy in hormone receptor-positive patients (P < .0001). At univariate analysis, ER-ve status, chemotherapy and age resulted as the only statistically significant variables (HR = 2.02, P = .004, and >40 versus ≤40, P < .0001, resp.). At multivariate analysis, after adjustment for significant clinical and pathological factors, age remains a significant prognostic variable (HR = 0.93, P = .0021). Conclusion. This cohort study suggests that age per sè is an important prognostic factor. The restricted role of early diagnosis and the aggressive behavior of cancer in this population make necessary the application of targeted medical strategies crucial.
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Affiliation(s)
- P Pronzato
- Oncologia Medica, IST, Genova 16010, Italy
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Camerini A, Valsuani C, Mazzoni F, Siclari O, Puccetti C, Donati S, Rondini M, Tartarelli G, Puccinelli P, Di Costanzo F, Amoroso D. Phase II trial of single-agent oral vinorelbine in elderly (> or =70 years) patients with advanced non-small-cell lung cancer and poor performance status. Ann Oncol 2009; 21:1290-1295. [PMID: 19914959 DOI: 10.1093/annonc/mdp525] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Elderly patients with advanced non-small-cell lung cancer (NSCLC) with poor performance status (PS) are a special population requiring particular attention. Single-agent oral vinorelbine could be an attractive option. PATIENTS AND METHODS A total of 43 patients with stage IIIB-IV NSCLC and Eastern Cooperative Oncology Group (ECOG) PS of two or more with good functional status were prospectively recruited. Oral vinorelbine was administered at the dose of 60 mg/m(2) on days 1-8 every 3 weeks. Primary end points were response rate and safety. RESULTS Overall response rate was 18.6% with 8 partial responses; 18 of 43 (41.8%) experienced stable disease lasting >12 weeks and 17 of 43 (39.6%) disease progression for an overall clinical benefit of 60.4%. Median time to progression was 4.0 (range 2-22) months and median overall survival 8.0 (range 3-35) months. Treatment was well tolerated. Of 187 cycles, we did not observe any grade 3/4 toxicity with the exception of a single not-febrile G3 neutropenia. Regardless of severity, main toxic effects observed were nausea in 48.1% and vomiting in 22.9% of patients, anemia in 43.2%, fatigue in 32.6% and leukopenia in 23.2%. CONCLUSION Single-agent oral vinorelbine is extremely safe in elderly patients with advanced NSCLC and ECOG PS of two or more and may represent a valid option in this very special population.
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Affiliation(s)
- A Camerini
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca.
| | - C Valsuani
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca
| | - F Mazzoni
- Department of Medical Oncology, Careggi Hospital and Istituto Toscano Tumori, Firenze, Italy
| | - O Siclari
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca
| | - C Puccetti
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca
| | - S Donati
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca
| | - M Rondini
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca
| | - G Tartarelli
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca
| | - P Puccinelli
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca
| | - F Di Costanzo
- Department of Medical Oncology, Careggi Hospital and Istituto Toscano Tumori, Firenze, Italy
| | - D Amoroso
- Department of Medical Oncology, Versilia Hospital and Istituto Toscano Tumori, Lido di Camaiore, Lucca
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Rotella V, Mazzoni F, Pratesi N, Simi L, Orlando C, Boni L, Comin C, Maddau C, Costanzo FD. 9136 Erlotinib as a second-line therapy in advanced non small cell lung cancer: correlation between clinical characteristics and biomarkers. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71849-x] [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: 10/20/2022] Open
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Colucci G, Labianca R, Di Costanzo F, Gebbia V, Cartenì G, Massidda B, Frontini L, Falconi M, Gallo C, Di Maio M. A randomized trial of gemcitabine (G) versus G plus cisplatin in chemotherapy-naive advanced pancreatic adenocarcinoma: The GIP-1 (Gruppo Italiano Pancreas— GOIM/GISCAD/GOIRC) study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4504 Background: Single-agent gemcitabine (G) remains standard treatment for advanced pancreatic adenocarcinoma (APC). The GIP-1 randomized phase III trial (clinicaltrials.gov ID NCT00813696 ) was performed to compare the combination of cisplatin (P) and G vs. G alone as 1st-line treatment. Methods: Patients (pts) with locally advanced and/or metastatic pancreatic adenocarcinoma, age 18–75, Karnofsky Performance Status (KPS) ≥50, were randomized to receive G (arm A) or G+P (arm B). In arm A, G was administered at 1000 mg/m2 weekly for 7 consecutive wks, and, after a 2-week rest, on day 1, 8, 15 every 4 wks. In Arm B, P 25 mg/m2 weekly (with the exception of day 22) was added to G, same dose used in Arm A (Colucci et al, Cancer 2002; 94:902–10). No maximum number of cycles was planned. Primary endpoint was overall survival (OS). Clinical benefit (CB), objective response rate (ORR), progression-free survival (PFS), toxicity and quality of life were secondary endpoints. To have 80% power of detecting a 0.74 Hazard Ratio (HR) of death (corresponding to increase in median OS from 4.8 to 6.5 months, with bilateral alpha=0.05, 400 pts were planned and 355 deaths were required for final analysis. Results: From April 2002 to April 2007, 400 pts were enrolled (A:199, B; 201) in 46 Italian Institutions. Median age was 63 yrs (range 35–75), 59% were males, 84% stage IV, 83% KPS≥80. After a median follow-up of 38.2 months and 357 deaths, median OS was 8.3 vs 7.2 months in arm A and B, respectively (HR 1.10, 95% CI 0.89–1.35, p=0.38). Median PFS was 3.9 vs 3.8 months in arm A and B, respectively (HR 0.97, 95% CI 0.80–1.19, p=0.80). ORR was 10.1% in arm A and 12.9% in B (p=0.37). CB response was experienced by 23.0% and 15.1% (Arm A vs B, p=0.057). Patients assigned to combination arm experienced more anaemia (all grades: 50% vs 39%, G3: 5% vs 1%), more neutropenia (all grades: 44% vs 36%, G3&4: 25% vs 14%) and more thrombocytopenia (all grades: 57% vs 29%, G3&4: 16% vs 5%). No relevant differences were seen in non-haematological toxicity. Conclusions: Weekly combination of P and G, compared to single-agent G as 1st-line treatment of APC, failed to demonstrate any improvement in OS, PFS, ORR and clinical benefit. No significant financial relationships to disclose.
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Affiliation(s)
- G. Colucci
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - R. Labianca
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - F. Di Costanzo
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - V. Gebbia
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - G. Cartenì
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - B. Massidda
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - L. Frontini
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - M. Falconi
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - C. Gallo
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
| | - M. Di Maio
- National Cancer Institute, Bari, Italy; Ospedali Riuniti, Bergamo, Italy; Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy; Università di Palermo, Casa di Cura La Maddalena, Palermo, Italy; Cardarelli Hospital, Napoli, Italy; Policlinico Universitario, Cagliari, Italy; San Gerardo Hospital, Monza, Italy; University of Verona, Policlinico G.B. Rossi, Verona, Italy; Seconda Università, Napoli, Italy; National Cancer Institute, Napoli, Italy
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Celio L, Sternberg CN, Labianca R, La Torre I, Amoroso V, Barone C, Pinotti G, Cascinu S, Di Costanzo F, Cetto GL, Bajetta E. Pemetrexed in combination with oxaliplatin as a first-line therapy for advanced gastric cancer: a multi-institutional phase II study. Ann Oncol 2009; 20:1062-7. [PMID: 19218305 DOI: 10.1093/annonc/mdn766] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND This clinical trial assessed the efficacy of pemetrexed combined with oxaliplatin (PEMOX) in patients with advanced gastric cancer (AGC). PATIENTS AND METHODS Forty-four patients with untreated AGC were enrolled to evaluate response rate (RR). Patients received pemetrexed (500 mg/m(2)) with vitamin supplementation and oxaliplatin (120 mg/m(2)) every 21 days for six cycles or until disease progression occurred. RESULTS Median age was 62 years (range 26-76). The majority of patients (93%) had metastatic disease. Sixteen of the 44 patients achieved confirmed response [RR 36%; 95% confidence interval (CI) 22% to 52%]; four complete responses and 12 partial responses (complete and partial responses according to the RECIST guidelines are the confirmed-responses observed in the study population). Median time to tumor progression (TTP) was 6.2 months (95% CI 4.3-7.5) and median survival was 10.8 months (95% CI 7.7-17.2). A total of 220 cycles were administered, with a median of six cycles. Most common grade 3/4 toxic effects were neutropenia in 41% of patients (19% of cycles) and thrombocytopenia in 11% of patients (4% of cycles). Treatment delays or dose reductions for toxicity occurred in 10% and 5% of cycles, respectively. CONCLUSIONS PEMOX is active and well tolerated in AGC. RR, TTP, and survival were comparable to those achieved in studies using different 5-fluorouracil (5-FU)-oxaliplatin combinations, without the inconvenience of prolonged 5-FU schedules.
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Affiliation(s)
- L Celio
- Medical Oncology Unit 2, Foundation IRCCS National Tumour Institute, Milan, Italy
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Cazzaniga M, Pronzato P, Mustacchi G, De Matteis A, Di Costanzo F, Rulli E, Floriani I. The anthracyclines and the clinical practice: do all breast cancer patients benefit? Results from the NORA study. Ann Oncol 2008; 19:1811-2. [DOI: 10.1093/annonc/mdn547] [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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Porcu L, Poli D, Torri V, Rulli E, Di Tullio MC, Cinquini M, Bajetta E, Labianca R, Di Costanzo F, Nitti D, Floriani I. Impact of recent legislative bills regarding clinical research on Italian ethics committee activity. J Med Ethics 2008; 34:747-750. [PMID: 18827108 DOI: 10.1136/jme.2007.022178] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIMS AND BACKGROUND The present work assessed the impact of two decrees on ethics committees in Italy, aimed at bringing the national laws on the conduct of clinical trials into line with the rest of the EC, and regulating and facilitating not-for-profit research. MATERIAL AND METHODS Prospectively collected data from an Italian multicentre study were examined with respect to the ethics review process. Administrative and time elements of the review process were audited. Main outcome measures were time between the application submission and the ethics committee definitive opinion, type and number of application submission forms, number of ethics committees that refused fee exemption, and time between the ethics committee approval and the administrative authorisation. RESULTS A total of 134 local research ethics committees (LRECs) were approached. Application submission procedures and application forms varied greatly; paper submission was mandatory. The median time from submission to approval was 72 days. Only two LRECs refused the fee exemption. The median time from LREC approval to administrative agreement was 50 days and only 9.6% of local authorities came to a verbal agreement with the sponsor. CONCLUSIONS Italian LRECs are still not sufficiently efficient in complying with the Directive 2001/20/EC requirement (60 days). Better coordination of LRECs work is needed although the optimal level of coordination between them is still not known. In the meantime, national guidelines are needed concerning the application of Directive 2001/20/EC. The behaviour of Italian LRECs towards not-for-profit research was excellent although only the fee exemption was requested.
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Affiliation(s)
- L Porcu
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
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Sarti M, Pagani O, Bertoni F, Longhi S, Cafaro C, Graffeo R, Di Costanzo F, Goldhirsch A. Retinal metastases treated with lapatinib (L) in a young HER2-positive breast cancer patient: Case report. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.12008] [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: 11/20/2022] Open
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Affiliation(s)
- F Di Costanzo
- Medical Oncology Unit, Department of Oncology, University Hospital Careggi, Florence, Italy.
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Cazzaniga ME, Mustacchi G, Pronzato P, De Matteis A, Di Costanzo F, Floriani I. Adjuvant treatment of early breast cancer: do the St Gallen recommendations influence clinical practice? Results from the NORA study. Ann Oncol 2007; 18:1976-80. [PMID: 17761700 DOI: 10.1093/annonc/mdm365] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The NORA study is a prospective longitudinal cohort study aiming at investigating treatment in patients with early breast cancer. Here, we present the impact of the St Gallen recommendations on clinical practice. PATIENTS AND METHODS We compared adjuvant strategies in patients enrolled in 2000-2002 to those in 2003-2004 to verify the impact of the 2003 St Gallen recommendations. RESULTS The use of aromatase inhibitors (AIs) doubled: 65/629 patients (10.3%) vs 100/458 patients (21.8) (P < 0.0001). Following chemotherapy, AIs were administered in 8.5% of the retrospective cohort and in 15.1% of the prospective one (P < 0.0001). The use of taxanes plus hormones dropped (P = 0.0026), but not when used as single agents. A marked increase was observed in the use of anthracycline-based chemotherapy (46.3% vs 65.2%), mainly three-drug regimens (33.3% vs 46.6%). CONCLUSION Our results suggest that the St Gallen recommendations have had a major impact on clinical practice.
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Affiliation(s)
- M E Cazzaniga
- Medical Oncology, Treviglio Hospital, Treviglio, Italy.
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Cazzaniga ME, Mustacchi G, Pronzato P, Di Costanzo F, De Matteis A, Ravaioli A, Gamucci T, Brugia M, Bari M, Rulli E. Pathological characteristics and clinical outcome in triple-negative breast cancer (BC) patients (PTS): Results from the NORA study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11014 Background: Different studies have recently focused the attention on the so-called triple-negative pts, defined as ER-/PR- /HER2-. Although triple-negative tumours have been reported to be more aggressive, there are limited long-term data evaluating outcome as a function of this classification. Methods: NORA is an observational study aimed at investigating treatment modalities and clinical outcome of 3515 patients (pts) with early breast cancer (EBC) treated in 77 Oncological Centres in Italy from to 2000 to 2003, whose overall results have been already published. We now compare pathological characteristics and clinical outcome of pts for whom ER and PR andHER2 tests are negative with remaining pts (OTH). Results: 123 (4.1%) of 2968 evaluable pts resulted triple-negative. Out of these 123, 76 pts (61.7% vs 63.2% of OTH) were treated with conservative surgery (CS). Pathological T stage was T1 in55.3% pts (OTH: 59.6%), 47.9% were pN+ (OTH: 45.3%), 63.2 had G3 tumours (OTH: 34.1%). Chemotherapy alone was administered in 89.4% pts, mainly anthracycline-based (54.1%). At a median follow up of 27 months, all triple-negative pts were alive, 11 (8.9%) with relapse. No difference has been observed between two groups both in DFS (HR=0.74; 95%CI: 0.39–1.40; p=0.35) and OS (HR not estimated, p=0.99). Conclusions: Our results suggest that triple-negative pts have pathological characteristics similar to what observed in the other pts, receive CS in the same percentage of the cases, but have a 3-fold increase of undifferentiated tumours. On the contrary to what observed by other Authors, our data show that triple- negative pts do not have worse prognosis. Longer follow up is required to confirm these data. No significant financial relationships to disclose.
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Affiliation(s)
- M. E. Cazzaniga
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - G. Mustacchi
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - P. Pronzato
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - F. Di Costanzo
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - A. De Matteis
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - A. Ravaioli
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - T. Gamucci
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - M. Brugia
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - M. Bari
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
| | - E. Rulli
- Treviglio Hospital, Treviglio, Italy; University of Trieste, Trieste, Italy; Isituto Tumori, Genova, Italy; Ospedale Careggi, Firenze, Italy; Istituto Pascale, Napoli, Italy; Ospedale degli Infermi, Rimini, Italy; Ospedale Civile Umberto I, Frosinone, Italy; Az Osp S Maria, Terni, Italy; Osp Calvi, Noale, Italy; Istituto Mario Negri, Milano, Italy
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Cascinu S, Berardi R, Siena S, Labianca R, Falcone A, Aitini E, Barni S, Di Costanzo F, Frontini L, Tonini G, Zaniboni A. The impact of cetuximab on the gemcitabine/cisplatin combination in first-line treatment of EGFR-positive advanced pancreatic cancer (APC): A randomized phase II trial of GISCAD. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4544 Background: Cetuximab, an EGFR antibody inhibitor, has been shown to increase the activity of gemcitabine (GEM) in APC. Based on data from randomised trials and meta-analyses suggesting that the combination of a GEM with a platinum analog significantly improves survival as compared to GEM alone, we assessed the activity and feasibility of a combination of GEM/cisplatin (CDDP) plus cetuximab. Methods: Multicenter, randomised two-arm phase II trial: GEM 1,000 mg/m2 day 1,8 and CDDP 35 mg/m2 day 1,8 every 21 days alone or in combination with cetuximab 250 mg/m2 weekly after a loading dose of 400 mg/m2. Treatment was limited to a maximum of 9 cycles. With 37 patients in each arm the power was 90% to select the truly better arm if the true between arm difference in response rate (RECIST) is at least 15%. The study was open for accrual until June 2005. Results: We present here the results of 74 patients including in the study. In all the patients, the first response rate are available (investigators’ assessment after 3 cycles) as well as toxicity data. Conclusions: Cetuximab does not seem to positively interact with GEM/CDDP combination in terms of activity especially concerning time to progression. Although toxicity was not increased by cetuximab, this combination should not be assessed in a phase III trial.The trial was supported in part by by Merck KGaA. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- S. Cascinu
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - R. Berardi
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - S. Siena
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - R. Labianca
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - A. Falcone
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - E. Aitini
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - S. Barni
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - F. Di Costanzo
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - L. Frontini
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - G. Tonini
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
| | - A. Zaniboni
- Universita Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliera Cà Granda, Milan, Italy; Ospedali Riuniti di Bergamo, Bergamo, Italy; Azienda USL 6, Livorno, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; Azienda Ospedaliera Careggi, Firenze, Italy; Ospedale S.Gerardo, Monza (MI), Italy; Li. Ist. Univ. Campus Biomedico, Roma, Italy; Casa di Cura Poliambulanza, Brescia, Italy
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Mustacchi G, Cazzaniga ME, Pronzato P, De Matteis A, Di Costanzo F, Floriani I. Breast cancer in elderly women: a different reality? Results from the NORA study. Ann Oncol 2007; 18:991-6. [PMID: 17351258 DOI: 10.1093/annonc/mdm063] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The incidence of breast cancer increases with age, and the disease affects many older women; however, attitudes about prevention and treatment of breast cancer vary based on the patient's age. Older women have less access to clinical trials and fewer opportunities for treatment with innovative therapies. The National Oncological Research observatory on Adjuvant therapy in breast cancer (NORA) study was a cohort study designed to obtain information about adjuvant strategies for treatment of breast cancer after surgery, patterns of recurrence, and possible correlations between cancer-related events and biological factors. PATIENTS AND METHODS This report describes patient characteristics, disease status, and local and systemic adjuvant treatments in a population of breast cancer patients aged >or=65 years. The NORA study consecutively enrolled >3500 patients from 2000 through 2002 at 77 Italian hospitals; of these, 1085 were aged >or=65 years. Data on patient characteristics, cancer presentation, and treatments were analyzed to identify possible relationships between these factors and age. RESULTS The findings indicate that age is significantly related to later diagnosis and different patterns of treatment. Choice of adjuvant systemic treatment was primarily related to hormone receptor status and tumor stage but was strongly influenced by the patient's age; there was a proportional relationship between endocrine treatment and increasing age. Cyclophosphamide, methotrexate, and 5-fluorouracil as well as anthracyclines were widely used, but the use of taxanes was limited to a very small percentage of patients. CONCLUSIONS The findings of the NORA study may help to change attitudes that currently exclude a significant proportion of breast cancer patients from secondary prevention policies, more active treatment strategies, and clinical research trials based on age.
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Affiliation(s)
- G Mustacchi
- Medical Oncology, University of Trieste, Trieste, Italy.
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Cazzaniga M, Di Costanzo F, Mustacchi G, Pronzato P, De Matteis A, Tabiadon D, Botta M, Pisconti S, Danese S, Rulli E. 314 POSTER Young (≤45) and old (≥65) early breast cancer (EBC) patients (pts): two different populations for surgeons? Results from the NORA study. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70749-1] [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: 10/23/2022] Open
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Cazzaniga ME, Mustacchi G, Pronzato P, De Matteis A, Di Costanzo F, Floriani I. Adjuvant systemic treatment of early breast cancer: the NORA study. Ann Oncol 2006; 17:1386-92. [PMID: 16790520 DOI: 10.1093/annonc/mdl132] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite recommendations contained in international guidelines, factors such as the type of oncology centre, geographic distribution and the introduction of scientific advances into clinical practice can influence the choice of recommended treatment for early breast cancer. The NORA study is a prospective, longitudinal cohort study aimed at investigating tumour characteristics, treatment modalities, and other factors that influence therapeutic choices in early breast cancer patients who have undergone mastectomy or breast-conserving surgery (BCS). PATIENTS AND METHODS From January 2000 to early 2004, we collected data on methods of cancer diagnosis, type of surgery and adjuvant medical treatment administered to the first 10 consecutive patients treated in 2000-2002 and the first 20 consecutive patients in 2003 and 2004 at 71 oncology centres in Italy, with the approval of the ethical committee at each centre. RESULTS Approximately one-quarter of the cases (26.5%) were detected through screening programmes. BCS was performed in 63.7% and sentinel node biopsy (SNB) occurred in 11.1% of the patients. Of the 3515 total cases, 56.5% were node-negative. Grade 2 cancers comprised 51.3%, and 66.2% were hormone-receptor positive (ER+/PgR+). Chemotherapy (CHT) followed by hormone therapy (HT) was the most prescribed treatment (48.5%). CHT was mainly anthracycline-based (52.9%) and most patients received tamoxifen alone (77.7%) or after CHT (85.2%). For node-negative patients, HR+ and menopause status are the factors influencing the choice to add HT after CHT; patients with HR+ and pT4 tumours are more likely to receive HT instead of CHT. In node-positive patients, the addition of HT is influenced by HR+ status, the opportunity to have HT instead of CHT, and menopause. CONCLUSIONS NORA is the first large cohort study to describe the factors that influence therapeutic choices in early breast cancer. Understanding these findings can help physicians in daily clinical practice.
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Affiliation(s)
- M E Cazzaniga
- Medical Oncology, Treviglio Hospital, Treviglio, Italy.
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Celio L, Sachetta S, Mosconi S, La Torre I, Barone C, Berardi R, Amoroso V, Pinotti G, Di Costanzo F, Bajetta E. Multicenter phase II study of pemetrexed and oxaliplatin as first-line therapy in advanced gastric cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14045 Background: We have previously reported that single-agent pemetrexed is active in metastatic gastric cancer. On the basis of the potential synergism of pemetrexed and oxaliplatin, we explored the combination in patients with locally advanced/metastatic gastric carcinoma. Methods: The primary objective was activity of the combination. Eligible patients had to ≥1 measurable lesion according to RECIST. Pemetrexed 500 mg/m2 was given intravenously over 10 minutes, and oxaliplatin 120 mg/m2 was given over 2 hours; both drugs were given on day 1 of a 21-day cycle. Patients were to receive ≥6 (maximum of 8) cycles unless disease progression occurred. Vitamin supplementation was given as well as dexamethasone. A total of 43 patients were planned in a two-stage design with 13 patients in the first stage. An interim analysis was planned at the end of the first stage, so the trial could be stopped if ≤3 responses were observed. Results: Between May 2004 and January 2005, 13 patients (6 females) entered the study. Median age was 52 years (range, 27–75). One patient (7.8%) had locally advanced disease, and 5 patients (38.5%) retained primary gastric cancer. Main disease sites included lymph nodes (100%) and liver (23.1%). A total of 60 cycles were administered (median 6; range, 2–6). All 13 patients were evaluable for efficacy with 3 complete and 2 partial responses (ORR 38.5%; 95% CI, 13.9%-68.4%). Stable disease occurred in 3 patients (23.1%). G3 toxicities were neutropenia (30.8%), vomiting, hepatic toxicities and leucopenia (7.7%) each; no G4 toxicity were found. Conclusions: This interim analysis suggests that the activity and tolerability of the combination in advanced gastric cancer is very promising. Study accrual was ended in October 2005, and final results will be presented at the meeting. No significant financial relationships to disclose.
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Affiliation(s)
- L. Celio
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - S. Sachetta
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - S. Mosconi
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - I. La Torre
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - C. Barone
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - R. Berardi
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - V. Amoroso
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - G. Pinotti
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - F. Di Costanzo
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
| | - E. Bajetta
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy; Istituto Nazionale Tumori, Milan Italy; San Camillo Hospital, Rome Italy; Ospedali Riuniti, Bergamo; Eli Lilly, Florence Italy; Catholic University., Rome; Torrette Hospital, Ancona; Spedali Civili, Brescia; Ospedale Circolo, Varese; Careggi Hospital, Florence, Italy
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