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Panzuto F, Partelli S, Campana D, de Braud F, Spada F, Cives M, Tafuto S, Bertuzzi A, Gelsomino F, Bergamo F, Marcucci S, Mastrangelo L, Massironi S, Appetecchia M, Filice A, Badalamenti G, Bartolomei M, Amoroso V, Landoni L, Rodriquenz MG, Valente M, Colao A, Isidori A, Fanciulli G, Bollina R, Ciola M, Butturini G, Marconcini R, Arvat E, Cinieri S, Berardi R, Baldari S, Riccardi F, Spoto C, Giuffrida D, Gattuso D, Ferone D, Rinzivillo M, Bertani E, Versari A, Zerbi A, Lamberti G, Lauricella E, Pusceddu S, Fazio N, Dell'Unto E, Marini M, Falconi M. Epidemiology of gastroenteropancreatic neuroendocrine neoplasms: a review and protocol presentation for bridging tumor registry data with the Italian association for neuroendocrine tumors (Itanet) national database. Endocrine 2024; 84:42-47. [PMID: 38175391 PMCID: PMC10987336 DOI: 10.1007/s12020-023-03649-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
Neuroendocrine neoplasms (NENs) are rare tumors with diverse clinical behaviors. Large databases like the Surveillance, Epidemiology, and End Results (SEER) program and national NEN registries have provided significant epidemiological knowledge, but they have limitations given the recent advancements in NEN diagnostics and treatments. For instance, newer imaging techniques and therapies have revolutionized NEN management, rendering older data less representative. Additionally, crucial parameters, like the Ki67 index, are missing from many databases. Acknowledging these gaps, the Italian Association for Neuroendocrine Tumors (Itanet) initiated a national multicenter prospective database in 2019, aiming to gather data on newly-diagnosed gastroenteropancreatic neuroendocrine (GEP) NENs. This observational study, coordinated by Itanet, includes patients from 37 Italian centers. The database, which is rigorously maintained and updated, focuses on diverse parameters including age, diagnostic techniques, tumor stage, treatments, and survival metrics. As of October 2023, data from 1,600 patients have been recorded, with an anticipation of reaching 3600 by the end of 2025. This study aims at understanding the epidemiology, clinical attributes, and treatment strategies for GEP-NENs in Italy, and to introduce the Itanet database project. Once comprehensive follow-up data will be acquired, the goal will be to discern predictors of treatment outcomes and disease prognosis. The Itanet database will offer an unparalleled, updated perspective on GEP-NENs, addressing the limitations of older databases and aiding in optimizing patient care. STUDY REGISTRATION: This protocol was registered in clinicaltriasl.gov (NCT04282083).
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Affiliation(s)
- Francesco Panzuto
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy.
| | - Stefano Partelli
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, ENETS Center of Excellence, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Davide Campana
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Medical Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, ENETS Center of Excellence, Milan, Italy
| | - Francesca Spada
- Gastrointestinal and Neuroendocrine Tumors Oncology Unit - ENETS Center of Excellence, European Institute of Oncology (IEO) - IRCCS, Milan, Italy
| | - Mauro Cives
- Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro", Bari, Italy
| | - Salvatore Tafuto
- S.C. Sarcomi e Tumori Rari, Istituto Nazionale Tumori, I.R.C.C.S. - Fondazione "G. Pascale", ENETS Center of Excellence, Napoli, Italy
| | - Alexia Bertuzzi
- Sezione Sarcomi/NET e Oncologia del Giovane Adulto (AYA-Adolescent Young Adult) Humanitas Research Hospital-IRCCS Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Fabio Gelsomino
- Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, Modena, Italy
| | | | - Stefano Marcucci
- Department of Surgery & Hepato-Biliary and Pancreatic Unit Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Laura Mastrangelo
- UO Chirurgia Generale e d'Urgenza IRCCS Azienda Ospedaliera Universitaria Sant'Orsola Malpighi c/o Ospedale Maggiore, Bologna, Italy
| | - Sara Massironi
- Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, and University of Milano-Bicocca, School of Medicine, Monza, Italy
| | - Marialuisa Appetecchia
- Oncological Endocrinology Unit, Regina Elena National Cancer Institutre - IFO IRCCS, Roma, Italy
| | - Angelina Filice
- Servizio di Medicina Nucleare, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppe Badalamenti
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Mirco Bartolomei
- Nuclear Medicine Unit, Azienda Ospedaliera Universitaria-Ferrara, Ferrara, Italy
| | - Vito Amoroso
- Medical Oncology Unit, Department of Medical & Surgical Specialties, Radiological Sciences & Public Health, University of Brescia at Spedali Civili Hospital, Brescia, Italy
| | - Luca Landoni
- Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, ENETS Center of Excellence, Verona, Italy
| | - Maria Grazia Rodriquenz
- Oncology Unit - Ospedale IRCCS Casa Sollievo della Sofferenza - San Giovanni Rotondo, Foggia, Italy
| | - Monica Valente
- Center for Immuno-Oncology, Oncology Department, University Hospital of Siena, Siena, Italy
| | - Annamaria Colao
- Department of Endocrinology University of Naples, Azienda Ospedaliera Universitaria "Federico II", ENETS CEnter of Excellence, Napoli, Italy
| | - Andrea Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Fanciulli
- Endocrine Oncology Program, Endocrine Unit, University Hospital (AOU) of Sassari, Sassari, Italy
| | | | | | | | - Riccardo Marconcini
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Emanuela Arvat
- Oncological Endocrinology Unit, Department of Medical Sciences University of Turin, Turin, Italy
| | | | - Rossana Berardi
- Department of Medical Oncology, Università Politecnica Delle Marche, AOU Ospedali Riuniti Delle Marche, Ancona, Italy
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | | | - Chiara Spoto
- Medical Oncology, Santa Maria Goretti Hospital, Latina, Italy
| | - Dario Giuffrida
- Medical Oncology Department, Istituto Oncologico del Mediterraneo, Viagrande, Catania, Italy
| | | | - Diego Ferone
- Endocrinology Unit, Department of Internal Medicine & Medical Specialties (DiMI), IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Maria Rinzivillo
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - Emilio Bertani
- Digestive Surgery, European Institute of Oncology IRCCS, ENETS Center of Excellence, Milan, Italy
| | - Annibale Versari
- Servizio di Medicina Nucleare, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandro Zerbi
- Humanitas Research Hospital -IRCCS, Pancreatic Surgery Unit, Rozzano, and Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy
| | - Giuseppe Lamberti
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Medical Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Eleonora Lauricella
- Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro", Bari, Italy
| | - Sara Pusceddu
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, ENETS Center of Excellence, Milan, Italy
| | - Nicola Fazio
- Gastrointestinal and Neuroendocrine Tumors Oncology Unit - ENETS Center of Excellence, European Institute of Oncology (IEO) - IRCCS, Milan, Italy
| | - Elisabetta Dell'Unto
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - Marco Marini
- IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Massimo Falconi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, ENETS Center of Excellence, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
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2
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Cazzaniga ME, Pronzato P, Amoroso D, Bernardo A, Biganzoli L, Bisagni G, Blasi L, Bria E, Cognetti F, Crinò L, De Laurentiis M, Del Mastro L, De Placido S, Beano A, Ferraù F, Foladore S, Forcignanò R, Gamucci T, Garrone O, Gennari A, Giordano M, Giotta F, Giovanardi F, Latini L, Livi L, Marchetti P, Mattioli R, Michelotti A, Montemurro F, Putzu C, Riccardi F, Ricciardi G, Romagnoli E, Sarobba G, Spazzapan S, Tagliaferri P, Tinari N, Tonini G, Turletti A, Verusio C, Zambelli A, Mustacchi G. Clinical Outcomes of HER2-Negative Metastatic Breast Cancer Patients in Italy in the Last Decade: Results of the GIM 13-AMBRA Study. Cancers (Basel) 2023; 16:117. [PMID: 38201545 PMCID: PMC10777910 DOI: 10.3390/cancers16010117] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/14/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
GIM 13-AMBRA is a longitudinal cohort study aimed at describing therapeutic strategies and the relative outcome parameters in 939 HER2-ve MBC patients. Taxanes-based regimens, or taxanes + targeted agents, mainly Bevacizumab, were the preferred first choice in both Luminal (30.2%) and TNBC (33.3%) patients. The median PFS1 was 12.5 months (95% CI 16.79-19.64), without any significant difference according to subtypes, while the median Time to first Treatment Change (TTC1) was significantly lower in TNBC patients (7.7 months-95% CI 5.7-9.2) in comparison to Luminal A (13.2 months, 95% CI 11.7-15.1) and Luminal B patients (11.8 months, 95% CI 10.3-12.8). PFS2 was significantly shorter in TNBC patients (5.5 months, 95% CI 4.3-6.5 vs. Luminal A-9.4, 95% CI 8.1-10.7, and Luminal B-7.7 95% CI 6.8-8.2, F-Ratio 4.30, p = 0.014). TTC2 was significantly lower in patients with TNBC than in those with the other two subtypes. The median OS1 was 35.2 months (95% CI 30.8-37.4) for Luminal A patients, which was significantly higher than that for both Luminal B (28.9 months, 95% CI 26.2-31.2) and TNBC (18.5 months, 95% CI 16-20.1, F-ratio 7.44, p = 0.0006). The GIM 13-AMBRA study is one of the largest collections ever published in Italy and provides useful results in terms of time outcomes for first, second, and further lines of treatment in HER2- MBC patients.
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Affiliation(s)
- Marina Elena Cazzaniga
- Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, Università Milano Bicocca, 20900 Monza, Italy
| | - Paolo Pronzato
- Oncologia Medica IRCCS IRST San Martino, 16100 Genova, Italy; (P.P.); (L.D.M.)
| | - Domenico Amoroso
- Oncologia Medica, Ospedale Versilia USL Nord Ovest Toscana, 55041 Lido di Camaiore, Italy;
| | - Antonio Bernardo
- Oncologia Istituti Clinici Scientifici Maugeri Spa Società Benefit, 27100 Pavia, Italy;
| | - Laura Biganzoli
- U.O. Oncologia Medica, Ospedale Santo Stefano, 59100 Prato, Italy;
| | - Giancarlo Bisagni
- Oncologia Medica, IRCCS Arcispedale S. Maria Nuova, 42121 Reggio Emilia, Italy;
| | - Livio Blasi
- Oncologia Medica, ARNAS Civico–Di Cristina-Benfratelli, Presidio Ospedaliero ‘Civico e Benfratelli’, 20121 Palermo, Italy;
| | - Emilio Bria
- Oncologia Medica, A.O.U. Integrata Verona, Ospedale Borgo Roma, 37100 Verona, Italy;
| | - Francesco Cognetti
- Oncologia Medica 1, Istituto Nazionale Tumori “Regina Elena”, 00042 Roma, Italy
| | - Lucio Crinò
- Oncologia, Ospedale S. Maria della Misericordia, 06121 Perugia, Italy;
| | | | - Lucia Del Mastro
- Oncologia Medica IRCCS IRST San Martino, 16100 Genova, Italy; (P.P.); (L.D.M.)
| | - Sabino De Placido
- Oncologia Medica, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi Federico II, 80013 Napoli, Italy;
| | - Alessandra Beano
- Oncologia Medica, Città della Salute e della Scienza, ASL “Città di Torino”, 10024 Torino, Italy;
| | | | - Silva Foladore
- SSD Oncologica e dell’apparato Riproduttivo Femminile, Azienda Sanitaria Universitaria “Giuliano Isontina, 34121 Trieste, Italy;
| | | | | | - Ornella Garrone
- Oncologia Medica, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy;
| | - Alessandra Gennari
- Oncologia Medica, Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Dipartimento di Medicina e Chirurgia, Università degli Studi del Piemonte Orientale, 28100 Novara, Italy;
| | | | - Francesco Giotta
- Oncologia, IRCCS Istituto Tumori ‘Giovanni Paolo II’, 70100 Bari, Italy;
| | - Filippo Giovanardi
- UOS Day Hospital Oncologico, AUSL Reggio Emilia, Presidio Ospedaliero di Guastalla, 42016 Guastalla, Italy;
| | | | - Lorenzo Livi
- Dipartimento di Scienze Biomediche, Sperimentali e Cliniche ‘Mario Serio’, Università degli Studi di Firenze, UOC Radioterapia, A.O.U. Careggi, 50100 Firenze, Italy;
| | | | - Rodolfo Mattioli
- Oncologia Medica, A.O. Ospedali Riuniti Marche Nord-Ospedale Santa Croce, 61032 Fano, Italy
| | | | - Filippo Montemurro
- Fondazione del Piemonte per l’Oncologia-Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 10024 Torino, Italy;
| | - Carlo Putzu
- Oncologia Medica, AOU Sassari, 07100 Sassari, Italy
| | - Ferdinando Riccardi
- Oncologia Medica, Azienda Ospedaliera ‘A. Cardarelli’ (AORN), 80013 Napoli, Italy
| | | | | | - Giuseppina Sarobba
- Oncologia Medica, Ospedale ‘San Francesco’, Azienda Sanitaria Locale 3 Nuoro, 08100 Nuoro, Italy
| | - Simon Spazzapan
- Centro di Riferimento Oncologico, IRCCS, 33081 Aviano, Italy;
| | | | - Nicola Tinari
- Oncologia Medica, Policlinico ‘SS. Annunziata’, 66100 Chieti, Italy;
| | - Giuseppe Tonini
- Policlinico Universitario Campus Biomedico, 00042 Roma, Italy;
| | - Anna Turletti
- Presidio Ospedaliero Martini, ASL TO1, 10024 Torino, Italy
| | - Claudio Verusio
- Oncologia Medica, ASST della Valle Olona, Ospedale di Saronno, 21047 Saronno, Italy;
| | - Alberto Zambelli
- Oncologia Medica, ASST Papa Giovanni XXIII, Ospedale Papa Giovanni XXIII, 24100 Bergamo, Italy;
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Di Maio M, Bighin C, Schettini F, Ruelle T, Marandino L, Fabi A, De Angelis C, Giuliano M, De Placido P, De Laurentiis M, Riccardi F, Picotto C, Puglisi F, Del Mastro L, Arpino G. Evolving treatments and outcomes in HER2-Positive metastatic breast cancer: Data from the GIM14/BIOMETA study. Breast 2023; 72:103583. [PMID: 37783133 PMCID: PMC10551556 DOI: 10.1016/j.breast.2023.103583] [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: 06/05/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Treatment for HER2-positive (+) metastatic breast cancer has improved in the last decade. We analyzed treatment changes over time and their impact on patients outcomes in a real-world dataset. METHODS Data from 637 HER2+ patients with metastatic breast cancer enrolled in the multicenter Italian GIM14/BIOMETA study were retrieved. Progression-free survival (PFS) over time was evaluated according to the type of anti-HER2 therapy, disease onset (de novo vs. relapsing), metastatic site, and year of treatment (2000-2013 vs. 2014-2020). RESULTS Median follow-up was 64.4 months. Overall, for first-line therapies, mPFS was 16.5 vs 19.5 months for patients treated in 2000-2013 vs 2014-2020 (HR: 0.78, 95% CI:0.65-0.94, P = 0.008). mPFS improved over time in all patients except for those with brain metastasis. Interestingly mPFS was 17.4 vs13.4 months (HR, 1.49; 95% CI, 1.13-1.98, P = 0.005) in 2000-2013 and 24.4 vs 20.9 months (HR 1.04; 95% CI 0.78-1.40 p = 0.77) in 2014-2020 in pts without vs with liver metastases. For second line therapies, the overall median PFS was 9.6 months (95% CI, 8.31-10.97) and did not change over time. CONCLUSION Median first-line PFS improved since 2014, mainly due to the introduction of pertuzumab. The outcome of patients with liver metastases appears to have improved in recent years. Patients with brain metastases had the worst PFS, which also did not improve over time.
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Affiliation(s)
- Massimo Di Maio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Claudia Bighin
- Department of Medical Oncology, U.O. Oncologia Medica 2, Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Schettini
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Tommaso Ruelle
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Laura Marandino
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alessandra Fabi
- Precision Medicine in Senology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy
| | - Pietro De Placido
- Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy
| | - Michelino De Laurentiis
- Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy
| | | | - Caterina Picotto
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Fabio Puglisi
- Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Lucia Del Mastro
- Department of Medical Oncology, U.O. Oncologia Medica 2, Ospedale Policlinico San Martino, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy.
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Trevisan B, Pepe FF, Vallini I, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Baldelli A, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Sarti S, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Clivio L, Torri V, Cazzaniga ME. Final results of the real-life observational VICTOR-6 study on metronomic chemotherapy in elderly metastatic breast cancer (MBC) patients. Sci Rep 2023; 13:12255. [PMID: 37507480 PMCID: PMC10382472 DOI: 10.1038/s41598-023-39386-x] [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] [Received: 04/06/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
Nowadays, treatment of metastatic breast cancer (MBC) has been enriched with novel therapeutical strategies. Metronomic chemotherapy (mCHT) is a continuous and frequent administration of chemotherapy at a lower dose and so whit less toxicity. Thus, this strategy could be attractive for elderly MBC patients. Aim of this analysis is to provide insights into mCHT's activity in a real-life setting of elderly MBC patients. Data of patients ≥ 75 years old included in VICTOR-6 study were analyzed. VICTOR-6 is a multicentre, Italian, retrospective study, which collected data on mCHT in MBC patients treated between 2011 and 2016. A total of 112 patients were included. At the beginning of mCHT, median age was 81 years (75-98) and in 33% of the patients mCHT was the first line choice. Overall Response Rate (ORR) and Disease Control Rate (DCR) were 27.9% and 79.3%, respectively. Median PFS ranged between 7.6 and 9.1 months, OS between 14.1 and 18.5 months. The most relevant toxicity was the hematological one (24.1%); severe toxicity (grade 3-4) ranged from 0.9% for skin toxicity up to 8% for hematologic one. This is a large study about mCHT in elderly MBC patients, providing insights to be further investigated in this subgroup of frail patients.
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Affiliation(s)
- B Trevisan
- Azienda Ospedaliera San Gerardo, Monza, Italy
| | - F F Pepe
- Azienda Ospedaliera San Gerardo, Monza, Italy
| | - I Vallini
- Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - E Montagna
- European Institute of Oncology, Milan, Italy
| | | | - R Berardi
- Azienda Ospedaliera Universitaria Ospedali Riuniti, Torrette, Italy
| | - A Butera
- Nuovo Ospedale San Giovanni Di Dio, Florence, Italy
| | | | - L Cavanna
- Azienda Ospedaliera Piacenza, Piacenza, Italy
| | | | - S Cinieri
- Ospedale A. Perrino, Brindisi, Italy
| | | | | | - A Febbraro
- Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Ospedale San Vincenzo, Taormina, Italy
| | - A Ferzi
- Azienda Ospedaliera Ospedale Civile Di Legnano, Magenta, Italy
| | | | - A Fontana
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - O Garrone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - V Gebbia
- Ospedale La Maddalena, Palermo, Italy
| | - D Generali
- Istituti Ospitalieri Cremona, Cremona, Italy
| | | | | | | | | | - S Sarti
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | | | - C Putzu
- Azienda Ospedaliera-Universitaria, Sassari, Italy
| | - F Riccardi
- Ospedale Antonio Cardarelli, Naples, Italy
| | - D Santini
- Università Campus Bio-Medico, RomE, Italy
| | | | | | | | - P Spadaro
- Casa di Cura Villa Salus-Messina, Messina, Italy
| | | | | | | | | | | | - M R Valerio
- A.O.U. Policlinico Paolo Giaccone, Palermo, Italy
| | - P Vici
- INT Regina Elena, Rome, Italy
| | - L Clivio
- IRCCS Mario Negri Institute of Pharmacological Research, Milan, Italy
| | - V Torri
- IRCCS Mario Negri Institute of Pharmacological Research, Milan, Italy
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Di Lisa FS, Krasniqi E, Pizzuti L, Barba M, Cannita K, De Giorgi U, Borella F, Foglietta J, Cariello A, Ferro A, Picardo E, Mitidieri M, Sini V, Stani S, Tonini G, Santini D, La Verde N, Gambaro AR, Grassadonia A, Tinari N, Garrone O, Sarobba G, Livi L, Meattini I, D’Auria G, Vergati M, Gamucci T, Pistelli M, Berardi R, Risi E, Giotta F, Lorusso V, Rinaldi L, Artale S, Cazzaniga ME, Zustovich F, Cappuzzo F, Landi L, Torrisi R, Scagnoli S, Botticelli A, Michelotti A, Fratini B, Saltarelli R, Paris I, Muratore M, Cassano A, Gianni L, Gaspari V, Veltri EM, Zoratto F, Fiorio E, Fabbri MA, Mazzotta M, Ruggeri EM, Pedersini R, Valerio MR, Filomeno L, Minelli M, Scavina P, Raffaele M, Astone A, De Vita R, Pozzi M, Riccardi F, Greco F, Moscetti L, Giordano M, Maugeri-Saccà M, Zennaro A, Botti C, Pelle F, Cappelli S, Cavicchi F, Vizza E, Sanguineti G, Tomao F, Cortesi E, Marchetti P, Tomao S, Speranza I, Sperduti I, Ciliberto G, Vici P. Adjuvant capecitabine in triple negative breast cancer patients with residual disease after neoadjuvant treatment: real-world evidence from CaRe, a multicentric, observational study. Front Oncol 2023; 13:1152123. [PMID: 37260975 PMCID: PMC10227592 DOI: 10.3389/fonc.2023.1152123] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
Background In triple negative breast cancer patients treated with neoadjuvant chemotherapy, residual disease at surgery is the most relevant unfavorable prognostic factor. Current guidelines consider the use of adjuvant capecitabine, based on the results of the randomized CREATE-X study, carried out in Asian patients and including a small subset of triple negative tumors. Thus far, evidence on Caucasian patients is limited, and no real-world data are available. Methods We carried out a multicenter, observational study, involving 44 oncologic centres. Triple negative breast cancer patients with residual disease, treated with adjuvant capecitabine from January 2017 through June 2021, were recruited. We primarily focused on treatment tolerability, with toxicity being reported as potential cause of treatment discontinuation. Secondarily, we assessed effectiveness in the overall study population and in a subset having a minimum follow-up of 2 years. Results Overall, 270 patients were retrospectively identified. The 50.4% of the patients had residual node positive disease, 7.8% and 81.9% had large or G3 residual tumor, respectively, and 80.4% a Ki-67 >20%. Toxicity-related treatment discontinuation was observed only in 10.4% of the patients. In the whole population, at a median follow-up of 15 months, 2-year disease-free survival was 62%, 2 and 3-year overall survival 84.0% and 76.2%, respectively. In 129 patients with a median follow-up of 25 months, 2-year disease-free survival was 43.4%, 2 and 3-year overall survival 78.0% and 70.8%, respectively. Six or more cycles of capecitabine were associated with more favourable outcomes compared with less than six cycles. Conclusion The CaRe study shows an unexpectedly good tolerance of adjuvant capecitabine in a real-world setting, although effectiveness appears to be lower than that observed in the CREATE-X study. Methodological differences between the two studies impose significant limits to comparability concerning effectiveness, and strongly invite further research.
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Affiliation(s)
| | - Eriseld Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maddalena Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Katia Cannita
- Oncology Division, Mazzini Hospital, ASL Teramo, Teramo, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Fulvio Borella
- Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, Sant' Anna Hospital, University of Turin, Turin, Italy
| | | | | | | | - Elisa Picardo
- Gynecology and Obstetrics 4, Department of Surgical Sciences, City of Health and Science, Sant' Anna Hospital, University of Turin, Turin, Italy
| | - Marco Mitidieri
- Gynecology and Obstetrics 4, Department of Surgical Sciences, City of Health and Science, Sant' Anna Hospital, University of Turin, Turin, Italy
| | | | | | - Giuseppe Tonini
- Department of Medical Oncology, Fondazione Policlinico Universitario Campus Biomedico, Rome, Italy
| | - Daniele Santini
- Medical Oncology A, Policlinico Umberto I, Department of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Nicla La Verde
- Department of Oncology, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Anna Rita Gambaro
- Department of Oncology, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonino Grassadonia
- Department of Innovative Technologies in Medicine and Dentistry and Centre for Advanced Studies and Technology (CAST), G. D’Annunzio University, Chieti, Italy
| | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences and Center for Advanced Studies and Technology (CAST), G. D’Annunzio University, Chieti, Italy
| | - Ornella Garrone
- Medical Oncology, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | | | - Lorenzo Livi
- Department of Biomedical, Experimental and Clinical Sciences “M. Serio”, University of Florence, Florence, Italy
- Radiotherapy Unit, Oncology Department, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Icro Meattini
- Department of Biomedical, Experimental and Clinical Sciences “M. Serio”, University of Florence, Florence, Italy
- Radiotherapy Unit, Oncology Department, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | | | - Matteo Vergati
- UOC of Medical Oncology, Sandro Pertini Hospital, Rome, Italy
| | - Teresa Gamucci
- UOC of Medical Oncology, Sandro Pertini Hospital, Rome, Italy
| | - Mirco Pistelli
- Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti Hospital, Ancona, Italy
| | - Rossana Berardi
- Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti Hospital, Ancona, Italy
| | - Emanuela Risi
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Francesco Giotta
- Department of Medical Oncology, IRCCS Giovanni Paolo II Institute, Bari, Italy
| | - Vito Lorusso
- Department of Medical Oncology, IRCCS Giovanni Paolo II Institute, Bari, Italy
| | - Lucia Rinaldi
- “Don Tonino Bello” Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Salvatore Artale
- Oncology Department, Ospedale di Gallarate, ASST Valle Olona, Gallarate, Italy
| | - Marina Elena Cazzaniga
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Monza, Italy
- Oncology Unit, ASST Monza, Monza, Italy
| | - Fable Zustovich
- Oncology Division, AULSS 1 Dolomiti, San Martino Medical Hospital, Belluno, Italy
| | - Federico Cappuzzo
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Lorenza Landi
- Phase I Clinical Studies Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Rosalba Torrisi
- Department of Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Simone Scagnoli
- Department of Medical and Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Andrea Botticelli
- Medical Oncology A, Policlinico Umberto I, Department of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Andrea Michelotti
- UO Medical Oncology I, S. Chiara Hospital, Pisa University Hospital, Pisa, Italy
| | - Beatrice Fratini
- UO Medical Oncology I, S. Chiara Hospital, Pisa University Hospital, Pisa, Italy
| | - Rosa Saltarelli
- Oncology Division, San Giovanni Evangelista Hospital, ASL RM5, Rome, Italy
| | - Ida Paris
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Margherita Muratore
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alessandra Cassano
- Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo Gianni
- Oncology Unit Rimini, Azienda USL Romagna, Rimini, Italy
| | | | | | - Federica Zoratto
- Medical Oncology Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - Elena Fiorio
- Pathology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Marco Mazzotta
- Medical Oncology Unit, Belcolle Hospital, Viterbo, Italy
| | | | | | - Maria Rosaria Valerio
- Medical Oncology, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Lorena Filomeno
- Phase IV Clinical Studies Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mauro Minelli
- Division of Oncology, San Giovanni Hospital, Rome, Italy
| | - Paola Scavina
- Division of Oncology, San Giovanni Hospital, Rome, Italy
| | - Mimma Raffaele
- Presidio Oncologico Cassia – S. Andrea, ASL Roma 1, Rome, Italy
| | - Antonio Astone
- Oncology Division, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Roy De Vita
- Department of Plastic and Reconstructive Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marcello Pozzi
- Department of Plastic and Reconstructive Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Filippo Greco
- Medical Oncology Unit, AULSS 9 Regione Veneto, Scaligera - Ospedale Generale Mater Salutis, Legnago, Italy
| | - Luca Moscetti
- Division of Medical Oncology, Department of Oncology-Hematology, University Hospital of Modena, Modena, Italy
| | | | - Marcello Maugeri-Saccà
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
- Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alessandro Zennaro
- Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Claudio Botti
- Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabio Pelle
- Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Sonia Cappelli
- Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Flavia Cavicchi
- Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Enrico Vizza
- Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Federica Tomao
- Department of Maternal and Child Health and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I, Rome, Italy
| | - Enrico Cortesi
- Medical Oncology B, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Paolo Marchetti
- Scientific Direction, IRCCS IDI, Istituto Dermopatico dell'Immacolata, Rome, Italy
| | - Silverio Tomao
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Iolanda Speranza
- Medical Oncology A, Policlinico Umberto I, Department of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Isabella Sperduti
- Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Vici
- Phase IV Clinical Studies Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Mauro C, Capone V, Cocchia R, Cademartiri F, Riccardi F, Arcopinto M, Alshahid M, Anwar K, Carafa M, Carbone A, Castaldo R, Chianese S, Crisci G, D’Assante R, De Luca M, Franzese M, Galzerano D, Maffei V, Marra AM, Valente V, Giardino F, Mazza A, Ranieri B, D’Agostino A, Rega S, Romano L, Scagliarini S, Sepe C, Vriz O, Izzo R, Cittadini A, Bossone E, Salzano A. Cardiovascular Side Effects of Anthracyclines and HER2 Inhibitors among Patients with Breast Cancer: A Multidisciplinary Stepwise Approach for Prevention, Early Detection, and Treatment. J Clin Med 2023; 12:2121. [PMID: 36983126 PMCID: PMC10056500 DOI: 10.3390/jcm12062121] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Cardiovascular (CV) diseases (CVD) are a major cause of long-term morbidity and mortality affecting life expectancy amongst cancer survivors. In recent years, because of the possibility of early diagnosis and the increased efficacy of neo-adjuvant and adjuvant systemic treatments (targeting specific molecular pathways), the high percentage of survival from breast cancer led CVD to become the first cause of death among survivors. Therefore, it is mandatory to adopt cardioprotective strategies to minimize CV side effects and CVD in general in breast cancer patients. Cancer therapeutics-related cardiac dysfunction (CTRCD) is a common group of side effects of chemotherapeutics widely employed in breast cancer (e.g., anthracycline and human epidermal growth factor receptor 2 inhibitors). The aim of the present manuscript is to propose a pragmatic multidisciplinary stepwise approach for prevention, early detection, and treatment of cardiotoxicity in patients with breast cancer.
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Affiliation(s)
- Ciro Mauro
- Cardiology Division, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
| | - Valentina Capone
- Cardiology Division, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Rosangela Cocchia
- Cardiology Division, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
| | - Filippo Cademartiri
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi 1, 56124 Pisa, Italy
| | - Ferdinando Riccardi
- Oncology Unit, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
| | - Michele Arcopinto
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Maie Alshahid
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh 11564, Saudi Arabia
| | - Kashif Anwar
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh 11564, Saudi Arabia
| | - Mariano Carafa
- Emergency Medicine Division, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
| | - Andreina Carbone
- Unit of Cardiology, Department of Translational Medical Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Rossana Castaldo
- IRCCS SYNLAB SDN, Via Emanuele Gianturco 113, 80143 Naples, Italy
| | - Salvatore Chianese
- Cardiology Division, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giulia Crisci
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Roberta D’Assante
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Mariarosaria De Luca
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Monica Franzese
- IRCCS SYNLAB SDN, Via Emanuele Gianturco 113, 80143 Naples, Italy
| | - Domenico Galzerano
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh 11564, Saudi Arabia
| | - Vincenzo Maffei
- Post Operative Intensive Care Division, Antonio Cardarelli Hospital, 80131 Naples, Italy
| | - Alberto M. Marra
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Valeria Valente
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Federica Giardino
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Alfredo Mazza
- Unit of Cardiology, Camerino Hospital, 62032 Macerata, Italy
| | - Brigida Ranieri
- IRCCS SYNLAB SDN, Via Emanuele Gianturco 113, 80143 Naples, Italy
| | - Anna D’Agostino
- IRCCS SYNLAB SDN, Via Emanuele Gianturco 113, 80143 Naples, Italy
| | - Salvatore Rega
- Department of Public Health, University Federico II of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Luigia Romano
- Department of General and Emergency Radiology, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
| | - Sarah Scagliarini
- Oncology Unit, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
| | - Chiara Sepe
- Technical Nursing and Rehabilitation Service (SITR) Department, Cardarelli Hospital, 80131 Naples, Italy
| | - Olga Vriz
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh 11564, Saudi Arabia
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Eduardo Bossone
- Department of Public Health, University Federico II of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Andrea Salzano
- Cardiology Division, Antonio Cardarelli Hospital, Via Cardarelli 9, 80131 Naples, Italy
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 7TG, UK
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Cucciniello L, Blondeaux E, Bighin C, Gasparro S, Russo S, Dri A, Pugliese P, Fontana A, Naso G, Ferzi A, Riccardi F, Sini V, Boni L, Fabi A, Montemurro F, De Laurentiis M, Arpino G, Mastro LD, Gerratana L, Puglisi F. Abstract P1-11-04: Assessing the clinico-pathological characteristics of HER2 positive metastatic breast cancer patients experiencing radiologic complete response in a nationwide cohort. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p1-11-04] [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: 03/06/2023]
Abstract
Abstract
Background: Up to 6% of patients (pts) with HER2 positive (pos) metastatic breast cancer (MBC) experience a radiologic complete response (rCR) to a first line of therapy, but these results mostly derive from dated and/or limited cohorts. Aim of this study was to define the clinico-pathological characteristics of HER2 positive (pos) MBC pts experiencing a rCR. Methods: Pts were selected from the database of the GIM14 study (NCT02284581) and classified according to the best radiologic response obtained to the first line chemotherapy (CT) and upon time-to-treatment-failure (TTF). rCR was defined as complete response (CR) with a TTF > 3 months. The association across variables was tested through logistic regression and their prognostic impact in terms of overall survival (OS) was estimated using the Kaplan-Meier method and compared using the log-rank test. Results: Of the 3,423 pts included in the GIM14 study, 814 had HER2 pos MBC. After exclusion of pts treated with first line endocrine therapy and/or with TTF < 3 months, 656 pts were included in the present analysis, of which 96 (14.6%) experienced a rCR. Instead, the best response was a partial response for 295 pts (45.0%), stable disease for 221 pts (33.7%), and progression for 44 pts (6.7%). Most pts (59.8%) presented de novo MBC; 379 pts (57.8%) had visceral metastases (mets), 609 pts (92.8%) did not have central nervous system (CNS) involvement and 318 pts (48.5%) had only 1 site of distant mets. Also, 445 pts (67.9%) had hormone receptor (HR) pos disease, a HER2 3+ score at immunohistochemistry (IHC) was present in 59.8% of cases versus 40.2% with HER2 2+ at IHC and in situ hybridization (ISH) + disease. Taxanes were the main CT backbone (489 pts, 74.5%), 341 pts (52.0%) had received a Trastuzumab-Pertuzumab doublet. At multivariable analysis, higher odds of experiencing a rCR were reported for presence of non-visceral mets (OR 1.87, 95%CI 1.10-3.17), low number of metastatic sites (OR 2.42, 95%CI 0.80-7.33 for 1 site only) and HER2 3+ score at IHC (OR 1.80, 95%CI 1.09-2.98). Disease-free interval (DFI) was associated to rCR at univariable but not at multivariable analysis. HR status, CT backbone and type of anti-HER2 regimen were not associated with rCR neither at univariable nor at multivariable analysis. Median follow-up was 76.2 months. Amongst pts with TTF>12 months, those with rCR had a significantly higher OS compared to those not experiencing a rCR (median OS 133 and 90 months, respectively; p=0.0191). OS rates in pts with TTF ≥ 12 months were 97.8% at 2-year follow-up and 59.4% at 5-year follow-up. Instead, in pts with TTF ≥ 60 months, OS rates were 76.7% at 10-year follow-up. Amongst the 96 pts experiencing a CR, 38 had a rCR with TTF between 12 and 60 months, while 22 pts had a rCR with a TTF ≥ 60 months. The remaining pts had a CR with a TTF < 12 months. Pts with HR negative (neg) disease were found to be more likely to experience a rCR with a with TTF between 12 and 60 months, whilst pts with HR pos disease had a higher probability to experience a rCR with a TTF ≥ 60 months (p=0.0074). Pts with HER2 3+ score at IHC had a higher probability to achieve a rCR with a TTF ≥ 12 months compared to pts with HER2 2+ score at IHC and ISH + (p=0.0216). Age at diagnosis, menopausal status, DFI, number and site of mets, CT backbone and anti-HER2 therapy did not influence the duration of the rCR obtained. Conclusions: This study characterized a real-world cohort of HER2 positive MBC patients experiencing radiologic complete response to a first line treatment. Based on these results a clinical trial focused on liquid biopsy-based minimal residual disease is being designed. Novel anti-HER2 agents are gaining momentum as ever increasingly effective treatments and future de-escalation strategies after complete response will represent a growing need.
Citation Format: Linda Cucciniello, Eva Blondeaux, Claudia Bighin, Simona Gasparro, Stefania Russo, Arianna Dri, Palma Pugliese, Andrea Fontana, Giuseppe Naso, Antonella Ferzi, Ferdinando Riccardi, Valentina Sini, Luca Boni, Alessandra Fabi, Filippo Montemurro, Michelino De Laurentiis, Grazia Arpino, Lucia Del Mastro, Lorenzo Gerratana, Fabio Puglisi. Assessing the clinico-pathological characteristics of HER2 positive metastatic breast cancer patients experiencing radiologic complete response in a nationwide cohort [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-11-04.
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Affiliation(s)
- Linda Cucciniello
- 1Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano
| | | | | | | | - Stefania Russo
- 5Department of Medical Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC) Udine, Italy
| | - Arianna Dri
- 6Santa Maria della Misericordia University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine
| | | | | | | | | | | | - Valentina Sini
- 12Centro Oncologico S. Spirito-Nuovo Regina Margherita, ASL Roma 1, Rome
| | - Luca Boni
- 13IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alessandra Fabi
- 14Precision Medicine in Breast Cancer, Fondazione Policlinico Universitario A. Gemelli, IRCCS Rome, Rome,, Italy
| | | | | | | | | | - Lorenzo Gerratana
- 19Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano
| | - Fabio Puglisi
- 20Department of Medicine (DAME), University of Udine, Udine, Italy and Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Friuli-Venezia Giulia, Italy
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Vitale MG, Crispo A, Arundine D, Ronga R, Barbato C, Luongo A, Habetswallner F, De Martino BM, Maione A, Eisenwagen S, Vitale G, Riccardi F. Survival analyses of the ZeOxaNMulti trial: Follow-up randomized, double-blinded, placebo-controlled trial of oral PMA-zeolite to prevent chemotherapy-induced side effects, especially peripheral neuropathy. Front Pharmacol 2022; 13:874028. [DOI: 10.3389/fphar.2022.874028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
Following the previously published results of the clinical randomized ZeOxaNMulti trial, we evaluated the potential of the tested product PMA-ZEO (Multizeo Med) in the prevention of chemotherapy-induced side effects (especially peripheral neuropathy) within a 30-month follow-up analysis. The aim was to determine the disease-free survival (DFS), progression-free survival (PFS), and overall survival (OS) in a study-population suffering from colorectal cancer that was previously enrolled in the ZeOxaNMulti trial from April 2015 to October 2018. The participants of the study were randomized to receive either PMA-ZEO or placebo while undergoing oxaliplatin-based chemotherapy. A total of 104 patients (pts) (51% of participants randomized to the PMA-ZEO group and 49% to the placebo group), out of a total of 120 pts included in the ZeOxaNMulti trial in 2015, were followed up until March 2021 and were included in the follow-up analysis. According to the chemotherapy line, 44.2% of patients received chemotherapy in an adjuvant setting, and 55.8% of patients received chemotherapy as first-line treatment. The statistical analysis for DFS, PFS, and OS was performed by comparison of the end results with data from the PMA-ZEO/placebo-intervention start point. The analysis of OS did not show statistically significant differences in the first-line chemotherapy patients randomized to PMA-ZEO than among the placebo group (p = 0.1) over the whole period of follow-up (30 months). However, focusing on the PMA-ZEO supplementation time point (7 months), a positive and statistically significant trend (p = 0.004) was documented in the OS analysis for the first-line chemotherapy patients with increasing months of PMA-ZEO treatment compared to the placebo group. Furthermore, borderline statistical significance was reached for PFS at the PMA-ZEO supplementation time point (7 months) in the first-line chemotherapy patients (p = 0.05) for cancer progression events. After stratification of the first-line chemotherapy patients, statistically relevant trends for OS for age, comorbidities, and oxaliplatin dosage (cycles) were also determined. The overall results for DFS (adjuvant patients), PFS (first-line chemotherapy patients), and OS (adjuvant and first-line chemotherapy patients) were generally slightly better in the PMA-ZEO group than in the placebo group, even though no statistically significant results were obtained between the groups within the follow-up period until 2021 (30 months). Based on this follow-up analysis, protective effects of PMA-zeolite supplementation can be deduced. A positive trend and more importantly, significant results in PFS and OS for specific patient groups during and/or after PMA-ZEO treatment were determined, which supports the use of PMA-ZEO as an oncological supportive therapy.
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9
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Lesieur E, Riccardi F, Bault JP, Levaillant JM, Torrents J, Paternostre A, Couly G, Quarello E. [Antenatal ear examination: When, how and why?]. Gynecol Obstet Fertil Senol 2022; 50:624-637. [PMID: 35817342 DOI: 10.1016/j.gofs.2022.05.005] [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] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/30/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
Antenatal ear examination is an integral part of the thorough examination of the fetal face. The discovery of an anomaly, whether it is made by chance or during a complementary in-depth examination, leads the practitioner to determine its isolated or associated character, in order to characterise its possible belonging to a syndromic entity. In this context, the realization of genetic analysis more precise and wider allowing a return of the results in a time compatible with an evolutive pregnancy, gives to the geneticist a central role in the management of these couples. The main challenge lies in obtaining a set of concordant clinical and biological clues, enabling the genetic results identified to be interpreted correctly, the optimised functioning of the ultrasound practitioner - geneticist duo is therefore fundamental. This results in a complex information to deliver, in the fact that the clinical translation of an ear anomaly in antenatal can go from an isolated aesthetic anomaly to a genetic syndrome with neurodevelopmental disorder. The objective of this work is to describe, from a methodological analysis of antenatal ears, the accessible malformative entities, isolated or associated, and to discuss the problems in the need or not to propose their screening.
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Affiliation(s)
- E Lesieur
- Department of obstetrics and gynaecology, Prenatal Diagnosis Center, La Conception hospital, Aix Marseille university, boulevard Baille, 13005 Marseille, France; UMR 7268 ADES, Aix-Marseille université, CNRS, EFS, Marseille, France.
| | - F Riccardi
- MMG, Inserm, Aix-Marseille université, Marseille, France
| | - J-P Bault
- Department of gynaecology and obstetrics, CHI Poissy-St-Germain, 78300 Poissy, France; Centre d'échographie Ambroise-Paré, 68/70, rue Aristide-Briand, 78130 Les Mureaux, France; Plateforme Lumière, hôpital Necker-Enfant Malade, Paris, France
| | - J-M Levaillant
- Center for Woman and Fetal Imaging, 59000, France; Hôpital Privé Armand Brillard, Groupe Ramsay Générale De Santé, 94130 Nogent-sur-Marne, France
| | - J Torrents
- Department of Pathology and Neuropathology, La Timone Hospital, Aix Marseille University, Marseille, France
| | - A Paternostre
- Department of gynaecology and obstetrics, CHI Poissy-St-Germain, 78300 Poissy, France; European Center of Diagnosis and Exploration of the Woman, 78150 Le Chesnay, France
| | - G Couly
- Center for Woman and Fetal Imaging, 59800 Lille, France
| | - E Quarello
- Department of obstetrics and gynecology, screening and diagnosis unit, Saint Joseph hospital, 26, boulevard de Louvain, 13008 Marseille, France; IMAGE2 Center, 6, rue Rocca, 13008 Marseille, France
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10
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Cucciniello L, Blondeaux E, Bighin C, Gasparro M, Russo S, Dri A, Pugliese P, Fontana A, Naso G, Ferzi A, Riccardi F, Sini V, Fabi A, Montemurro F, De Laurentiis M, Arpino G, Del Mastro L, Gerratana L, Puglisi F. 270P Defining clinico-pathological characteristics of HER2 positive metastatic breast cancer (MBC) patients experiencing radiologic complete response (rCR) in a nationwide real-world cohort. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1854] [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: 11/01/2022] Open
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11
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Andrini E, Lamberti G, Mazzoni F, Riccardi F, Bonetti A, Follador A, Giardina D, Genova C, Guaitoli G, Frassoldati A, Brighenti M, Colantonio I, Pasello G, Ficorella C, Cinieri S, Tiseo M, Gelsomino F, Tognetto M, Rihawi K, Ardizzoni A. EP14.01-006 CeLEBrATE: Phase II trial of CarbopLatin, Etoposide, Bevacizumab and Atezolizumab in Patients with exTEnsive-Stage SCLC-GOIRC-01-2019. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.942] [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: 11/16/2022]
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12
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Andrini E, Lamberti G, Mazzoni F, Riccardi F, Bonetti A, Follador A, Artioli F, Genova C, Barbieri F, Frassoldati A, Brighenti M, Colantonio I, Pasello G, Ficorella C, Cinieri S, Tiseo M, Gelsomino F, Tognetto M, Rihawi K, Ardizzoni A. A phase II, open-label, single-arm trial of carboplatin plus etoposide with bevacizumab and atezolizumab in patients with extended-stage small-cell lung cancer (CeLEBrATE study): background, design and rationale. Future Oncol 2022; 18:771-779. [PMID: 35068173 DOI: 10.2217/fon-2021-1027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Indexed: 01/01/2023] Open
Abstract
Based on improved survival from the addition of PD-L1 inhibitors in phase III trials, the combination of immunotherapy and platinum-doublet chemotherapy has become the new standard treatment for extended-stage small-cell lung cancer (ES-SCLC). Furthermore, the antiangiogenetic agent bevacizumab showed a longer progression-free survival by targeting VEGF that has pleiotropic effects, including immunosuppressive ones. We, therefore, hypothesized that targeting angiogenesis would improve the efficacy of chemoimmunotherapy. The CeLEBrATE trial is an open-label, multicenter, phase II study designed to assess the efficacy and safety of the combination of carboplatin and etoposide plus bevacizumab and atezolizumab in treatment-naive patients with ES-SCLC. The primary end point is overall survival rate at 1 year, while secondary end points include overall response rate, progression-free survival and toxicity.
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Affiliation(s)
- Elisa Andrini
- Department of Experimental, Diagnostic & Specialty Medicine (DIMES), University of Bologna, Bologna 40138, Italy
| | - Giuseppe Lamberti
- Department of Experimental, Diagnostic & Specialty Medicine (DIMES), University of Bologna, Bologna 40138, Italy
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Francesca Mazzoni
- Medical Oncology Unit, University Hospital Careggi, Firenze 50134, Italy
| | | | - Andrea Bonetti
- Department of Oncology, Mater Salutis Hospital, Legnago 37045, Italy
| | - Alessandro Follador
- Department of Oncology, University Hospital Santa Maria Della Misericordia, Udine 33100, Italy
| | - Fabrizio Artioli
- Oncology & Palliative Care Units, Civil Hospital Carpi, USL, Carpi 41012, Italy
| | - Carlo Genova
- Academic Oncology Unit, IRCCS Ospedale Policlinico San Martino, Genoa 16132, Italy
- Department of Internal Medicine & Medical Specialties (DiMI), Università degli Studi di Genova, Genoa 16132, Italy
| | - Fausto Barbieri
- Division of Medical Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena 41125, Italy
| | - Antonio Frassoldati
- Department of Oncology, Azienda Ospedaliero Universitaria di Ferrara-Arcispedale Sant'Anna, Ferrara 44124, Italy
| | | | - Ida Colantonio
- Medical Oncology Unit, Hospital of Cuneo, Cuneo 12100, Italy
| | - Giulia Pasello
- Department of Surgery, Oncology & Gastroenterology, University of Padova, Padova 35122, Italy
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova 35122, Italy
| | - Corrado Ficorella
- Department of Biotechnological & Applied Clinical Sciences, St Salvatore Hospital, University of L'Aquila, L'Aquila 67100, Italy
| | - Saverio Cinieri
- Department of Oncology, Medical Oncology & Breast Unit, Antonio Perrino Hospital, Brindisi 72100, Italy
| | - Marcello Tiseo
- Department of Medicine & Surgery, University of Parma & Medical Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma 43126, Italy
| | - Francesco Gelsomino
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Michele Tognetto
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Karim Rihawi
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Andrea Ardizzoni
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
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13
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Romano F, Barbato C, Arundine D, Ambrosio F, Ronga R, Failla G, Moccia L, Corcione N, Guggino G, Raucci A, Romano L, Campione S, De Dominicis G, Santoriello C, Tinto A, Russo C, De Michele F, Russo A, Starace A, Riccardi F. 13P High neutrophils-to-lymphocyte ratio (NLR) predicts poor survival of high-PD-L1-expressing metastatic non-small cell lung carcinoma patients undergoing first-line immunotherapy with pembrolizumab. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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14
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Pizzuti L, Krasniqi E, Sperduti I, Barba M, Gamucci T, Mauri M, Veltri EM, Meattini I, Berardi R, Di Lisa FS, Natoli C, Pistelli M, Iezzi L, Risi E, D’Ostilio N, Tomao S, Ficorella C, Cannita K, Riccardi F, Cassano A, Bria E, Fabbri MA, Mazzotta M, Barchiesi G, Botticelli A, D’Auria G, Ceribelli A, Michelotti A, Russo A, Salimbeni BT, Sarobba G, Giotta F, Paris I, Saltarelli R, Marinelli D, Corsi D, Capomolla EM, Sini V, Moscetti L, Mentuccia L, Tonini G, Raffaele M, Marchetti L, Minelli M, Ruggeri EM, Scavina P, Bacciu O, Salesi N, Livi L, Tinari N, Grassadonia A, Fedele Scinto A, Rossi R, Valerio MR, Landucci E, Stani S, Fratini B, Maugeri-Saccà M, De Tursi M, Maione A, Santini D, Orlandi A, Lorusso V, Cortesi E, Sanguineti G, Pinnarò P, Cappuzzo F, Landi L, Botti C, Tomao F, Cappelli S, Bon G, Pelle F, Cavicchi F, Fiorio E, Foglietta J, Scagnoli S, Marchetti P, Ciliberto G, Vici P. PANHER study: a 20-year treatment outcome analysis from a multicentre observational study of HER2-positive advanced breast cancer patients from the real-world setting. Ther Adv Med Oncol 2021; 13:17588359211059873. [PMID: 35173816 PMCID: PMC8842182 DOI: 10.1177/17588359211059873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/18/2021] [Accepted: 10/27/2021] [Indexed: 12/16/2022] Open
Abstract
Background: The evolution of therapeutic landscape of human epidermal growth factor
receptor-2 (HER2)-positive breast cancer (BC) has led to an unprecedented
outcome improvement, even if the optimal sequence strategy is still debated.
To address this issue and to provide a picture of the advancement of
anti-HER2 treatments, we performed a large, multicenter, retrospective study
of HER2-positive BC patients. Methods: The observational PANHER study included 1,328 HER2-positive advanced BC
patients treated with HER2 blocking agents since June 2000 throughout July
2020. Endpoints of efficacy were progression-free survival (PFS) and overall
survival (OS). Results: Patients who received a first-line pertuzumab-based regimen showed better PFS
(p < 0.0001) and OS (p = 0.004)
than those receiving other treatments. Median PFS and mOS from second-line
starting were 8 and 28 months, without significant differences among various
regimens. Pertuzumab-pretreated patients showed a mPFS and a mOS from
second-line starting not significantly affected by type of second line, that
is, T-DM1 or lapatinib/capecitabine (p = 0.80 and
p = 0.45, respectively). Conversely, pertuzumab-naïve
patients receiving second-line T-DM1 showed a significantly higher mPFS
compared with that of patients treated with lapatinib/capecitabine
(p = 0.004). Median OS from metastatic disease
diagnosis was higher in patients treated with trastuzumab-based first line
followed by second-line T-DM1 in comparison to pertuzumab-based first-line
and second-line T-DM1 (p = 0.003), although these data
might be partially influenced by more favorable prognostic characteristics
of patients in the pre-pertuzumab era. No significant
differences emerged when comparing patients treated with ‘old’ or ‘new’
drugs (p = 0.43), even though differences in the length of
the follow-up between the two cohorts should be taken into account. Conclusion: Our results confirmed a relevant impact of first-line pertuzumab-based
treatment and showed lower efficacy of second-line T-DM1 in
trastuzumab/pertuzumab pretreated, as compared with pertuzumab-naïve
patients. Our findings may help delineate a more appropriate therapeutic
strategy in HER2-positive metastatic BC. Prospective randomized trials
addressing this topic are awaited.
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Affiliation(s)
- Laura Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Eriseld Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144 Rome, Italy
| | - Isabella Sperduti
- Biostatistics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maddalena Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144 Rome, Italy
| | | | - Maria Mauri
- Division of Oncology, San Giovanni Hospital, Rome, Italy
| | | | - Icro Meattini
- Radiation Oncology Unit and Department of Clinical and Experimental Biomedical Sciences ‘Mario Serio’, Careggi University Hospital, University of Florence, Florence, Italy
| | - Rossana Berardi
- Oncology Clinic, ‘Ospedali iuniti di Ancona’ Hospital, Ancona, Italy
| | - Francesca Sofia Di Lisa
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
- Medical Oncology A, Policlinico Umberto I, Rome, Italy
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, ‘Sapienza’ University of Rome, Umberto I University Hospital, Rome, Italy
| | - Clara Natoli
- Department of Medical, Oral and Biotechnological Sciences and Center for Advanced Studies and Technology (CAST), G. D’Annunzio University, Chieti, Italy
| | - Mirco Pistelli
- Oncology Clinic, ‘Ospedali Riuniti di Ancona’ Hospital, Ancona, Italy
| | - Laura Iezzi
- Oncology Division, Hospital ‘Maria SS. dello Splendore’ ASL 4, Giulianova, Italy
| | - Emanuela Risi
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | | | - Silverio Tomao
- Medical Oncology A, Policlinico Umberto I, Rome, Italy
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, ‘Sapienza’ University of Rome, Umberto I University Hospital, Rome, Italy
| | - Corrado Ficorella
- Medical Oncology, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | | | | | - Alessandra Cassano
- U.O.C. Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emilio Bria
- U.O.C. Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Marco Mazzotta
- Medical Oncology Unit, Belcolle Hospital, Viterbo, Italy
| | - Giacomo Barchiesi
- Medical Oncology A, Policlinico Umberto I, Rome, Italy
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, ‘Sapienza’ University of Rome, Umberto I University Hospital, Rome, Italy
- Medical Oncology Unit, Ospedale dell’Angelo, Mestre, Italy
| | - Andrea Botticelli
- Medical Oncology B, Policlinico Umberto I, Rome, Italy
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuliana D’Auria
- Medical Oncology, Sandro Pertini Hospital, Rome, Italy
- Paola ScavinaSan Giovanni Addolorata Hospital, 00184 Rome, Italy
| | - Anna Ceribelli
- Medical Oncology Unit, San Camillo de Lellis Hospital, ASL Rieti, Rieti, Italy
| | - Andrea Michelotti
- UO Medical Oncology I, S. Chiara Hospital, Pisa, Italy
- Oncology, Transplant and New Technologies Department, Pisa University Hospital, Pisa, Italy
| | - Antonio Russo
- Medical Oncology, AOU Policlinico Paolo Giaccone, Palermo, Italy
| | | | | | - Francesco Giotta
- Department of Medical Oncology, IRCCS Giovanni Paolo II Institute, Bari, Italy
| | - Ida Paris
- Gynaecology – Oncology Unit, IRCCS Catholic University of the Sacred Heart, Rome, Italy
| | - Rosa Saltarelli
- UOC Oncology, San Giovanni Evangelista Hospital, ASL RM5, Rome, Italy
| | - Daniele Marinelli
- Medical Oncology B, Policlinico Umberto I, Rome, Italy
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Corsi
- Medical Oncology Unit, Fatebenefratelli Hospital, Rome, Italy
| | | | | | - Luca Moscetti
- Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Lucia Mentuccia
- Medical Oncology, Ospedale ‘Parodi-Delfino’, Colleferro, Italy
| | - Giuseppe Tonini
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Mimma Raffaele
- UOSD Presidio Oncologico Cassia – S. Andrea, ASL Roma 1, Rome, Italy
| | - Luca Marchetti
- UOC Oncology, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Mauro Minelli
- Division of Oncology, San Giovanni Hospital, Rome, Italy
| | | | | | - Olivia Bacciu
- Division of Oncology, San Giovanni Hospital, Rome, Italy
| | - Nello Salesi
- Medical Oncology Unit, Santa Maria Goretti, Latina, Italy
| | - Lorenzo Livi
- Radiation Oncology Unit and Department of Clinical and Experimental Biomedical Sciences ‘Mario Serio’, Careggi University Hospital, University of Florence, Florence, Italy
| | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences and Center for Advanced Studies and Technology (CAST), G. D’Annunzio University, Chieti, Italy
| | - Antonino Grassadonia
- Department of Medical, Oral and Biotrechnological Sciences and Centre for Advanced Studues and Echnology (CAST), G. D’Annunzio University, Chieti, Italy
| | | | | | | | - Elisabetta Landucci
- UO Medical Oncology I, S. Chiara Hospital, Pisa, Italy
- Oncology, Transplant and New Technologies Department, Pisa University Hospital, Pisa, Italy
| | | | - Beatrice Fratini
- UO Medical Oncology I, S. Chiara Hospital, Pisa, Italy
- Oncology, Transplant and New Technologies Department, Pisa University Hospital, Pisa, Italy
| | - Marcello Maugeri-Saccà
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences and Center for Advanced Studies and Technology (CAST), G. D’Annunzio University, Chieti, Italy
| | - Angela Maione
- Oncology Unit, Antonio Cardarelli Hospital, Naples, Italy
| | - Daniele Santini
- Department of Oncology, University Campus Biomedico of Rome, Rome, Italy
| | - Armando Orlandi
- U.O.C. Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vito Lorusso
- Department of Medical Oncology, IRCCS Giovanni Paolo II Institute, Bari, Italy
| | - Enrico Cortesi
- Medical Oncology B, Policlinico Umberto I, Rome, Italy
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paola Pinnarò
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Federico Cappuzzo
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Lorenza Landi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Claudio Botti
- Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Federica Tomao
- Department of Gynecologic Oncology, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Sonia Cappelli
- Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giulia Bon
- Cellular Network and Molecular Therapeutic Target Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabio Pelle
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Flavia Cavicchi
- Department of Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Elena Fiorio
- U.O.C. Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Simone Scagnoli
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Medical Oncology B, Policlinico Umberto I, Rome, Italy
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
- Sperimentazioni di Fase IV, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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15
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Cazzaniga ME, Vallini I, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Baldelli A, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Marchetti P, Sarti S, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Saracchini S, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Di Mauro P, Cogliati V, Capici S, Clivio L, Torri V. Metronomic chemotherapy (mCHT) in metastatic triple-negative breast cancer (TNBC) patients: results of the VICTOR-6 study. Breast Cancer Res Treat 2021; 190:415-424. [PMID: 34546500 PMCID: PMC8558172 DOI: 10.1007/s10549-021-06375-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Purpose Triple-negative breast cancer (TNBC) represents a subtype of breast cancer which lacks the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2): TNBC accounts for approximately 20% of newly diagnosed breast cancers and is associated with younger age at diagnosis, greater recurrence risk and shorter survival time. Therapeutic options are very scarce. Aim of the present analysis is to provide further insights into the clinical activity of metronomic chemotherapy (mCHT), in a real-life setting. Methods We used data included in the VICTOR-6 study for the present analysis. VICTOR-6 is an Italian multicentre retrospective cohort study, which collected data of metastatic breast cancer (MBC) patients who have received mCHT between 2011 and 2016. Amongst the 584 patients included in the study, 97 were triple negative. In 40.2% of the TNBC patients, mCHT was the first chemotherapy treatment, whereas 32.9% had received 2 or more lines of treatment for the metastatic disease. 45.4% out of 97 TNBC patients received a vinorelbine (VRL)-based regimen, which resulted in the most used type of mCHT, followed by cyclophosphamide (CTX)-based regimens (30.9%) and capecitabine (CAPE)-based combinations (22.7%). Results Overall response rate (ORR) and disease control rate (DCR) were 17.5% and 64.9%, respectively. Median progression free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.9–7.2) and 12.1 months (95% CI: 9.6–16.7). Median PFS was 6.9 months for CAPE-based regimens (95% CI: 5.0–18.4), 6.1 months (95% CI: 4.0–8.9) for CTX-based and 5.3 months (95% CI: 4.1–9.5) for VRL-based ones. Median OS was 18.2 months (95% CI: 9.1-NE) for CAPE-based regimens and 11.8 months for VRL- (95% CI: 9.3–16.7 and CTX-based ones (95%CI: 8.7–52.8). Tumour response, PFS and OS decreased proportionally in later lines. Conclusion This analysis represents the largest series of TNBC patients treated with mCHT in a real-life setting and provides further insights into the advantages of using this strategy even in this poor prognosis subpopulation.
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Affiliation(s)
- M E Cazzaniga
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy.
- Oncology Unit, ASST Monza, Monza, MB, Italy.
| | - I Vallini
- Medical Oncology, ASST Sette Laghi Ospedale Di Circolo E Fondazione Macchi, Varese, VA, Italy
| | - E Montagna
- Medical Senology Division, IEO, Milan, Italy
| | - D Amoroso
- Medical Oncology, Ospedale Versilia, ATNO, Lido Di Camaiore, LU, Italy
| | - R Berardi
- Medical Oncology, Università Politecnica Delle Marche, AOU Ospedali Riuniti, Ancona, Italy
| | - A Butera
- Medical Oncology, Ospedale San Giovanni Di Dio, Agrigento, Italy
| | - K Cagossi
- Medical Oncology, Ospedale Ramazzini, Carpi, Italy
| | - L Cavanna
- Medical Oncology, Azienda Ospedaliera Piacenza, Piacenza, Italy
| | - M Ciccarese
- Medical Oncology, Ospedale Vito Fazzi, Lecce, Italy
| | - S Cinieri
- Medical Oncology, ASL Brindisi, Brindisi, Italy
| | - E Cretella
- Medical Oncology, Ospedale Bolzano, Bolzano, Italy
| | | | - A Febbraro
- Medical Oncology, Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Medical Oncology, Osp Taormina, Taormina, Italy
| | - A Ferzi
- Medical Oncology, A.S.S.T. Ovest Milanese Legnano, Legnano, Italy
| | - A Baldelli
- Medical Oncology, Ospedale San Salvatore, Pesaro, Italy
| | - A Fontana
- Medical Oncology 2, Az. Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A R Gambaro
- Medical Oncology, ASST Fatebenefratelli Sacco, Milano, Italy
| | - O Garrone
- Breast Unit Medical Oncology, A.O. S. Croce e Carle, Cuneo, Italy
| | - V Gebbia
- Medical Oncology, Ospedale La Maddalena, Palermo, Italy
| | - D Generali
- Medical Oncology, Istituti Ospitalieri Cremona, Cremona, Italy
| | - L Gianni
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, Italy
| | - F Giovanardi
- AUSL IRCCS Reggio Emilia Provincial Oncology Unit, Reggio Emilia, Italy
| | - A Grassadonia
- Medical Oncology, P.O. SS Annunziata -ASL2 Lanciano-Vasto, Chieti, Italy
| | - V Leonardi
- Medical Oncology, Ospedale Civico, Palermo, Italy
| | - P Marchetti
- Medical Oncology, A.O. Sant'Andrea, Roma, Italy
| | - S Sarti
- IRCCS Istituto Romagnolo per lo studio dei Tumori (IRST) "Dino Amadori", 47014, Meldola, Italy
| | - A Musolino
- Department of Medicine and Surgery, Medical Oncology and Breast Unit, University of Parma and University Hospital of Parma, Parma, Italy
| | - M Nicolini
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, Italy
| | - C Putzu
- Medical Oncology, A. Ospedaliera-Universitaria, Sassari, Italy
| | - F Riccardi
- Medical Oncology, A. Ospedaliera Antonio Cardarelli, Napoli, Italy
| | - D Santini
- Medical Oncology, Università Campus Bio-Medico, Roma, Italy
| | - S Saracchini
- Medical Oncology, Az. Osp. Santa Maria degli Angeli, Pordenone, Italy
| | - M G Sarobba
- Medical Oncology, Ospedale San Francesco, Nuoro, Italy
| | - M G Schintu
- Medical Oncology, Osp Giovanni Paolo II, Olbia, Italy
| | | | - P Spadaro
- Medical Oncology, Casa di Cura Villa Salus-Messina, Messina, Italy
| | - C Taverniti
- Medical Oncology, A.O.U. Città della Salute e della Scienza, Osp. Molinette, Torino, Italy
| | - D Toniolo
- Medical Oncology, ASST Rhodense, Ospedale di Circolo Rho, Rho, Italy
| | - P Tralongo
- Medical Oncology, Osp. Umberto I, Siracusa, Italy
| | - A Turletti
- Medical Oncology, P.O. Martini, Torino, Italy
| | - R Valenza
- Medical Oncology, P.O. Vittorio Emanuele, Gela, Italy
| | - M R Valerio
- Department of Discipline Chirurgiche, Oncologiche e Stomatologiche (DICHIRONS), Medical Oncology, A.O.U. Policlinico Paolo Giaccone, Palermo, Italy
| | - P Vici
- Phase IV trials, IRCCS, INT Regina Elena, Rome, Italy
| | - P Di Mauro
- Oncology Unit, ASST Monza, Monza, MB, Italy
| | - V Cogliati
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - S Capici
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - L Clivio
- Oncology Department, IRCCS Mario Negri Institute, Milan, Italy
| | - V Torri
- Oncology Department, IRCCS Mario Negri Institute, Milan, Italy
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Liotta G, Madaro O, Scarcella P, Inzerilli MC, Frattini B, Riccardi F, Accarino N, Mancinelli S, Terracciano E, Orlando S, Marazzi MC. Assessing the Impact of A Community-Based Pro-Active Monitoring Program Addressing the need for Care of Community-Dwelling Citizens aged more than 80: Protocol for a Prospective Pragmatic Trial and Results of the Baseline Assessment. Transl Med UniSa 2021. [PMID: 34447708 PMCID: PMC8370536 DOI: 10.37825/2239-9747.1004] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this paper is to describe the protocol of a study assessing the impact of a Community-based pro-Active Monitoring Program, by measuring the effect in counteracting the adverse outcomes related to frailty. Methods a prospective pragmatic trial will be carried out to describe the impact of an intervention on people aged>80, adjusted for relevant parameters: demographic variables, comorbidities, disability and bio-psycho-social frailty. They have been assessed with the Functional Geriatric Evaluation questionnaire that is a validated tool. Mortality, Acute Hospital Admission rates, Emergency Room Visit rates and Institutionalization rates are the main outcomes to be evaluated annually, over three years. Two groups of patients, made up by 578 cases (undergoing the intervention under study) and 607 controls have been enrolled and interviewed. Results at baseline the two groups are quite similar for age, living arrangement, comorbidity, disability and cognitive status. They differ in education, economic resources and physical status (that are better in the control group) and in social resources (that is better in the case group). The latter was expected since the intervention is focused on increasing social capital at individual and community level and aimed at improving survival among the cases as well as reducing the recourse to hospital and residential Long Term Care. Conclusion The proposed study addresses a crucial issue: assessing the impact of a bottom up care service consisting of social and health interventions aimed at reducing social isolation and improving access to health care services.
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Affiliation(s)
- G Liotta
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - O Madaro
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - P Scarcella
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - M C Inzerilli
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - B Frattini
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - F Riccardi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - N Accarino
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - S Mancinelli
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - E Terracciano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - S Orlando
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - M C Marazzi
- LUMSA University, Via della Traspontina 21, 00193, Rome, Italy
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Gelsomino F, Tiseo M, Barbieri F, Riccardi F, Cavanna L, Frassoldati A, Delmonte A, Longo L, Dazzi C, Cinieri S, Colantonio I, Sperandi F, Lamberti G, Brocchi S, Tofani L, Boni L, Ardizzoni A. Correction to: Phase 2 study of NAB-paclitaxel in SensiTivE and refractory relapsed small cell lung cancer (SCLC) (NABSTER TRIAL). Br J Cancer 2021; 125:306. [PMID: 34012035 PMCID: PMC8292309 DOI: 10.1038/s41416-021-01439-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Schettini F, Conte B, Buono G, De Placido P, Parola S, Griguolo G, Fabi A, Bighin C, Riccardi F, Cianniello D, De Laurentiis M, Puglisi F, Pelizzari G, Bonotto M, Russo S, Frassoldati A, Pazzola A, Montemurro F, Lambertini M, Guarneri V, Cognetti F, Locci M, Generali D, Conte P, De Placido S, Giuliano M, Arpino G, Del Mastro L. T-DM1 versus pertuzumab, trastuzumab and a taxane as first-line therapy of early-relapsed HER2-positive metastatic breast cancer: an Italian multicenter observational study. ESMO Open 2021; 6:100099. [PMID: 33819752 PMCID: PMC8047485 DOI: 10.1016/j.esmoop.2021.100099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/06/2021] [Accepted: 02/27/2021] [Indexed: 02/06/2023] Open
Abstract
Background The current standard first-line treatment of human epidermal growth factor receptor 2 (HER2)-positive (+) metastatic breast cancer is the combination of pertuzumab, trastuzumab and a taxane (P + T + taxane), while standard second-line is ado-trastuzumab-emtansine (T-DM1). The registration trial of pertuzumab, however, did not include early-relapsing patients, defined as patients experiencing tumor relapse ≤12 months from the end of (neo)adjuvant anti-HER2 therapy. Conversely, the pivotal trial of T-DM1 included some patients relapsing ≤6 months after the end of (neo)adjuvant trastuzumab. Thus, a proportion of early-relapsing patients are currently eligible to receive T-DM1 as first-line treatment. Nevertheless, no direct comparison exists between the two regimens in this clinical setting. Patients and methods We retrospectively compared T-DM1 versus P + T + taxane as first-line treatment in two cohorts of early-relapsing patients in an Italian ‘real-world’ setting, involving 14 public health care institutions. The primary endpoint was progression-free survival. Secondary endpoints included patients' characterization, overall survival and post-progression survival. Univariate and multivariate analyses were carried out. All tests were two-sided and a P ≤ 0.05 was considered statistically significant. Results Among 1252 screened patients, 75 met the inclusion criteria. Forty-four (58.7%) received P + T + taxane and 31 (41.3%) received T-DM1. The two cohorts showed similar characteristics of aggressiveness and no significant differences in treatment history. T-DM1, compared with P + T + taxane was associated with worse progression-free survival (adjusted hazard ratio: 2.26, 95% confidence interval: 1.13-4.52, P = 0.021) and overall survival (adjusted hazard ratio: 3.95, 95% confidence interval: 1.38-11.32, P = 0.010), irrespective of previous (neo)adjuvant treatment, age, hormone receptors status, time-to-relapse (≤6 months or within 6-12 months) and presence of visceral/brain metastases. No differences were observed in post-progression survival (P = 0.095). Conclusions Our study suggests superiority for P + T + taxane over T-DM1 as up-front treatment of early-relapsing HER2+ metastatic breast cancer, which merits further assessment in larger and prospective trials. This is the first study comparing pertuzumab + trastuzumab + taxane (P + T + taxane) with T-DM1 in early-relapsing HER2+ MBC. The majority of early-relapsing HER2+ MBC have high-grade, node-positive, large primary tumors. First-line T-DM1 compared with P + T + taxane is associated with worse progression-free survival. First-line T-DM1 compared with P + T + taxane is associated with worse overall survival. Post-progression survival does not differ between the two treatments cohorts.
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Affiliation(s)
- F Schettini
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy; Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain.
| | - B Conte
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Medical Oncology Unit 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G Buono
- Oncology Unit, San Rocco Hospital, Sessa Aurunca, Italy
| | - P De Placido
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - S Parola
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - G Griguolo
- Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy
| | - A Fabi
- Division of Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - C Bighin
- Medical Oncology Unit 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - F Riccardi
- Medical Oncology, 'A. Cardarelli' Hospital, Naples, Italy
| | - D Cianniello
- National Cancer Institute Fondazione 'G. Pascale', Naples, Italy
| | - M De Laurentiis
- National Cancer Institute Fondazione 'G. Pascale', Naples, Italy
| | - F Puglisi
- Department of Medicine (DAME), University of Udine, Udine, Italy; Department of Clinical Oncology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - G Pelizzari
- Department of Clinical Oncology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - M Bonotto
- Department of Oncology, ASUFC University Hospital, Udine, Italy
| | - S Russo
- Department of Oncology, ASUFC University Hospital, Udine, Italy
| | - A Frassoldati
- Oncology Unit, University Hospital St. Anna, Ferrara, Italy
| | - A Pazzola
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | - F Montemurro
- Depertment of Medical Oncology, Candiolo Cancer Institute, Candiolo, Italy
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy; Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - V Guarneri
- Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy
| | - F Cognetti
- Department of Clinic and Molecular Medicine, 'La Sapienza' University of Rome, Rome, Italy
| | - M Locci
- Department of Neuroscience, Reproductive Medicine, Odontostomatology, University of Naples 'Federico II', Naples, Italy
| | - D Generali
- Breast Cancer Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy; Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - P Conte
- Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy
| | - S De Placido
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - M Giuliano
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - G Arpino
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - L Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy; U.O.S.D. Breast Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Romano FJ, Barbato C, Biglietto M, Di Lauro V, Arundine D, Fiorentino R, Ambrosio F, Cammarota M, Chiurazzi B, Puglia L, Scagliarini S, Ruocco R, Mocerino C, Cerillo I, Brangi MF, Riccardi F. Folinic acid in colorectal cancer: esquire or fellow knight? Real-world results from a mono institutional, retrospective study. Oncotarget 2021; 12:221-229. [PMID: 33613849 PMCID: PMC7869580 DOI: 10.18632/oncotarget.27872] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/07/2021] [Indexed: 11/25/2022] Open
Abstract
The stock of therapeutic weapons available in metastatic colorectal cancer (mCRC) has been progressively grown over the years, with improving both survival and patients' clinical outcome: notwithstanding advances in the knowledge of mCRC biology, as well as advances in treatment, fluoropyrimidine antimetabolite drugs have been for 30 years the mainstay of chemotherapy protocols for this malignancy. 5-Fluorouracil (5FU) seems to act differently depending on administration method: elastomer-mediated continuous infusion better inhibits Thymidylate Synthase (TS), an enzyme playing a pivotal role in DNA synthetic pathway. TS overexpression is an acknowledged poor prognosis predicting factor. The simultaneous combination of 5FU and folinate salt synergistically strengthens fluorouracil cytotoxic effect. In our experience, levofolinate and 5FU together in continuous infusion prolong progression free survival of patients suffering from mCRC, moreover decreasing death risk and showing a clear clinical benefit for patients, irrespective of RAS mutational status, primitive tumor side and metastases surgery.
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Affiliation(s)
| | | | | | - Vincenzo Di Lauro
- Federico II University, Department of Medicine and Surgery, Oncology Unit, Naples, Italy
| | - Dario Arundine
- Federico II University, Department of Medicine and Surgery, Oncology Unit, Naples, Italy
| | | | | | | | | | - Livio Puglia
- Antonio Cardarelli Hospital, Oncology Unit, Naples, Italy
| | | | | | | | - Ivana Cerillo
- Antonio Cardarelli Hospital, Oncology Unit, Naples, Italy
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Terracciano E, Gentili S, Madaro O, Curti E, Inzerilli MC, Albanese L, Accarino N, Tardi A, Orlando S, Riccardi F, Palombi L, Marazzi MC, Liotta G. The effect of community nurse on mortality and hospi- talization in a group of over-75 older adults: a nested case-control study. Ann Ig 2020; 33:487-498. [PMID: 33300943 DOI: 10.7416/ai.2020.2398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Bio-psycho-social frailty can negatively affect the health status of an ageing population. The integration between community nurses and social services can emphasize community care and prevent the onset of both health and social negative outcomes in the older population. The aim of the paper is to explore the causal association through the analysis of the hospitalization and mortality rate after a pro-active social service integrated by the community nurse. Study Design A nested case-control study comparing groups of older adults has been carried out. Methods. The paper compares data stem from a cohort followed up by the University of Rome "Tor Vergata" with data from the "Long Live the Elderly!" program (LLE) cohort. Results One-year standardized mortality rate was 6.5%, 4.7% and 7.5% in the control group, the LLE group and the LLE group integrated by the community nurse (LLE-CN), respectively. One-year hospitalization rate was 15.4%, 15.5% and 10.8% in the control group, the LLE group and the LLE-CN group, respectively. Conclusions According to our results a social service with a pro-active approach, integrated by the community nurse, appears to be able to reduce mortality and hospitalization in a group of older adults aged>75. The multidimensional assessment of frailty stands for the first step of a new organization of community services.
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Affiliation(s)
- E Terracciano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - S Gentili
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - O Madaro
- Community of Sant'Egidio, "Long Live the Elderly!" program; ASL Roma 3, Rome, Italy
| | - E Curti
- Master of Nursing Sciences, University of Rome "Tor Vergata", Rome, Italy
| | - M C Inzerilli
- Community of Sant'Egidio, "Long Live the Elderly!" program; ASL Roma 3, Rome, Italy
| | - L Albanese
- Master of Nursing Sciences, University of Rome "Tor Vergata", Rome, Italy
| | - N Accarino
- Community of Sant'Egidio, "Long Live the Elderly!" program; ASL Roma 3, Rome, Italy
| | - A Tardi
- Master of Nursing Sciences, University of Rome "Tor Vergata", Rome, Italy
| | - S Orlando
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - F Riccardi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - L Palombi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | | | - G Liotta
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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Ciccarese M, Orlando L, Fedele P, Schiavone P, Maiello E, Cilenti G, Aieta M, Bozza G, Forcignanò R, Febbraro A, Bordonaro R, Romito S, Rinaldi A, Borsellino N, Riccardi F, Pisconti S, Lorusso V, Colucci G, Surico G, Saracino V, Cinieri S. A multicenter phase II trial of nab‐paclitaxel and capecitabine in HER‐2 negative and triple‐ negative advanced breast cancer: Could be an old regimen a valid approach to a changing disease? Breast J 2020; 26:1857-1859. [DOI: 10.1111/tbj.13856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 12/01/2022]
Affiliation(s)
| | - Laura Orlando
- Medical Oncology & Breast Unit Ospedale "A. Perrino" Brindisi Italy
| | - Palma Fedele
- Medical Oncology & Breast Unit Ospedale "A. Perrino" Brindisi Italy
| | - Paola Schiavone
- Medical Oncology & Breast Unit Ospedale "A. Perrino" Brindisi Italy
| | - Evaristo Maiello
- Oncology Unit IRCCS "Casa Sollievo della Sofferenza" S. Giovanni Rotondo Italy
| | - Giuseppina Cilenti
- Oncology Unit IRCCS "Casa Sollievo della Sofferenza" S. Giovanni Rotondo Italy
| | - Michele Aieta
- Division of Medical Oncology IRCCS Rionero in Vulture Italy
| | - Giovanni Bozza
- Division of Medical Oncology IRCCS Rionero in Vulture Italy
| | | | | | | | - Sante Romito
- Division of Medical Oncology "Ospedali Riuniti" Foggia Italy
| | - Antonio Rinaldi
- Division of Medical Oncology "Presidio OspedalieroOccidentale" Castellaneta Italy
| | - Nicolo' Borsellino
- Division of Medical Oncology "Buccheri La Ferla‐Fatebenefratelli" Hospital Palermo Italy
| | | | | | - Vito Lorusso
- Medical Oncology IRCCS Ospedale Oncologico Giovanni Paolo II Bari Italy
| | - Giuseppe Colucci
- Medical Oncology IRCCS Ospedale Oncologico Giovanni Paolo II Bari Italy
| | - Giammarco Surico
- Oncology Unit Ospedale Generale “F. Miulli” Acquaviva delle Fonti Italy
| | - Valeria Saracino
- Division of Medical Oncology & Breast Unit Ospedale “Vito Fazzi” Lecce Italy
| | - Saverio Cinieri
- Medical Oncology & Breast Unit Ospedale "A. Perrino" Brindisi Italy
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22
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Napolitano M, Ranieri A, Maniscalco GT, Riccardi F, De Dominicis G, Caiazzo P. Brain Radionecrosis After Adjuvant Radiation Therapy for a Primary Intracerebral Undifferentiated Sarcoma. World Neurosurg 2020; 143:285-288. [PMID: 32763370 DOI: 10.1016/j.wneu.2020.07.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/03/2020] [Accepted: 07/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Primary intracranial sarcomas of the central nervous system are rare tumors. They mainly arise from intracranial mesenchymal tissue present in the meninges and can occur at any age. Sometimes osteosarcoma can involve the skull rather than long body bones. In this latter case it is the more common subtype. Surgery, when possible, is a mandatory option often associated with radiation therapy (RT) and chemotherapy. Brain radionecrosis (BRN) is commonly observed due to the growing use of radiosurgery and higher cumulative doses of radiation therapy. The combination of perfusion magnetic resonance imaging and 18fluoro-deoxy-glucose positron emission tomography can help to differentiate tumor progression from radiation injury. Steroids, anticoagulants, and bevacizumab usually control BRN. However, BRN can also have an unfavorable course. CASE DESCRIPTION Here, we present a case of a 60-year-old male who underwent surgery for a brain tumor. The examination showed a primary undifferentiated high-grade sarcoma. Adjuvant RT was given with a total dose of 60 Gy. Six months later, the patient underwent a second surgery that revealed a BRN progressing despite different pharmacologic attempts. CONCLUSIONS Primary intracranial sarcomas of the central nervous system are less prevalent among older adults with respect to the younger population. The use of RT alone or combined with chemotherapy is aimed at prolonging survival. However, it is not clearly defined if adjuvant treatments affect this parameter in older patients. RT should be carefully discussed owing to its potential severe neurologic toxicity. Indeed, a BRN can have a significant impact on quality of life and lead to death in certain cases.
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Affiliation(s)
- Massimo Napolitano
- Neurology Division, Neuro-Oncology Service, Cardarelli Hospital, Naples, Italy.
| | - Angelo Ranieri
- Neurology Division, Neuro-Oncology Service, Cardarelli Hospital, Naples, Italy
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23
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Sciammarella C, Luce A, Riccardi F, Mocerino C, Modica R, Berretta M, Misso G, Cossu AM, Colao A, Vitale G, Necas A, Fedacko J, Galdiero M, Correale P, Faggiano A, Caraglia M, Capasso A, Grimaldi A. Lanreotide Induces Cytokine Modulation in Intestinal Neuroendocrine Tumors and Overcomes Resistance to Everolimus. Front Oncol 2020; 10:1047. [PMID: 32766136 PMCID: PMC7379869 DOI: 10.3389/fonc.2020.01047] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
Somatostatin analogs mantain their major role in the treatment of patients with advanced neuroendocrine tumors (NETs) and have multiple modulatory effects on the immune system. Here, we evaluated the effects of lanreotide treatment on expression of Th1, Th2 cytokine patterns in serum of patients with NETs and in bronchial and pancreatic NET cell lines. Our results showed that lanreotide treatment promoted a Th1 cytotoxic immune-phenotype in patients with NETs originated by intestinal sites. Similar results were obtained also in vitro where lanreotide induced expression of Th1 cytokines only in pancreatic and not in bronchial-derived NET cell lines. It seems, therefore, that cytokinomics can represent a useful tool for the identification of tumor biomarkers for the early diagnosis and evaluation of the response to therapy in NET patients. To avoid the drug-resistance induced by everolimus (mTOR inhibitor), we made the pancreatic NET cell line resistant to this drug. After treatment with lanreotide we found that the drug reduced its viability compared to that of sensitive cells. These data may have direct implications in design of future translation combination trial on NET patients.
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Affiliation(s)
- Concetta Sciammarella
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Clinical Medicine and Surgery, University "Federico II" of Naples, Naples, Italy
| | - Amalia Luce
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | | | - Roberta Modica
- Department of Clinical Medicine and Surgery, University "Federico II" of Naples, Naples, Italy
| | - Massimiliano Berretta
- Department of Medical Oncology, Centro di Riferimento Oncologico, Istituto Nazionale Tumori CRO, Aviano, Italy
| | - Gabriella Misso
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessia Maria Cossu
- Laboratory of Precision and Molecular Oncology, Institute of Genetic Research, Biogem Scarl, Avellino, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University "Federico II" of Naples, Naples, Italy
| | - Giovanni Vitale
- Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Alois Necas
- CEITEC - Central European Institute of Technology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czechia
| | - Jan Fedacko
- 1st Department of Internal Medicine, Centre of Excellency for Atherosclerosis Research, University of Pavol Jozef Safarik, Košice, Slovakia
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pierpaolo Correale
- Medical Oncology Unit, "Bianchi-Melacrino-Morelli" Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Antongiulio Faggiano
- Department of Experimental Medicine, Division of Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Michele Caraglia
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Laboratory of Precision and Molecular Oncology, Institute of Genetic Research, Biogem Scarl, Avellino, Italy
| | - Anna Capasso
- Department of Oncology, Livestrong Cancer Institutes, Dell Medical School, The University of Texas, Austin, TX, United States
| | - Anna Grimaldi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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24
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Gelsomino F, Tiseo M, Barbieri F, Riccardi F, Cavanna L, Frassoldati A, Delmonte A, Longo L, Dazzi C, Cinieri S, Colantonio I, Sperandi F, Lamberti G, Brocchi S, Tofani L, Boni L, Ardizzoni A. Phase 2 study of NAB-paclitaxel in SensiTivE and refractory relapsed small cell lung cancer (SCLC) (NABSTER TRIAL). Br J Cancer 2020; 123:26-32. [PMID: 32346071 PMCID: PMC7341887 DOI: 10.1038/s41416-020-0845-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 03/14/2020] [Accepted: 04/01/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Despite sensitivity to first-line chemotherapy, most small-cell lung cancer (SCLC) patients relapse. In this setting, topotecan demonstrated modest activity with significant toxicity. Paclitaxel was also active. This study was designed to evaluate activity and safety of nab-paclitaxel in relapsed SCLC. METHODS In this multicentre prospective Phase 2 trial, patients with refractory or sensitive SCLC progressed to first-line platinum-based chemotherapy received nab-paclitaxel 100 mg/smq on days 1, 8, 15 every 4 weeks up to six cycles, progressive disease or intolerable toxicity. Primary endpoint was investigator-assessed objective tumour response. Secondary endpoints were toxicity, progression-free survival (PFS) and overall survival (OS). RESULTS Of the 68 patients treated, partial response was 8% in the refractory cohort and 14% in the sensitive cohort. Most common toxicities of any grade were fatigue (54%), anaemia (38%), neutropenia (29%), leukopenia (26%) and diarrhoea (21%). Median PFS was similar in both refractory (1.8 months) and sensitive cohorts (1.9 months), while median OS was longer in sensitive one (6.6 versus 3.6 months). CONCLUSIONS Although nab-paclitaxel has shown some modest anti-tumour activity in relapsed SCLC, associated with a favourable toxicity profile, the primary end-point of the study was not met. CLINICAL TRIAL REGISTRATION Clinical Trial registration number is ClinicalTrials.gov Identifier: NCT03219762.
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Affiliation(s)
| | - Marcello Tiseo
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy.
| | | | | | - Luigi Cavanna
- Medical Oncology Unit, AUSL of Piacenza, Piacenza, Italy
| | - Antonio Frassoldati
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Angelo Delmonte
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Lucia Longo
- Medical Oncology Unit, AUSL of Modena, Hospital of Carpi, Carpi, Italy
| | - Claudio Dazzi
- Medical Oncology Unit, AUSL of Romagna, Hospital of Ravenna, Ravenna, Italy
| | - Saverio Cinieri
- Medical Oncology Unit, Hospital of Brindisi, Brindisi, Italy
| | | | | | - Giuseppe Lamberti
- Medical Oncology Unit, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Stefano Brocchi
- Radiology Unit, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Lorenzo Tofani
- Clinical Trial Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
| | - Luca Boni
- Clinical Trial Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
| | - Andrea Ardizzoni
- Medical Oncology Unit, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
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25
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Prete SD, Montella L, Arpino G, Buono G, Buonerba C, Dolce P, Fiorentino O, Aliberti M, Febbraro A, Savastano C, Colantuoni G, Riccardi F, Ruggiero A, Placido SD, Orditura M. Second line trastuzumab emtansine following horizontal dual blockade in a real-life setting. Oncotarget 2020; 11:2083-2091. [PMID: 32547706 PMCID: PMC7275781 DOI: 10.18632/oncotarget.27603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022] Open
Abstract
Despite relevant medical advancements, metastatic breast cancer remains an uncurable disease. HER2 signaling conditions tumor behavior and treatment strategies of HER2 expressing breast cancer. Cancer treatment guidelines uniformly identify dual blockade with pertuzumab and trastuzumab plus a taxane as best first line and trastuzumab emtansine as preferred second line choice. However, there is no prospectively designed available study focusing on the sequence and outcomes of patients treated with T-DM1 following the triplet. In the following report, data concerning a wide series of patients treated in a real-life setting are presented. Results obtained in terms of response and median progression free survival suggests a significant role for T-DM1 in disease control of metastatic HER2 expressing breast cancer.
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Affiliation(s)
- Salvatore Del Prete
- Medical Oncology Unit "San Giovanni di Dio" Hospital, Frattamaggiore, Naples 80027, Italy
| | - Liliana Montella
- Medical Oncology Unit "Santa Maria delle Grazie" Hospital, Pozzuoli, Naples 80078, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples 80131, Italy
| | - Giuseppe Buono
- Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples 80131, Italy
| | - Carlo Buonerba
- Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples 80131, Italy
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, Naples 80131, Italy
| | - Olga Fiorentino
- Medicina Futura Group, via Alcide de Gasperi, Acerra, Naples 80011, Italy
| | - Maria Aliberti
- Medicina Futura Group, via Alcide de Gasperi, Acerra, Naples 80011, Italy
| | - Antonio Febbraro
- Medical Oncology Unit, Hospital Sacro Cuore di Gesù Fatebenefratelli, Benevento 82100, Italy
| | - Clementina Savastano
- Medical Oncology Unit, San Giovanni di Dio e Ruggi d'Aragona, Salerno 84121, Italy
| | | | | | - Angela Ruggiero
- Medical Oncology Unit "Santa Maria delle Grazie" Hospital, Pozzuoli, Naples 80078, Italy
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples 80131, Italy
| | - Michele Orditura
- Division of Medical Oncology, Department of Precision Medicine, School of Medicine, University of Study of Campania "Luigi Vanvitelli", Naples 80131, Italy
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26
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Vitale MG, Barbato C, Crispo A, Habetswallner F, De Martino BM, Riccardi F, Maione A, Eisenwagen S, Vitale G, Cartenì G. ZeOxaNMulti Trial: A Randomized, Double-Blinded, Placebo-Controlled Trial of Oral PMA-zeolite to prevent Chemotherapy-Induced Side Effects, in particular, Peripheral Neuropathy. Molecules 2020; 25:molecules25102297. [PMID: 32414185 PMCID: PMC7288011 DOI: 10.3390/molecules25102297] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 01/22/2023] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is the most frequently reported adverse effect of oxaliplatin. In this study, we set out to evaluate the role of the panaceo-micro-activation (PMA) zeolite in the reduction of the incidence of CIPN and hematological and liver toxicity. The possible impact of the PMA-zeolite as an adjuvant therapeutic agent is based on its detoxification properties toward agents promoting the development of neuropathy (e.g., ammonium—recognized as a neurotoxic agent produced by tumors), as well as its positive impact on immunity and oxidative stress through its effects in the gastrointestinal tract. From April 2015 to October 2018, a total of 120 patients (pts) diagnosed with predominantly colorectal cancer requiring oxaliplatin-based chemotherapy were randomized to receive either the PMA-zeolite (Multizeo Med) or placebo while undergoing oxaliplatin-based chemotherapy. A nerve-conduction study (NCS) was planned at the baseline, after three and six months of chemotherapy, to evaluate CIPN. Furthermore, the evaluation of hematological and liver toxicity was performed during every cycle of chemotherapy. 70.6% and 64.3% of patients developed CIPN in the placebo and the PMA-zeolite group, respectively. Patients treated with the PMA-zeolite were able to undergo more cycles of chemotherapy (p = 0.03), which also indicates a significant improvement in tolerance to the therapy. The group treated with the PMA-zeolite showed a lower CIPN (although not statistically significant within the whole group of subjects) compared to patients receiving placebo. This advantage was, however, statistically significant in men (p = 0.047). In addition, supplementation with the PMA-zeolite resulted in a lower incidence of severe-grade hematological toxicity (trend toward statistical significance of p = 0.09 was observed). Cancer patients may benefit from the therapy with the appropriate certified zeolite-products (e.g., the PMA-zeolite) for human use in CIPN. The lower CIPN (statistically significant results in the male subgroup) was accompanied by a trend of lower incidence of severe-grade hematological toxicity. Furthermore, these benefits led to a better tolerance toward chemotherapy (increase in cycles) and allow an improved compliance with the oncological treatment protocol.
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Affiliation(s)
- Maria Giuseppa Vitale
- Medical Oncology Unit, University Hospital of Modena, 41125 Modena, Italy
- Correspondence:
| | - Carmela Barbato
- Medical Oncology Unit, AORN Antonio Cardarelli, 80131 Naples, Italy; (C.B.); (F.R.); (A.M.); (G.C.)
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy;
| | | | | | - Ferdinando Riccardi
- Medical Oncology Unit, AORN Antonio Cardarelli, 80131 Naples, Italy; (C.B.); (F.R.); (A.M.); (G.C.)
| | - Angela Maione
- Medical Oncology Unit, AORN Antonio Cardarelli, 80131 Naples, Italy; (C.B.); (F.R.); (A.M.); (G.C.)
| | | | - Giovanna Vitale
- School of Medicine and Surgery, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy;
| | - Giacomo Cartenì
- Medical Oncology Unit, AORN Antonio Cardarelli, 80131 Naples, Italy; (C.B.); (F.R.); (A.M.); (G.C.)
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27
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Cazzaniga ME, Verusio C, Ciccarese M, Fumagalli A, Sartori D, Valerio MR, Airoldi M, Moretti G, Ficorella C, Gianni L, Michelotti A, Zambelli A, Febbraro A, Generali D, Pistelli M, Garrone O, Musolino A, Vici P, Maur M, Mentuccia L, La Verde N, Bianchi GV, Artale S, Blasi L, De Laurentiis M, Atzori F, Turletti A, Porpiglia M, Santini D, Fabi A, Gebbia V, Schirone A, Palumbo R, Ferzi A, Frassoldati A, Scavelli C, Clivio L, Giordano M, Donadio M, Biganzoli L, Del Mastro L, Bisagni G, Livi L, Natoli C, Montemurro F, Riccardi F, Romagnoli E, Marchetti P, Torri V, Pronzato P, Mustacchi G. Is There Still a Role for Endocrine Therapy Alone in HR+/HER2- Advanced Breast Cancer Patients? Results from the Analysis of Two Data Sets of Patients Treated with High-Dose Fulvestrant as First-Line Therapy in the Real-World Setting: The EVA and GIM-13 AMBRA Studies. Breast Care (Basel) 2020; 15:30-37. [PMID: 32231495 DOI: 10.1159/000495469] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 11/15/2018] [Indexed: 11/19/2022] Open
Abstract
Background Different studies suggest that fulvestrant 500 mg every 28 days (HD-FUL) could be an active treatment in HR+ advanced breast cancer (ABC) patients even treated with aromatase inhibitors in the adjuvant setting. The aim of this analysis is to describe the outcome of ABC patients treated with HD-FUL as first-line treatment in terms of median duration of treatment and the overall response rate in a real-world setting. Methods For the purpose of the present analysis, we considered two data sets of HR+ ABC patients collected in Italy between 2012 and 2015 (EVA and GIM-13 AMBRA studies). Results Eighty-one and 91 patients have been identified from the two data sets. The median age was 63 years (range 35-82) for the EVA and 57.8 years (range 35.0-82.3) for the AMBRA patients. ORRs were 23.5 and 24.3% in the whole population, 26.9% in the patients with bone only, and 21.8 and 21.4% in those with visceral metastases. The median duration of HD-FUL was 11.6 months (range 1-48) and 12.4 months (range 2.9-70.0) in the two data sets, respectively. Conclusion These data suggest that HD-FUL should still continue to play a significant role as first-line therapy in HR+ ABC patients.
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Affiliation(s)
- Marina Elena Cazzaniga
- Research Unit Phase I Trials, ASST Monza, Monza, Italy.,Oncology Unit, ASST Monza, Monza, Italy
| | - Claudio Verusio
- Oncology Unit, ASST della Valle Olona - Presidio Ospedaliero di Saronno, Saronno, Italy
| | | | | | | | | | - Mario Airoldi
- Oncology Unit 2 - Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gabriella Moretti
- Oncology Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Corrado Ficorella
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche (DISCAB) - Università Degli Studi Dell'Aquila, L'Aquila, Italy
| | - Lorenzo Gianni
- Oncology Unit Rimini, Azienda USL Romagna, Rimini, Italy
| | - Andrea Michelotti
- Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | - Antonio Febbraro
- Oncology Unit, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Italy
| | | | - Mirco Pistelli
- Oncology Unit, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Ornella Garrone
- Oncology Unit, A.O.S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Antonino Musolino
- Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Patrizia Vici
- Oncology Unit 2, Istituto Nazionale Tumori Regina Elena - IFO, Rome, Italy
| | - Michela Maur
- Oncology Unit, Policlinico University Hospital of Modena, Modena, Italy
| | - Lucia Mentuccia
- Oncology Unit, ASL di Frosinone, Osp. "SS. Trinità", Sora, Italy
| | - Nicla La Verde
- Oncology Unit, ASST Fatebenefratelli Sacco Presidio Ospedaliero Fatebenefratelli, Milan, Italy
| | | | - Salvatore Artale
- Oncology Departement, Ospedale di Gallarate, ASST Valle Olona, Gallarate, Italy
| | - Livio Blasi
- Oncology Unit, ARNAS Civico Palermo, Palermo, Italy
| | | | | | | | - Mauro Porpiglia
- Oncology Unit, ASST della Valle Olona - Presidio Ospedaliero di Saronno, Saronno, Italy
| | | | - Alessandra Fabi
- Oncology Unit, Ospedale Moriggia Pelascini, Gravedona, Italy
| | | | - Alessio Schirone
- Oncology Department, Policlinico "Paolo Giaccone", Palermo, Italy
| | - Raffaella Palumbo
- Oncology Unit 2 - Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonella Ferzi
- Oncology Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Antonio Frassoldati
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche (DISCAB) - Università Degli Studi Dell'Aquila, L'Aquila, Italy
| | | | - Luca Clivio
- Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | - Michela Donadio
- Oncology Unit, Ospedale Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Italy
| | | | | | - Giancarlo Bisagni
- Oncology Unit, A.O.S. Croce e Carle Ospedale di Insegnamento, Cuneo, Italy
| | - Lorenzo Livi
- Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Clara Natoli
- Oncology Unit 2, Istituto Nazionale Tumori Regina Elena - IFO, Rome, Italy
| | | | | | - Emanuela Romagnoli
- Oncology Unit, ASST Fatebenefratelli Sacco Presidio Ospedaliero Fatebenefratelli, Milan, Italy
| | - Paolo Marchetti
- Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Valter Torri
- Oncology Unit 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Paolo Pronzato
- Oncology Departement, Ospedale di Gallarate, ASST Valle Olona, Gallarate, Italy
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28
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Benzaquen M, Fareau J, Riccardi F, Philip‐Sarles N, Bertrand F, Berbis P, Delaporte E. Multiple venous malformations revealing a familial cerebral cavernomatosis. Clin Exp Dermatol 2020; 45:263-264. [DOI: 10.1111/ced.14051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2019] [Indexed: 11/26/2022]
Affiliation(s)
- M. Benzaquen
- Department of Dermatology Aix Marseille University, APHM, Hôpital Nord Marseille France
| | - J. Fareau
- Department of Dermatology Aix Marseille University, APHM, Hôpital Nord Marseille France
| | - F. Riccardi
- Department of Genetics and Molecular Biology Aix Marseille University, APHM, Hôpital Timone Enfants Marseille France
| | - N. Philip‐Sarles
- Department of Genetics and Molecular Biology Aix Marseille University, APHM, Hôpital Timone Enfants Marseille France
| | - F. Bertrand
- Dermatological Center Aix‐en‐Provence France
| | - P. Berbis
- Department of Dermatology Aix Marseille University, APHM, Hôpital Nord Marseille France
| | - E. Delaporte
- Department of Dermatology Aix Marseille University, APHM, Hôpital Nord Marseille France
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29
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Cazzaniga ME, De Placido S, D'Alonzo A, Piezzo M, Natoli C, Milani A, Bologna A, Alu M, Turletti A, Pugliese P, Biganzoli L, De Angelis C, Garrone O, Marchetti P, Riccardi F, Bernardo A, Livi L, Fabi A, Taverniti C, Romagnoli E, Pronzato P, Mustacchi G. Abstract P5-07-10: Progression-free survival (PFS) and overall survival (OS) in HER2-ve advanced breast cancer (ABC) patients (pts) according to the molecular subtype in the era of modern agents. Results from the GIM-13 AMBRA study. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-07-10] [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: 11/16/2022]
Abstract
Abstract
BACKGROUND Pts with ABC have a diverse clinical course and OS rates vary significantly among pts. New strategies had potentially changed the natural history of these pts, however data from clinical studies are still lacking and Real-World Studies (RWS) are crucial in clinical outcome evaluation.
PATIENTS AND METHODS AMBRA is a longitudinal cohort study, aiming to describe the choice of first and subsequent lines of treatment in HER2-ve ABC pts receiving at least one CHT (SABCS 2016, P5-15-07 & P5-14-09) in the years 2012-2015. The present analysis is focused on the description of Progression-Free Survival (PFS) and OS according to the biologic subtype in the deceased population. So far, 791/1500 pts have been registered into the study and 255 (32.2%) are evaluable. Time to event analysis between subtypes was evaluated by Cox-Mantel Hazard Ratio and Logrank Test. DFS by Wilcoxon Rank-Sum Test
RESULTS Pts distribution according to molecular subtype was: Luminal A (86, 33.7%), Luminal B (107 (42.1%), TNBC (62, 24.3%). Median ages at diagnosis were 55.8, 52.9 and 55.1 years for the 3 subgroups, respectively. Mean DFS was significantly different according to the molecular subtypes: 87.28, 61.37 and 23.9 months. The difference between Luminal B and TNBC is statistically significant as well. Mean PFS of 1st-line therapy was 17.9 11.7 and 7.8 months respectively. Mean OS from 1stprogression was 32.9 24.2 and 15.8 months respectively.
CONCLUSIONS Our data confirm in a RWS the different biological behaviour between Lum A and B. Metastatic life span is quite good for Luminals and disappointing for TNBC. Median time from last CHT and Death is quite short and similar.
Luminal ALuminal BTNBCMean DFS (months)87.28 [95%CI: 72.9-101.7]61.37 [95%CI: 52.3-70.4] p=0003623.9 months [95%CI: 18.5-29.3] p=0.000000Mean PFS (months)17.9 [95%CI: 12.5-23.5]11.7 [95%CI:9.8-13.7]7.8 months [95%CI: 5.9-9.6]Mean OS from 1st progression (months)32.9 [95%CI:25.4-40.4]24.2 [95%CI: 21.3-26.9]15.8 [95%CI: 13.0-18.6]Median time from last CHT and Death (months)2.231.951.53Lum A/Lum B HR (p value)Lum A/TNBC HR (p value)Lum B/TNBC HR (p value)PFS 1st-Line0.73 (0.02)0.49 (0.0000)0.63 (0.003)OS from diagnosis (years)0.59 (0.0003)0.25 (0.0000)0.34 (0.0000)OS from 1st-PD0.72 (0.02)0.47 (0.0000)0.50 (0.0002)
Citation Format: Marina Elena Cazzaniga, Sabino De Placido, Alessia D'Alonzo, Michela Piezzo, Clara Natoli, Andrea Milani, Alessandra Bologna, Massimiliano Alu, Anna Turletti, Palma Pugliese, Laura Biganzoli, Claudia De Angelis, Ornella Garrone, Paolo Marchetti, Ferdinando Riccardi, Antonio Bernardo, Lorenzo Livi, Alessandra Fabi, Cristiana Taverniti, Emanuela Romagnoli, Paolo Pronzato, Giorgio Mustacchi, on behalf of GIM-13 AMBRA Study Group. Progression-free survival (PFS) and overall survival (OS) in HER2-ve advanced breast cancer (ABC) patients (pts) according to the molecular subtype in the era of modern agents. Results from the GIM-13 AMBRA study [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-07-10.
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Affiliation(s)
| | | | - Alessia D'Alonzo
- 3Ospedale Policlinico San Martino- Oncologia Medica, Napolio, Italy
| | - Michela Piezzo
- 4INT Fondazione Giovanni Pascale-IRCCS -Breast Oncology Unit, Napoli, Italy
| | - Clara Natoli
- 5Dep. of Medical, Oral and Biotechnological Sciences and CeSI-MeT- University G. D'Annunzio, Chieti, Italy
| | - Andrea Milani
- 6Candiolo Cancer Institute, FPO-IRCCS, Torino, Italy
| | | | | | | | | | - Laura Biganzoli
- 11Ospedale Santo Stefano- U.O. Oncologia Medica, Prato, Italy
| | - Claudia De Angelis
- 12Azienda Ospedaliera Universitaria Pisana- Oncologia Medica, Pisa, Italy
| | - Ornella Garrone
- 13Breast Unit, Medical Oncology S.Croce and Carle Teaching Hospital Cuneo, Cuneo, Italy
| | | | | | - Antonio Bernardo
- 16Istituti Clinici Scientifici Maugeri Spa Società Benefit, Pavia, Italy
| | - Lorenzo Livi
- 17AOU Careggi - Radioterapia Oncologica, Firenze, Italy
| | - Alessandra Fabi
- 18Istituto Nazionale Tumori “Regina Elena”- Oncologia Medica 1, Roma, Italy
| | - Cristiana Taverniti
- 19A.O.U. Città della Salute e della Scienza- SSCVD Oncologia Medica Senologica, Torino, Italy
| | | | - Paolo Pronzato
- 21Ospedale Policlinico San Martino- Oncologia Medica, Genova, Italy
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Mustacchi G, Beano A, Fabi A, Livi L, Bernardo A, Riccardi F, Marchetti P, Garrone O, Diodati L, Biganzoli L, Giordano M, Turletti A, Blasi L, Milani A, Natoli C, Riemma M, D'Alonzo A, Arpino G, Pronzato P, Cazzaniga ME. Abstract P2-15-14: Triple negative (TNBC) metastatic breast cancer (MBC) patients (pts): Is chemotherapy (CHT) choice influenced by adjuvant (adj) treatments? Results from the GIM-13 AMBRA study. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-15-14] [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: 11/16/2022]
Abstract
Abstract
Background: TNBC shows a very bad prognosis: median time to relapse is 18 months and median overall survival (OS) is less than 24 months.
Methods: AMBRA is a longitudinal cohort study, describing the choice of 1st- and subsequent treatments in HER2-ve MBC pts in the years 2012-2015. The present analysis is focused on TNBC pts (127 out of 879 evaluable; 14.4%) and CHT strategies, overall and according to adj treatment. Kaplan Meyer probability of survival from primary (DFS), 1st(PFS1) and 2nd(PFS2) progression and Time from last CHT and death were calculated for the whole population and according the main adj regimens.
Results: Median age at primary diagnosis was 53 years. The most used regimens in the adj setting were anthra/taxane(tax) 50.7%, anthra 22.1% or others (CMF included) 20.6%. Median time to events was: DFS 23.2, PFS1 6.5 and PFS2 4.3 months, respectively.
CHT choices in the metastatic setting according to adj treatment were:
Adj Anthra-basedAdj Taxane-basedAdj other1st-lineTax* 57.6% - VRL/CAPE 18.2% - Plat 15.2% Other 3% - None 6.1%Tax* 46.2% - VRL/CAPE 24.6% Plat 24.6% - Other 4.6%Tax*52% - VRL/CAPE 16% - Anthra 16% - Anthra/Tax 8%2nd-lineTax**18.2% - Anthra 13.6% - VRL/CAPE 22.7% - Plat 27.3% - Erib 9.1% - Other 9.1%Tax**22% - VRL/CAPE 22% Plat 22% - Erib 14.6% - Other 17.1%VRL/CAPE 38.5% - Anthra 23.1% - Tax**23.1% - Plat 15.4%3rd lineVRL/CAPE 37.5% - Erib 25% - Anthra 18.8% - Tax***12.5% - Plat 6.3%Erib 26.9% - VRL/CAPE 23.1% - Plat 15.4% - Anthra 11.5% - Tax***11.5% - Other 11.5%VRL/CAPE 42.9% - Erib 28.6% - Plat 14.3% - Other 14.3%*docetaxel 8.4%, nab-paclitaxel 7%, paclitaxel 59%**docetaxel 7%, nab-paclitaxel 71.4%, paclitaxel 21%***docetaxel 20%, nab-paclitaxel 80%At a median follow up of 3.3 years 50% of pts are still alive.
OS rates at 5 and 8 years from primary are 50% and 40%. OS rates from 1st progression are 50% and 20% at 22 and 40 months. Median OS (months) according to 1st line regimen was similar (ns) across the regimens (paclitaxel+bevacizumab: 17.8; Platinum-based: 14.1; CAPE/VRL: 16.3). Median time from last CHT and death was 1.5 months (29.6%< 1 month; 14% < 2 weeks)
Conclusion: Our results show that taxanes play a crucial role in MBC even if used in 50% of Adj. CAPE/VRL, Platinum regimens and Eribuline are also widely used. Time from last CHT administration and Death is very short in 30% of cases
Citation Format: Giorgio Mustacchi, Alessandra Beano, Alessandra Fabi, Lorenzo Livi, Antonio Bernardo, Ferdinando Riccardi, Paolo Marchetti, Ornella Garrone, Lucrezia Diodati, Laura Biganzoli, Monica Giordano, Anna Turletti, Livio Blasi, Andrea Milani, Clara Natoli, Marta Riemma, Alessia D'Alonzo, Grazia Arpino, Paolo Pronzato, Marina E Cazzaniga, on behalf of GIM-13 AMBRA Study Group. Triple negative (TNBC) metastatic breast cancer (MBC) patients (pts): Is chemotherapy (CHT) choice influenced by adjuvant (adj) treatments? Results from the GIM-13 AMBRA study [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-15-14.
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Affiliation(s)
| | - Alessandra Beano
- 2A.O.U. Città della Salute e della Scienza- SSCVD Oncologia Medica Senologica, Torino, Italy
| | - Alessandra Fabi
- 3Istituto Nazionale Tumori “Regina Elena”- Oncologia Medica 1, Roma, Italy
| | - Lorenzo Livi
- 4AOU Careggi - Radioterapia Oncologica, Firenze, Italy
| | | | | | | | - Ornella Garrone
- 8Breast Unit, Medical Oncology S.Croce and Carle Teaching Hospital Cuneo, Trieste, Italy
| | - Lucrezia Diodati
- 9Azienda Ospedaliera Universitaria Pisana- Oncologia Medica, Pisa, Italy
| | - Laura Biganzoli
- 10Ospedale Santo Stefano- U.O. Oncologia Medica, Prato, Italy
| | | | | | - Livio Blasi
- 13ARNAS Civico Palermo-Oncologia Medica, Palermo, Italy
| | - Andrea Milani
- 14Candiolo Cancer Institute, FPO-IRCCS, Torino, Italy
| | - Clara Natoli
- 15Dep. of Medical, Oral and Biotechnological Sciences and CeSI-MeT- University G. D'Annunzio, Chieti, Italy
| | - Marta Riemma
- 16INT Fondazione Giovanni Pascale-IRCCS -Breast Oncology Unit, Napoli, Italy
| | - Alessia D'Alonzo
- 17Ospedale Policlinico San Martino- Oncologia Medica, Genova, Italy
| | - Grazia Arpino
- 18Università degli Studi di Napoli "Federico II"-Dip. Medicina Clinica e Chirurgia – Oncologia, Napoli, Italy
| | - Paolo Pronzato
- 17Ospedale Policlinico San Martino- Oncologia Medica, Genova, Italy
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Lamberti G, Faggiano A, Brighi N, Tafuto S, Ibrahim T, Brizzi MP, Pusceddu S, Albertelli M, Massironi S, Panzuto F, Badalamenti G, Riccardi F, Butturini G, Gelsomino F, De Divitiis C, Modica R, Bongiovanni A, La Salvia A, Torchio M, Colao A, Ferone D, Campana D. Nonconventional Doses of Somatostatin Analogs in Patients With Progressing Well-Differentiated Neuroendocrine Tumor. J Clin Endocrinol Metab 2020; 105:5572657. [PMID: 31545377 DOI: 10.1210/clinem/dgz035] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 05/06/2019] [Accepted: 09/20/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the antiproliferative activity and safety of nonconventional high doses of somatostatin analogs (HD-SSA) in patients with well-differentiated gastroenteropancreatic (GEP) neuroendocrine tumors (NET) with radiological disease progression according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria on a previous treatment. METHODS A retrospective analysis of prospectively maintained databases from 13 Italian NET-dedicated centers was performed. Main inclusion criteria were: well-differentiated G1 or G2 GEP-NET, progressive disease on a previous treatment, and subsequent treatment with HD-SSA (either by increased administered dose [dose intensity] or shortened interval between administrations [dose density]). Main endpoints were progression-free survival (PFS) and safety. RESULTS Of 198 patients, 140 matched inclusion criteria and were included in the analysis. Overall, median PFS was 31 months. Use of HD-SSA as second-line treatment was associated with reduced risk for progression or death compared with third- or further-line treatment (HR: 2.12; P = 0.004). There was no difference in PFS between HD-SSA by increased dose density (N = 133; 95%) or intensity (N = 7; 5%). Partial response according to RECIST criteria was observed in 12 patients (8.6%), and stable disease was achieved in 106 (75.7%) patients. Adverse events occurred in 21 patients (15.0%), 2 of whom had grade 3 biliary stone disease. No patients discontinued HD-SSA treatment due to adverse events. CONCLUSIONS HD-SSA is an active and safe treatment option in patients with progressive well-differentiated GEP-NET. The high rate of objective responses observed deserves prospective validation in ad hoc clinical trials.
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Affiliation(s)
- Giuseppe Lamberti
- NET Team Bologna ENETS Center of Excellence, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | - Nicole Brighi
- NET Team Bologna ENETS Center of Excellence, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | - Toni Ibrahim
- Osteoncology and Rare Tumors Center- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCSS, Meldola, Italy
| | | | - Sara Pusceddu
- Department of medical oncology, Fondazione IRCCS Istituto Tumori Milano, ENETS Center of Excellence, Milan, Italy
| | - Manuela Albertelli
- Endocrinology Department of Internal Medicine and Medical Specialties (DiMi), San Martino University Hospital, Genova, Italy
| | - Sara Massironi
- Gastroenterology and Endoscopy Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Panzuto
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy
| | - Giuseppe Badalamenti
- Medical Oncology, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | | | | | - Fabio Gelsomino
- Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | | | - Roberta Modica
- Clinical medicine and Surgery Department - Federico II University, Naples, Italy
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCSS, Meldola, Italy
| | | | - Martina Torchio
- Department of medical oncology, Fondazione IRCCS Istituto Tumori Milano, ENETS Center of Excellence, Milan, Italy
| | - Annamaria Colao
- Clinical medicine and Surgery Department - Federico II University, Naples, Italy
| | - Diego Ferone
- Endocrinology Department of Internal Medicine and Medical Specialties (DiMi), San Martino University Hospital, Genova, Italy
| | - Davide Campana
- NET Team Bologna ENETS Center of Excellence, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
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32
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Panzuto F, Pusceddu S, Faggiano A, Rinzivillo M, Brighi N, Prinzi N, Riccardi F, Iannicelli E, Maggio I, Femia D, Tafuto S, Manuzzi L, Di Sarno A, Annibale B, de Braud F, Campana D. Prognostic impact of tumour burden in stage IV neuroendocrine neoplasia: A comparison between pancreatic and gastrointestinal localizations. Pancreatology 2019; 19:1067-1073. [PMID: 31587962 DOI: 10.1016/j.pan.2019.09.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 03/14/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Although prognosis of NENs is affected by several features including tumour burden, the specific role of this factor in pancreatic NENs (PanNENs) and gastrointestinal NENs (GI NENs) is not well established. AIM To compare the prognostic role of tumour burden in PanNENs and GI NENs. PATIENTS AND METHODS This study was a retrospective analysis of stage IV PanNENs and GI NENs. Tumours were classified based on liver tumour volume (<25% or >25%). Overall survival as assessed by Kaplan-Meier curves, and Cox proportional hazards method was used to perform risk factor analysis. RESULTS The analysis included 300 patients, including 166 panNENs (55.3%) and 134 GI NENs (44.7%). A total of 158 patients (52.7%) had G2 tumours, 107 had G1 tumours (35.7%), and 35 had G3 tumours (11.6%). Tumour liver involvement >25% was observed in 187 patients (62.3%): 106 PanNENs (56.7%), and 81 GI NENs (43.3%) (p = 0.551). Bone metastases were present in 45 patients (15%): 22 PanNENs (13.2%) and 23 GI NENs (17.1%) (p = 0.416). Characteristics of the PanNENs, including: grading (G2 vs G1, HR = 3.7; G3 vs G1, HR = 16.40), liver involvement > 25% (HR = 3.09), and bone metastases (HR = 2.27) were independent predictors for poor survival, whereas the only significant risk factor in GI NENs was grading (G2 vs G1, HR = 4.36; G3 vs G1, HR = 8.60). CONCLUSIONS PanNENs and GI NENs have different risk profiles. Liver tumour volume and the presence of bone metastases significantly affect survival in patients with PanNENs but has no impact on the clinical outcomes of GI NENs.
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Affiliation(s)
- Francesco Panzuto
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy.
| | - Sara Pusceddu
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENET Center of Excellence, Milan, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Dept. of Experimental Medicine, Sapienza University of Rome, Italy
| | - Maria Rinzivillo
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy
| | - Nicole Brighi
- NET Team Bologna ENETS Center of Excellence, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy
| | - Natalie Prinzi
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENET Center of Excellence, Milan, Italy
| | - Ferdinando Riccardi
- Naples ENETS Center of Excellence, Oncology, Cardarelli Hospital, Naples, Italy
| | - Elsa Iannicelli
- Radiology, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy
| | - Ilaria Maggio
- NET Team Bologna ENETS Center of Excellence, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy
| | - Daniela Femia
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENET Center of Excellence, Milan, Italy
| | - Salvatore Tafuto
- Naples ENETS Center of Excellence, Department of Abdominal Oncology, Istituto Nazionale, Tumori di Napoli "G. Pascale" IRCCS, National Cancer Institute, Naples, Italy
| | - Lisa Manuzzi
- NET Team Bologna ENETS Center of Excellence, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy
| | - Antonella Di Sarno
- Naples ENETS Center of Excellence, Oncology Unit, AO dei Colli, Monaldi Unit, Naples, Italy
| | - Bruno Annibale
- Digestive Disease Unit, Sant'Andrea University Hospital, Dept. of Medical-Surgical Sciences and Translatioal Medicine, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENET Center of Excellence, Milan, Italy
| | - Davide Campana
- NET Team Bologna ENETS Center of Excellence, Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Italy
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Faggiano A, Di Maio S, Mocerino C, Ottaviano M, De Divitiis C, Guarnotta V, Dolce P, Modica R, Puliafito I, Tozzi L, Di Sarno A, Leo S, Riccardi F, Palmieri G, Tafuto S, Bianco A, Badalamenti G, Colao A. Therapeutic sequences in patients with grade 1-2 neuroendocrine tumors (NET): an observational multicenter study from the ELIOS group. Endocrine 2019; 66:417-424. [PMID: 30875056 DOI: 10.1007/s12020-019-01894-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 01/22/2019] [Accepted: 03/05/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE Many different treatments are suggested by guidelines to treat grade 1-2 (G1-G2) neuroendocrine tumors (NET). However, a precise therapeutic algorithm has not yet been established. This study aims at identifying and comparing the main therapeutic sequences in G1-G2 NET. METHODS A retrospective observational Italian multicenter study was designed to collect data on therapeutic sequences in NET. Median progression-free survival (PFS) was compared between therapeutic sequences, as well as the number and grade of side effects and the rate of dose reduction/treatment discontinuation. RESULTS Among 1182 patients with neuroendocrine neoplasia included in the ELIOS database, 131 G1-G2 gastroenteropancreatic, lung and unknown primary NET, unresectable or persistent/relapsing after surgery, treated with ≥2 systemic treatments, were included. Four main therapeutic sequences were identified in 99 patients: (A) somatostatin analogs (SSA) standard dose to SSA high dose (n = 36), (B) SSA to everolimus (n = 31), (C) SSA to chemotherapy (n = 17), (D) SSA to peptide receptor radionuclide therapy (PRRT) (n = 15). Median PFS of the second-line treatment was not reached in sequence A, 33 months in sequence B, 20 months in sequence C, 30 months in sequence D (p = 0.16). Both total number and severity of side effects were significantly higher in sequences B and C than A and D (p = 0.04), as well as the rate of dose reduction/discontinuation (p = 0.03). CONCLUSIONS SSA followed by SSA high dose, everolimus, chemotherapy or PRRT represent the main therapeutic sequences in G1-G2 NET. Median PFS was not significantly different between sequences. However, the sequences with SSA high dose or PRRT seem to be better tolerated than sequences with everolimus or chemotherapy.
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Affiliation(s)
| | - Silvana Di Maio
- Division of Endocrinology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Carmela Mocerino
- Oncology Unit, Azienda Ospedaliera Antonio Cardarelli, Naples, Italy
| | - Margaret Ottaviano
- Oncology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Chiara De Divitiis
- Medical Oncology Unit, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Valentina Guarnotta
- Division of Endocrinology, Diabetology and Metabolism, DIBIMIS, University of Palermo, Palermo, Italy
| | - Pasquale Dolce
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Roberta Modica
- Division of Endocrinology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Ivana Puliafito
- Oncology Unit, Department of Medical Oncology, IOM-Istituto Oncologico del Mediterraneo, Catania, Italy
| | - Lucia Tozzi
- Fondazione IRCCS Casa Sollievo della Sofferenza, UO di Oncologia, San Giovanni Rotondo, FG, Italy
| | | | - Silvana Leo
- Oncology Unit, Ospedale Civico, Lecce, Italy
| | | | - Giovannella Palmieri
- Oncology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Salvatore Tafuto
- Medical Oncology Unit, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | | | - Giuseppe Badalamenti
- Division of Oncology, Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - Annamaria Colao
- Division of Endocrinology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
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Gobbini E, Chiari R, Pizzutillo P, Bordi P, Ghilardi L, Pilotto S, Osman G, Cappuzzo F, Cecere F, Riccardi F, Scotti V, Martelli O, Borra G, Maiello E, Rossi A, Graziano P, Gregorc V, Casartelli C, Sergi C, Del Conte A, Delmonte A, Bareggi C, Cortinovis D, Rizzo P, Tabbò F, Rossi G, Bria E, Galetta D, Tiseo M, Di Maio M, Novello S. Real-world outcomes according to treatment strategies in ALK-rearranged non-small-cell lung cancer (NSCLC) patients: an Italian retrospective study. Clin Transl Oncol 2019; 22:294-301. [PMID: 31630357 DOI: 10.1007/s12094-019-02222-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/09/2019] [Accepted: 09/27/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE Anaplastic lymphoma kinase (ALK) rearrangement confers sensitivity to ALK inhibitors (ALKis) in non-small-cell lung cancer (NSCLC). Although several drugs provided an impressive outcome benefit, the most effective sequential strategy is still unknown. We describe outcomes of real-life patients according to the treatment strategy received. PATIENTS We retrospectively collected 290 ALK rearranged advanced NSCLC diagnosed between 2011 and 2017 in 23 Italian institutions. RESULTS After a median follow-up of 26 months, PFS for crizotinib and a new generation ALKis were 9.4 [CI 95% 7.9-11.2] and 11.1 months [CI 95% 9.2-13.8], respectively, while TTF were 10.2 [CI 95% 8.5-12.6] and 11.9 months [CI 95% 9.7-17.4], respectively, being consistent across the different settings. The composed outcomes (the sum of PFS or TTF) in patients treated with crizotinib followed by a new generation ALKis were 27.8 months [CI 95% 24.3-33.7] in PFS and 30.4 months [CI 95% 24.7-34.9] in TTF. The median OS from the diagnosis of advanced disease was 39 months [CI 95% 31.8-54.5]. Patients receiving crizotinib followed by a new generation ALKis showed a higher median OS [57 months (CI 95% 42.0-73.8)] compared to those that did not receive crizotinib [38 months (CI 95% 18.6-NR)] and those who performed only crizotinib as target agent [15 months (CI 95% 11.3-34.0)] (P < 0.0001). CONCLUSION The sequential administration of crizotinib and a new generation ALKis provided a remarkable clinical benefit in this real-life population, being an interesting option to consider in selected patients.
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Affiliation(s)
- E Gobbini
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043, Orbassano, Italy. .,Cancer Research Center Lyon, Centre Léon Bérard, 28 Rue Laennec, 69008, Lyon Cedex 08, France.
| | - R Chiari
- Oncology Unit, Santa Maria della Misericordia Hospital, Sant'Andrea delle Fratte, 6156, Perugia, Italy
| | - P Pizzutillo
- Medical Thoracic Unit, IRCCS Istituto Oncologico "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy
| | - P Bordi
- Medical Oncology Unit, University Hospital, Via Gramsci 14, 43123, Parma, Italy
| | - L Ghilardi
- Oncology Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy
| | - S Pilotto
- Oncology Unit, Department of Medicine, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - G Osman
- UOSD Pneumologia Oncologica, San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, 00152, Roma, Italy
| | - F Cappuzzo
- Oncology and Hematology Department, AUSL Romagna-Ravenna, Viale Randi 5, 48100, Ravenna, Italy
| | - F Cecere
- Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Roma, Italy
| | - F Riccardi
- Oncology Unit, Antonio Cardarelli Hospital, Via Antonio Cardarelli 9, 80131, Napoli, Italy
| | - V Scotti
- Radiotherapy Unit, University Hospital Careggi, Largo Brambilla 3, 50134, Firenze, Italy
| | - O Martelli
- Medical Oncology Unit, San Giovanni Addolorata Hospital, Via dell'Amba Aradam 9, 00184, Rome, Italy
| | - G Borra
- Oncology Unit, East Piedmont University, Maggiore della Carità Hospital, Corso Mazzini 18, 28100, Novara, Italy
| | - E Maiello
- Department of Oncology and Hematology, Foundation IRCCS 'Casa Sollievo della Sofferenza', Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy
| | - A Rossi
- Department of Oncology and Hematology, Foundation IRCCS 'Casa Sollievo della Sofferenza', Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy
| | - P Graziano
- Department of Oncology and Hematology, Foundation IRCCS 'Casa Sollievo della Sofferenza', Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy
| | - V Gregorc
- Department of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, San Raffaele Hospital, Via Olgettina Milano 60, 20132, Milano, Italy
| | - C Casartelli
- Oncology Unit, Valduce Hospital, Via Dante Alighieri 11, 22100, Como, Italy
| | - C Sergi
- Oncology Unit, A.O.R.N.A.S Garibaldi Nesima, Via Palermo 636, 95100, Catania, Italy
| | - A Del Conte
- S.O.C. Oncologia Medica e dei Tumori Immunocorrelati, Centro di Riferimento Oncologico (CRO), IRCCS, Via Gallini 2, Aviano, Italy
| | - A Delmonte
- Thoracic Oncology Group, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Via Maroncelli 40, 47014, Meldola, Italy
| | - C Bareggi
- Oncology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122, Milan, Italy
| | - D Cortinovis
- Oncology Unit, ASST San Gerardo Hospital, Via G. B. Pergolesi 33, 20052, Monza, Italy
| | - P Rizzo
- Medical Oncology Division and Breast Unit, Antonio Perrino Hospital, Strada Statale 7 per Mesagne, 72100, Brindisi, Italy
| | - F Tabbò
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043, Orbassano, Italy
| | - G Rossi
- Operative Unit of Pathologic Anatomy, Azienda Unità Sanitaria Locale della Romagna, Hospital St. Maria delle Croci, Viale Vincenzo Randi 5, 48121, Ravenna, Italy
| | - E Bria
- U.O.C. Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Roma, Italy
| | - D Galetta
- Medical Thoracic Unit, IRCCS Istituto Oncologico "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy
| | - M Tiseo
- Medical Oncology Unit, University Hospital, Via Gramsci 14, 43123, Parma, Italy
| | - M Di Maio
- Department of Oncology, University of Turin, Mauriziano Umberto I, Via Magellano 1, 10128, Turin, Italy
| | - S Novello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043, Orbassano, Italy
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Cazzaniga M, Pronzato P, Del Mastro L, Natoli C, Montemurro F, Bisagni G, Blasi L, Turletti A, Giordano M, Biganzoli L, Michelotti A, Garrone O, Marchetti P, Riccardi F, Bernardo A, Livi L, Cognetti F, Donadio M, Romagnoli E, Mustacchi G. Changes in hormone-receptor status in luminal breast cancers between primary tumour and metastases: Results of the observational cohort GIM-13 AMBRA study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.020] [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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Cani M, Incorvaia L, Fanale D, De Luca I, Gelsomino F, Ibrahim T, Pusceddu S, Riccardi F, Tafuto S, Lamberti G, Faggiano A, La salvia A, Albertelli M, Massironi S, Rinzivillo M, butturini G, Bazan V, Campana D, Russo A, Badalamenti G. Safety of high doses of somatostatin analogs in well differentiated NENs in elderly. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz245.008] [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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Cazzaniga ME, Pinotti G, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Fiorentini G, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Marchetti P, Melegari E, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Saracchini S, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Clivio L, Torri V. Metronomic chemotherapy for advanced breast cancer patients in the real world practice: Final results of the VICTOR-6 study. Breast 2019; 48:7-16. [PMID: 31470257 DOI: 10.1016/j.breast.2019.07.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 03/05/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 12/21/2022] Open
Abstract
Metronomic chemotherapy (mCHT) refers to the minimum biologically effective dose of a chemotherapy agent given as a continuous dosing regimen, with no prolonged drug-free breaks, that leads to antitumor activity. Aim of the present study is to describe the use of mCHT in a retrospective cohort of metastatic breast cancer (MBC) patients in order to collect data regarding the different types and regimens of drugs employed, their efficacy and safety. Between January 2011 and December 2016, data of 584 metastatic breast cancer patients treated with mCHT were collected. The use of VRL-based regimens increased during the time of observation (2011: 16.8% - 2016: 29.8%), as well as CTX-based ones (2011: 17.1% - 2016: 25.6%), whereas CAPE-based and MTX-based regimens remained stable. In the 1st-line setting, the highest ORR and DCR were observed for VRL-based regimens (single agent: 44% and 88%; combination: 36.7% and 82.4%, respectively). Assuming VRL-single agent as the referee treatment (median PFS: 7.2 months, 95% CI: 5.3-10.3), the longest median PFS were observed in VRL-combination regimens (9.5, 95%CI 88.8-11.3, HR = 0.72) and in CAPE-single agent (10.7, 95%CI 8.3-15.8, HR = 0.70). The VICTOR-6 study provides new data coming from the real-life setting, by adding new information regarding the use of mCHT as an option of treatment for MBC patients.
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Affiliation(s)
- M E Cazzaniga
- Research Unit Phase I Trials, ASST Monza, Monza, Italy; Oncology Unit, ASST Monza, Italy.
| | - G Pinotti
- Medical Oncology, ASST Sette Laghi "Ospedale di Circolo e Fondazione Macchi, Varese, VA, Italy
| | - E Montagna
- Medical Senology Division, IEO, Milan, Italy
| | - D Amoroso
- Medical Oncology, Ospedale Della Versilia, Lido di Camaiore, IT, Italy
| | - R Berardi
- Medical Oncology, A. Ospedaliero-universitaria Ospedali Riuniti, Ancona, IT, Italy
| | - A Butera
- Medical Oncology, Ospedale San Giovanni di Dio, Agrigento, IT, Italy
| | - K Cagossi
- Medical Oncology, Ospedale Ramazzini, Carpi, IT, Italy
| | - L Cavanna
- Medical Oncology, Azienda Ospedaliera Piacenza, Piacenza, IT, Italy
| | - M Ciccarese
- Medical Oncology, Ospedale Vito Fazzi, Lecce, IT, Italy
| | - S Cinieri
- Medical Oncology, ASL Brindisi, Brindisi, Italy
| | - E Cretella
- Medical Oncology, Ospedale Bolzano, IT, Italy
| | | | - A Febbraro
- Medical Oncology, Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Medical Oncology, Osp Taormina, Taormina, IT, Italy
| | - A Ferzi
- Medical Oncology, A.S.S.T. Ovest Milanese, Legnano, IT, Italy
| | - G Fiorentini
- Medical Oncology, Ospedale San Salvatore, Pesaro, Italy
| | - A Fontana
- Medical Oncology, Az. Ospedaliero-Universitaria, Pisana, IT, Italy
| | - A R Gambaro
- Medical Oncology, ASST Fatebenefratelli, Sacco, IT, Italy
| | - O Garrone
- Medical Oncology, A.O. S. Croce e Carle, Cuneo, Italy
| | - V Gebbia
- Medical Oncology, Ospedale La Maddalena, Palermo, IT, Italy
| | - D Generali
- Medical Oncology, Istituti Ospitalieri Cremona, Cremona, IT, Italy
| | - L Gianni
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, IT, Italy
| | - F Giovanardi
- Medical Oncology, Ospedale Civile, Guastalla, IT, Italy
| | - A Grassadonia
- Medical Oncology, P.O. SS Annunziata -ASL2 Lanciano-Vasto, Chieti, IT, Italy
| | - V Leonardi
- Medical Oncology, Ospedale Civico, Palermo, IT, Italy
| | - P Marchetti
- Medical Oncology, A.O. Sant'Andrea, Roma, IT, Italy
| | - E Melegari
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - A Musolino
- Medical Oncology, Azienda Ospedaliero-Universitaria di Parma, IT, Italy
| | - M Nicolini
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, IT, Italy
| | - C Putzu
- Medical Oncology, A. Ospedaliera-Universitaria, Sassari, IT, Italy
| | - F Riccardi
- Medical Oncology, A. Ospedaliera Antonio Cardarelli, Napoli, IT, Italy
| | - D Santini
- Medical Oncology Università Campus Bio-Medico, Roma, IT, Italy
| | - S Saracchini
- Medical Oncology, Az. Osp. Santa Maria Degli Angeli, Pordenone, IT, Italy
| | - M G Sarobba
- Medical Oncology, Ospedale San Francesco, Nuoro, IT, Italy
| | - M G Schintu
- Medical Oncology, Osp Giovanni Paolo II, Olbia, IT, Italy
| | | | - P Spadaro
- Medical Oncology, Casa di Cura Villa Salus, Messina, IT, Italy
| | - C Taverniti
- Medical Oncology, A.O.U. Città Della Salute e Della Scienza, Osp. Molinette, Torino, IT, Italy
| | - D Toniolo
- Medical Oncology, ASST Rhodense 3 Ospedale di Circolo Rho, IT, Italy
| | - P Tralongo
- Medical Oncology, Osp. Umberto I, Siracusa, IT, Italy
| | - A Turletti
- Medical Oncology, P.O. Martini, Torino, IT, Italy
| | - R Valenza
- Medical Oncology, P.O. Vittorio Emanuele, Gela, IT, Italy
| | - M R Valerio
- Medical Oncology, A.O.U. Policlinico Paolo Giaccone, Palermo, IT, Italy
| | - P Vici
- Medical Oncology, B, INT Regina Elena, Roma, IT, Italy
| | - L Clivio
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy
| | - V Torri
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy
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Pirozzi A, Riccardi F, Arpino G, Mocerino C, Campione S, Molino C, Cartenì G. Occurrence of second primary malignancies in patients with neuroendocrine tumors of the digestive tract: A case report. Medicine (Baltimore) 2019; 98:e16508. [PMID: 31335724 PMCID: PMC6708809 DOI: 10.1097/md.0000000000016508] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE There is an association between the presence of neuroendocrine neoplasms and incremented risk to develop second primary malignancies. This risk is estimated to be 17%. The most common secondary neoplasms were found in the Gastrointestinal and Genitourinary tracts. PATIENT CONCERNS A 74-year-old Caucasian patient with melaena came to our observation in June 2015. The Esophago-gastro-duodenoscopy exam found a polypoid formation in the duodenal bulb. Histopathological examination showed a well-differentiated neuroendocrine neoplasm (G1). DIAGNOSIS During the follow up for the neuroendocrine neoplasm, a CT scan was performed in August 2016 describing infiltration of the right renal sinus and the third proximal ureter segment with heterogeneous enhancement of vascular structure. An US-guided biopsy was conclusive for a Diffuse Large B Cell Lymphoma. In October 2016, a colonoscopy showed a neoplastic lesion at 20 cm from the anal orifice. The Histology exam was positive for an adenocarcinoma with a desmoplastic stroma infiltration. INTERVENTIONS In November 2016, the patient underwent a left hemicolectomy: the pathologic staging described a G2 adenocarcinoma pT3N1b. In May 2018, the Octreotide scan was negative. In the same month, the patient started a treatment based on 6 cycles of Rituximab, Oxaliplatin, and Capecitabine due to the persistence of lymphomatous disease and hepatic metastases. In July 2018, other 3 cycles of the same treatment were scheduled. OUTCOMES In January 2019, due to an increase in liver metastases' size, it was decided to start a new regimen for the colon cancer with FOLFIRI+Cetuximab. The patient is still in treatment with this regimen in April 2019. LESSONS The risk of a second primary tumor is increased among patients older than 70. Therefore, it is necessary to follow them using total body CT scan and endoscopic techniques of gastrointestinal and genitourinary tracts, not only for the evaluation of the neuroendocrine tumor but also for the higher risk to develop other neoplastic diseases.
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Affiliation(s)
- Angelo Pirozzi
- Department of Clinical Medicine and Surgery, University of Naples Federico II
| | | | - Grazia Arpino
- Department of Clinical Medicine and Surgery, University of Naples Federico II
| | - Carmela Mocerino
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria
| | | | - Carlo Molino
- Azienda Ospedaliero-Universitaria, Naples, Italy
| | - Giacomo Cartenì
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria
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Perrone F, De Laurentiis M, De Placido S, Orditura M, Cinieri S, Riccardi F, Ribecco AS, Putzu C, Del Mastro L, Rossi E, Tinessa V, Mosconi AM, Nuzzo F, Di Rella F, Gravina A, Iodice G, Landi G, Pacilio C, Forestieri V, Lauria R, Fabbri A, Ibrahim T, De Maio E, Barni S, Gori S, Simeon V, Arenare L, Daniele G, Piccirillo MC, Normanno N, de Matteis A, Gallo C. Adjuvant zoledronic acid and letrozole plus ovarian function suppression in premenopausal breast cancer: HOBOE phase 3 randomised trial. Eur J Cancer 2019; 118:178-186. [PMID: 31164265 DOI: 10.1016/j.ejca.2019.05.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 02/28/2019] [Revised: 04/15/2019] [Accepted: 05/02/2019] [Indexed: 11/13/2022]
Abstract
AIM The aim of the study is to analyse whether letrozole (L) and zoledronic acid plus L (ZL) are more effective than tamoxifen (T) as adjuvant endocrine treatment of premenopausal patients with breast cancer with hormone receptor-positive (HR+) tumours. PATIENTS AND METHODS In a phase 3 trial, 1065 premenopausal patients with HR + early breast cancer received triptorelin to suppress ovarian function and were randomly assigned (1:1:1) to adjuvant T, L or ZL for 5 years. Cancer recurrence, second breast or non-breast cancer and death were considered events for the intention-to-treat disease-free survival (DFS) analysis. RESULTS With a 64-month median follow-up and 134 reported events, the disease-free rate at 5 years was 85.4%, 93.2% and 93.3% with T, L and ZL, respectively (overall P = 0.008). The hazard ratio for a DFS event was 0.52 (95% confidence interval [CI], 0.34 to 0.80; P = 0.003) with ZL vs T, 0.72 (95% CI, 0.48 to 1.07; P = 0.06) with L vs T and 0.70 (95% CI, 0.44 to 1.12; P = 0.22) with ZL vs L. With 36 deaths, there was no significant difference in overall survival (P = 0.14). Treatment was stopped for toxicity or refusal in 7.3%, 7.3% and 16.6% patients, and in the safety population, grade 3-4 side-effects were reported in 4.2%, 6.9% and 9.1% patients treated with T, L or ZL, respectively. CONCLUSION HOBOE study shows that in premenopausal patients with early breast cancer undergoing ovarian function suppression with triptorelin, ZL significantly improves DFS, while worsening compliance and toxicity, as compared with T. (NCT00412022).
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Affiliation(s)
- Francesco Perrone
- Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy.
| | - Michelino De Laurentiis
- Clinical and Experimental Senology, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Sabino De Placido
- Department of Medical and Surgical Clinics, Università Federico II, Napoli, Italy
| | - Michele Orditura
- Oncoematology Unit, Università Degli Studi Della Campania "Luigi Vanvitelli", Napoli, Italy
| | | | | | | | - Carlo Putzu
- Medical Oncology, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Lucia Del Mastro
- IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine (DIMI), Università di Genova, Italy
| | - Emanuela Rossi
- Medical Oncology, A.O. San Giuseppe Moscati, Avellino, Italy
| | | | - Anna Maria Mosconi
- Medical Oncology, Ospedale Santa Maria Della Misericordia, S.Andrea Delle Fratte, Perugia, Italy
| | - Francesco Nuzzo
- Clinical and Experimental Senology, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Francesca Di Rella
- Clinical and Experimental Senology, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Adriano Gravina
- Clinical and Experimental Senology, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Giovanni Iodice
- Clinical and Experimental Senology, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Gabriella Landi
- Clinical and Experimental Senology, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Carmen Pacilio
- Clinical and Experimental Senology, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Valeria Forestieri
- Department of Medical and Surgical Clinics, Università Federico II, Napoli, Italy
| | - Rossella Lauria
- Department of Medical and Surgical Clinics, Università Federico II, Napoli, Italy
| | - Agnese Fabbri
- Department of Medical Oncology, Ospedale Belcolle, Viterbo, Italy
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola FC, Italy
| | | | - Sandro Barni
- Medical Oncology - Ospedale di Treviglio Caravaggio BG, Italy
| | - Stefania Gori
- Medical Oncology, IRCCS, Ospedale Sacro Cuore Don Calabria, Negrar VR, Italy
| | - Vittorio Simeon
- Medical Statistics, Università Degli Studi Della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Laura Arenare
- Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Gennaro Daniele
- Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | | | - Nicola Normanno
- Cellular Biology and Biotherapies, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Andrea de Matteis
- Clinical and Experimental Senology, Istituto Nazionale Tumori, IRCCS, Fondazione G.Pascale, Napoli, Italy
| | - Ciro Gallo
- Medical Statistics, Università Degli Studi Della Campania "Luigi Vanvitelli", Napoli, Italy
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Buono G, Fabi A, Del Mastro L, Cannita K, La Verde NM, Ardito R, Riccardi F, Montemurro F, Cazzaniga ME, Garrone O, Zambelli A, Conte B, Caputo R, Cianniello D, Bonotto M, Bartoletti M, Parola S, De Placido S, Di Maio M, Arpino G. Long-term toxicity profile of trastuzumab emtansine (T-DM1): A multicenter real-life study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e12507] [Citation(s) in RCA: 2] [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
e12507 Background: T-DM1 is widely used in HER2 positive metastatic breast cancer (MBC) patients (pts), often for many cycles until progression. However, little is known about its long term toxicity. The aim of this study was to evaluate the safety profile of T-DM1 when delivered for ≥12 cycles. Methods: HER2 positive MBC pts who had received ≥12 cycles of T-DM1 across 18 Italian cancer centers were enrolled from January 2017 to September 2018. The 12 cycles cut-off was chosen based on the EMILIA trial median PFS (9.6 months), to identify a patient population treated with T-DM1 for longer time. Tumor and clinical characteristics were collected. Standard haematological tests, blood chemistries and side effects (nausea, vomiting, diarrhea, stomatitis, asthenia) were recorded cycle by cycle, according CTCAE criteria version 4. Haematological and laboratory toxicities were available for 86 patients, while other toxicities for all 115 patients. Results: Overall, 115 pts were enrolled. Median age was 54.5 (range 29.6–81.9); median time from diagnosis of metastatic disease to first T-DM1 cycle was 32.5 months. T-DM1 was administered as 2nd line and 3rd line of treatment in 45.2% and 27.8% of pts, respectively. Median number of cycles was 18 (range 12-59). Complete response, partial response and stable disease rates were 11.4%, 43% and 45.6%, respectively. Treatment related side effects are shown in table 1. Interestingly, no increased liver toxicity was observed in pts with liver metastases. Analysis of mean CTCAE grade by cycle showed that no relevant incremental toxicity was observed during long term T-DM1 therapy. Conclusions: T-DM1 is safe and well tolerated in these long responding pts. We found no relevant cumulative toxicity. Patients should be treated with T-DM1 as long as their tumor responds, as no safety issues are related to its long term use. [Table: see text]
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Affiliation(s)
- Giuseppe Buono
- Department of Clinical Medicine and Surgery, Oncology Division, University Federico II, Naples, Italy
| | - Alessandra Fabi
- Division of Medical Oncology, “Regina Elena” National Cancer Institute, Rome, Italy
| | - Lucia Del Mastro
- Department of Medical Oncology, IRCCS AOU San Martino–IST, National Cancer Institute, Genova, Italy
| | - Katia Cannita
- S. Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Nicla Maria La Verde
- Department of Oncology, ASST Fatebenefratelli Sacco, PO Fatebenefratelli, Milan, Italy
| | - Raffaele Ardito
- Oncology Day Hospital Unit, IRCCS CROB, Rionero in Vulture, Italy
| | | | - Filippo Montemurro
- Investigational and Clinical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | | | - Ornella Garrone
- Breast Unit Medical Oncology S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | | | - Benedetta Conte
- Department of Medical Oncology, IRCCS AOU San Martino–IST, National Cancer Institute, Genova, Italy
| | - Roberta Caputo
- Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" -Breast Oncology Division, Naples, Italy
| | - Daniela Cianniello
- Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" -Breast Oncology Unit, Naples, Italy
| | - Marta Bonotto
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | - Michele Bartoletti
- School of Medical Oncology, Department of Medicine, University of Udine, Udine, Italy
| | - Sara Parola
- Department of Clinical Medicine and Surgery, Oncology Division, University Federico II, Naples, Italy
| | - Sabino De Placido
- Oncology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | - Massimo Di Maio
- Medical Oncology, Mauriziano Hospital; Department of Oncology, University of Turin, Torino, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, Oncology Division, University Federico II, Naples, Italy
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Cazzaniga ME, Pronzato P, Schettini F, Del Mastro L, Riemma M, Alù M, Turletti A, Giordano M, Pugliese P, De Angelis C, Garrone O, Marchetti P, Riccardi F, Bernardo A, Livi L, Fabi A, Taverniti C, De Placido S, Mustacchi G. Progression-free survival (PFS) and overall survival (OS) in HER2-ve advanced breast cancer (ABC) patients (pts) according to the molecular subtype in the era of modern agents: Results from the GIM-13 AMBRA study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e12528] [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
e12528 Background: Pts with ABC have a diverse clinical course and OS rates vary significantly among pts. New strategies had potentially changed the natural history of these pts, however data from clinical studies are still lacking and Real-World Studies (RWS) are crucial in clinical outcome evaluation. Methods: AMBRA is a longitudinal cohort study, aiming to describe the choice of first and subsequent lines of treatment in HER2-ve ABC pts receiving at least one CHT (SABCS 2016, P5-15-07 & P5-14-09) in the years 2012-2015. The present analysis is focused on the description of Progression-Free Survival (PFS) and OS according to the biologic subtype in the deceased population. So far, 791/1500 pts have been registered into the study and 255 (32.2%) are evaluable. Time to event analysis between subtypes was evaluated by Cox-Mantel Hazard Ratio and Logrank Test. DFS by Wilcoxon Rank-Sum Test. Results: Pts distribution according to molecular subtype was: Luminal A (86, 33.7%), Luminal B (107 (42.1%), TNBC (62, 24.3%). Median ages at diagnosis were 55.8, 52.9 and 55.1 years for the 3 subgroups, respectively. Mean DFS was significantly different according to the molecular subtypes: 87.28, 61.37 and 23.9 months. The difference between Luminal B and TNBC is statistically significant as well. Mean PFS of first-line therapy was 17.9 11.7 and 7.8 months respectively. Mean OS from first progression was 32.9 24.2 and 15.8 months respectively. Statistical details. Conclusions: Our data confirm in a RWS the different biological behaviour between Lum A and B. Metastatic life span is quite good for Luminal and disappointing for TNBC. Median time from last CHT and Death is quite short and similar.[Table: see text]
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Affiliation(s)
| | - Paolo Pronzato
- San Martino- IST Ist Naz Per La Ricerca Sul Cancro, Genova, Italy
| | | | - Lucia Del Mastro
- Department of Medical Oncology, IRCCS AOU San Martino–IST, National Cancer Institute, Genova, Italy
| | - Maria Riemma
- Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" -Breast Oncology Unit, Naples, Italy
| | | | - Anna Turletti
- Medical Oncology, ASLTO1 Ospedale Martini, Torino, Italy
| | | | | | | | - Ornella Garrone
- Breast Unit Medical Oncology S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Paolo Marchetti
- Department of Medical Oncology Sant’Andrea University Hospital, Rome, Italy
| | | | | | | | - Alessandra Fabi
- Division of Medical Oncology, “Regina Elena” National Cancer Institute, Rome, Italy
| | | | - Sabino De Placido
- Oncology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
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Milh M, Riccardi F, Denis J. Genetics of neonatal onset epilepsies: An overview. Rev Neurol (Paris) 2019; 176:2-9. [PMID: 31097300 DOI: 10.1016/j.neurol.2019.01.396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/29/2018] [Revised: 01/03/2019] [Accepted: 01/08/2019] [Indexed: 11/29/2022]
Abstract
The weight of monogenic abnormalities in the possible causes of epilepsy has grown significantly in recent years, due to the emergence of next-generation sequencing (NGS) techniques. Especially notable in early neonatal and infantile epilepsies, which seem to be explained by monogenic abnormalities. This short review focuses on the major genes associated with very early-onset epilepsies, where NGS techniques are most cost-effective: early infantile epileptic encephalopathy, early myoclonic encephalopathy, and other neonatal epilepsies. The discovery of the genetic mutation often follows several weeks or months of management, and rarely modifies it. However, clinical studies can sometimes better define medical treatment. The genetic causes of these epilepsies are very numerous and the pathophysiological knowledge very minimal. The big challenge for the coming years is to develop more targeted treatments based on research on animal models.
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Affiliation(s)
- M Milh
- Aix-Marseille université, Inserm, MMG, 58, boulevard Charles-Livon, 13009 Marseille, France; Pediatric neurology unit, Timone Children Hospital, AP-HM, 278, rue Saint-Pierre, 13005 Marseille, France.
| | - F Riccardi
- Pediatric neurology unit, Timone Children Hospital, AP-HM, 278, rue Saint-Pierre, 13005 Marseille, France
| | - J Denis
- Pediatric neurology unit, Timone Children Hospital, AP-HM, 278, rue Saint-Pierre, 13005 Marseille, France
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Pirozzi A, Cartenì G, Scagliarini S, Fusco M, Riccardi F. Incidental finding of non-Hodgkin's lymphoma in a patient affected by castration-sensitive prostate cancer: A case report. Medicine (Baltimore) 2019; 98:e14805. [PMID: 30882658 PMCID: PMC6426560 DOI: 10.1097/md.0000000000014805] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
RATIONALE This article describes the case of a patient with 2 simultaneous malignant diseases: Follicular lymphoma and 'castration sensitive prostate cancer. Patients with multiple cancers are not easy to manage and it is difficult to find the appropriate approach and resources to use with them. We focused our attention on how to choose the correct strategy to face 2 different neoplasms and control the adverse reactions related to the corresponding treatments. PATIENT CONCERNS We present a case of a 71-year-old man who came to us complaining about an abnormal difficulty in urinating associated with an interrupted flow and excessive urination at night. Clinical examination detected multiple enlarged superior and inferior diaphragmatic lymph nodes. DIAGNOSIS Prostate biopsy revealed an acinar adenocarcinoma (Gleason 4+3, Grade group 3). Clinical staging by bone scan was negative but computed tomography scan (CT) detected multiple enlarged superior and inferior diaphragmatic, and inguinal lymph nodes. This type of lymph node involvement pattern is unusual for an acinar adenocarcinoma prostate cancer therefore we suspected the simultaneous presence of a lymphatic neoplasm. Fluorodeoxyglucose positron emission tomography scan. The exam showed one of the left inguinal lymph nodes had the highest standardized uptake value (13.0) so a biopsy was taken. The sample analysis confirmed the diagnosis of a follicular non-Hodgkin lymphoma of Grade 3a. INTERVENTIONS We used a multidisciplinary clinical approach based on Rituximab+CHOP administered every 21 days. Simultaneously, the patient underwent androgen deprivation therapy with triptorelin monthly and bicalutamide administered just during the first month of treatment. When we obtained a complete response for the lymphoma, the patient continued the therapy with Rituximab once every 2 months for the next 2 years. Then we added volumetric modulated arc therapy (VMAT) radiotherapy with simultaneous integrated boost (SIB) to androgen deprivation therapy for the duration of 1 month. OUTCOMES After 1 year and 6 months since the conclusion of therapy for prostate cancer and Follicular lymphoma, patient's conditions are good and he is in complete remission for both diseases. Gut toxicity is reduced with a mean number of 2 to 3 discharges daily and an increased body weight. LESSONS The presence of diffuse lymphadenopathy and urinary symptoms in the same patients must induce the suspect of 2 contemporary cancer diseases. Parallel treatments of follicular lymphoma and prostate cancer should consider the increased risk of severe adverse effects related to the treatment and their management. We describe our therapeutic strategy to highlight the importance to balance benefits and disadvantages to get the best possible response and maintain a good quality of life in this complex setting.
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Affiliation(s)
- Angelo Pirozzi
- Department of Clinical Medicine and Surgery, University Federico II of Naples
| | - Giacomo Cartenì
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
| | - Sarah Scagliarini
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Ferdinando Riccardi
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
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Cazzaniga ME, Blasi L, Pronzato P, Giordano M, Garrone O, Donadio M, Del Mastro L, Livi L, Natoli C, Michelotti A, Turletti A, Riccardi F, De Laurentiis M, Marchetti P, Montemurro F, Romagnoli E, De Placido S, Biganzoli L, Bologna A, Bria E, Mustacchi G. Abstract P4-13-04: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-13-04] [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: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the conference.
Citation Format: Cazzaniga ME, Blasi L, Pronzato P, Giordano M, Garrone O, Donadio M, Del Mastro L, Livi L, Natoli C, Michelotti A, Turletti A, Riccardi F, De Laurentiis M, Marchetti P, Montemurro F, Romagnoli E, De Placido S, Biganzoli L, Bologna A, Bria E, Mustacchi G. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-13-04.
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Affiliation(s)
- ME Cazzaniga
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - L Blasi
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - P Pronzato
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - M Giordano
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - O Garrone
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - M Donadio
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - L Del Mastro
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - L Livi
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - C Natoli
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - A Michelotti
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - A Turletti
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - F Riccardi
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - M De Laurentiis
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - P Marchetti
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - F Montemurro
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - E Romagnoli
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - S De Placido
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - L Biganzoli
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - A Bologna
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - E Bria
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
| | - G Mustacchi
- ASST Monza, Monza, Italy; University of Trieste, Trieste, Italy; AOU San Martino, Genova, Italy; ASST Lariana, Como, Italy; Osp S. Croce, Cuneo, Italy; Az. Sanitaria Osped. Molinette, Torino, Italy; University of Firenze, Firenze, Italy; University of Chieti, Chieti, Italy; AOU Santa Chiara, Pisa, Italy; Osp. Evangelico Valdese, Torino, Italy; Osp. Cardarelli, Napoli, Italy; Istituto Pascale, Napoli, Italy; La Sapienza Università di Roma, Roma, Italy; Istituto di Candiolo - FPO (IRCCS), Torino, Italy; Oncologia AV3, Macerata, Italy; Università Federico II, Napoli, Italy; Nuovo Ospedale S. Stefano, Prato, Italy; Az. Osp. Reggio Emilia, Reggio Emilia, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli', Roma, Italy; Presidio Ospedaliero Civico e Benfratelli, Palermo, Italy
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Gobbini E, Pizzutilo P, Chiari R, Pilotto S, Dazzi C, Osman G, Bordi P, Ghilardi L, Cecere F, Graziano P, Maiello E, Borra G, Martelli O, Gregorc V, Scotti V, Casartelli C, Riccardi F, Rizzo P, Del Conte A, Delmonte A, Bareggi C, Cortinovis D, Sergi C, Rossi A, Rossi G, Bria E, Di Maio M, Novello S. MA26.02 Upfront or Sequential Strategy for New Generation Anaplastic Lymphoma Kinase (ALK) Inhibitors: An Italian Retrospective Study. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.539] [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: 10/28/2022]
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Perrone F, De Laurentiis M, de Placido S, Orditura M, Cinieri S, Riccardi F, Ribecco A, Putzu C, Del Mastro L, Rossi E, Daniele B, Mosconi A, Di Rella F, Landi G, Nuzzo F, Pacilio C, Lauria R, Arenare L, Piccirillo M, Gallo C. The HOBOE-2 multicenter randomized phase III trial in premenopausal patients with hormone-receptor positive early breast cancer comparing triptorelin plus either tamoxifen or letrozole or letrozole + zoledronic acid. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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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Gelsomino F, Tiseo M, Barbieri F, Riccardi F, Cavanna L, Frassoldati A, Delmonte A, Longo L, Dazzi C, Cinieri S, Colantonio I, Tognetto M, Baldari D, Tofani L, Ardizzoni A. Phase II study of NAB-paclitaxel in sensitive and refractory relapsed SCLC (NABSTER TRIAL). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy298.009] [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: 11/15/2022] Open
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Gridelli C, Morabito A, Cavanna L, Luciani A, Maione P, Bonanno L, Filipazzi V, Leo S, Cinieri S, Ciardiello F, Burgio MA, Bilancia D, Cortinovis D, Rosetti F, Bianco R, Gebbia V, Artioli F, Bordonaro R, Fregoni V, Mencoboni M, Nelli F, Riccardi F, di Isernia G, Costanzo R, Rocco G, Daniele G, Signoriello S, Piccirillo MC, Gallo C, Perrone F. Cisplatin-Based First-Line Treatment of Elderly Patients With Advanced Non-Small-Cell Lung Cancer: Joint Analysis of MILES-3 and MILES-4 Phase III Trials. J Clin Oncol 2018; 36:2585-2592. [PMID: 30028656 DOI: 10.1200/jco.2017.76.8390] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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
Purpose To test the efficacy of adding cisplatin to first-line treatment for elderly patients with advanced non-small-cell lung cancer (NSCLC) within a combined analysis of two parallel phase III trials, MILES-3 and MILES-4. Patients and Methods Patients with advanced NSCLC who were older than age 70 years with Eastern Cooperative Oncology Group performance status 0 to 1 were randomly assigned to gemcitabine or pemetrexed, without or with cisplatin. In each trial, 382 events were required to detect a hazard ratio (HR) of death of 0.75, with 80% power and two-tailed α of .05. Trials were closed prematurely because of slow accrual, but the joint database allowed us to analyze the efficacy of cisplatin on the basis of intention-to-treat and adjusted by trial, histotype, non-platinum companion drug, stage, performance status, sex, age, and size of the study center. Results From March 2011 to August 2016, 531 patients (MILES-3, 299; MILES-4, 232) were assigned to gemcitabine or pemetrexed without (n = 268) or with cisplatin (n = 263). Median age was 75 years, 79% were male, and 70% had nonsquamous histology. At a median 2-year follow-up, 384 deaths and 448 progression-free survival events were recorded. Overall survival was not significantly prolonged with cisplatin (HR, 0.86; 95% CI, 0.70 to 1.05; P = .14) and global health status score of quality of life was not improved, whereas progression-free survival (HR, 0.76; 95% CI, 0.63 to 0.92; P = .005) and objective response rate (15.5% v 8.5%; P = .02) were significantly better. Significantly more severe hematologic toxicity, fatigue, and anorexia were found with cisplatin. Conclusion The addition of cisplatin to single-agent chemotherapy does not significantly prolong overall survival, and it does not improve global health status score of quality of life in elderly patients with advanced NSCLC.
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Affiliation(s)
- Cesare Gridelli
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Alessandro Morabito
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Luigi Cavanna
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Andrea Luciani
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Paolo Maione
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Laura Bonanno
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Virginio Filipazzi
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Silvana Leo
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Saverio Cinieri
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Fortunato Ciardiello
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Marco Angelo Burgio
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Domenico Bilancia
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Diego Cortinovis
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Francesco Rosetti
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Roberto Bianco
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Vittorio Gebbia
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Fabrizio Artioli
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Roberto Bordonaro
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Vittorio Fregoni
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Manlio Mencoboni
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Fabrizio Nelli
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Ferdinando Riccardi
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Giuditta di Isernia
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Raffaele Costanzo
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Gaetano Rocco
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Gennaro Daniele
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Simona Signoriello
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Maria Carmela Piccirillo
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Ciro Gallo
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Francesco Perrone
- Cesare Gridelli and Paolo Maione, Azienda Ospedaliera (AO) San Giuseppe Moscati, Avellino; Alessandro Morabito, Raffaele Costanzo, Gaetano Rocco, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) -Fondazione G. Pascale; Fortunato Ciardiello, Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli; Roberto Bianco, Università degli Studi di Napoli Federico II; Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Naples; Luigi Cavanna, Ospedale di Piacenza, Piacenza; Andrea Luciani, Ospedale S. Paolo; Virginio Filipazzi, Ospedale L. Sacco, Polo Universitario, Milan; Andrea Luciani and Silvana Leo, Gruppo Italiano di Oncologia Geriatrica; Manlio Mencoboni, Ospedale Villa Scassi, Azienda Sanitaria Locale 3 Genovese, Genoa; Laura Bonanno, Istituto Oncologico Veneto, IRCCS, Padova; Silvana Leo, AO Vito Fazzi, Lecce; Saverio Cinieri, Ospedale Senatore Antonio Perrino, Brindisi; Marco Angelo Burgio, Istituto Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Meldola; Domenico Bilancia, AO San Carlo, Potenza; Diego Cortinovis, Ospedale San Gerardo, Monza; Francesco Rosetti, Mirano Unità Locale Socio Sanitaria 3, Serenissima Regione Veneto, Mirano; Vittorio Gebbia, Casa di Cura La Maddalena Università di Palermo, Palermo; Fabrizio Artioli, Ospedale Ramazzini di Carpi e Ospedale di Mirandola, Carpi; Roberto Bordonaro, AO Garibaldi Nesima, Catania; Vittorio Fregoni, Istituti Clinici Scientifici Maugeri, Pavia; Fabrizio Nelli, Ospedale Belcolle, Viterbo; and Giuditta di Isernia, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
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Riccardi F, Colantuoni G, Diana A, Mocerino C, Cartenì G, Lauria R, Febbraro A, Nuzzo F, Addeo R, Marano O, Incoronato P, De Placido S, Ciardiello F, Orditura M. Exemestane and Everolimus combination treatment of hormone receptor positive, HER2 negative metastatic breast cancer: A retrospective study of 9 cancer centers in the Campania Region (Southern Italy) focused on activity, efficacy and safety. Mol Clin Oncol 2018; 9:255-263. [PMID: 30155246 PMCID: PMC6109668 DOI: 10.3892/mco.2018.1672] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/05/2018] [Indexed: 01/19/2023] Open
Abstract
Exemestane (Exe) in combination with Everolimus (Eve) represents an important treatment option for patients diagnosed with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) metastatic breast cancer (MBC), which was previously treated with non-steroidal aromatase inhibitors (NSAI). Data from unselected populations may be useful for defining the optimal therapeutic algorithm within a clinical setting. Data from 264 HR+, HER2-MBC patients who received Exe-Eve treatment in combination, following the failure of NSAIs was retrospectively analyzed. Different lines of endocrine treatment (ET) were investigated to evaluate the efficacy and toxicity of the treatment within the ‘everyday clinical practice’ population. The disease control rate (DCR) was 73.1%, with no statistically significant difference among the different settings. At a median follow-up of 42 months, the median progression free survival (PFS) was 11.6, 9.7 and 7.5 months for patients treated with Exe-Eve as first, second or third line therapy, respectively. There was a statistically significant correlation with younger age, no previous adjuvant chemotherapy (CT), no previous adjuvant endocrine therapy (ET), HT duration ≥36 months, involvement of liver and/or lung, no prior CT for metastatic disease and PS=0 at the start of treatment. The median overall survival (OS) was 33.0 months; at a median follow-up of 67 months, the median OS was 43.1, 31.7 and 27.9 months in patients treated with Exe-Eve in first, second or third line therapy, respectively. On multivariate analysis, diabetes and previous CT for metastatic disease were revealed to correlate with a worse outcome. Conversely, the presence of mucositis was significantly associated with long-term survival. Overall, Exe-Eve was typically well tolerated and the majority toxicities were G1 or 2, while treatment discontinuation due to unacceptable toxicity was only required in 5.7% of patients. Despite the limitations due to the observational nature of this study, the findings suggest that treatment with Exe-Eve is an active and safe therapeutic option for endocrine-sensitive MBC patients in a real-world clinical setting, regardless of treatment lines.
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Affiliation(s)
| | | | - Anna Diana
- Division of Medical Oncology, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', I-80131 Naples, Italy
| | | | | | - Rossella Lauria
- Medical Oncology, Department of Clinical Medicine and Surgery, University of Naples Federico II, I-80131 Naples, Italy
| | - Antonio Febbraro
- Medical Oncology, Sacro Cuore di Gesù Fatebenefratelli Hospital, I-82100 Benevento, Italy
| | - Francesco Nuzzo
- Breast Cancer Unit, Cancer Institute G. Pascale Foundation, I-80131 Naples, Italy
| | - Raffaele Addeo
- Medical Oncology, Frattamaggiore Hospital, I-80027 Frattamaggiore, Italy
| | - Ombretta Marano
- Medical Oncology, Santa Maria della Pietà Hospital, I-80035 Nola, Italy
| | | | - Sabino De Placido
- Medical Oncology, Department of Clinical Medicine and Surgery, University of Naples Federico II, I-80131 Naples, Italy
| | - Fortunato Ciardiello
- Division of Medical Oncology, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', I-80131 Naples, Italy
| | - Michele Orditura
- Division of Medical Oncology, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', I-80131 Naples, Italy
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Rosati G, Riccardi F, Tucci A, De Rosa P, Pacilio G. A Phase II Study of Paclitaxel/Cisplatin Combination in Patients with Metastatic Breast Cancer Refractory to Anthracycline-Based Chemotherapy. Tumori 2018; 86:207-10. [PMID: 10939600 DOI: 10.1177/030089160008600306] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 11/16/2022]
Abstract
AIMS AND BACKGROUND To investigate the safety and efficacy of a paclitaxel and cisplatin regimen in a selected group of metastatic breast cancer patients with primary or acquired chemo-resistance to anthracycline-based chemotherapy. PATIENTS AND METHODS Thirty-eight consecutive women with metastatic breast cancer (PS < or =2) were entered in this phase II trial; all patients had been previously treated for metastatic disease with chemotherapy containing anthracyclines and had shown a progression of the disease during drug administration or after a clinical response lasting less than 6 months. Fifteen patients had received 2 or more chemotherapeutic regimens for advanced disease; 31 patients had > or =2 sites of metastatic disease. Paclitaxel (135 mg/m2) was administered iv by a 3-hr infusion followed by iv infusion of cisplatin (75 mg/m2) on day 1, every 3 weeks for 6 cycles. After the completion of the planned chemotherapy administration, 9 responsive patients continued to receive paclitaxel alone (175 mg/m2) iv, on day 1, every 3 weeks, until disease progression or unacceptable toxicity. RESULTS A partial clinical response was recorded in 17 cases (45%; 95% CI, 30-64%). The median duration of overall response was 8 months; for the 9 responsive patients who continued treatment with paclitaxel alone, 4 had maintained the partial clinical response at the median follow-up of 24 months from the onset of therapy. The median time to progression was 6 months and median overall survival 8 months. Neurotoxicity was the most frequent adverse effect and caused treatment discontinuation in 5 cases for grade 3-4 paresthesia and/or an arthralgia/myalgia syndrome. Grade 3-4 neutropenia occurred in 16 patients (44%). CONCLUSIONS Paclitaxel/cisplatin is an active regimen for the treatment of patients with metastatic breast cancer refractory to anthracycline-based chemotherapy. However, the cumulative neurotoxicity should limit the efficacy of prolonged paclitaxel monotherapy in responsive patients.
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Affiliation(s)
- G Rosati
- Division of Medical Oncology, San Carlo Hospital, Potenza, Naples, Italy
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