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Mesquita LA, Spiazzi BF, Piccoli GF, Nogara DA, da Natividade GR, Garbin HI, Wayerbacher LF, Wiercinski VM, Baggio VA, Zingano CP, Schwartsmann G, Lopes G, Petrie JR, Colpani V, Gerchman F. Does metformin reduce the risk of cancer in obesity and diabetes? A systematic review and meta-analysis. Diabetes Obes Metab 2024; 26:1929-1940. [PMID: 38389430 DOI: 10.1111/dom.15509] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/28/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024]
Abstract
AIM To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes. MATERIALS AND METHODS We searched MEDLINE, Embase and CENTRAL for randomized controlled trials (RCTs) in adults with overweight/obesity and/or prediabetes/diabetes that compared metformin to other interventions for ≥24 weeks. Independent reviewers selected and extracted data including population and intervention characteristics and new diagnoses of cancer. We used the RoB 2.0 risk-of-bias tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess risk of bias and certainty of evidence. RESULTS From 14 895 records after removal of duplicates, 27 trials were included, providing a total of 10 717 subjects in the metformin group and 10 003 in the control group, with 170 and 208 new cases of cancer, respectively. Using a random-effects model, the relative risk was 1.07 (95% confidence interval 0.87-1.31), with similar results in subgroup analyses by study duration or effect of control intervention on weight. Risk of bias in most studies was low, and no evidence of publication bias was found. Trial sequential analysis provided evidence that the cumulative sample size was large enough to exclude a significant effect of metformin on cancer incidence. CONCLUSIONS Metformin did not reduce cancer incidence in RCTs involving subjects with overweight/obesity and/or prediabetes/diabetes.
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Affiliation(s)
- Leonardo A Mesquita
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Critical Care Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Bernardo F Spiazzi
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giovana F Piccoli
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniela A Nogara
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriella R da Natividade
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Henrique I Garbin
- Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Laura F Wayerbacher
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa M Wiercinski
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Viviane A Baggio
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Carolina P Zingano
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gilberto Schwartsmann
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gilberto Lopes
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida, USA
| | - John R Petrie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Verônica Colpani
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Gerchman
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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de Andrade Mesquita L, Wayerbacher LF, Schwartsmann G, Gerchman F. Obesity, diabetes, and cancer: epidemiology, pathophysiology, and potential interventions. Arch Endocrinol Metab 2023; 67:e000647. [PMID: 37364149 PMCID: PMC10660996 DOI: 10.20945/2359-3997000000647] [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: 12/08/2022] [Accepted: 02/22/2023] [Indexed: 06/28/2023]
Abstract
The proportion of deaths attributable to cancer is rising, and malignant neoplasms have become the leading cause of death in high-income countries. Obesity and diabetes are now recognized as risk factors for several types of malignancies, especially endometrial, colorectal, and postmenopausal breast cancers. Mechanisms implicated include disturbances in lipid-derived hormone secretion, sex steroids biosynthesis, hyperinsulinemia, and chronic inflammation. Intentional weight loss is associated with a mitigation of risk for obesity-related cancers, a phenomenon observed specially with bariatric surgery. The impact of pharmacological interventions for obesity and diabetes is not uniform: while metformin seems to protect against cancer, other agents such as lorcaserin may increase the risk of malignancies. However, these interpretations must be carefully considered, since most data stem from bias-prone observational studies, and high-quality randomized controlled trials with appropriate sample size and duration are needed to achieve definite conclusions. In this review, we outline epidemiological and pathophysiological aspects of the relationship between obesity, diabetes, and malignancies. We also highlight pieces of evidence regarding treatment effects on cancer incidence in these populations.
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Affiliation(s)
- Leonardo de Andrade Mesquita
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil, Porto Alegre, RS, Brasil
| | - Laura Fink Wayerbacher
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Gilberto Schwartsmann
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Fernando Gerchman
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil, Porto Alegre, RS, Brasil,
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3
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Basso J, Schwartsmann G, Ibaldi MR, Schaefer VD, Pavei CC, Hahn RZ, Antunes MV, Linden R. Evaluation of UGT1A1 and CYP3A Genotyping and Single-Point Irinotecan and Metabolite Concentrations as Predictors of the Occurrence of Adverse Events in Cancer Treatment. J Gastrointest Cancer 2023; 54:589-599. [PMID: 35710870 DOI: 10.1007/s12029-022-00840-0] [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] [Accepted: 06/05/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The variability on irinotecan (IRI) pharmacokinetics and toxicity has been attributed mostly to genetic variations in the UGT1A1 gene, responsible for conjugation of the active metabolite SN-38. Also, CYP3A mediates the formation of inactive oxidative metabolites of IRI. The association between the occurrence of severe adverse events, pharmacokinetics parameters, and UGT1A1 and CYP3A4 predicted phenotypes was evaluated, as the evaluation of [SN-38]/IRI dose ratio as predictor of severe adverse events. METHODS Forty-one patients undergoing IRI therapy were enrolled in the study. Blood samples were collected 15 min after the end of drug the infusion, for IRI, SN-38, SN-38G, bilirubin concentrations measurements, and UGT1A1 and CYP3A genotype estimation. Data on adverse event was reported. RESULTS Fifteen patients (36.5%) developed grade 3/4 adverse events. A total of 9.8% (n = 4) of the patients had UGT1A1 reduced activity phenotype, and 48.7% (n = 20) had UGT1A1 and 63.4% (n = 26) CYP3A intermediary phenotypes. Severe neutropenia and diarrhea were more prevalent in patients with reduced UGT1A1 in comparison with functional metabolism (50% and 75% versus 0% and 13%, respectively). SN-38 levels and its concentrations adjusted by IRI dose were significantly correlated to toxicity (rs = 0.31 (p = 0.05) and rs = 0.425 (p < 0.01)). The [SN-38]/IRI dose ratio had a ROC curve of 0.823 (95% CI 0.69-0.956) to detect any severe adverse event and 0.833 (95% CI 0.694-0.973) to detect severe diarrhea. The cut-off of 0.075 ng mL-1 mg-1 had 100% sensitivity and 65.7% specificity to predict severe diarrhea. CONCLUSION Our data confirmed the relevance of the pre-emptive genotypic information of UGT1A1. The [SN-38]/IRI ratio, measured 15 min after the end of the IRI infusion, was a strong predictor of severe toxicity and could be applied to minimize the burden of patients after IRI administration.
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Affiliation(s)
- Jeziel Basso
- Universidade Federal Do Rio Grande Do Sul, UFRGS, Postgraduate program, Porto Alegre, Brazil
| | - Gilberto Schwartsmann
- Universidade Federal Do Rio Grande Do Sul, UFRGS, Postgraduate program, Porto Alegre, Brazil
| | | | - Vitoria Daniela Schaefer
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil
- Graduate Program On Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | - Carla Casagrande Pavei
- Medical Residency in Oncology of Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Roberta Zilles Hahn
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | - Marina Venzon Antunes
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil
- Graduate Program On Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | - Rafael Linden
- Analytical Toxicology Laboratory, Universidade Feevale, Novo Hamburgo, RS, Brazil.
- Graduate Program On Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo, RS, Brazil.
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Peruzzo N, Basso J, Buiar PG, Gössling G, Schwartsmann G. A treatment-naive cancer patient in critical condition. Am J Med 2023:S0002-9343(23)00161-4. [PMID: 36893832 DOI: 10.1016/j.amjmed.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023]
Affiliation(s)
- Nicolas Peruzzo
- Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil; Hospital Regina, Novo Hamburgo RS, Brazil, 93510-223.
| | - Jeziel Basso
- Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil; Hospital Moinhos de Vento, Porto Alegre RS, Brazil, 90035-000
| | - Pedro Grachinski Buiar
- Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil; Department of Pharmaceutical Sciences, Universidade Estadual de Ponta Grossa, Ponta Grossa PR, Brazil, 84030-900
| | - Gustavo Gössling
- Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil; Latin American Cooperative Oncology Group, Porto Alegre RS, Brazil, 90619-900
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Basso J, Linden R, Ibaldi M, Venzon M, Schwartsmann G. 1128P Genotypic and phenotypic evaluation of the pharmacokinetics of irinotecan and its relationship with the occurrence of toxicity in the treatment of cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gössling GCL, Chedid MF, Pereira FS, da Silva RK, Andrade LB, Peruzzo N, Saueressig MG, Schwartsmann G, Parikh AR. Outcomes and Prognostic Factors of Patients with Metastatic Colorectal Cancer Who Underwent Pulmonary Metastasectomy with Curative Intent: A Brazilian Experience. Oncologist 2021; 26:e1581-e1588. [PMID: 33896091 DOI: 10.1002/onco.13802] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 11/26/2020] [Accepted: 01/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We aimed to identify clinicopathological and molecular features associated with progression-free survival (PFS) and overall survival (OS) after pulmonary metastasectomy for metastatic colorectal cancer in a retrospective cohort in Brazil. MATERIALS AND METHODS We did a retrospective review of thoracic surgeries performed in a single large academic hospital in Brazil from January 1985 to September 2019. Demographics, previously described prognostic factors, and clinicopathological and molecular characteristics were abstracted. Univariate Cox regression was performed for each variable, and, when significant, data were dichotomized to provide clinically meaningful thresholds. RESULTS Records from 698 patients were reviewed. Fifty-eight patients underwent pulmonary metastasectomy with curative intent. Of those, 53.4% had a single metastatic lesion. The median size of the largest lesion was 1.5 cm. Results of RAS, RAF, and mismatch repair testing and of cytokeratin 20 (CK20) and CDX2 testing were available for 13.8% and 58.6% of the sample, respectively. Median PFS was 14 months, median OS was 58 months, and 5-year survival was 49.8%. Unfavorable prognostic factors for OS included disease-free interval (DFI) <24 months, synchronous presentation, size of the largest lesion ≥2 cm, and loss of CK20 expression. Presenting with more than one lesion was prognostic for PFS but not for OS. CONCLUSION In this Brazilian cohort, our findings corroborate existing data supporting DFI, synchronous presentation, and number and size of lesions as prognostic factors. Furthermore, we found that loss of CK20 expression may be associated with more aggressive disease and shorter OS. Additional molecular prognostic factors after pulmonary metastasectomy for colorectal cancer should be further explored. IMPLICATIONS FOR PRACTICE This study consolidates disease-free interval, synchronous presentation, and number and size of lesions as clinically relevant data that may help guide therapy for patients with colorectal cancer and lung metastases who are candidates for curative-intent metastasectomy. Additionally, in this sample, lack of cytokeratin 20 expression in metastases was associated with shorter progression-free survival and overall survival, suggesting that biomarkers also may have a role in guiding therapy in this setting and that additional biomarkers should be further explored.
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Affiliation(s)
- Gustavo C L Gössling
- Medical Oncology Department, Hospital de Clínicas de Porto Alegre, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Medical Oncology Department, Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil
| | - Márcio F Chedid
- Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Fernando S Pereira
- Medical Oncology Department, Hospital de Clínicas de Porto Alegre, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Leonardo B Andrade
- Medical Oncology Department, Hospital de Clínicas de Porto Alegre, Brazil
| | - Nícolas Peruzzo
- Medical Oncology Department, Hospital de Clínicas de Porto Alegre, Brazil
| | - Maurício G Saueressig
- Thoracic Surgery Department, Hospital de Clínicas de Porto Alegre, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Gilberto Schwartsmann
- Medical Oncology Department, Hospital de Clínicas de Porto Alegre, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Aparna R Parikh
- Department of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Dillenburg Weiss TL, Gössling G, Venzon Antunes M, Schwartsmann G, Linden R, Gasparin Verza S. Evaluation of dried blood spots as an alternative matrix for therapeutic drug monitoring of abiraterone and delta(4)-abiraterone in prostate cancer patients. J Pharm Biomed Anal 2020; 195:113861. [PMID: 33373824 DOI: 10.1016/j.jpba.2020.113861] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 02/07/2023]
Abstract
Therapeutic drug monitoring (TDM) approaches may benefit patients treated with abiraterone acetate (AA) as drug efficacy is imprecise and important pharmacokinetic variability is known. Current methods based on the analysis of plasma present the disadvantage of the fast degradation of the analytes in the liquid sample. Dried blood spots (DBS) consist of a minimally invasive and unexplored sampling strategy to monitor the levels of abiraterone (ABI) and delta(4)-abiraterone (D4A) in patients. This study presents the development and validation of a precise and accurate method to monitor ABI and D4A in DBS samples by UPLC-MS/MS. Bioanalytical method validation was carried out according to current guidelines, evaluating the impact of DBS-specific parameters such as hematocrit and spot volume on accuracy. Based on the analysis of quality control samples prepared at low, medium and high concentrations, the method was precise with CV ≤ 6.97 % and 10.26 % for ABI and D4A, respectively. The method was also highly accurate, between 93.6-106.8 % for ABI and 96.0-108.5 % for D4A. The DBS method is compatible with the analysis of samples of unknown volume and hematocrit range of the studied population. In addition, ABI and D4A were stable for 7 days in DBS at room temperature, which is feasible for sample transportation in postal service and analysis in the laboratory. Method application to 16 clinical samples revealed good correlation between measured plasma concentrations and estimated plasma concentrations for ABI (r = 0.884, P < 0.05) and D4A (r = 0.920, P < 0.05). Passing-Bablok regression analysis and Bland-Altmann plots indicated correlation between the results obtained from DBS and plasma, with a slight overestimation of the concentrations of ABI in DBS, which could be related to the small study cohort. Therefore, the results of this first work indicate that DBS consist of a promising alternative sampling strategy in TDM studies of AA.
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Affiliation(s)
- Thaís Luise Dillenburg Weiss
- Graduate Program in Toxicology and Analytical Toxicology, Institute of Health Sciences, University Feevale, Novo Hamburgo, Brazil
| | - Gustavo Gössling
- Department of Oncology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marina Venzon Antunes
- Graduate Program in Toxicology and Analytical Toxicology, Institute of Health Sciences, University Feevale, Novo Hamburgo, Brazil
| | | | - Rafael Linden
- Graduate Program in Toxicology and Analytical Toxicology, Institute of Health Sciences, University Feevale, Novo Hamburgo, Brazil
| | - Simone Gasparin Verza
- Graduate Program in Toxicology and Analytical Toxicology, Institute of Health Sciences, University Feevale, Novo Hamburgo, Brazil.
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Weiss TLD, Furtado CM, Antunes MV, Gössling G, Schwartsmann G, Linden R, Verza SG. A quick UPLC–MS/MS method for therapeutic drug monitoring of abiraterone and delta(4)‐abiraterone in human plasma. Biomed Chromatogr 2020; 34:e4947. [DOI: 10.1002/bmc.4947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/19/2020] [Accepted: 07/09/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Thaís Luise Dillenburg Weiss
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
| | - Carolina Mesquita Furtado
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
| | - Marina Venzon Antunes
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
| | - Gustavo Gössling
- Oncology Department, Hospital de Clínicas de Porto Alegre Porto Alegre RS Brazil
| | | | - Rafael Linden
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
| | - Simone Gasparin Verza
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
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Peters GJ, Leyva A, Schwartsmann G. Resistance to differentiation affects ribo- and deoxyribonucleotide pools and sensitivity to pyrimidine metabolism antagonists in HL60 cells. Nucleosides Nucleotides Nucleic Acids 2020; 39:1369-1378. [PMID: 32727257 DOI: 10.1080/15257770.2020.1782933] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
HL60 myeloid leukemia cells are extensively used as a differentiation model. We investigated a variant of HL60 which is resistant to differentiation induction (HL60-R) by standard differentiation inducers such as retinoic acid and dimethylsulfoxide (DMSO). To find an explanation for this resistance, we examined nucleotide (NTP) and deoxynucleotide (dNTP) pools in HL60-R and its parent cell line, sensitive to differentiation, HL60-S. We also explored whether these differences led to a difference in sensitivity to various antimetabolites. Drug sensitivity was measured with the tetrazolium (MTT) assay, while nucleotides were measured with anion-exchange HPLC. HL60-R cells were between 2- and 5-fold resistant to the antimetabolites 5-fluorouracil, Brequinar, hydroxyurea and N-(phosphonacetyl)-L-aspartate (PALA), but more sensitive to aza-2'-deoxycytidine (DAC), cytarabine and thymidine (5- to 10-fold). The NTP pools in both HL60 variants showed a normal pattern with ATP being the highest (2530-2876 pmol/106 cells) and CTP being lowest. However, UTP pools were 2-fold higher in the HL60-S cells (p < .01), while CTP and GTP pools were 30% higher (p < .01) compared to HL60-R cells. For the dNTP pools, larger differences were observed, with dATP (50 pmol/106 cells) being highest in HL60-R cells, but dATP was 4-fold lower in HL60-S cells. In HL-60-R, the triple combination retinoic acid, DMSO and DAC increased all NTPs almost 2-fold in contrast to HL60-S. Uridine increased UTP (1.4-fold), CTP (2-fold) and dCTP (1.4.-fold) pools in both cell lines, but thymidine increased only dTTP pools (4- to 7-fold), with a depletion of dCTP. PALA decreased UTP and CTP in both cell lines, but increased ATP (only in HL60-R). Hydroxyurea decreased dNTP especially in HL60-S cells. In conclusion, the pronounced differences in NTP and dNTP pools between HL60-S and HL60-R possibly play a role in the induction of differentiation and drug sensitivity.
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Affiliation(s)
- Godefridus J Peters
- Laboratory Medical Oncology, Amsterdam UMC, Location VUMC, Amsterdam, the Netherlands.,Department of Biochemistry, Medical University of Gdansk, Gdansk, Poland
| | - Albert Leyva
- Department of Physiology and Pharmacology, Federal University of Ceara, Ceara, Brazil
| | - Gilberto Schwartsmann
- Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Gössling GCDL, Pereira FDS, Silva RKD, Andrade LDB, Peruzzo N, Saueressig MG, Chedid MF, Schwartsmann G, Parikh AR. Outcomes and prognostic factors of patients (pts) with metastatic colorectal cancer (mCRC) who underwent pulmonary metastasectomy (PM) with curative intent. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.4034] [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
4034 Background: Indications for PM in pts with mCRC are often based on the presence of favorable prognostic factors. We aimed to analyze the prognostic factors and outcomes of pts treated with PM for mCRC. Methods: We retrospectively identified pts with mCRC who underwent PM with curative intent between Jan 1985 and Dec 2019 at Hospital de Clínicas de Porto Alegre. Demographics, clinicopathological features and previously described prognostic factors were collected. Univariate Cox regression was performed and followed by Kaplan-Meier (KM) curves with log-rank test when significant. Results: Fifty-eight pts underwent PM. Demographics are described in Table. Wedge resection was performed in 87.9% and margins were negative in 89.1%. Mean number of lesions was 2.4 ± 1.7, with the largest measuring 1.7 ± 0.9 cm. Two or more resections were performed in 36.2%, nodal sampling in 27.3%, and nodal disease was found in 5.2%.Thirty-day readmission rate was 5.2%. One pt had a Clavien-Dindo grade IIIb complication. RAS/RAF/MMR and CK20/CDX2 were available for 13.8% and 58.6% of the sample. Median PFS 14 months (m) (95% CI 10.4 - 17.5), median OS 58 m (95% CI 33.5 - 82.4) and 5-year survival 49.8%. Unfavorable prognostic factors for OS included disease-free interval (DFI) < 24 m (40 m, 95% CI 31.8 - 48.1 vs 85 m, 95% CI 75.7 -96.2; P < 0.005), synchronous presentation (33 m, 95% CI 23.9 - 42.0 vs 77 m, 95% CI 50.7 - 103.2; P < 0.001), largest lesion size ≥ 2cm (37 m, 95% CI 22.9 - 51.0 m vs 81 m, 95% CI - 33.7 - 128.2, P = 0.019) and lack of CK20 expression (19 m, 95% CI 12.1 - 27.2 vs. 83 m, 95% CI 46.9 - 119.0; P < 0.001). More than one lesion at presentation was prognostic for PFS (11 m, 95% CI 7.6 - 14.3 vs 23 m, 95% CI 0.1 - 59.2; P = 0.003) but not OS (P = 0.11). Grade was significant at Cox regression but showed no effect in further analysis. Neither CEA at baseline or relapse, resection margins, Charlson comorbidity index (CCI) or adjuvant chemotherapy were prognostic. Conclusions: Our results suggest a benefit for select pts and PM. Lack of CK20 expression may be associated with more aggressive disease and shorter OS. Additional molecular prognostic factors after PM should be further explored. [Table: see text]
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Gössling GCDL, Pinto BS, Martins EF, Silva RKD, Peruzzo N, Schwartsmann G, Parikh AR. Clinicopathological features and outcomes of patients with esophageal cancer undergoing neoadjuvant chemoradiation (chemoRT) in Southern Brazil: A comparison to the Worldwide Esophageal Cancer Collaboration. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e16535] [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
e16535 Background: Despite low- and middle-income countries representing 80% of esophageal cancer global burden, TNM staging is based on data from the Worldwide Esophageal Cancer Collaboration (WECC) that is mainly composed of patients from developed countries. Notably, 87.8% of patients staged after neoadjuvant chemoRT in the WECC were from North America or Europe and only 0.09% (N = 7) from Latin America (LA), raising questions about its applicability. We wanted to see if the characteristics of patients undergoing neoadjuvant chemoradiation in LA were representative of patients in the WECC. Methods: We retrospectively identified patients with esophageal adenocarcinoma (EAC) and squamous cell carcinoma (ESCC) who underwent chemoRT at Hospital de Clínicas de Porto Alegre (HCPA), an academic hospital in southern Brazil, and compared their clinicopathological features, treatments and outcomes data with WECC patients. WECC data were extracted from previous publications. Results: Compared to WECC, there were no differences in age (ESCC: 61±7.7 vs. 61±9.4, P = 0.91; EAC: 62±7.2 vs. 61±9.8, P = 0.67) and sex (female: 30.0% vs. 33.2%, P = 0.64; 30.8% vs. 11.6%, P = 0.06). However, we found statistically significant differences in histology (ESCC: 79.4% vs. 26.5%, P < 0.001), PS 0/1/≥2 (ESCC: 24/70/6% vs. 50.6/41.7/7.7%, P = 0.002; EAC: 38.5/61.5/0% vs. 34.9/61.5/3.6%, P = 0.91), active tobacco use (62% vs 27.8%, P < 0.001; 38.5% vs. 15.7%, P < 0.001), weight loss (8.4±5.8Kg vs. 2.6±6Kg, P < 0.001; 14.0±11.6Kg vs. 3,6±7,1Kg, P < 0.001), location (upper/middle/lower: 0/30/70% vs. 16.3/46.6/37.1%, P < 0.001; 0/0/100% vs. 0.7/3/96.3%, P = 0.63) and lymphadenectomy extension ( > 20 resected lymph nodes: 8.6% vs. 38.1%, P < 0.001; 0% vs. 37.9%, P = 0.027). There were no statistically significant differences in pathologic stage (Table) or overall survival in 30 days and 1 year from treatment decision (97.7% vs 98%, P = 0.69; 74.7% vs 75%, P = 0.78). Conclusions: Despite clinically significant differences in presentation were found, they did not implicate worse prognosis in this analysis. [Table: see text]
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12
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Binotto M, Schwartsmann G. Qualidade de Vida Relacionada à Saúde de Pacientes com Câncer de Mama: Revisão Integrativa da Literatura. Rev Brasileira De Cancerologia 2020. [DOI: 10.32635/2176-9745.rbc.2020v66n1.405] [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] [Indexed: 10/24/2022] Open
Abstract
Introdução: O câncer de mama pode alterar a qualidade de vida relacionada à saúde das pacientes. Objetivo: Compreender o impacto da quimioterapia para câncer de mama na qualidade de vida relacionada à saúde de pacientes. Método: Trata-se de uma revisão integrativa da literatura, compreendendo artigos publicados entre 2007 e 2019, disponíveis nas bases de dados PubMed, LILACS e SciELO. Analisaram-se 25 artigos na íntegra. Resultados: Os questionários mais frequentemente utilizados nos estudos foram o European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) e o módulo complementar European Organization for Research and Treatment of Cancer Breast Cancer-specific Quality of Life Questionnaire (EORTC QLQ-BR23). Em relação às alterações da qualidade de vida, a saúde global diminui durante a quimioterapia, mas pode melhorar após o término do tratamento. O aumento dos sintomas é relatado em diversos estudos e prejudicou a qualidade de vida relacionada à saúde das pacientes. Entretanto, os sintomas diminuem após o término da quimioterapia, exceto para algumas escalas. As escalas de imagem corporal, função sexual e funcionamento físico pioram ao longo do tratamento. A qualidade de vida mental/psicológica tem oscilações durante o tratamento, assim como a escala sobre as relações sociais. Conclusão: A qualidade de vida relacionada à saúde de mulheres com câncer de mama é afetada negativamente pelo tratamento quimioterápico, expressando maior impacto nas escalas de sintomas.
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13
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Binotto M, Reinert T, Werutsky G, Zaffaroni F, Schwartsmann G. Health-related quality of life before and during chemotherapy in patients with early-stage breast cancer. Ecancermedicalscience 2020; 14:1007. [PMID: 32104209 PMCID: PMC7039692 DOI: 10.3332/ecancer.2020.1007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 10/24/2019] [Indexed: 12/19/2022] Open
Abstract
Objectives Identify the main changes in the health-related quality of life (HRQoL) of women diagnosed with breast cancer (BC) undergoing chemotherapy. Methods Prospective cohort study that included 33 women diagnosed with clinical stages I–III BC and who underwent adjuvant chemotherapy. HRQoL was assessed using the EORTC QLQ-C30 and EORTC QLQ-BR23 instruments 1 week before the start of chemotherapy and during the third month of chemotherapy. Results There was a decline in the HRQoL scores of patients during treatment. Therefore, chemotherapy alters the patient’s perceptions of their HRQoL since there is a decrease in global health status/quality of life (QoL) and functional scales such as physical functioning, role functioning, emotional functioning, social functioning, body image, sexual function and sexual enjoyment. We also observed an increase in side effects related to the systemic therapy, fatigue, nausea and vomiting, insomnia, appetite loss and diarrhoea, despite a decrease in breast symptoms and arm symptoms. Conclusions HRQoL was negatively affected during chemotherapy. Even though HRQoL assessment is a useful method for optimising patients’ care, its implementation into clinical practice remains a challenge. Since side effects are very often underestimated, we consider that the evaluation of HRQoL parameters should be done for BC patients treated with chemotherapy.
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Affiliation(s)
- Monique Binotto
- Postgraduate Program in Clinical Research, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, RS 90035-007, Brazil.,Centro de Pesquisa da Serra Gaúcha, CEPESG, Caxias do Sul, RS 95020-450, Brazil.,https://orcid.org/0000-0002-5799-5390
| | - Tomás Reinert
- Centro de Pesquisa da Serra Gaúcha, CEPESG, Caxias do Sul, RS 95020-450, Brazil.,https://orcid.org/0000-0003-4715-1415
| | - Gustavo Werutsky
- Latin American Cooperative Oncology Group, LACOG, Porto Alegre, RS 90619-900, Brazil.,https://orcid.org/0000-0001-6271-105X
| | - Facundo Zaffaroni
- Latin American Cooperative Oncology Group, LACOG, Porto Alegre, RS 90619-900, Brazil
| | - Gilberto Schwartsmann
- Postgraduate Program in Clinical Research, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, RS 90035-007, Brazil.,https://orcid.org/0000-0002-7850-1644
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14
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Raymundo S, Müller V, Tegner M, Artmann A, Andriguetti N, Schwartsmann G, Linden R, Antunes M. DETERMINAÇÃO DE DOCETAXEL E METABÓLITOS EM PLASMA POR UPLC-MS/MS: DESENVOLVIMENTO DE METODOLOGIA ANALÍTICA E APLICAÇÃO CLÍNICA. QUIM NOVA 2020. [DOI: 10.21577/0100-4042.20170498] [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: 11/04/2022] Open
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15
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Hahn RZ, Antunes MV, Verza SG, Perassolo MS, Suyenaga ES, Schwartsmann G, Linden R. Pharmacokinetic and Pharmacogenetic Markers of Irinotecan Toxicity. Curr Med Chem 2019; 26:2085-2107. [PMID: 29932028 DOI: 10.2174/0929867325666180622141101] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Irinotecan (IRI) is a widely used chemotherapeutic drug, mostly used for first-line treatment of colorectal and pancreatic cancer. IRI doses are usually established based on patient's body surface area, an approach associated with large inter-individual variability in drug exposure and high incidence of severe toxicity. Toxic and therapeutic effects of IRI are also due to its active metabolite SN-38, reported to be up to 100 times more cytotoxic than IRI. SN-38 is detoxified by the formation of SN-38 glucuronide, through UGT1A1. Genetic polymorphisms in the UGT1A1 gene are associated to higher exposures to SN-38 and severe toxicity. Pharmacokinetic models to describe IRI and SN-38 kinetic profiles are available, with few studies exploring pharmacokinetic and pharmacogenetic-based dose individualization. The aim of this manuscript is to review the available evidence supporting pharmacogenetic and pharmacokinetic dose individualization of IRI in order to reduce the occurrence of severe toxicity during cancer treatment. METHODS The PubMed database was searched, considering papers published in the period from 1995-2017, using the keywords irinotecan, pharmacogenetics, metabolic genotyping, dose individualization, therapeutic drug monitoring, pharmacokinetics and pharmacodynamics, either alone or in combination, with original papers being selected based on the presence of relevant data. CONCLUSION The findings of this review confirm the importance of considering individual patient characteristics to select IRI doses. Currently, the most straightforward approach for IRI dose individualization is UGT1A1 genotyping. However, this strategy is sub-optimal due to several other genetic and environmental contributions to the variable pharmacokinetics of IRI and its active metabolite. The use of dried blood spot sampling could allow the clinical application of limited sampling and population pharmacokinetic models for IRI doses individualization.
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Affiliation(s)
- Roberta Zilles Hahn
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo- RS, Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | - Marina Venzon Antunes
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo- RS, Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | - Simone Gasparin Verza
- Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | - Magda Susana Perassolo
- Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | - Edna Sayuri Suyenaga
- Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | | | - Rafael Linden
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo- RS, Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
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Peruzzo N, Ce Coelho J, Gössling G, Buiar PG, Macedo GDS, Lenz G, Rocha DL, Liedke PER, Schwartsmann G. Treatment delay and outcomes in stage IV lung cancer: The reality of a public hospital in a developing country. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e20709] [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
e20709 Background: Lung cancer is the leading cause of cancer deaths globally. Despite the development of a number of new therapeutic options for stage IV non-small cell lung cancer (NSCLC), many patients (pts) still face difficulties in accessing proper treatment in adequate time, especially in developing countries. We analyzed clinical outcomes in a population with stage IV NSCLC treated at a public hospital in Southern Brazil. Methods: In this retrospective cohort study, we enrolled 57 pts with stage IV NSCLC treated at Hospital de Clinicas de Porto Alegre (HCPA) between 2016 and 2018. Results: Median follow-up was 20.3 months, 53% were men, mean age was 65 years, 86% had smoked, 84% had de novo metastatic disease, 96% had non-squamous histology, and 16% had EGFR mutations. At the point of therapeutic decision-making, 72% had ECOG performance status (PS) 0-2 (deemed as good), whereas 28% had PS 3-4 (poor). Among pts diagnosed at HCPA (91%), median time from symptoms to diagnosis was 23 days, and median time from diagnosis to palliative systemic therapy (PST) was 65 days. PST was delivered to 60% of pts, and the most used first-line protocol was Taxol-Carboplatin (79%). Two or more lines of PST were delivered to 23% of pts. In the subgroup of pts with sensitizing EGFR mutations, 75% received anti-EGFR therapy (Gefitinib). The main reason for upfront best supportive care (BSC) was poor PS. In the poor PS subgroup, 44% initially presented at HCPA with good PS; however, PS deterioration precluded them from starting PST. No pts with poor PS received PST. In the whole cohort, median overall survival (OS) was 7.7 months. In the Cox regression multivariate analysis, poor PS (HR 3.80, P < 0.0001, 95% CI 1.90–7.61) and second-line PST (HR 0.23, P = 0.002, 95% CI 0.09–0.58) were independent predictors of OS. Median OS was 10.3 months vs. 2.4 months in PST and BSC subgroups, respectively. Conclusions: In our cohort, which reflects the reality of a publicly insured population and thus most of Brazilian lung cancer pts, poor PS deprives nearly one-third of pts from PST and is associated with a worse prognosis. Postponement of PST may lead to a loss of opportunity for pts to being treated; therefore, it is crucial to develop strategies to improve time to PST.
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Antunes LCM, Cartell A, de Farias CB, Bakos RM, Roesler R, Schwartsmann G. Tropomyosin-Related Kinase Receptor and Neurotrophin Expression in Cutaneous Melanoma Is Associated with a Poor Prognosis and Decreased Survival. Oncology 2019; 97:26-37. [PMID: 31071716 DOI: 10.1159/000499384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/13/2019] [Accepted: 03/05/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Normally, activation of tropomyosin-related kinase (TRK) receptors by neurotrophins (NTs) stimulates intracellular pathways involved in cell survival and proliferation. Dysregulation of NT/TRK signaling may affect neoplasm prognosis. Data on NT and TRK expression in melanomas are limited, and it is unclear whether NT/TRK signaling pathways are involved in the origin and progression of this neoplasm. METHODS We examined whether NT/TRK expression differs across different cutaneous melanoma grades and subtypes, and whether it is associated with melanoma prognosis and survival. A cross-sectional study was performed in which the expression of TrkA, TrkB, nerve growth factor (NGF), and brain-derived neurotrophic factor (BDNF) was analyzed by immunohistochemistry of 154 melanoma samples. We investigated NT/TRK expression associations with prognostic factors for melanoma, relapse-free survival (RFS), and overall survival (OS). RESULTS Of the 154 melanoma samples, 77 (55.4%) were TrkA immunopositive, 81 (58.3%) were TrkB immunopositive, 113 (81.3%) were BDNF immunopositive, and 104 (75.4%) were NGF immunopositive. We found NT/TRK expression associated strongly with several clinical prognostic factors, including the tumor-node-metastasis stage (p < 0.001), histological subtype (p < 0.001), and Clark level (p < 0.05), as well as with a worse OS (p < 0.05 for all, except TrkB) and RFS (p < 0.05 for all). CONCLUSIONS Our results show strong associations of NT/TRK expression with melanoma stage progression and a poor prognosis.
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Affiliation(s)
- Luís Carlos Moreira Antunes
- Graduate Program in Medical Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil,
- Hematology and Oncology Service, Santa Maria University Hospital, Federal University of Santa Maria, Santa Maria, Brazil,
| | - André Cartell
- Department of Pathology, Porto Alegre Clinical Hospital, Porto Alegre, Brazil
| | - Caroline Brunetto de Farias
- Cancer and Neurobiology Laboratory, Experimental Research Center, Porto Alegre Clinical Hospital, Porto Alegre, Brazil
| | - Renato Marchiori Bakos
- Graduate Program in Medical Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Dermatology, Porto Alegre Clinical Hospital, Porto Alegre, Brazil
| | - Rafael Roesler
- Cancer and Neurobiology Laboratory, Experimental Research Center, Porto Alegre Clinical Hospital, Porto Alegre, Brazil
- Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gilberto Schwartsmann
- Graduate Program in Medical Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Cancer and Neurobiology Laboratory, Experimental Research Center, Porto Alegre Clinical Hospital, Porto Alegre, Brazil
- Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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18
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Oliveira LM, Portela P, Merzoni J, Beppler J, Dias FS, Graebin P, Alho CS, Schwartsmann G, Dal-Pizzol F, Jobim LF, Jobim M, Roesler R. KIR gene haplotype A is associated with hospital mortality in patients with sepsis. Clin Immunol 2019; 200:37-38. [PMID: 30710693 DOI: 10.1016/j.clim.2019.01.008] [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: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Luciana M Oliveira
- Cancer and Neurobiology Laboratory, Experimental Research Center, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Immunology Service, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Pamela Portela
- Immunology Service, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Joice Merzoni
- Immunology Service, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jaqueline Beppler
- Immunology Service, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando S Dias
- Intensive Care Unit, Pompéia Hospital, Caxias do Sul, Brazil
| | - Pietra Graebin
- Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Clarice S Alho
- Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gilberto Schwartsmann
- Cancer and Neurobiology Laboratory, Experimental Research Center, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Dal-Pizzol
- Experimental Physiopathology Laboratory, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciúma, Brazil; Intensive Care Unit, São José Hospital, Criciúma, Brazil
| | - Luiz Fernando Jobim
- Immunology Service, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mariana Jobim
- Immunology Service, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rafael Roesler
- Cancer and Neurobiology Laboratory, Experimental Research Center, Porto Alegre Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Chen LT, Siveke JT, Wang-Gillam A, Li CP, Bodoky G, Dean AP, Shan YS, Jameson GS, Macarulla T, Lee KH, Cunningham D, Blanc JF, Chiu CF, Schwartsmann G, Braiteh FS, Mamlouk K, Belanger B, de Jong FA, Hubner RA. Survival with nal-IRI (liposomal irinotecan) plus 5-fluorouracil and leucovorin versus 5-fluorouracil and leucovorin in per-protocol and non-per-protocol populations of NAPOLI-1: Expanded analysis of a global phase 3 trial. Eur J Cancer 2018; 105:71-78. [PMID: 30414528 DOI: 10.1016/j.ejca.2018.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 04/12/2018] [Revised: 08/31/2018] [Accepted: 09/14/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND In the phase 3 randomised NAPOLI-1 clinical study, a 45% increase in median overall survival (OS) was shown with liposomal irinotecan, 5-fluorouracil and leucovorin (nal-IRI+5-FU/LV) versus 5-FU/LV in patients with metastatic pancreatic cancer progressing after gemcitabine-based therapy. Here, we report data from a pre-specified, expanded analysis of outcomes in the per-protocol (PP) population. MATERIALS AND METHODS The PP population comprised patients receiving ≥80% of planned treatment during the first 6 weeks, with no major protocol violations. A post-hoc analysis of the non-PP population was also performed. RESULTS For PP patients, median OS was 8.9 (95% confidence interval: 6.4-10.5) months with nal-IRI+5-FU/LV (n = 66) vs 5.1 (4.0-7.2) months with 5-FU/LV (n = 71; unstratified hazard ratio [HR] 0.57, p = 0.011). For non-PP patients, it was 4.4 (3.3-5.3) months with nal-IRI+5-FU/LV (n = 51) vs 2.8 (1.7-3.2) months with 5-FU/LV (n = 48; unstratified HR 0.64, p = 0.0648). CONCLUSION A statistically significant survival advantage was observed with nal-IRI+5-FU/LV vs 5-FU/LV in the PP patient population.
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Affiliation(s)
- Li-Tzong Chen
- National Institute of Cancer Research, National Health Research Institutes (NHRI), 367 Sheng-Li Road, Tainan 704, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Sheng-Li Road, Tainan 704, Taiwan.
| | - Jens T Siveke
- Division of Solid Tumor Translational Oncology, West German Cancer Center, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany; German Cancer Consortium (DKTK, Partner Site Essen) and German Cancer Research Center, DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Andrea Wang-Gillam
- Division of Oncology, Washington University in St. Louis, 660 South Euclid Ave, St. Louis, MO 63110, USA
| | - Chung-Pin Li
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Rd, Beitou District, Taipei 112, Taiwan; National Yang-Ming University School of Medicine, No. 155, Section 2, Linong St, Beitou District, Taipei 112, Taiwan
| | - György Bodoky
- Department of Oncology, Szent László Hospital, Albert Flórián út 5, 1097 Budapest, Hungary
| | - Andrew P Dean
- St. John of God Hospital, 12 Salvado Rd, Subiaco, WA 6008, Australia
| | - Yan-Shen Shan
- Department of Surgery, National Cheng Kung University Hospital, No. 138, Shengli Rd, North District, Tainan 704, Taiwan
| | - Gayle S Jameson
- Virginia G. Piper Cancer Center at HonorHealth/TGen, 10460N 92(nd) St #206, Scottsdale, AZ 85258, USA
| | - Teresa Macarulla
- Vall d'Hebron University Hospital (HUVH), Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Centro Cellex, Calle Natzaret, 115-117, 08035 Barcelona, Spain
| | - Kyung-Hun Lee
- Department of Internal Medicine and Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 1 Gwanak-ro, Daehak-dong, Gwanak-gu, Seoul 03080, South Korea
| | - David Cunningham
- The Royal Marsden Hospital NHS Foundation Trust, 203 Fulham Rd, Chelsea, SW3 6JJ London, UK; The Royal Marsden Hospital NHS Foundation Trust (Surrey), Downs Rd, Sutton, SM2 5PT Surrey, UK
| | | | - Chang-Fang Chiu
- China Medical University Hospital, No. 2, Yuh-Der Rd, Taichung 404, Taiwan
| | - Gilberto Schwartsmann
- Federal University of Rio Grande do Sul, Av. Paulo Gama, 110 - Farroupilha, Porto Alegre, RS 90040-060, Brazil
| | - Fadi S Braiteh
- Comprehensive Cancer Centers of Nevada, University of Nevada School of Medicine, 3730 S Eastern Ave, Las Vegas, NV 89169, USA
| | - Khalid Mamlouk
- Ipsen Bioscience, Inc., 650 East Kendall St, Cambridge, MA 02142, USA
| | - Bruce Belanger
- Ipsen Bioscience, Inc., 650 East Kendall St, Cambridge, MA 02142, USA
| | | | - Richard A Hubner
- Department of Medical Oncology, The Christie Hospital NHS Foundation Trust, 550 Wilmslow Rd, M20 4BX Manchester, UK
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Paz-Ares L, Yang J, Zielinski C, Novello S, Schwartsmann G, Spigel D, Griesinger F, Dowlati A, Small T, De Jong F, Zhang B, Nazarenko N, Bunn P. P2.12-04 Liposomal Irinotecan vs Topotecan in Patients with Small Cell Lung Cancer Who Have Progressed On/After Platinum-Based Therapy. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Raymundo S, Muller V, Andriguetti N, Tegner M, Artmann A, Kluck H, Franzoi M, Vilela R, Schwartsmann G, Linden R, Antunes M. Determination of docetaxel in dried blood spots by LC–MS/MS: Method development, validation and clinical application. J Pharm Biomed Anal 2018; 157:84-91. [DOI: 10.1016/j.jpba.2018.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 01/05/2023]
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Hahn RZ, Antunes MV, Verza SG, Perassolo MS, Suyenaga ES, Schwartsmann G, Linden R. Pharmacokinetic and Pharmacogenetic Markers of Irinotecan Toxicity. Curr Med Chem 2018. [PMID: 29932028 DOI: 10.2174/0929867325666180622141101)] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Irinotecan (IRI) is a widely used chemotherapeutic drug, mostly used for first-line treatment of colorectal and pancreatic cancer. IRI doses are usually established based on patient's body surface area, an approach associated with large inter-individual variability in drug exposure and high incidence of severe toxicity. Toxic and therapeutic effects of IRI are also due to its active metabolite SN-38, reported to be up to 100 times more cytotoxic than IRI. SN-38 is detoxified by the formation of SN-38 glucuronide, through UGT1A1. Genetic polymorphisms in the UGT1A1 gene are associated to higher exposures to SN-38 and severe toxicity. Pharmacokinetic models to describe IRI and SN-38 kinetic profiles are available, with few studies exploring pharmacokinetic and pharmacogenetic-based dose individualization. The aim of this manuscript is to review the available evidence supporting pharmacogenetic and pharmacokinetic dose individualization of IRI in order to reduce the occurrence of severe toxicity during cancer treatment. METHODS The PubMed database was searched, considering papers published in the period from 1995-2017, using the keywords irinotecan, pharmacogenetics, metabolic genotyping, dose individualization, therapeutic drug monitoring, pharmacokinetics and pharmacodynamics, either alone or in combination, with original papers being selected based on the presence of relevant data. CONCLUSION The findings of this review confirm the importance of considering individual patient characteristics to select IRI doses. Currently, the most straightforward approach for IRI dose individualization is UGT1A1 genotyping. However, this strategy is sub-optimal due to several other genetic and environmental contributions to the variable pharmacokinetics of IRI and its active metabolite. The use of dried blood spot sampling could allow the clinical application of limited sampling and population pharmacokinetic models for IRI doses individualization.
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Affiliation(s)
- Roberta Zilles Hahn
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo- RS, Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | - Marina Venzon Antunes
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo- RS, Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | - Simone Gasparin Verza
- Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | - Magda Susana Perassolo
- Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | - Edna Sayuri Suyenaga
- Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
| | | | - Rafael Linden
- Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo- RS, Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo- RS, Brazil
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Schwartsmann G, Franzoi MAB, Alves GV, Antunes MV, Neto O, Artmann A, Raymundo S, Tegner M, Muller V, Hahn RZ, Linden R. Predicting 5-Fluorouracil related severe toxicity with DPD functional tests in plasma, fresh saliva and dried saliva samples. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e14563] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Olavo Neto
- Feevale University, Novo Hamburgo, Brazil
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Schwartsmann G, Sprinz E, Kalakun L, Yamagushi N, Sander E, Grivicich I, Koya R, Mans DR. Phase II Study of Pentosan Polysulfate (PPS) in Patients with AIDS-related Kaposi's Sarcoma. Tumori 2018; 82:360-3. [PMID: 8890970 DOI: 10.1177/030089169608200412] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background To evaluate the response rate, toxicity and survival of patients with AIDS-related Kaposi's sarcoma (AIDS-KS) treated in a phase II clinical trial of pentosan polysulpate (PPS), an inhibitor of basic-fibroblast growth factor (b-FGF) which blocks the growth of Kaposi's sarcoma cells both in culture and in animal models. Patients and methods Between March 1992 and March 1994 16 homosexual males with histopathologically confirmed AIDS-KS were accrued for this phase II clinical trial. PPS was administered at the dose of 25 mg/m2 q6 hrs at day 1, followed by 25 mg/m2 q12 hrs daily by a subcutaneous injection. The number of patients to be included in the trial was calculated according to the two-stage Gehan method. Toxicity was graded according to the NCI Common Toxicity Criteria, while responses were evaluated according to the WHO Criteria adapted for KS lesions. Patients were all homosexual males, median age 35 (27-43) years, performance status (WHO) 1 (0-2), NYU stage II-IV and prior therapy included vincristine and etoposide (3 cases), local irradiation (4 cases) and meges-trol acetate (2 cases). Concomitant AZT (zidovudine) was given to 3 patients, while DDI (dideoxyinosine) was administered in one case. Results A median of 5 (3-11) weeks of therapy was administered to the patients. Pain at the injection site and low grade fever were the only toxicities observed. Drug-related effects on coagulation parameters or thrombocytopenia were not observed in the trial. One objective response (6%) was documented, which lasted for 9 weeks, while stable disease was observed in three patients, lasting for 11, 9 and 5 weeks, respectively. Conclusion This is the first observation of objective antitumor activity with a b-FGF inhibitor in patients with AIDS-KS. Considering its novelty and the lack of significant toxicity, the authors suggest that this experimental approach deserves further evaluation.
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Affiliation(s)
- G Schwartsmann
- Department of Medical Oncology, Academic Hospital of Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Brazil
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Mans DR, Di Leone L, Ferrary Caldas AP, Maino M, Almeida L, Cancela AI, Grivicich I, Brondani da Rocha A, Schwartsmann G. Cellular and Clinical Pharmacokinetic/Pharmacodynamic Basis for Lack of Efficacy of 21-Day Continuous Topotecan in Patients with Untreated Advanced Adenocarcinoma of the Pancreas. Tumori 2018; 86:458-64. [PMID: 11218186 DOI: 10.1177/030089160008600605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background In a phase II study, topotecan was evaluated for response and toxicity in patients with advanced pancreatic carcinoma at the schedule of 0.7 mg/m2/day q 21 days q 28 days. Methods Responses were assessed after at least 2 courses using WHO criteria, and toxicity was evaluated after each course according to the CTC-NCI standards. Between December 1995 and September 1997, 15 assessable patients (median age, 55 years; range, 36-74; median ECOG performance, 1; range, 0-3) were included in the study. All had biopsy-proven and measurable disease, a life-expectancy of at least 3 months, and normal bone marrow, liver, and renal function. None of the patients had undergone prior cytotoxic or radiation therapy, and 10 were initially treated by surgery. Twenty-five cycles were assessable for toxicity. Plasma was collected from 7 patients who had received a total of 10 cycles and was, after extraction with methanol at −20°C, analyzed for total topotecan by an HPLC method. The thus determined steady-state concentrations were assessed for their capacity to affect growth and DNA integrity in the BxPC-3 human pancreatic carcinoma cell line after 21 days of continuous exposure. For these purposes, we used a sulforhodamine B staining assay, and agarose gel electrophoresis, respectively. Results Grades 3-4 leukopenia, thrombocytopenia, granulocytopenia, and anemia occurred in 8, 6, 8 and 8 cycles, respectively. Other mild to moderate side effects (grades 1-2) included malaise, nausea and vomiting, anorexia, and alopecia. No objective tumor response was documented. HPLC analysis of patients' plasma showed the attainment of constant steady-state levels of 1.0 ± 0.1 ng/mL during the entire infusion period. At such a concentration, topotecan did not significantly affect growth or DNA integrity in the BxPC-3 cells. Fifty percent cell growth inhibition and appreciable oligonucleosomal DNA fragmentation were only evident with 21 days topotecan ≥ 50 ng/mL. Conclusions Our data suggest that the lack of clinical activity of 0.7 mg/m2 daily topotecan for 21 days q 28 days in patients with advanced pancreatic carcinoma might be partially attributed to the achievement of non-tumoricidal plasma drug concentrations.
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Affiliation(s)
- D R Mans
- South-American Office for Anticancer Drug Development (SOAD), Lutheran University of Brazil, Canoas
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26
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Andriguetti NB, Hahn RZ, Lizot LF, Raymundo S, Costa JL, da Cunha KF, Vilela RM, Kluck HM, Schwartsmann G, Antunes MV, Linden R. Analytical and clinical validation of a dried blood spot assay for the determination of paclitaxel using high-performance liquid chromatography-tandem mass spectrometry. Clin Biochem 2018. [DOI: 10.1016/j.clinbiochem.2018.02.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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27
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Kersting N, Kunzler Souza B, Araujo Vieira I, Pereira Dos Santos R, Brufatto Olguins D, José Gregianin L, Tesainer Brunetto A, Lunardi Brunetto A, Roesler R, Brunetto de Farias C, Schwartsmann G. Epidermal Growth Factor Receptor Regulation of Ewing Sarcoma Cell Function. Oncology 2018. [PMID: 29539615 DOI: 10.1159/000487143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Ewing sarcoma (ES) is a type of childhood cancer probably arising from stem mesenchymal or neural crest cells. The epidermal growth factor receptor (EGFR) acts as a driver oncogene in many types of solid tumors. However, its involvement in ES remains poorly understood. METHODS Human SK-ES-1 and RD-ES ES cells were treated with EGF, the EGFR inhibitor tyrphostin (AG1478), or phosphoinositide 3-kinase (PI3K) or extracellular-regulated kinase (ERK)/mitogen-activated kinase (MAPK) inhibitors. Cell proliferation survival, cycle, and senescence were analyzed. The protein content of possible targets of EGFR manipulation was measured by Western blot. RESULTS Cell proliferation and survival were increased by EGF and inhibited by AG1478. The EGFR inhibitor also altered the cell cycle, inducing arrest in G1 and increasing the sub-G1 population, reduced polyploidy and increased the population of senescent cells. In addition, AG1478 reduced the levels of phosphorylated AKT (p-AKT), ERK, p-ERK, cyclin D1, and brain-derived neurotrophic factor (BDNF), while enhancing p53 levels. Cell proliferation was also impaired by inhibitors of PI3K or ERK, alone or combined with AG1478. CONCLUSIONS Our findings reveal novel aspects of EGFR regulation of ES cells and provide early evidence for antitumor activities of EGFR inhibitors in ES.
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Affiliation(s)
- Nathália Kersting
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil
| | - Bárbara Kunzler Souza
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil
| | - Igor Araujo Vieira
- Laboratory of Genomic Medicine, Experimental Research Center, Clinical Hospital (CPE-HCPA), Porto Alegre, Brazil
| | - Rafael Pereira Dos Santos
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil.,Department of Pharmacology, Institute for Basic Health Sciences, Porto Alegre, Brazil
| | - Danielly Brufatto Olguins
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil
| | - Lauro José Gregianin
- Department of Pediatrics, Faculty of Medicine, Porto Alegre, Brazil.,Pediatric Oncology Service, Clinical Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - André Tesainer Brunetto
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil.,Rafael Koff Acordi Research Center, Children's Cancer Institute, Porto Alegre, Brazil
| | - Algemir Lunardi Brunetto
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil.,Rafael Koff Acordi Research Center, Children's Cancer Institute, Porto Alegre, Brazil
| | - Rafael Roesler
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil.,Department of Pharmacology, Institute for Basic Health Sciences, Porto Alegre, Brazil
| | - Caroline Brunetto de Farias
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil.,Rafael Koff Acordi Research Center, Children's Cancer Institute, Porto Alegre, Brazil
| | - Gilberto Schwartsmann
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE HCPA), Porto Alegre, Brazil.,Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Hahn RZ, Arnhold PC, Andriguetti NB, Schneider A, Klück HM, dos Reis SL, Bastiani MF, Kael I, da Silva ACC, Schwartsmann G, Antunes MV, Linden R. Determination of irinotecan and its metabolite SN-38 in dried blood spots using high-performance liquid-chromatography with fluorescence detection. J Pharm Biomed Anal 2018; 150:51-58. [DOI: 10.1016/j.jpba.2017.11.079] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 11/28/2017] [Accepted: 11/30/2017] [Indexed: 12/22/2022]
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Macarulla TM, Hubner R, Blanc JF, Wang-Gillam A, Li CP, Bodoky G, Dean AP, Yanshen S, Jameson GS, Lee KH, Chiu CF, Schwartsmann G, Braiteh FS, Cunningham D, Chen LT, Von Hoff DD, Mamlouk KK, de Jong FA, Siveke JT. Subgroup analysis by baseline (BL) weight-associated parameters: A phase III study of liposomal irinotecan (nal-IRI)±5-fluorouracil/leucovorin (5-FU/LV) in patients (pts) with metastatic pancreatic ductal adenocarcinoma (mPDAC) previously treated with gemcitabine-based (gem) therapy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.410] [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
410 Background: We report prognostic evaluation of BL weight-associated parameters (body-mass index [BMI], body surface area [BSA] and weight) in pts with mPDAC after progression following gem-based therapy (NAPOLI-1 trial; NCT01494506). Pts received nal-IRI+5-FU/LV, nal-IRI monotherapy or 5-FU/LV in NAPOLI-1, an international, randomised, phase 3 trial; nal-IRI+5-FU/LV treatment resulted in a 45% increased median OS vs. 5-FU/LV (unstratified HR = 0.67; p = 0.012). Methods: This exploratory subgroup analysis compares outcomes by BL BMI, BSA and weight, using primary survival analysis data from the ITT population for all treatment arms combined (n = 417) and the nal-IRI+5-FU/LV arm on its own (n = 117). Results: OS and PFS were not significantly different between BL BMI, BSA and weight median subgroups in the entire NAPOLI-1 ITT population (HR range 1.06–1.15; log-rank p-value range 0.21–0.60; Table) and in the nal-IRI+5-FU/LV arm (HR range 0.94–1.19; log-rank p-value range 0.43–1.00). Conclusions: This post-hoc subgroup analysis did not detect any prognostic impact on treatment outcome by BL BMI, BSA and weight for mPDAC pts progressed following gem-based therapy. This observation rules out a treatment-independent effect. No evidence of a predictive effect on nal-IRI+5-FU/LV efficacy was found. Clinical trial information: NCT01494506. [Table: see text]
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Affiliation(s)
| | - Richard Hubner
- Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | - Chung-Pin Li
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | - Shan Yanshen
- National Cheng Kung University Hospital, Tainan, Taiwan
| | | | - Kyung-Hun Lee
- Seoul National University Hospital, Seoul, Korea, Republic of (South)
| | | | | | | | | | - Li-Tzong Chen
- National Health Research Institutes/ National Institute of Cancer Research, Tainan, Taiwan
| | | | | | | | - Jens T. Siveke
- West German Cancer Center, University Hospital Essen, Essen, Germany
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Blanc J, Hubner R, Li CP, Wang-Gillam A, Bodoky G, Dean A, Shan YS, Jameson G, Macarulla Mercade T, Lee KH, Cunningham D, Chiu CF, Schwartsmann G, Braiteh F, von Hoff D, Chen LT, Mamlouk K, de Jong F, Siveke J. Subgroup analysis by prior non-liposomal irinotecan therapy in NAPOLI-1: a phase 3 study of nal-IRI±5-fluorouracil/leucovorin in patients with metastatic pancreatic ductal adenocarcinoma previously treated with gemcitabine-based therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx660.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Chen LT, Wang-Gillam A, Shan YS, Macarulla Mercade T, Blanc J, Hubner R, Chiu CF, Schwartsmann G, Siveke J, Belanger B, de Jong F, Mamlouk K, von Hoff D. CA19-9 decrease and overall survival (OS) in the NAPOLI-1 trial of liposomal irinotecan (nal-IRI) ± 5-fluorouracil and leucovorin (5-FU/LV) in metastatic pancreatic ductal adenocarcinoma (mPDAC) previously treated with gemcitabine-based therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx660.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Franz JM, Portela P, Salim PH, Berger M, Fernando Jobim L, Roesler R, Jobim M, Schwartsmann G. CXCR2 +1208 CT genotype may predict earlier clinical stage at diagnosis in patients with prostate cancer. Cytokine 2017; 97:193-200. [DOI: 10.1016/j.cyto.2017.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/30/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
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Valiati FE, Vasconcelos M, Lichtenfels M, Petry FS, de Almeida RMM, Schwartsmann G, Schröder N, de Farias CB, Roesler R. Administration of a Histone Deacetylase Inhibitor into the Basolateral Amygdala Enhances Memory Consolidation, Delays Extinction, and Increases Hippocampal BDNF Levels. Front Pharmacol 2017; 8:415. [PMID: 28701956 PMCID: PMC5487430 DOI: 10.3389/fphar.2017.00415] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 05/05/2017] [Accepted: 06/13/2017] [Indexed: 01/28/2023] Open
Abstract
Gene expression related to the formation and modification of memories is regulated epigenetically by chromatin remodeling through histone acetylation. Memory formation and extinction can be enhanced by treatment with inhibitors of histone deacetylases (HDACs). The basolateral amygdala (BLA) is a brain area critically involved in regulating memory for inhibitory avoidance (IA). However, previous studies have not examined the effects of HDAC inhibition in the amygdala on memory for IA. Here we show that infusion of an HDAC inhibitor (HDACi), trichostatin A (TSA), into the BLA, enhanced consolidation of IA memory in rats when given at 1.5, 3, or 6 h posttraining, but not when the drug was infused immediately after training. In addition, intra-BLA administration of TSA immediately after retrieval delayed extinction learning. Moreover, we show that intra-BLA TSA in rats given IA training increased the levels of brain-derived neurotrophic factor in the dorsal hippocampus, but not in the BLA itself. These findings reveal novel aspects of the regulation of fear memory by epigenetic mechanisms in the amygdala.
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Affiliation(s)
- Fernanda E Valiati
- Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do SulPorto Alegre, Brazil.,Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital, Federal University of Rio Grande do SulPorto Alegre, Brazil
| | - Mailton Vasconcelos
- Institute of Psychology, Federal University of Rio Grande do SulPorto Alegre, Brazil
| | - Martina Lichtenfels
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital, Federal University of Rio Grande do SulPorto Alegre, Brazil
| | - Fernanda S Petry
- Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do SulPorto Alegre, Brazil.,Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital, Federal University of Rio Grande do SulPorto Alegre, Brazil
| | - Rosa M M de Almeida
- Institute of Psychology, Federal University of Rio Grande do SulPorto Alegre, Brazil
| | - Gilberto Schwartsmann
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital, Federal University of Rio Grande do SulPorto Alegre, Brazil.,Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do SulPorto Alegre, Brazil
| | - Nadja Schröder
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do SulPorto Alegre, Brazil
| | - Caroline B de Farias
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital, Federal University of Rio Grande do SulPorto Alegre, Brazil.,Children's Cancer InstitutePorto Alegre, Brazil
| | - Rafael Roesler
- Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do SulPorto Alegre, Brazil.,Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital, Federal University of Rio Grande do SulPorto Alegre, Brazil
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Chen LT, Wang-Gillam A, Shan YS, Macarulla T, Blanc JF, Hubner R, Chiu CF, Schwartsmann G, Siveke J, Marc PJ, Belanger B, de Jong F, Mamlouk K, Von Hoff D. CA19-9 decrease and overall survival (OS) in the NAPOLI-1 trial of liposomal irinotecan (nal-IRI) ± 5-fluorouracil and leucovorin (5-FU/LV) in metastatic pancreatic ductal adenocarcinoma (mPDAC) previously treated with gemcitabine-based therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx263.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Andrade Galarza A, Schwartsmann G, Venzon Antunes M. An easy-to-handle DPD deficiency test in saliva to identify patients at high-risk for life-threatening toxicity due to fluoropyrimidine therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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36
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Blanc JF, Hubner R, Li CP, Wang-Gillam A, Bodoky G, Dean A, Shan YS, Jameson G, Macarulla T, Lee KH, Cunningham D, Chiu CF, Schwartsmann G, Braiteh F, Von Hoff D, Chen LT, Mamlouk K, Bhargava P, de Jong F, Siveke J. Subgroup analysis by prior non-liposomal irinotecan therapy in NAPOLI-1: A phase 3 study of nal-IRI±5-fluorouracil/leucovorin in patients with metastatic pancreatic ductal adenocarcinoma previously treated with gemcitabine-based therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx263.017] [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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Macarulla TM, Siveke JT, Wang-Gillam A, Li CP, Bodoky G, Dean AP, Yanshen S, Jameson GS, Lee KH, Blanc JF, Chiu CF, Schwartsmann G, Braiteh FS, Cunningham D, Chen LT, Von Hoff DD, Mamlouk KK, Bhargava P, de Jong FA, Hubner R. Subgroup analysis by prior lines of metastatic therapy (mtx) in NAPOLI-1: A global, randomized phase 3 study of liposomal irinotecan (nal-IRI) ± 5-fluorouracil and leucovorin (5-FU/LV), vs. 5-FU/LV in patients (pts) with metastatic pancreatic ductal adenocarcinoma (mPDAC) who have progressed following gemcitabine-based therapy. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.4127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4127 Background: In the NAPOLI-1 study, nal-IRI+5-FU/LV significantly increased median OS vs. 5-FU/LV control (6.1 vs. 4.2 mo; unstratified HR = 0.67 [0.49–0.92]; p = .012). This is a subgroup analysis by prior lines of mtx. Methods: Study methodology has been published (Wang-Gillam; Lancet 2016). This exploratory subgroup analysis compares outcomes in pts with 0–1 vs. ≥2 prior mtx lines, based on primary survival analysis data (cut-off February 2014) of the ITT population. Results: OS, PFS and CA19-9 response rates in pts with 0–1 (65.8% of pts) or ≥2 (34.2%) prior mtx lines are shown (see Table). Median OS for nal-IRI+5-FU/LV improved vs. 5-FU/LV by 2.1 mo to 6.2 mo (HR = 0.66; p = .03) in pts with 0–1 prior mtx lines and by 1.1 mo to 5.4 mo (HR = 0.68; p = .18) in pts with ≥2 prior mtx lines. The safety profile was similar between subgroups with nal-IRI+5-FU/LV (≥grade 3 drug-related AEs: 43 [55%] with 0–1 and 20 [51%] with ≥2 prior mtx lines). Conclusions: This post-hoc subgroup analysis shows significant increases for nal-IRI+5-FU/LV over 5-FU/LV in OS, PFS and CA19-9 response in pts with 0–1 prior mtx lines. Median OS benefit was less prominent in later lines, but conclusions are restricted by limited pt numbers. Clinical trial information: NCT01494506. [Table: see text]
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Affiliation(s)
| | - Jens T. Siveke
- West German Cancer Center, University Hospital, Essen, Germany
| | | | - Chung-Pin Li
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | - Shan Yanshen
- National Cheng Kung University (NCKU) Hospital, Tainan, Taiwan
| | | | - Kyung-Hun Lee
- Seoul National University Hospital, Seoul, South Korea
| | | | | | | | | | | | - Li-Tzong Chen
- National Health Research Institutes - National Institute of Cancer Research, Tainan, Taiwan
| | - Daniel D. Von Hoff
- Translational Genomics Research Institute (TGen) and HonorHealth, Phoenix, AZ
| | | | | | | | - Richard Hubner
- Christie NHS Foundation Trust, Manchester, United Kingdom
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Ce Coelho J, Weis L, Marks P, Geib G, Liedke PER, Pereira RP, Rebelato T, Franzoi MAB, Branco M, Schwartsmann G, Azevedo SJ. Outcomes after the diagnosis of brain metastases in Brazilian NSCLC patients. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20568] [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
e20568 Background: Brain metastases (BM) are common and affects near half of patients with non-small-cell lung cancer (NSCLC), with poor prognosis. Few data is available about this group of patients and Brazilian are underrepresented. Methods: Patients with NSCLC that developed BM between January 05 and December 15 at Hospital de Clinicas de Porto Alegre were identified and medical records were reviewed. OS and PFS were estimated by Kaplan-Meier curves. Multivariate analysis was performed to identify factors associated with survival. Statistical analysis was performed with SPSS 22.0. Results: 113 patients were identified. Mean age was 60.1 ± 8.7 years, 50% were female, 84% were Caucasian, 87% had a positive smoking history, 71% had adenocarcinoma histology and 72% had stage IV disease at presentation. BM was present at initial diagnosis in 38% of patients. At diagnosis of BM, 39% of patients had a Karnofsky performance status < 70, 20% had systemic disease under control, 31% had more than 3 brain lesions and 81% had a GPA score ≤2. 35 patients (31%) were submitted to either surgery or stereotaxic radiotherapy (SRDT), 52 (46%) to whole brain radiation (WBRT) and 26 (23%) to best supportive care (BSC). With a median follow-up of 11.2 months, 96% of patients have died. The OS was 11.2 months (95% IC, 9.4 to 13.1). The median survival time following diagnosis of BM was 4.9 months and survival according to treatment was 16.3 months for resection, 8.9 months for SRDT, 3.8 months for WBRT and 0.7 months for BSC. A Karnofsky performance status < 70 at diagnosis of BM and palliative treatment to BM (WBRT or BSC) were associated with worse outcome in multivariate analysis. The GPA score wasn't statically associated with prognosis. A longer survival of patients submitted to WBRT was seen when compare to BSC, HR of 0.38. There is a trend for longer survival in patients submitted to BM resection when compared to SRDT, but without statically significance. Conclusions: To our knowledge this is the largest report of NSCLC patients with BM from Latin America. Our data is in line with previous reports. A poor Karnofsky performance status and palliative treatment to BM are associated with poor survival. WBRT is associated with longer survival when compared to BSC in all the GPA score stratus.
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Affiliation(s)
| | - Luiza Weis
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Patricia Marks
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Guilherme Geib
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | | | | | - Mariane Branco
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Schwartsmann G, Antunes MV, Galarza A, Hahn RZ, Raymundo S, da Silva ACC, Staggemeier R, Spilki FR, Longhinoti LB, Anjos GM, Franzoi MAB, Linden R. An easy-to-handle DPD deficiency test in saliva to identify patients at high-risk for life-threatening toxicity due to fluoropyrimidine therapy. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e14019] [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
e14019 Background: Severe dihydropyrimidine dehydrogenase (DPD) deficiency can be lethal in 0.5-3.0% of patients receiving fluoropyrimidines. Unfortunately, there is no routine test in medical practice to identify high-risk patients. Here, we evaluated the use of plasma and saliva uracil (U) to dihydrouracil (UH2) metabolic ratio and DPYD genotyping, as a means to identify patients with DPD deficiency and fluoropyrimidine toxicity. In addition, we report on a functional test using UH2/U metabolic ratio in dried saliva spots (DSS). Methods: Prior to fluoropyrimidine therapy, plasma and saliva samples were obtained from 60 patients with GI cancer. U and UH2 levels were measured by LC-MS/MS in plasma and saliva. Patients were also genotyped for DPYD (*7/*2A/*13/Y186C). WHO grading were used to report treatment toxicity. Results: In 21 patients (35%) toxicity was documented. For those, no variant allele carrier for DPYD was identified. The UH2/U metabolic ratios were 0.1-26.7 in plasma and 0.1-24.0 in saliva, with a higher correlation with toxicity grade in saliva as compared to plasma (rs 0.52 vs 0.28). Median metabolic ratios were lower in patients with severe toxicity as compared to those with no toxicity (0.59 vs 2.83 saliva; 1.62 vs 6.75 plasma, P < 0.01). A cut-off of 1.16 for the salivary UH2/U ratio was set (AUC 0.84) with 86% sensitivity and 77% specificity for the identification of grade 3-4 toxicity. A plasma cut-off of 4.0 (AUC 0.75) revealed a 71% sensitivity and 76% specificity. Moreover, saliva of 21 patients were applied to filter paper to obtain DSS and sent to the laboratory by regular mail. U and UH2 were stable in DSS stored at 45°C up to 7 days. In this set of patients, grade 3-4 toxicity was documented in 3/21 cases (14%), all three cases had metabolic ratios below 1.16 in DSS, confirming our prior results. Conclusions: DPYD genotyping failed to identify severe DPD deficiency, but the UH2/U metabolic ratios in saliva showed enough sensitivity and specificity to deserve further evaluation. DSS samples allowed medical oncologists working at distant sites to send us samples by post, with results available within a week. This test is being validated in a larger sample population.
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Affiliation(s)
| | | | - Andres Galarza
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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40
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Chen LT, Wang-Gillam A, Yanshen S, Macarulla T, Blanc JF, Hubner R, Chiu CF, Schwartsmann G, Siveke JT, Pipas JM, Belanger B, de Jong F, Mamlouk K, Von Hoff DD. Efficacy and safety of liposomal irinotecan (nal-IRI) + 5-fluorouracil and leucovorin (5-FU/LV) in patients (pts) with metastatic pancreatic ductal adenocarcinoma (mPDAC) who previously received gemcitabine (gem)-based therapy: Post-hoc analysis of the NAPOLI-1 trial. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.303] [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
303 Background: nal-IRI+5-FU/LV is approved in the United States and Taiwan for pts with mPDAC previously treated with gem-based therapy based on the NAPOLI-1 study which showed that nal-IRI+5-FU/LV improved overall survival (OS) vs 5-FU/LV (6.1 vs 4.2 mo; HR, 0.67; 95% CI, 0.49-0.92; P = 0.012; Wang-Gillam et al, Lancet. 2016). This post hoc analysis evaluated the efficacy and safety of nal-IRI+5-FU/LV in subgroups of pts defined by prior gem regimen including gem monotherapy and gem combinations (combo). Methods: This analysis (data cutoff, Nov 2015) focuses on the 236 pts assigned to nal-IRI+5-FU/LV q2w (n = 117) or 5-FU/LV qw for weeks 1-4 q6w cycle (n = 119). Pts previously received gem-based therapy in a neoadjuvant, adjuvant, locally advanced, or metastatic setting. Results: Of 117 pts in the nal-IRI+5-FU/LV arm, 53 (45%) previously received gem monotherapy and 64 (55%) previously received gem combo including erlotinib (n = 9) or nab-paclitaxel (n = 20). Of the 119 pts in the 5-FU/LV arm, 55 (46%) previously received gem monotherapy and 64 (54%) previously received gem combo including erlotinib (n = 17) or nab-paclitaxel (n = 11). Nal-IRI+5-FU/LV improved median OS, median PFS, and ORR vs 5-FU/LV, regardless of prior therapy (Table). Grade ≥3 treatment-emergent adverse events were not influenced by prior treatment. Clinical trial information: NCT01494506. Conclusions: These resultsshow consistent benefit of nal-IRI+5-FU/LV treatment across subgroups of pts who previously received gem therapy and support the ASCO guidelines recommending nal-IRI+5-FU/LV for this pt population. These analyses may be limited by the small sample size of treatment arms.[Table: see text]
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Affiliation(s)
- Li-Tzong Chen
- National Health Research Institutes- National Institute of Cancer Research, Tainan, Taiwan
| | | | - Shan Yanshen
- National Cheng Kung University, Institute of Clinical Medicine, Tainan, Taiwan
| | - Teresa Macarulla
- Vall d' Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - Richard Hubner
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | - Gilberto Schwartsmann
- Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jens T. Siveke
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | | | | | | | | | - Daniel D. Von Hoff
- Translational Genomics Research Institute and HonorHealth Research Institute, Phoenix and Scottsdale, AZ
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41
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Caglevic C, Gallardo J, de la Torre M, Mahave M, Müller B, Solé S, Moscoso Y, De La Fuente H, Roa JC, Hoefler S, Butte JM, González M P, O'Connor JM, Torres J, Pérez Encalada V, Alarcón Cano D, Ubillos L, Rolfo C, Lingua A, Díaz Romero C, Padilla Rosciano A, Cuartero V, Calderillo Ruiz G, Schwartsmann G, Kon Jara X, Andrade G A, Mas López L, Barajas O, Carballido M, Lembach H, Morillas G L, Roca E, Lobatón J, Montenegro B P, Yepes A, Marsiglia H. [Recommendations for the management of pancreatic cancer type adenocarcinoma: A consensus statement reached during the 2015 Latin American Symposium on Gastroenterological Oncology]. Rev Med Chil 2017; 144:1305-1318. [PMID: 28074986 DOI: 10.4067/s0034-98872016001000010] [Citation(s) in RCA: 3] [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: 11/17/2022]
Abstract
Pancreatic cancer is a malignancy of great impact in developed countries and is having an increasing impact in Latin America. Incidence and mortality rates are similar for this cancer. This is an important reason to offer to the patients the best treatments available. During the Latin American Symposium of Gastroenterology Oncology (SLAGO) held in Viña del Mar, Chile, in April 2015, a multidisciplinary group of specialists in the field met to discuss about this disease. The main conclusions of this meeting, where practitioners from most of Latin American countries participated, are listed in this consensus that seek to serve as a guide for better decision making for patients with pancreatic cancer in Latin America.
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Affiliation(s)
| | | | - Marcela de la Torre
- Centro Especializado en Terapia Radiante, Hospital Clínicas San José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Mauricio Mahave
- Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile,
| | | | | | - Yuri Moscoso
- Unidad de Cuidados Paliativos, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | | | | | | | - Jean M Butte
- Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile
| | | | - Juan Manuel O'Connor
- Sección de Tumores Gastrointestinales, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Javiera Torres
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - Luis Ubillos
- Servicio de Oncología Clínica, Hospital de Clínicas, Montevideo, Uruguay
| | - Christian Rolfo
- Unidad de Desarrollo Temprano de Drogas-Estudios Fase I, Hospital Universitario de Antwerp, Amberes, Bélgica
| | - Alejo Lingua
- Área Oncología Digestiva, Clínica Privada Universitaria Reina Fabiola, Córdoba, Argentina
| | - Consuelo Díaz Romero
- Unidad Funcional de Tumores Digestivos, Instituto Nacional de Cancerología, México, México
| | | | | | | | | | | | | | - Luis Mas López
- Instituto Nacional de Enfermedades Neoplásicas,Lima,Perú
| | - Olga Barajas
- Instituto Oncológico Fundación Arturo López Pérez,Santiago,Chile
| | - Marcela Carballido
- Hospital de Gastroenterologia Dr. Carlos Bonorino Udaondo,Buenos Aires,Argentina
| | | | - Lena Morillas G
- Centro de Enfermedades Neoplásicas ONCOVIDA, La Paz, Bolivia
| | - Enrique Roca
- Hospital de Gastroenterologia Dr. Carlos Bonorino Udaondo,Buenos Aires,Argentina
| | | | | | - Andrés Yepes
- Fundación Colombiana de Cancerología, Medellín,Colombia
| | - Hugo Marsiglia
- nstituto Oncológico Fundación Arturo López Pérez,Santiago,Chile
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42
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Portela P, Merzoni J, Lindenau JD, Damin DC, Wilson TJ, Roesler R, Schwartsmann G, Jobim LF, Jobim M. KIR genes and HLA class I ligands in a Caucasian Brazilian population with colorectal cancer. Hum Immunol 2017; 78:263-268. [PMID: 28088355 DOI: 10.1016/j.humimm.2017.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 12/31/2016] [Accepted: 01/08/2017] [Indexed: 12/22/2022]
Abstract
Colorectal cancer (CRC) can occur anywhere in the colon or rectum and represents the third most common cancer in the world in both sexes. Natural killer cells (NK) are part of the innate immune system recognizing class I HLA molecules on target cells through their membrane receptors, called killer cell immunoglobulin-like receptors (KIR). The aim of our study was to evaluate the association between the KIR genes and HLA ligands in patients with colorectal cancer and healthy controls. We examined the polymorphism of 16 KIR genes and their HLA ligands in 154 caucasoid CRC patients and 216 controls. When both groups were compared, no significant differences were found for HLA ligands and KIR genes after Bonferroni correction. However, the Bx haplotypes (heterozygous and homozygous for the haplotype B) were more frequent in controls, when compared with patients. These findings suggest that individuals with Bx haplotypes could have some protection to colorectal cancer. The hypothesis is not related with the presence of a special KIR gene and HLA ligand related to the disease, but to the presence of several activating genes in the individuals with no better action of one in relation to other. Further studies to confirm this observation are warranted.
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Affiliation(s)
- Pâmela Portela
- Department of Immunology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Joice Merzoni
- Department of Immunology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Juliana D Lindenau
- Department of Genetic, Institute of Biosciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Daniel C Damin
- Division of Coloproctology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Timothy John Wilson
- Department of Immunology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Rafael Roesler
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gilberto Schwartsmann
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Internal Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luiz Fernando Jobim
- Department of Immunology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Department of Internal Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mariana Jobim
- Department of Immunology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Chen LT, Wang-Gillam A, Li CP, Bodoky G, Dean A, Shan YS, Jameson G, Macarulla T, Lee KH, Cunningham D, Blanc JF, Hubner R, Chiu CF, Schwartsmann G, Braiteh F, Belanger B, Bayever E, de Jong F, von Hoff D, Siveke J. Final results of NAPOLI-1: A phase 3 study of nal-IRI (MM-398) ± 5-fluorouracil and leucovorin (5-FU/LV) vs 5-FU/LV in metastatic pancreatic cancer (mPAC) previously treated with gemcitabine-based therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hubner R, Chen LT, Siveke J, Li CP, Bodoky G, Dean A, Shan YS, Jameson G, Macarulla T, Lee KH, Cunningham D, Blanc JF, Chiu CF, Schwartsmann G, Braiteh F, Mamlouk K, Belanger B, de Jong F, von Hoff D, Wang-Gillam A. Time course of selected treatment emergent adverse events (TEAEs) in NAPOLI-1: A phase 3 study of nal-IRI (MM-398) ± 5-fluorouracil and leucovorin (5-FU/LV) vs 5-FU/LV in metastatic pancreatic cancer (mPAC) previously treated with gemcitabine-based therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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45
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Weis LN, Coelho JC, Marks P, Geib G, Liedke P, Pereira R, Schwartsmann G, Azevedo S. P1.36: Non-Small-Cell Lung Cancer and Brain Metastases in Brazil. J Thorac Oncol 2016. [DOI: 10.1016/j.jtho.2016.08.058] [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: 11/25/2022]
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46
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Pinheiro KV, Alves C, Buendia M, Gil MS, Thomaz A, Schwartsmann G, de Farias CB, Roesler R, Bowman RL, Wang Q, Carro A, Verhaak RGW, Squatrito M. Targeting tyrosine receptor kinase B in gliomas. Neuro Oncol 2016; 19:138-139. [PMID: 27630272 DOI: 10.1093/neuonc/now199] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Kelly V Pinheiro
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Camila Alves
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Marienela Buendia
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Mirela S Gil
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Amanda Thomaz
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Gilberto Schwartsmann
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Caroline Brunetto de Farias
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Rafael Roesler
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.).
| | - Robert L Bowman
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Qianghu Wang
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Angel Carro
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Roel G W Verhaak
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
| | - Massimo Squatrito
- Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., G.S., C.B.F., R.R.); Department of Pharmacology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (K.V.P., C.A., M.B., M.S.G., A.T., R.R.); Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (G.S.), Children's Cancer Institute, Porto Alegre, Brazil (C.B.F.)
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Galarza AFA, Linden R, Antunes MV, Hahn RZ, Raymundo S, da Silva ACC, Staggemeier R, Spilki FR, Schwartsmann G. Endogenous plasma and salivary uracil to dihydrouracil ratios and DPYD genotyping as predictors of severe fluoropyrimidine toxicity in patients with gastrointestinal malignancies. Clin Biochem 2016; 49:1221-1226. [PMID: 27399164 DOI: 10.1016/j.clinbiochem.2016.07.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 05/21/2016] [Revised: 06/20/2016] [Accepted: 07/06/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the use of plasma and saliva uracil (U) to dihydrouracil (UH2) metabolic ratio and DPYD genotyping, as a means to identify patients with dihydropyrimidine dehydrogenase (DPD) deficiency and fluoropyrimidine toxicity. METHODS Paired plasma and saliva samples were obtained from 60 patients with gastrointestinal cancer, before fluoropyrimidine treatment. U and UH2 concentrations were measured by LC-MS/MS. DPYD was genotyped for alleles *7, *2A, *13 and Y186C. Data on toxicity included grade 1 to 4 neutropenia, mucositis, diarrhea, nausea/vomiting and cutaneous rash. RESULTS 35% of the patients had severe toxicity. There was no variant allele carrier for DPYD. The [UH2]/[U] metabolic ratios were 0.09-26.73 in plasma and 0.08-24.0 in saliva, with higher correlation with toxicity grade in saliva compared to plasma (rs=-0.515 vs rs=-0.282). Median metabolic ratios were lower in patients with severe toxicity as compared to those with absence of toxicity (0.59 vs 2.83 saliva; 1.62 vs 6.75 plasma, P<0.01). A cut-off of 1.16 for salivary ratio was set (AUC 0.842), with 86% sensitivity and 77% specificity for the identification of patients with severe toxicity. Similarly, a plasma cut-off of 4.0 (AUC 0.746), revealed a 71% sensitivity and 76% specificity. CONCLUSIONS DPYD genotyping for alleles 7, *2A, *13 and Y186C was not helpful in the identification of patients with severe DPD deficiency in this series of patients. The [UH2]/[U] metabolic ratios, however, proved to be a promising functional test to identify the majority of cases of severe DPD activity, with saliva performing better than plasma.
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Affiliation(s)
- Andrés Fernando Andrade Galarza
- Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Serviço de Oncologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Rafael Linden
- Instituto de Ciências da Saúde, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | | | - Roberta Zilles Hahn
- Instituto de Ciências da Saúde, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | - Suziane Raymundo
- Instituto de Ciências da Saúde, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | | | - Rodrigo Staggemeier
- Instituto de Ciências da Saúde, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | | | - Gilberto Schwartsmann
- Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Serviço de Oncologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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48
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Sternberg C, Armstrong A, Pili R, Ng S, Huddart R, Agarwal N, Khvorostenko D, Lyulko O, Brize A, Vogelzang N, Delva R, Harza M, Thanos A, James N, Werbrouck P, Bögemann M, Hutson T, Milecki P, Chowdhury S, Gallardo E, Schwartsmann G, Pouget JC, Baton F, Nederman T, Tuvesson H, Carducci M. Randomized, Double-Blind, Placebo-Controlled Phase III Study of Tasquinimod in Men With Metastatic Castration-Resistant Prostate Cancer. J Clin Oncol 2016; 34:2636-43. [PMID: 27298414 DOI: 10.1200/jco.2016.66.9697] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [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
PURPOSE Tasquinimod, a novel oral therapy targeting the tumor microenvironment, significantly improved progression-free survival (PFS) in a randomized, placebo-controlled phase II trial in men with metastatic castration-resistant prostate cancer (mCRPC). This phase III study was conducted to confirm the phase II results and to detect an overall survival (OS) benefit. PATIENTS AND METHODS Men with chemotherapy-naïve mCRPC and evidence of bone metastases were assigned (2:1) to receive tasquinimod once per day or placebo until progression or toxicity. The primary end point was radiographic PFS (rPFS; time from random assignment to radiologic progression or death) per Prostate Cancer Working Group 2 criteria and RECIST 1.1. The study had 99.9% power to detect an rPFS hazard ratio (HR) of 0.6 with a two-sided alpha error of .05 and 80% power to detect a target HR of 0.8 for OS, the key secondary end point. RESULTS In all, 1,245 patients were randomly assigned to either tasquinimod (n = 832) or placebo (n = 413) between March 2011 and December 2012 at 241 sites in 37 countries. Baseline characteristics were balanced between groups: median age, 71 years; Karnofsky performance status ≥ 90%, 77.3%; and visceral metastases, 21.1%. Estimated median rPFS by central review was 7.0 months (95% CI, 5.8 to 8.2 months) with tasquinimod and 4.4 months (95% CI, 3.5 to 5.5 months) with placebo (HR, 0.64; 95% CI, 0.54 to 0.75; P < .001). Median OS was 21.3 months (95% CI, 19.5 to 23.0 months) with tasquinimod and 24.0 months (95% CI, 21.4 to 26.9 months) with placebo (HR, 1.10; 95% CI, 0.94 to 1.28; P = .25). Grade ≥ 3 adverse events were more frequent with tasquinimod (42.8% v 33.6%), the most common being anemia, fatigue, and cancer pain. CONCLUSION In chemotherapy-naïve men with mCRPC, tasquinimod significantly improved rPFS compared with placebo. However, no OS benefit was observed.
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Affiliation(s)
- Cora Sternberg
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Andrew Armstrong
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Roberto Pili
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Siobhan Ng
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Robert Huddart
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Neeraj Agarwal
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Denis Khvorostenko
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Olexiy Lyulko
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Arija Brize
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Nicholas Vogelzang
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Rémy Delva
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Mihai Harza
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Anastasios Thanos
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Nicholas James
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Patrick Werbrouck
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Martin Bögemann
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Thomas Hutson
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Piotr Milecki
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Simon Chowdhury
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Enrique Gallardo
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Gilberto Schwartsmann
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Jean-Christophe Pouget
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Frédérique Baton
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Thore Nederman
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Helen Tuvesson
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Michael Carducci
- Cora Sternberg, San Camillo Forlanini Hospitals, Rome, Italy; Andrew Armstrong, Duke Cancer Institute, Duke University, Durham, NC; Roberto Pili, Indiana University School of Medicine, Indianapolis, IN; Siobhan Ng, St John of God Medical Centre, Subiaco, Western Australia, Australia; Robert Huddart, Royal Marsden Hospital, Sutton; Nicholas James, Queen Elizabeth Hospital, Birmingham; Simon Chowdhury, Guy's Hospital and Sarah Cannon Research UK, London, United Kingdom; Neeraj Agarwal, University of Utah, Salt Lake City, UT; Denis Khvorostenko, Leningrad Regional Oncology Dispensary, St Petersburg, Russia; Olexiy Lyulko, Zaporizhzhya Regional Clinical Hospital, Zaporizhzhya, Ukraine; Arija Brize, Riga Eastern Clinical University Hospital, Riga, Latvia; Nicholas Vogelzang, Comprehensive Cancer Centers of Nevada, Las Vegas, NV; Rémy Delva, Centre Régional de Lutte Contre le Cancer Paul Papin, Angers; Jean-Christophe Pouget and Frédérique Baton, Ipsen Innovation, Les Ulis, France; Mihai Harza, Fundeni Clinical Institute, Bucharest, Romania; Anastasios Thanos, Agios Savas Anticancer Oncology Hospital of Athens, Athens, Greece; Patrick Werbrouck, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium; Martin Bögemann, Universitätsklinikum Münster, Münster, Germany; Thomas Hutson, Texas Oncology, Dallas, TX; Piotr Milecki, Poznan University of Medical Sciences, Poznan, Poland; Enrique Gallardo, Corporació Sanitaria Parc Taulí, Sabadell, Spain; Gilberto Schwartsmann, Hospital De Clinicas De Porto Alegre, Porto Alegre, Brazil; Thore Nederman and Helen Tuvesson, Active Biotech, Lund, Sweden; and Michael Carducci, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD.
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Ce Coelho J, Alves GV, Debiasi M, Azeredo A, Weis L, Marks P, Sartori Pacini G, Dias de Moraes R, Branco M, Grasselli J, Zimmermann de Souza R, Muller C, Klamt F, Schwartsmann G, Azevedo SJ. Outcomes of chemoradiotherapy neoadjuvant for esophagus cancer in Brazil. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e15568] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Luiza Weis
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Patricia Marks
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | - Mariane Branco
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Carolina Muller
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fábio Klamt
- UFRGS/Departamento de Bioquimica, Porto Alegre, Brazil
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Wang-Gillam A, Li CP, Bodoky G, Dean A, Shan YS, Jameson GS, Macarulla T, Lee KH, Cunningham D, Blanc JF, Hubner R, Chiu CF, Schwartsmann G, Siveke JT, Braiteh FS, Moyo VM, Belanger B, Bayever E, Von Hoff DD, Chen LT. Updated overall survival (OS) analysis of NAPOLI-1: Phase 3 study of nanoliposomal irinotecan (nal-IRI, MM-398), with or without 5-fluorouracil and leucovorin (5-FU/LV), vs 5-FU/LV in metastatic pancreatic cancer (mPAC) previously treated with gemcitabine (gem)-based therapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.4126] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Chung-Pin Li
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Andrew Dean
- St. John of God Hospital, Subiaco, Australia
| | - Yang-Shen Shan
- National Institute of Cancer Research, National Health Institutes and National Cheng Kung University Hospital, Tainan, Taiwan
| | | | - Teresa Macarulla
- Vall d´Hebron University Hospital (HUVH) and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Kyung-Hun Lee
- Seoul National University Hospital, Seoul, South Korea
| | | | | | - Richard Hubner
- Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | | | | | - Jens T Siveke
- Klinikum rechts der Isar der TU Muenchen, Munich, Germany
| | | | | | | | | | | | - Li-Tzong Chen
- National Health Research Institutes (NHRI) - National Institute of Cancer Research, Taipei, Taiwan
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