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Del Mastro L, Poggio F, Blondeaux E, de Placido S, Giuliano M, De Laurentiis M, Bisagni G, Cantore M, Turletti A, Nisticò C, Urracci Y, Garrone O, Bighin C, Mansutti M, Montemurro F, Colantuoni G, Lambertini M, Boni L. 134O Dose-dense adjuvant chemotherapy in early-stage breast cancer patients: End-of-study results from a randomised, phase III trial of the Gruppo Italiano Mammella (GIM). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Petrelli F, Rulli E, Labianca R, Lonardi S, Rosati G, Dotti K, Ronzoni M, Pella N, Pusceddu V, Banzi M, Zampino MG, Yasmina M, Marchetti P, Cantore M, Zaniboni A, Rimassa L, Ciuffreda L, Ferrari D, Zagonel V, Maiello E, Sobrero A. Overall survival with 3 or 6 months of adjuvant chemotherapy in Italian TOSCA phase 3 randomised trial. Ann Oncol 2020; 32:66-76. [PMID: 33098997 DOI: 10.1016/j.annonc.2020.10.477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Oxaliplatin-based adjuvant chemotherapy is the standard treatment of high-risk colon cancer (CC). A shorter duration (3 months) can achieve a similar outcome [in terms of relapse-free survival (RFS)] to a longer duration. This study reports the overall survival (OS) analysis of the three or six colon adjuvant (TOSCA) phase III study. It assessed different adjuvant chemotherapy durations in patients with resected high-risk stage II and stage III CC. MATERIAL AND METHODS TOSCA was an open-label, phase III, multicentre, non-inferiority trial conducted in 130 Italian centres. Patients were randomly assigned, in a 1 : 1 ratio, to receive 3 months of standard doses of FOLFOX/CAPOX, or 6 months of FOLFOX/CAPOX. Patients with histologically confirmed high-risk stage II and III CC were included, with RFS being the primary end point. OS was a secondary end point. RESULTS From June 2007 to March 2013, 3759 patients were accrued. At a median follow-up of 7 years, the hazard ratio (HR) for RFS of the 3-month versus 6-month arms was 1.13; 95% confidence interval (CI) 0.99-1.29, P for non-inferiority = 0.380, P for superiority = 0.068, crossing the non-inferiority limit of 1.20. This result did not allow us to reject the null hypothesis of the inferiority of the 3-month arm. The HR for OS of the 3-month versus 6-month arms was 1.09 (95% CI 0.93-1.26, P for superiority = 0.288). At the last follow-up analysis, the absolute OS difference between arms was <1%. CONCLUSIONS The present analysis of the TOSCA trial does not indicate any significant difference in OS between the treatment groups. The extra benefit provided by the longer treatment should be balanced against the extra toxicity of more prolonged therapy. The trial is registered with ClinicalTrials.gov, registration number: NCT0064660.
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Affiliation(s)
- F Petrelli
- Medical Oncology Unit, Treviglio, Caravaggio Hospital, Treviglio, Bergamo, Italy.
| | - E Rulli
- Laboratory of Methodology for Clinical Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - R Labianca
- Cancer Center ASST Papa Giovanni XXIII, Bergamo, Italy
| | - S Lonardi
- Medical Oncology Unit 1, Istituto Oncologico Veneto - IRCCS, Padua, Italy
| | - G Rosati
- Medical Oncology Unit, Ospedale San Carlo, Potenza, Italy
| | - K Dotti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - M Ronzoni
- Medical Oncology Unit, Ospedale San Raffaele - IRCCS, Milan, Italy
| | - N Pella
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy
| | - V Pusceddu
- Medical Oncology, University Hospital and University of Cagliari, Cagliari, Italy
| | - M Banzi
- Medical Oncology Unit, AUSL-IRCCS, Reggio Emilia, Italy
| | - M G Zampino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumours, IRCCS, Milan, Italy
| | - M Yasmina
- Medical Oncology Unit, Rovigo Hospital, Rovigo, Italy
| | - P Marchetti
- Medical Oncology Unit, Sant'Andrea Hospital, Sapienza University of Rome and IDI-IRCCS, Rome, Italy
| | - M Cantore
- Medical Oncology Unit, ASST Mantova, Mantua, Italy
| | - A Zaniboni
- Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy
| | - L Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center-IRCCS, Rozzano (MI); Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - L Ciuffreda
- Medical Oncology Unit, Azienda Ospedaliero Universitaria San Giovanni Battista, Molinette, Turin, Italy
| | - D Ferrari
- Medical Oncology Unit, Azienda Ospedaliera San Paolo, Milan, Italy
| | - V Zagonel
- Medical Oncology Unit 1, Istituto Oncologico Veneto - IRCCS, Padua, Italy
| | - E Maiello
- Medical Oncology Unit, Hospital Casa Sollievo della Sofferenza-IRCCS, San Giovanni Rotondo, Italy
| | - A Sobrero
- Medical Oncology Unit, IRCCS San Martino-IST, Genoa, Italy
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Rosati G, Galli F, Cantore M, Lonardi S, Banzi M, Zampino M, Mattioli R, Pella N, Ronzoni M, Bartolomeo MD, Tamberi S, Marchetti P, Bozzarelli S, Corsi D, Bochicchio A, Artioli F, Labianca R, Galli F, Bilancia D, Bregni G. Clinical impact of mucinous and poorly differentiated tumours on the outcome of patients with stage II colon cancer: A TOSCA subgroup analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.028] [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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Blondeaux E, Cantore M, Michelotti A, Conte B, Benasso M, Bighin C, Lambertini M, Poggio F, Del Mastro L. Dose-dense adjuvant chemotherapy in early breast cancer: 15–year results of the phase III Mammella InterGruppo (MIG)-1 study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Obazee O, Archibugi L, Andriulli A, Soucek P, Małecka-Panas E, Ivanauskas A, Johnson T, Gazouli M, Pausch T, Lawlor RT, Cavestro GM, Milanetto AC, Di Leo M, Pasquali C, Hegyi P, Szentesi A, Radu CE, Gheorghe C, Theodoropoulos GE, Bergmann F, Brenner H, Vodickova L, Katzke V, Campa D, Strobel O, Kaiser J, Pezzilli R, Federici F, Mohelnikova-Duchonova B, Boggi U, Lemstrova R, Johansen JS, Bojesen SE, Chen I, Jensen BV, Capurso G, Pazienza V, Dervenis C, Sperti C, Mambrini A, Hackert T, Kaaks R, Basso D, Talar-Wojnarowska R, Maiello E, Izbicki JR, Cuk K, Saum KU, Cantore M, Kupcinskas J, Palmieri O, Delle Fave G, Landi S, Salvia R, Fogar P, Vashist YK, Scarpa A, Vodicka P, Tjaden C, Iskierka-Jazdzewska E, Canzian F. Germline BRCA2
K3326X and CHEK2
I157T mutations increase risk for sporadic pancreatic ductal adenocarcinoma. Int J Cancer 2019; 145:686-693. [PMID: 30672594 DOI: 10.1002/ijc.32127] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/23/2018] [Accepted: 12/05/2018] [Indexed: 02/05/2023]
Affiliation(s)
- O. Obazee
- Genomic Epidemiology Group; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - L. Archibugi
- Digestive and Liver Disease Unit, Pancreatic Disorders Clinic; S. Andrea Hospital, University of Sapienza; Rome Italy
- Pancreatico/Biliary Endoscopy and Endosonography Division; Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute; Milan Italy
| | - A. Andriulli
- Division of Gastroenterology and Research Laboratory, Department of Oncology; IRCCS Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”; San Giovanni Rotondo Italy
| | - P. Soucek
- Laboratory of Pharmacogenomics, Biomedical Centre, Faculty of Medicine in Plzen; Charles University in Prague; Plzen Czech Republic
| | - E. Małecka-Panas
- Department of Digestive Tract Diseases; Medical University of Lodz; Lodz Poland
| | - A. Ivanauskas
- Department of Gastroenterology; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - T. Johnson
- Division of Cancer Epidemiology; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - M. Gazouli
- Department of Basic Medical Sciences, Laboratory of Biology; Medical School National and Kapodistrian University of Athens; Athens Greece
| | - T. Pausch
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie; Heidelberg Germany
| | - R. T. Lawlor
- ARC-Net, Applied Research on Cancer Centre; University of Verona; Verona Italy
| | - G. M. Cavestro
- Gastroenterology and Gastrointestinal Endoscopy Unit; Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute; Milan Italy
| | - A. C. Milanetto
- Department of Surgery, Oncology and Gastroenterology -DiSCOG; University of Padova; Padova Italy
| | - M. Di Leo
- Gastroenterology and Gastrointestinal Endoscopy Unit; Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute; Milan Italy
| | - C. Pasquali
- Department of Surgery, Oncology and Gastroenterology -DiSCOG; University of Padova; Padova Italy
| | - P. Hegyi
- Institute for Translational Medicine and 1st Department of Medicine; University of Pécs; Pécs Hungary
| | - A. Szentesi
- Institute for Translational Medicine and 1st Department of Medicine; University of Pécs; Pécs Hungary
| | - C. E. Radu
- Fundeni Clinical Institute; Bucharest Romania
| | - C. Gheorghe
- Fundeni Clinical Institute; Bucharest Romania
| | - G. E. Theodoropoulos
- First Propaedeutic Surgical Department, "Hippocratio" General Hospital Athens Medical School; National and Kapodistrian University of Athens; Athens Greece
| | - F. Bergmann
- Pathologisches Institut der Universität Heidelberg; Heidelberg Germany
| | - H. Brenner
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
- Division of Preventive Oncology; German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT); Heidelberg Germany
- German Cancer Consortium (DKTK); German Cancer Research Center (DKFZ); Heidelberg Germany
| | - L. Vodickova
- Institute of Biology and Medical Genetics; 1st Medical Faculty, Charles University, Prague and Biomedical Center, Faculty of Medicine in Pilsen, Charles University; Prague Czech Republic
| | - V. Katzke
- Division of Cancer Epidemiology; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - D. Campa
- Dipartimento di Biologia; Università di Pisa; Pisa Italy
| | - O. Strobel
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie; Heidelberg Germany
| | - J. Kaiser
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie; Heidelberg Germany
| | - R. Pezzilli
- Pancreas Unit, Department of Digestive System; Sant'Orsola-Malpighi Hospital; Bologna Italy
| | - F. Federici
- Department of Massa Carrara Oncological; Azienda USL Toscana Nord Ovest; Carrara Italy
| | - B. Mohelnikova-Duchonova
- Department of Oncology, Faculty of Medicine and Dentistry; Palacky University Olomouc and University Hospital Olomouc; Olomouc Czech Republic
| | - U. Boggi
- Division of General and Transplant Surgery; Pisa University Hospital; Pisa Italy
| | - R. Lemstrova
- Department of Oncology, Faculty of Medicine and Dentistry; Palacky University Olomouc and University Hospital Olomouc; Olomouc Czech Republic
| | - J. S. Johansen
- Department of Oncology; Herlev and Gentofte Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - S. E. Bojesen
- Department of Clinical Biochemistry; Herlev and Gentofte Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - I. Chen
- Department of Oncology; Herlev and Gentofte Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - B. V. Jensen
- Department of Oncology; Herlev and Gentofte Hospital, Copenhagen University Hospital; Copenhagen Denmark
| | - G. Capurso
- Digestive and Liver Disease Unit, Pancreatic Disorders Clinic; S. Andrea Hospital, University of Sapienza; Rome Italy
- Pancreatico/Biliary Endoscopy and Endosonography Division; Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute; Milan Italy
| | - V. Pazienza
- Division of Gastroenterology and Research Laboratory, Department of Oncology; IRCCS Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”; San Giovanni Rotondo Italy
| | - C. Dervenis
- Department of Surgery; Konstantopouleion General Hospital of Athens; Athens Greece
| | - C. Sperti
- Department of Surgery, Oncology and Gastroenterology -DiSCOG; University of Padova; Padova Italy
| | - A. Mambrini
- Department of Massa Carrara Oncological; Azienda USL Toscana Nord Ovest; Carrara Italy
| | - T. Hackert
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie; Heidelberg Germany
| | - R. Kaaks
- Division of Cancer Epidemiology; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - D. Basso
- Department of Laboratory Medicine; University-Hospital of Padova; Padova Italy
| | | | - E. Maiello
- Division of Gastroenterology and Research Laboratory, Department of Oncology; IRCCS Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”; San Giovanni Rotondo Italy
| | - J. R. Izbicki
- Department of General; Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - K. Cuk
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - K. U. Saum
- Division of Clinical Epidemiology and Aging Research; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - M. Cantore
- Department of Massa Carrara Oncological; Azienda USL Toscana Nord Ovest; Carrara Italy
| | - J. Kupcinskas
- Department of Gastroenterology; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - O. Palmieri
- Division of Gastroenterology and Research Laboratory, Department of Oncology; IRCCS Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”; San Giovanni Rotondo Italy
| | - G. Delle Fave
- Digestive and Liver Disease Unit, Pancreatic Disorders Clinic; S. Andrea Hospital, University of Sapienza; Rome Italy
| | - S. Landi
- Dipartimento di Biologia; Università di Pisa; Pisa Italy
| | - R. Salvia
- Department of Surgery; Pancreas Institute, University and Hospital Trust of Verona; Verona Italy
| | - P. Fogar
- Department of Laboratory Medicine; University-Hospital of Padova; Padova Italy
| | - Y. K. Vashist
- Department of General; Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf; Hamburg Germany
- Section for Visceral Surgery; Department of Surgery, Kantonsspital Aarau AG; Aarau Switzerland
| | - A. Scarpa
- ARC-Net, Applied Research on Cancer Centre; University of Verona; Verona Italy
| | - P. Vodicka
- Institute of Experimental Medicine, Czech Academy of Science, Prague and Institute of Biology and Medical Genetics, 1 Medical Faculty, Charles University; Prague Czech Republic
| | - C. Tjaden
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie; Heidelberg Germany
| | | | - F. Canzian
- Genomic Epidemiology Group; German Cancer Research Center (DKFZ); Heidelberg Germany
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Cantore M, Fiorentini G, Aitini E, Davitti B, Cavazzini G, Rabbi C, Lusenti A, Bertani M, Morandi C, Benedini V. Intra-Arterial Hepatic Carboplatin-Based Chemotherapy for Ocular Melanoma Metastatic to the Liver. Report of a Phase II Study. Tumori 2018; 80:37-9. [PMID: 8191596 DOI: 10.1177/030089169408000107] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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
Aims and Background ocular melanoma tends to metastasize to the liver, sparing for a long time the rest of the organism. Therefore, a regional treatment is especially indicated. Methods eight patients with ocular melanoma metastatic to the liver were treated with intraarterial hepatic carboplatin-based chemotherapy at the dose of 300 mg/m2 once every two weeks at an outpatient clinic. All the patients were submitted to laparotomy with surgical implantation of an arterial port device through the gastroduodenal artery. Results the overall response rate was 38% with a median survival time of 15 months. The regimen was well tolerated and the principle toxicity was myelosuppression; any instance of hepatic and/ or cholangitic damage was reported. Conclusions Carboplatin seems suitable for intraarterial hepatic chemotherapy and active in ocular melanoma metastic to the liver.
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Affiliation(s)
- M Cantore
- Oncology Department, Civil Hospital of Mantova, Italy
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7
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Cavazzini G, Colpani F, Cantore M, Aitini E, Rabbi C, Taffurelli M, Pari F, Bellomi A, Bertuzzi A, Smerierl F. Breast Metastasis from Gastric Signet Ring Cell Carcinoma, Mimicking Inflammatory Carcinoma. A Case Report. Tumori 2018; 79:450-3. [PMID: 8171750 DOI: 10.1177/030089169307900617] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report a case of breast metastasis of signet ring cell gastric cancer clinically presented as a primary inflammatory carcinoma. Metastases to the breast are uncommon; review of the literature demonstrated only 300 cases. The clinical and radiographic features of the metastatic lesion were unlike those reported in the literature. Although a primary signet ring cell breast carcinoma was described, the pathologic patterns of the breast lesion, here reported, lead us to conclude this was a metastasis and not another primary tumor.
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Affiliation(s)
- G Cavazzini
- Medical Oncology Department, Ospedale Civile Carlo Poma, Mantova, Italy
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Aitini E, Rabbi C, Mambrini A, Cavazzini G, Pari F, Zamagni D, Cantore M, Pagani M, Sorio M, Lusenti A, Adami F, Smerieri F. Epirubicin, Cisplatin and Continuous Infusion 5-Fluorouracil (ECF) in Locally Advanced or Metastatic Gastric Cancer: A Single Institution Experience. Tumori 2018; 87:20-4. [PMID: 11669552 DOI: 10.1177/030089160108700105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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
Aims and Background The role of chemotherapy in locally advanced or metastatic gastric cancer has been controversial, but chemotherapy has recently been shown to relieve tumor-related symptoms, improve quality of life and prolong survival when compared with best supportive care. Furthermore, palliative chemotherapy is also cost-effective. “Second-generation” combination chemotherapy regimens were developed in the 1980s with high activity in advanced or metastatic gastric cancer (EAP, FAMTX, PELF, ECF). In randomized studies, EAP demonstrated no difference in activity but a significantly higher overall toxicity and toxic death rate than FAMTX, and the ECF (epirubicin, cisplatin, 5-fluorouracil) regimen gave a survival and response advantage, tolerable toxicity, better quality of life and was more cost-effective than FAMTX. Methods Sixty patients with locally advanced or metastatic gastric cancer were treated with the ECF regimen (21 weeks of 5-fluorouracil given by continuous infusion through a central line at 200 mg/m2 for 24-hr combined with cisplatin at 60 mg/m2 iv and epirubicin at 50 mg/m2 iv beginning on day 1 and repeated every 3 weeks for 8 courses). There were 42 males and 18 females, with a median age of 64 years (range, 40-74). The median performance status was 1. The histologic type was adenocarcinoma in 44 patients and undifferentiated carcinoma in 16 (27%). Three patients had locally advanced disease (5%) and 57 had metastatic disease (95%). Seven patients (12%) had received prior chemotherapy for advanced disease. Results All patients were assessable for toxicity and 55 for response (5 had insufficient treatment). Toxicity was mild or moderate, and there was no toxic death. Incidence of WHO toxicity ≥ 2 was nausea and vomiting in 3%, mucositis in 3%, leukopenia in 7%, anemia in 3%, and thrombocytopenia in 2%. Port-a-Cath toxicity was thrombosis in 4, dislocation in 2 and infection in 3 patients. Seven complete responses and 13 partial responses (overall response rate, 36%) were achieved, with a response rate of 39% in untreated and 17% in pretreated patients. Nine patients (16%) had stable disease and 26 (47%) progressive disease. Most patients felt symptomatically improved on ECF. Conclusions Our study confirms that the ECF regimen has a favorable pattern of toxicity and is feasible on an outpatient basis. However, it did not confirm the high response rate reported in other phase II trials.
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Affiliation(s)
- E Aitini
- Medical Oncology and Hematology Department, Carlo Poma Hospital, Mantua, Italy.
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Bandini G, Ricci P, Ruggero D, Cantore M, Visani G, Tura S. Lithium and Granulocytopenia during Induction Treatment of Adult Acute Lymphoblastic Leukemia. Tumori 2018; 68:427-30. [PMID: 6960590 DOI: 10.1177/030089168206800512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Twelve adult patients with acute lymphoblastic leukemia (ALL) received lithium carbonate, 300 mg, three times a day during induction treatment. They were compared to 12 similar patients consecutively treated with the same induction regimen; patients and controls were comparable for age, degree and presence of splenomegaly, hemoglobin level, blast cell count, polymorphonuclear (PMN) cell count and platelet count at diagnosis. All patients developed a severe neutropenia. PMN count at nadir was slightly higher in the lithium group, but not at a level of statistical significance (p = 0.100). The median number of days with PMN < 1 × 109/liter was 4 in the lithium group and 14.5 in the non-lithium group (p = 0.014), while the median number of days with PMN < 0.5 × 109/liter was 0 and 2 days, respectively (p = 0.004). Duration of thrombocytopenia was similar in the 2 groups and so was the remission rate; 2 infective episodes occurred, one in the lithium group and one in the controls.
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Fiorentini G, Lucchi SR, Giovanis P, Cantore M, Guadagni S, Papiani G. Irinotecan Hepatic Arterial Infusion Chemotherapy for Hepatic Metastases from Colorectal Cancer: Results of a Phase I Clinical Study. Tumori 2018; 87:388-90. [PMID: 11989591 DOI: 10.1177/030089160108700606] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 11/17/2022]
Abstract
Background Hepatic arterial infusion chemotherapy is a promising approach in liver metastases from colorectal cancer, but chemical hepatitis, biliary sclerosis, arterial thrombosis and right upper quadrant pain are limiting factors. Irinotecan (CPT-11) is an active drug in colorectal cancer. We planned a short hepatic arterial infusion of CPT-11 to describe the toxicity, to determine the dose-limiting toxicity, and to define the doses of CPT-11 to be recommended for phase II studies. Patients and Methods Fourteen patients with a median liver substitution of 30% (10-60%) were enrolled. All patients received hepatic arterial infusion chemotherapy with CPT-11 on an outpatient basis every 3 weeks as a short, 30-min infusion. Results At 240 mg/m2, 2 of 4 patients experienced grade 4 diarrhea and neutropenia, and 3 of them also reported grade 4 abdominal pain of the right upper quadrant. The maximum tolerated dose was reached at 240 mg/m2. The recommended doses of CPT-11 for phase II studies is 200 mg/m2, given every 3 weeks. Conclusions CPT-11 presents a low hepatic toxic profile and could be considered a new active drug, suitable for hepatic arterial infusion in liver metastases from colorectal cancer.
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Affiliation(s)
- G Fiorentini
- Department of Oncology and Hematology, City Hospital S Maria delle Croci, Ravenna, Italy.
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Lonardi S, Sobrero A, Rosati G, Di Bartolomeo M, Ronzoni M, Aprile G, Massida B, Scartozzi M, Banzi M, Zampino MG, Pasini F, Marchetti P, Cantore M, Zaniboni A, Rimassa L, Ciuffreda L, Ferrari D, Barni S, Zagonel V, Maiello E, Rulli E, Labianca R. Phase III trial comparing 3-6 months of adjuvant FOLFOX4/XELOX in stage II-III colon cancer: safety and compliance in the TOSCA trial. Ann Oncol 2017; 28:3110. [PMID: 28327986 DOI: 10.1093/annonc/mdx021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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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Labianca R, Lonardi S, Rosati G, Di Bartolomeo M, Ronzoni M, Pella N, Scartozzi M, Banzi M, Zampino M, Pasini F, Marchetti P, Cantore M, Zaniboni A, Rimassa L, Ciuffreda L, Barni S, Zagonel V, Maiello E, Rulli E, Sobrero A. FOLFOX4/XELOX in stage II–III colon cancer: Efficacy and safety results of the Italian Three Or Six Colon Adjuvant (TOSCA) trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.016] [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: 11/14/2022] Open
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Guadagni S, Müller H, Valenti M, Clementi M, Fiorentini G, Cantore M, Amicucci G. Thoracic Stop-Flow Perfusion in the Treatment of Refractory Non Small Cell Lung Cancer. J Chemother 2016; 16 Suppl 5:40-3. [PMID: 15675476 DOI: 10.1080/1120009x.2004.11782382] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This study was undertaken to determine the survival of patients with unresectable and refractory non small cell lung cancer (NSCLC) submitted to thoracic stop-flow perfusion (TSP). Forty-five patients with NSCLC confined to thoracic region entered the study. All 45 patients had been pretreated with some form of chemotherapy and had progression of disease. The cytostatic regimen was mitomycin 10 mg/m2, navelbine 25 mg/m2 and cisplatin 60 mg/m2. In 39/45 patients, immediately after TSP, hemofiltration was performed to reduce systemic side effects There were 16/45 responses to the first TSP (CR 0; PR 16): a response rate of 35.6%. Median time to progression was 4 months. Median survival was 7.5 months.1-year survival rate was 36.4%, 2-year survival rate was 14%, and 3-year survival rate was 5.7%.
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Affiliation(s)
- S Guadagni
- Dept of Surgical Sciences, University of L'Aquila, L'Aquila, Italy.
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Toccafondi A, Bonacchi A, Mambrini A, Miccinesi G, Prosseda R, Cantore M. Live concerts reduce cancer inpatients' anxiety. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27726208 DOI: 10.1111/ecc.12590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 11/29/2022]
Abstract
In Italy a new experience of music medicine called "The Music Givers" is spreading among Oncology Units; it aims to organise weekly live concerts (length 45-60 min) followed by a buffet. Purpose of the present study is to evaluate the effect of the format of The Music Givers on cancer in-patients' anxiety. State-Trait Anxiety Inventory (STAI-Y) was administered to 111 in-patients before and after the concerts. After the concerts we observed a 3.87 point decrease in state anxiety (p < .001) and statistically significant differences in most of the domains assessed by STAI-Y. These results invite a reflection on the importance of offering to inpatients events such as live music concerts, in order to improve their psychological condition during hospitalisation.
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Affiliation(s)
| | - A Bonacchi
- Research Center Synthesis, Florence, Italy.,Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
| | - A Mambrini
- Oncological Department, AUSL 1 Massa Carrara, Massa Carrara, Italy
| | - G Miccinesi
- Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
| | - R Prosseda
- Art Director of Donatori di Musica, Massa Carrara, Italy
| | - M Cantore
- Oncological Department, AUSL 1 Massa Carrara, Massa Carrara, Italy
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15
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Lonardi S, Sobrero A, Rosati G, Di Bartolomeo M, Ronzoni M, Aprile G, Massida B, Scartozzi M, Banzi M, Zampino MG, Pasini F, Marchetti P, Cantore M, Zaniboni A, Rimassa L, Ciuffreda L, Ferrari D, Barni S, Zagonel V, Maiello E, Rulli E, Labianca R. Phase III trial comparing 3-6 months of adjuvant FOLFOX4/XELOX in stage II-III colon cancer: safety and compliance in the TOSCA trial. Ann Oncol 2016; 27:2074-2081. [PMID: 27573560 DOI: 10.1093/annonc/mdw404] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 04/27/2016] [Accepted: 08/15/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Six months of oxaliplatin-based adjuvant chemotherapy is standard of care for radically resected stage III colon cancer and an accepted option for high-risk stage II. A shorter duration of therapy, if equally efficacious, would be advantageous for patients and Health-Care Systems. PATIENTS AND METHODS TOSCA ['Randomized trial investigating the role of FOLFOX-4 or XELOX (3 versus 6 months) regimen duration and bevacizumab as adjuvant therapy for patients with stage II/III colon cancer] is an open-label, phase III, multicenter, noninferiority trial randomizing patients with high-risk stage II or stage III radically resected colon cancer to receive 3 months (arm 3 m) versus 6 months (arm 6 m) of FOLFOX4/XELOX. Primary end-point was relapse-free survival. We present here safety and compliance data. RESULTS From June 2007 to March 2013, 3759 patients were accrued from 130 Italian sites, 64% receiving FOLFOX4 and 36% XELOX in either arm. Treatment completion rate without any modification was 35% versus 12% and with delays or dose reduction 52% versus 44% in arm 3 and 6 m. Treatment was permanently discontinued in 8% (arm 3 m) and 33% (arm 6 m). In arm 6 m, 50% of patients discontinuing treatment did so after completing 80% of planned program. Grade 3+ toxicities were higher in arm 6 m than that in 3 m. Grade 2+ neuropathy was 31.2% versus 8.8% (P < 0.0001) while grade 3+ was 8.4 versus 1.3 (P < 0.0001), in arm 3 and 6 m. Seven deaths within 30 days from last treatment administration in arm 6 m and three deaths in arm 3 m were observed (0.3% versus 0.1%, P = 0.34). CONCLUSIONS TOSCA is the first trial comparing 3 versus 6 months of adjuvant chemotherapy completing accrual within the international initiative of treatment duration evaluation (International Duration Evaluation of Adjuvant, IDEA). High compliance to treatment in control arm will allow a correct assessment of potential differences between the two treatment durations. CLINICALTRIALSGOV REGISTRATION NUMBER NCT00646607.
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Affiliation(s)
- S Lonardi
- Medical Oncology Unit 1, Istituto Oncologico Veneto-IRCCS, Padova
| | - A Sobrero
- Medical Oncology Unit, IRCCS San Martino-IST, Genova
| | - G Rosati
- Medical Oncology Unit, Ospedale San Carlo, Potenza
| | - M Di Bartolomeo
- Medical Oncology Unit, Fondazione Istituto Nazionale Tumori-IRCCS, Milano
| | - M Ronzoni
- Medical Oncology Unit, Ospedale San Raffaele-IRCCS, Milano
| | - G Aprile
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine
| | | | - M Scartozzi
- Medical Oncology, University Hospital and University of Cagliari, Cagliari
| | - M Banzi
- Medical Oncology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia
| | - M G Zampino
- Gastrointestinal Medical Oncology Unit and Neuroendocrine Tumors, Istituto Europeo di Oncologia-IRCCS, Milano
| | - F Pasini
- Medical Oncology Unit, Ospedale Santa Maria della Misericordia, Rovigo
| | - P Marchetti
- Medical Oncology Unit, Sant'Andrea Hospital, Sapienza University of Rome and IDI-IRCCS, Roma
| | - M Cantore
- Medical Oncology Unit, Civico Hospital Carrara (MS)
| | - A Zaniboni
- Medical Oncology Unit, Fondazione Poliambulanza, Brescia
| | - L Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (MI)
| | - L Ciuffreda
- Medical Oncology Unit, Azienda Ospedaliero Universitaria San Giovanni Battista, Molinette, Torino
| | - D Ferrari
- Medical Oncology Unit, Azienda Ospedaliera San Paolo, Milano
| | - S Barni
- Medical Oncology, ASST Bergamo Ovest, Ospedale di Treviglio, Bergamo
| | - V Zagonel
- Medical Oncology Unit 1, Istituto Oncologico Veneto-IRCCS, Padova
| | - E Maiello
- Medical Oncology Unit, Ospedale Casa Sollievo della Sofferenza-IRCCS, San Giovanni Rotondo
| | - E Rulli
- Laboratory of Clinical Research Methodology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano
| | - R Labianca
- Medical Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
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16
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Sommerfeld A, Mayer PGK, Cantore M, Häussinger D. Regulation of Plasma Membrane Localization of the Na+-taurocholate cotransporting polypeptide (Ntcp) by Hyperosmolarity and Tauroursodeoxycholate. Z Gastroenterol 2015. [DOI: 10.1055/s-0035-1568046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Fiorentini G, Aliberti C, Sarti D, Coschiera P, Tilli M, Mulazzani L, Giordani P, Graziano F, Marqués Gonzalez A, García Marcos R, Gómez Mugnoz F, Cantore M, Ricci S, Catalano V, Mambrini A. DEBIRI and cetuximab (DEBIRITUX) as a secondline treatment for unresectable colorectal liver metastases (UCLM): results of a phase II trial exploring a new sequence. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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18
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Di Bartolomeo M, Pellegrinelli A, Iacovelli R, Pietrantonio F, Berenato R, Caporale M, Niger M, Barbera M, Labianca R, Martoni A, Rosati G, Nitti D, Boni C, Amadori D, Cantore M, de Braud F, Bajetta E. Association with programmed death ligand-1 (PDL-1) expression and Helicobacter Pylori infection in patients with non-diffuse type gastric carcinoma. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.12] [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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19
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Pisanelli M, Panizza E, Carbonardi F, Iridile C, Cavazzini M, Carra S, Cantore M, Adami F. Cancer with BRCA mutations in high-risk families. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.35] [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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20
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Bonacchi A, Toccafondi A, Mambrini A, Cantore M, Muraca MG, Focardi F, Lippi D, Miccinesi G. Complementary needs behind complementary therapies in cancer patients. Psychooncology 2015; 24:1124-30. [PMID: 25690807 DOI: 10.1002/pon.3773] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 01/14/2015] [Accepted: 01/20/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Although many studies indicate that the use of complementary and alternative medicine by cancer patients is common and widespread, few studies have focused on unmet needs of patients using complementary therapies (CTs). The aim of the present study was to evaluate, through a quantitative approach, possible associations between the use of CTs and the presence of specific unmet needs in cancer patients. METHODS In six Italian oncology departments, 783 patients were interviewed about CTs use and completed the Needs Evaluation Questionnaire. Patients included in the study had different primary tumor sites and were in different phases of the disease and care process. RESULTS At the time of the survey, 38.3% of patients were using one or more types of CTs. According to Needs Evaluation Questionnaire, the use of CTs was associated (p < .05) with the need to be more involved in therapeutic choices (40% vs. 31.7%), the need to have a better dialogue with clinicians (44.4% vs. 37.2%), and the need to have more economic-insurance information in relation to their illness (46.1% vs. 36.4%). Statistical significance was confirmed with multivariable analysis for the last two items, whereas three more needs were associated with the use of CTs after adjustment: to receive more explanation on treatments (46.8% vs. 41.0%), to receive more comprehensible information (38% vs. 31.9%), and to receive more attention from nurses (16% vs. 12.1%). CONCLUSIONS Our study shows interesting differences regarding perceived needs between cancer patients who use and who do not use CTs. Unmet needs that are more expressed in CTs users should be known and, when possible, could be taken into account to improve both psychosocial interventions in the context of conventional care process and the quality of the relationship between patient and medical and nursing staff.
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Affiliation(s)
- A Bonacchi
- Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy.,Centro Studi e Ricerca Synthesis, Florence, Italy
| | - A Toccafondi
- Centro Studi e Ricerca Synthesis, Florence, Italy
| | - A Mambrini
- Oncologia Medica AUSL 1, Massa Carrara, Italy
| | - M Cantore
- Oncologia Medica AUSL 1, Massa Carrara, Italy
| | - M G Muraca
- Centro Riabilitazione Oncologica, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
| | - F Focardi
- Oncologia Medica Aziendale AUSL 10, Florence, Italy
| | - D Lippi
- Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Miccinesi
- Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
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21
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Lonardi S, Labianca R, Rosati G, Di Bartolomeo M, Gianni L, Pella N, Massidda B, Boni C, Zampino M, Pasini F, Marchetti P, Cantore M, Santoro A, Ciuffreda L, Ferrari D, Zaniboni A, Montesarchio V, Maiello E, Floriani I, Sobrero A. Three or Six Months of Adjuvant Chemotherapy for Colon Cancer: Compliance and Safety of the Phase III Italian Tosca Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.7] [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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22
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Bajetta E, Floriani I, Di Bartolomeo M, Labianca R, Falcone A, Di Costanzo F, Comella G, Amadori D, Pinto C, Carlomagno C, Nitti D, Daniele B, Mini E, Poli D, Santoro A, Mosconi S, Casaretti R, Boni C, Pinotti G, Bidoli P, Landi L, Rosati G, Ravaioli A, Cantore M, Di Fabio F, Aitini E, Marchet A. Randomized trial on adjuvant treatment with FOLFIRI followed by docetaxel and cisplatin versus 5-fluorouracil and folinic acid for radically resected gastric cancer. Ann Oncol 2014; 25:1373-1378. [PMID: 24728035 DOI: 10.1093/annonc/mdu146] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Some trial have demonstrated a benefit of adjuvant fluoropirimidine with or without platinum compounds compared with surgery alone. ITACA-S study was designed to evaluate whether a sequential treatment of FOLFIRI [irinotecan plus 5-fluorouracil/folinic acid (5-FU/LV)] followed by docetaxel plus cisplatin improves disease-free survival in comparison with 5-FU/LV in patients with radically resected gastric cancer. PATIENTS AND METHODS Patients with resectable adenocarcinoma of the stomach or gastroesophageal junction were randomly assigned to either FOLFIRI (irinotecan 180 mg/m(2) day 1, LV 100 mg/m(2) as 2 h infusion and 5-FU 400 mg/m(2) as bolus, days 1 and 2 followed by 600 mg/m(2)/day as 22 h continuous infusion, q14 for four cycles) followed by docetaxel 75 mg/m(2) day 1, cisplatin 75 mg/m(2) day 1, q21 for three cycles (sequential arm) or De Gramont regimen (5-FU/LV arm). RESULTS From February 2005 to August 2009, 1106 patients were enrolled, and 1100 included in the analysis: 562 in the sequential arm and 538 in the 5-FU/LV arm. With a median follow-up of 57.4 months, 581 patients recurred or died (297 sequential arm and 284 5-FU/LV arm), and 483 died (243 and 240, respectively). No statistically significant difference was detected for both disease-free [hazard ratio (HR) 1.00; 95% confidence interval (CI): 0.85-1.17; P = 0.974] and overall survival (OS) (HR 0.98; 95% CI: 0.82-1.18; P = 0.865). Five-year disease-free and OS rates were 44.6% and 44.6%, 51.0% and 50.6% in the sequential and 5-FU/LV arm, respectively. CONCLUSIONS A more intensive regimen failed to show any benefit in disease-free and OS versus monotherapy. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01640782.
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Affiliation(s)
- E Bajetta
- Istituto di Oncologia, Policlinico di Monza, Monza
| | - I Floriani
- Laboratory of Clinical Research, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milano.
| | - M Di Bartolomeo
- Struttura Complessa di Medicina Oncologica 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - R Labianca
- Unità di Oncologia Medica, Ospedale Papa Giovanni XXIII, Bergamo
| | - A Falcone
- Dipartimento di Ricerca Traslazionale, Università di Pisa, Istituto Toscano Tumori, Pisa
| | - F Di Costanzo
- S.C. Oncologia Medica, Azienda Ospedaliero-Universitaria Careggi, Firenze
| | - G Comella
- Oncologia Medica A, Fondazione Pascale, Istituto Nazionale dei Tumori, Napoli
| | - D Amadori
- I.R.C.C.S. Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola
| | - C Pinto
- U.O. di Oncologia Medica, Policlinico S.Orsola Malpighi, Bologna
| | - C Carlomagno
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, Napoli
| | - D Nitti
- Clinica Chiurgica 1, Dipartimento di Scienze Chirurgiche Oncologiche e Gastroenterologiche, Padova
| | - B Daniele
- Dipartimento di Oncologia, A.O.G. Rummo, Benevento
| | - E Mini
- Dipartimento di Scienze Della Salute, Sezione di Farmacologia Clinica e Oncologia, Università degli Studi di Firenze, Firenze
| | - D Poli
- Laboratory of Clinical Research, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milano
| | - A Santoro
- U.O. Oncologia e Ematologia, Humanitas Cancer Center, Istituto Clinico Humanitas-I.R.C.C.S., Rozzano
| | - S Mosconi
- Unità di Oncologia Medica, Ospedale Papa Giovanni XXIII, Bergamo
| | - R Casaretti
- S.C. di Oncologia Medica Addominale, dell'Istituto Tumori di Napoli, Napoli
| | - C Boni
- Oncologia, Arcispedale Santa Maria Nuova-I.R.C.C.S., Reggio Emilia, Reggio Emilia
| | - G Pinotti
- Divisione di Oncologia Medica, A.O. Ospedale di Circolo, Varese
| | - P Bidoli
- S.C. Oncologia Medica, A.O.S. Gerardo, Monza
| | - L Landi
- U.O. Oncologia Medica, Azienda USL6 di Livorno, Istituto Toscano Tumori, Livorno
| | - G Rosati
- Unità Oncologia Medica, Ospedale S. Carlo, Potenza
| | - A Ravaioli
- U.O. di Oncologia, Ospedale Infermi Rimini, Ospedale Cervesi, Azienda USL di Rimini, Rimini, Cattolica
| | - M Cantore
- Oncologia Medica, USL 1, Massa Carrara
| | - F Di Fabio
- U.O. di Oncologia Medica, Policlinico S.Orsola Malpighi, Bologna
| | - E Aitini
- Ospedale Carlo Poma, Mantova, Italy
| | - A Marchet
- Clinica Chiurgica 1, Dipartimento di Scienze Chirurgiche Oncologiche e Gastroenterologiche, Padova
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Buzzoni R, Pusceddu S, Bajetta E, De Braud F, Platania M, Iannacone C, Cantore M, Mambrini A, Bertolini A, Alabiso O, Ciarlo A, Turco C, Mazzaferro V. Activity and safety of RAD001 (everolimus) in patients affected by biliary tract cancer progressing after prior chemotherapy: a phase II ITMO study. Ann Oncol 2014; 25:1597-603. [PMID: 24827133 DOI: 10.1093/annonc/mdu175] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [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: 12/13/2022] Open
Abstract
BACKGROUND Biliary tract cancer (BTC) is a highly lethal disease for which the best available therapy remains undetermined. The mammalian target of rapamycin (mTOR) pathway is up-regulated in several cancers, including BTC, and preclinical evidence indicates that mTOR inhibition may be effective in the treatment of BTC. We sought to evaluate the activity and tolerability of the mTOR inhibitor RAD001-everolimus-in patients with BTC progressing after prior chemotherapy. PATIENTS AND METHODS This was an open-label, single-arm, phase II study (EUDRACT 2008-007152-94) conducted in eight sites in Italy. Patients with locally advanced, metastatic or recurrent BTC progressing despite previous chemotherapy received a daily oral dose of everolimus 10 mg administered continuously in 28-day cycles. The two primary end points were disease control rate (DCR) and objective response rate (ORR). Secondary end points were progression-free survival (PFS), overall survival (OS) and time-to-progression (TTP). RESULTS Thirty-nine patients were enrolled. The DCR was 44.7%, and the ORR was 5.1%. One patient showed a partial response at 2 months and one patient showed a complete response sustained up to 8 months. The median (95% confidence interval) PFS was 3.2 (1.8-4.0) months, and the median OS was 7.7 (5.5-13.2) months. The median TTP was 2.0 (1.7-3.7) months. Most common toxicities were asthenia (43.6%), thrombocytopenia (35.9%), pyrexia (30.8%) and erythema, mainly of mild-to-moderate severity. Two patients required dose reduction due to adverse events. CONCLUSION Everolimus demonstrated a favourable toxicity profile and encouraging anti-tumour activity. Further trials are needed to establish the role of everolimus in the treatment of BTC. EUDRACT 2008-007152-94.
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Affiliation(s)
- R Buzzoni
- Day Hospital/Outpatient Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - S Pusceddu
- Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - E Bajetta
- Medical Oncology Unit, Policlinico of Monza, Monza
| | - F De Braud
- Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - M Platania
- Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | - M Cantore
- Medical Oncology Unit, Asl 1, Massa Carrara
| | - A Mambrini
- Medical Oncology Unit, Asl 1, Massa Carrara
| | - A Bertolini
- Medical Oncology Unit, Presidio Ospedaliero Sondrio, Sondrio
| | - O Alabiso
- Medical Oncology Unit, A.U.O. Maggiore della Carità, Novara
| | - A Ciarlo
- Medical Oncology Unit, Usl 4, Presidio Ospedaliero, Prato
| | - C Turco
- Medical Oncology Unit, Italian Trials in Medical Oncology (ITMO) Group, Fondazione IRCCS Istituto Nazionale Tumori, Milan
| | - V Mazzaferro
- Gastro-Intestinal Surgery, Liver Transplantation and Hepatology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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24
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Mazza E, Belli C, Terreni M, Doglioni C, Losio C, Cantore M, Mambrini A, Reni M. Breast metastases from oligodendroglioma: an unusual extraneural spread in two young women and a review of the literature. Crit Rev Oncol Hematol 2013; 88:564-72. [PMID: 23953683 DOI: 10.1016/j.critrevonc.2013.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/05/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Extraneural dissemination of oligodendroglioma is rare. Cases of breast metastases have never been described in the literature. CASE REPORTS We report the first two cases of young women with initial diagnosis of anaplastic oligodendroglioma who experienced mammary gland metastases and a review of the literature. RESULTS Immunohistochemical analysis performed on material from both primary and metastatic sites did not allow to draw any conclusion on possible etiopathogenetic hypothesis. A review of literature yielded 35 cases of extracranial metastatic oligodendroglioma from 1989 to 2012. CONCLUSION Though rare, extracranial dissemination from oligodendroglioma may occur not only in long surviving heavily pre-treated patients. The review of literature and these two cases suggest that spread is primarily to bone and then from bone to other organs through hematogenous route mostly due to leptomeningeal or dura mater invasion. Chemotherapy regimens similar to those commonly used for non metastatic oligodendroglioma are recommended for patients with good performance status.
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Affiliation(s)
- E Mazza
- Department of Medical Oncology, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy
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25
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Fiorentini G, Rossi S, Bonechi F, Vaira M, De Simone M, Dentico P, Bernardeschi P, Cantore M, Guadagni S. Intra-Arterial Hepatic Chemoembolization in Liver Metastases from Neuroendocrine Tumors: A Phase II Study. J Chemother 2013; 16:293-7. [PMID: 15330328 DOI: 10.1179/joc.2004.16.3.293] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Neuroendocrine tumors, particularly those of gastrointestinal tract origin, have a predisposition for metastasizing to the liver, causing parenchymal substitution and paraneoplastic syndrome. Lipiodol embolization combined with anticancer drugs is a recent tool in regional therapy. It has been proven that chemoembolization reduces tumor bulk and hormone levels, and that it palliates the symptoms of many patients with liver-dominant neuroendocrine metastases. Beginning in December 1988, ten patients with unresectable and chemotherapy-refractory liver metastatic neuroendocrine tumors were treated with chemoembolization based on a mixture of lipiodol, mitomycin, cisplatin, epirubicin, followed by gelfoam powder and contrast media. Toxicity encountered included: upper right quadrant pain requiring narcotics, elevation of lactate dehydrogenase, alkaline phosphatase, and transaminases. One patient had liver abscess and persistent fever for 2 weeks. We obtained two complete remissions lasting 12 and 34 months and 5 partial remissions. The median survival was 22 months. Four patients had urinary elevation of 5-hydroxyindolacetic acid (5-HIAA). They showed more than a 75% decrease in urinary secretion after treatment. In a patient with transplanted liver we noticed a partial response lasting 7 months. We conclude that chemoembolization will improve the clinical condition of a significant percentage of patients with liver metastases, that future therapy of carcinoid tumors will be based on specific tumor biology and that treatment will be customized for each individual patient combining the use of cytoreductive procedures including radiofrequency ablation, laser treatment and chemoembolization.
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Affiliation(s)
- G Fiorentini
- Oncology Department, San Giuseppe General Hospital, Empoli (Firenze), Italy.
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Cantore M, Fiorentini G, Luppi G, Rosati G, Caudana R, Piazza E, Comella G, Ceravolo C, Miserocchi L, Mambrini A, Del Freo A, Zamagni D, Rabbi C, Marangolo M. Ceravolo. J Chemother 2013; 16:589-94. [PMID: 15700852 DOI: 10.1179/joc.2004.16.6.589] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Gemcitabine is considered the gold standard treatment for unresectable pancreatic adenocarcinoma. Intra-arterial drug administration had shown some interesting results in small phase II studies. In this study, patients were randomly assigned to receive gemcitabine at a dose of 1,000 mg/m2 over 30 minutes intravenously weekly for 7 weeks, followed by 1 week of rest, then weekly for 3 weeks every 4 weeks or FLEC: 5-fluoruracil 1,000 mg/m2, leucovorin 100 mg/m2, epirubicin 60 mg/m2, carboplatin 300 mg/m2 infused bolus intra-arterially into celiac axis at a 3-week interval 3 times or 5-fluorouracil 400 mg/m2 plus folinic acid 20 mg/m2 for 5 days every 4 weeks for 6 cycles. The primary endpoint was overall survival, while time to treatment failure, response rate, clinical benefit response were secondary endpoints. Sixty-seven patients were randomly allocated gemcitabine and 71 were allocated FLEC intra-arterially. Patients treated with FLEC lived for significantly longer than patients on gemcitabine (p=0.036). Survival at 1 year increased from 21% in the gemcitabine group to 35% in the FLEC group. Median survival was 7.9 months in the FLEC group and 5.8 months in the gemcitabine group. Median time to treatment failure was longer with FLEC (5.3 vs 4.2 months for FLEC vs gemcitabine respectively; p=0.013). Clinical benefit was similar in both groups (17.9% for gemcitabine and 26.7% for FLEC; p=NS). CT-scan partial response was similar in both groups (5.9% for gemcitabine and 14% for FLEC; p=NS). Toxicity profiles were different. Compared with gemcitabine, the FLEC regimen given intra-arterially improved survival in patients with unresectable pancreatic adenocarcinoma.
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Affiliation(s)
- M Cantore
- Oncological Department, USL 1, Massa and Carrara, Italy.
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Cantore M, Girelli R, Mambrini A, Frigerio I, Boz G, Salvia R, Giardino A, Orlandi M, Auriemma A, Bassi C. Combined modality treatment for patients with locally advanced pancreatic adenocarcinoma. Br J Surg 2012; 99:1083-8. [PMID: 22648697 DOI: 10.1002/bjs.8789] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Radiofrequency ablation (RFA) is an emerging treatment for patients with locally advanced pancreatic carcinoma, and can be combined with radiochemotherapy and intra-arterial plus systemic chemotherapy. METHODS This observational study compared two groups of patients with locally advanced pancreatic carcinoma treated with either primary RFA (group 1) or RFA following any other primary treatment (group 2). RESULTS Between February 2007 and May 2010, 107 consecutive patients were treated with RFA. There were 47 patients in group 1 and 60 in group 2. Median overall survival was 25·6 months. Median overall survival was significantly shorter in group 1 than in group 2 (14·7 versus 25·6 months; P = 0·004) Patients treated with RFA, radiochemotherapy and intra-arterial plus systemic chemotherapy (triple-approach strategy) had a median overall survival of 34·0 months. CONCLUSION RFA after alternative primary treatment was associated with prolonged survival. This was further extended by use of a triple-approach strategy in selected patients. Further evaluation of this approach seems warranted.
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Affiliation(s)
- M Cantore
- Oncological Department, Carrara Hospital, Carrara, Italy.
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Pacetti P, Giovannetti E, Mambrini A, Zaccarelli E, Orlandi M, Alecci C, Tartarini R, Giancola F, Godefridus J, Cantore M. 6639 POSTER Polymorphisms Associated With the Clinical Outcome of Biliary Tract Cancer (BTC) Patients Treated With the Epirubicin, Cisplatin and Capecitabine (ECX) Regimen. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71950-5] [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: 11/26/2022]
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Buzzoni R, Pusceddu S, Biondani P, Cantore M, Aitini E, Bertolini A, Alabiso O, Isa L, Pinotti G, Bajetta E. 6626 POSTER Efficacy and Safety of RAD001 as Second Line Therapy in Biliary Tract Cancer (BTC) Patients (pts) – a Phase II I.T.M.O. (Italian Trials in Medical Oncology) Group Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71937-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Cantore M, Girelli R, Mambrini A, Frigerio I, Boz G, Simoncini E, Lusenti A, Orlandi M, Bassi C. A triple approach strategy for patients with locally advanced pancreatic adenocarcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Del Re M, Loupakis F, Michelucci A, Di Paolo A, Falcone A, Simi P, Bocci G, Cantore M, Bordonaro R, Di Leo A, Barbara C, Cappuzzo F, De Braud FG, Danesi R. Prediction of fluoropyrimidine toxicities by screening DPYD genetic variants. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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32
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Pezzuolo D, Pennucci MC, Mambrini A, Pacetti P, Orlandi M, Tartarini R, Del Freo A, Cantore M. Low dose fractionated cisplatin plus gemcitabine for elderly patients with advanced non small cell lung cancer: a retrospective analysis. J Chemother 2010; 22:275-9. [PMID: 20685634 DOI: 10.1179/joc.2010.22.4.275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The aim of the study was to evaluate safety and efficacy of gemcitabine-cisplatin in elderly patients with advanced non small cell lung cancer (NSCLC). This study included 59 patients aged >70 years consecutively admitted to our Department. treatment consisted of gemcitabine 1000 mg/m(2) on days 1 and 8, and low-dose fractionated cisplatin 20 mg/m(2) on days 1, 2, 3 of a 21-day cycle. Toxicity was graded according to the world Health Organization (WHO) criteria.A total of 281 cycles was administered. Hematological toxicities of grade 3 and 4 were seen in 17% and 5% of patients, respectively. Grade 3 gastrointestinal toxicity was 3%, grade 2 neuropathy was 2%. Twenty-nine partial responses with an objective response rate of 49% were obtained. No complete responses were observed. The median progression-free survival (PFS) and overall survival (OS) were 7.8 and 15.5 months respectively. Cisplatin-based combination chemotherapy at low doses appears to be safe and active in older patients with advanced NSCLC.
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Affiliation(s)
- D Pezzuolo
- Department of Oncology, USL1, Massa Carrara, Italy
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Pacetti P, Giovannetti E, Reni M, Mambrini A, Ghidini M, Gleon L, Funel N, Cereda S, Peters G, Cantore M. Association between DNA repair polymorphisms and survival in pancreatic cancer patients treated with combination chemotherapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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34
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Pacetti P, Giovannetti E, Mambrini A, Tartarini R, Del Tacca M, Danesi R, Grisanti S, Nannizzi S, Ricciardi S, Cantore M. Single nucleotide polymorphisms and clinical outcome in biliary tract carcinoma treated with epirubicin, cisplatin and capecitabine. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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35
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Mambrini A, Di Paolo A, Pacetti P, Muttini MP, Orlandi M, Danesi R, Fiorentini G, Cantore M. Pharmacokinetics of irinotecan: Comparison of intravenous and intra-arterial administration in patients with liver metastases. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14608] [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: 11/20/2022] Open
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36
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Mambrini A, Del Freo A, Pacetti P, Orlandi M, Torri T, Fiorentini G, Cantore M. Intra-arterial and systemic chemotherapy plus external hyperthermia in unresectable biliary cancer. Clin Oncol (R Coll Radiol) 2007; 19:805-6. [PMID: 17892927 DOI: 10.1016/j.clon.2007.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Revised: 07/23/2007] [Accepted: 08/28/2007] [Indexed: 12/26/2022]
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37
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Pacetti P, Mambrini A, Guglielmi A, Iacono C, Torri T, Orlandi M, Guadagni S, Fiorentini G, Cantore M. 3550 POSTER Capecitabine plus hepatic intra-arterial epirubicin and cisplatin in unresectable biliary cancer: a phase II study. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71053-4] [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: 10/22/2022] Open
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38
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Guadagni S, Clementi M, Valenti M, Fiorentini G, Cantore M, Kanavos E, Caterino GP, Di Giuro G, Amicucci G. Hypoxic abdominal stop-flow perfusion in the treatment of advanced pancreatic cancer: a phase II evaluation/trial. Eur J Surg Oncol 2006; 33:72-8. [PMID: 17166688 DOI: 10.1016/j.ejso.2006.10.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Accepted: 10/27/2006] [Indexed: 01/19/2023] Open
Abstract
In the past decade, some authors have reported objective responses and prolonged median survival times using hypoxic abdominal perfusion (HAP) for the treatment of advanced pancreatic cancer. However, these promising results have not been confirmed by others, making it difficult to define the effectiveness of this loco-regional chemotherapy. The aim of this study, therefore, was to evaluate the response rate, time to disease progression and overall survival following HAP treatment of 22 consecutive patients with advanced pancreatic tumors. Within the period from 1999 to 2003, 22 patients with histological diagnosis of unresectable stage III/IV pancreatic cancer, not responsive to systemic chemotherapy, were treated with mitomycin C 30mg/m(2) and cisplatin 60mg/m(2) by HAP (stop flow technique). Immediately after perfusion, hemofiltration was performed to reduce systemic side toxic effects. Responses were assessed by CT-scan 30days from the end of treatment. Minor or partial responses were confirmed by a second CT-scan 4weeks later. Following 26 treatment cycles no death or technical complications were recorded; four patients (18.2%) achieved a partial response, 2 (9.1%) a minimal response and 13 (59.1%) stable disease. The remaining 3 patients (13.6%) showed progression of the disease. The median time to disease progression was 3 months (range 1-10). The median survival time from the start of regional chemotherapy was 6 months (range 1.9-16), with a 1-year survival rate of 9%. Our data show that HAP is a relatively effective second-line treatment for advanced stage pancreatic cancer with a low complication rate. We do not concur with the opinion of others that HAP is an inactive treatment approach. However, taking into account the invasiveness of this procedure, and associated morbidity and cost, HAP would not appear to be preferable to less invasive loco-regional chemotherapeutic alternatives.
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Affiliation(s)
- S Guadagni
- Department of Surgical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
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Mambrini A, Bondavalli C, Caudana R, Amoroso V, Pacetti P, Fiorentini G, Cantore M. Intra-arterial chemotherapy in elderly patients with invasive bladder cancer. Clin Oncol (R Coll Radiol) 2005; 17:663-4. [PMID: 16372497 DOI: 10.1016/j.clon.2005.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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40
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Della Seta R, Pacetti P, Mambrini A, Santorsa T, Flora R, Orlandi M, Cantore M. Comparison of incidence of sepsis in cancer patients that underwent systemic or loco-regional chemotherapy. Infez Med 2005; 13:251-4. [PMID: 16388280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In this retrospective non controlled trial we evaluated the incidence of sepsis in cancer patients in two different periods (January-June 2003 versus January-June 2004). The main difference in these two periods was that in our oncology department we changed from systemic chemotherapy to loco-regional chemotherapy using less myelosuppressive drugs and developed the domiciliary assistance. The aim of the study was to assess the incidence of sepsis in order to demonstrate a reduction of the infection related to the change of chemotherapy. In addition, this study may be able to describe the epidemiology of sepsis in cancer patients afferent to our oncology department. The incidence of sepsis was reduced in the second period from 24.3% to 6.2%. The pathogens more frequently isolated in this study were coagulase-negative staphylococci (CNS) followed by Escherichia coli and Staphylococcus aureus. Less invasive therapy may reduce infective complication of chemotherapy. The epidemiology of sepsis may be very helpful to design empiric therapeutic protocol for febrile patients that have received chemotherapy.
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Affiliation(s)
- R Della Seta
- Department of Oncology, Massa Carrara City Hospital, Italy
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41
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Fiorentini G, Dentico P, Cantore M, Rossi S, Pacetti P, Bernardeschi P, Della Seta R, Tumolo S, de Giorgi U. Capecitabine (XE) plus Irinotecan (IRI) as second-line treatment (XELIRI) for metastatic colorectal cancer (MCRC) in elderly patients: Feasibility and safety results from a Phase II study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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)
- G. Fiorentini
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
| | - P. Dentico
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
| | - M. Cantore
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
| | - S. Rossi
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
| | - P. Pacetti
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
| | - P. Bernardeschi
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
| | - R. Della Seta
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
| | - S. Tumolo
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
| | - U. de Giorgi
- Gen Hosp S. Giuseppe, Empoli, Italy; Gen Hosp, Massa Carrara, Italy; Gen Hosp, Pordenone, Italy
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Fiorentini G, Rossi S, Bernardeschi P, Cantore M, Guadagni S. Is there a new drug beyond floxuridine for intra-arterial hepatic chemotherapy in liver metastases from colorectal cancer? J Clin Oncol 2005; 23:2105; author reply 2106. [PMID: 15774801 DOI: 10.1200/jco.2005.99.297] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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43
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Fiorentini G, Poddie DB, Cantore M, Rossi S, Tumolo S, Dentico P, Bernardeschi P, Guadagni S, Rossi G, Valori VM, De Simone M. Hepatic intra-arterial chemotherapy (HIAC) of high dose mitomycin and epirubicin combined with caval chemofiltration versus prolonged low doses in liver metastases from colorectal cancer: a prospective randomized clinical study. J Chemother 2005; 16 Suppl 5:51-4. [PMID: 15675479 DOI: 10.1080/1120009x.2004.11782385] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A multicenter randomized study comparing high dose of mitomycin and epirubicin given as hepatic intra-arterial chemotherapy (HIAC) combined with caval chemofiltration (CF) versus low doses of the same drugs in unresectable liver metastases from colorectal cancer showed a significant improvement in the survival rate of the 20 patients treated with high dose compared to the 22 patients treated with low doses with a 1 year survival of 69% vs 39%. The median survival was 17 vs 11 months and the responses were 65% vs 33%. Toxicity was colangitis in 50% of patients considered. The extrahepatic progression was similar in the two groups (7/20 vs 8/22).
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Affiliation(s)
- G Fiorentini
- Department of Oncology, "S Giuseppe" Hospital, Empoli (Florence), Italy.
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Mambrini A, Caudana R, Zamagni D, Rabbi C, Del Freo A, Sanguinetti F, Fiorentini G, Cantore M. Intra-arterial hepatic chemotherapy in heavily pretreated patients with epithelial ovarian cancer. Ann Oncol 2005; 16:334-5. [PMID: 15668294 DOI: 10.1093/annonc/mdi052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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45
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Cantore M, Rabbi C, Fiorentini G, Oliani C, Zamagni D, Iacono C, Mambrini A, Del Freo A, Manni A. Combined irinotecan and oxaliplatin in patients with advanced pre-treated pancreatic cancer. Oncology 2004; 67:93-7. [PMID: 15539911 DOI: 10.1159/000080993] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2003] [Accepted: 02/06/2004] [Indexed: 01/06/2023]
Abstract
OBJECTIVES This study evaluated the clinical activity and toxicity of combination chemotherapy with irinotecan and oxaliplatin in patients with advanced pancreatic cancer that had progressed despite > or =1 course of a gemcitabine-containing regimen. METHODS Thirty patients with metastatic pancreatic cancer and Karnofsky performance status > or =70 received oxaliplatin 60 mg/m2 on days 1 + 15 and irinotecan 60 mg/m2 on days 1 + 8 + 15 every 4 weeks. Patients were assessed on the basis of clinical benefit response, changes in serum tumour marker CA 19-9, objective tumour response, time to progressive disease (TTP), and survival. RESULTS Six patients (20%) had clinical benefit response (median duration of 7.2 months). CA 19-9 levels were reduced > or =50% from baseline in 8 patients (26%) and remained stable in 8 patients. CT scans revealed that 3 patients (10%) had a partial response and 7 (23%) had stable disease. Two patients (7%) were down-staged and underwent surgery. Median TTP was 4.1 months, median survival was 5.9 months and the 1-year survival rate was 23.3%. The most serious adverse events were grade 3-4 leukopenia in 2 patients (6%), grade 3 neuropathy in 2 (6%) and grade 3 diarrhoea in 1 (3%). CONCLUSION Chemotherapy with irinotecan and oxaliplatin is an active and well-tolerated combination in patients with advanced pre-treated pancreatic cancer.
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Affiliation(s)
- M Cantore
- Department of Oncology, ASL 1, Massa-Carrara, Italy.
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46
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Mambrini A, Fiorentini G, Pennucci C, Muttini MP, Manni A, Del Freo A, Zamagni D, Rabbi C, Sanguinetti F, Cantore M. Intra-arterial hepatic chemotherapy combined with systemic infusion of 5-FU in patients with advanced biliary tract cancers. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4197] [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)
| | | | | | | | - A. Manni
- Carrara Hospital, Carrara, Italy
| | | | | | - C. Rabbi
- Carrara Hospital, Carrara, Italy
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Louvet C, Labianca R, Hammel P, Lledo G, de Braud F, Andre T, Cantore M, Ducreux M, Zaniboni A, de Gramont A. GemOx (Gemcitabine + Oxaliplatin) versus Gem (Gemcitabine) in non resectable pancreatic adenocarcinoma : final results of the GERCOR /GISCAD Intergroup Phase III. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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)
- C. Louvet
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - R. Labianca
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - P. Hammel
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - G. Lledo
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - F. de Braud
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - T. Andre
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - M. Cantore
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - M. Ducreux
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - A. Zaniboni
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
| | - A. de Gramont
- Hopital St-Antoine, Paris, France; Ospidale Riuniti, Bergamo, Italy; Hopital Beaujon, Clichy, France; Clinique St-Jean, Lyon, France; Istituto Oncologico Europeo, Milano, Italy; Hopital Tenon, Paris, France; Ospedaliera C. Poma, Mantova, Italy; Institut Gustave Roussy, Villejuif, France; Poliambulanza di Brescia, Brescia, Italy
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48
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Cantore M, Fiorentini G, Mambrini A, Rabbi C, Zamagni D, Carlone N, Manni A, Caudana R, Torri T. Regional combined with systemic chemotherapy in unresectable biliary tract cancers: a phase II study. J Exp Clin Cancer Res 2003; 22:59-64. [PMID: 16767908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Unresectable biliary tract cancers have a very poor prognosis. No good systemic chemotherapeutic regimen is available. This study aimed to evaluated the activity and toxicity of a novel approach of combined loco-regional and systemic chemotherapy. Twenty four patients with advanced or metastatic biliary tumors were treated with epiadriamycin 50 mg/m2 and cisplatin 60 mg/m2 administered bolus in proper hepatic artery on day 1, combined with systemic continuous infusion of 5-fluorouracil 200 mg/m2/day, from day 1 to day 14, every 3 weeks. The overall response rate was 8/24 (33%), including one complete response and 7 partial responses (stable disease 46%, progression 21%). The treatment was well tolerated with a minimal hematological toxicity; the major clinical problem was the deep venous thrombosis related to central venous catheter, that occurred in 5 patients (21%). Median overall survival was 14,6 months and 1-year and 2-year survival were 54% and 38% respectively. Performance status improved in 33% of patients and weight gain more than 7% was observed in 17%. This novel combined loco-regional and systemic chemotherapeutic regimen is active and safe for advanced biliary tract cancer patients.
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Affiliation(s)
- M Cantore
- Oncological Department, USL 1 Massa e Carrara, Empoli.
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49
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Cantore M, Fiorentini G, Luppi G, Rosati G, Caudana R, Piazza E, Comella G, Ceravolo C, Miserocchi L, Mambrini A, Del Freo A, Zamagni D, Aitini E, Marangolo M. Randomised trial of gemcitabine versus flec regimen given intra-arterially for patients with unresectable pancreatic cancer. J Exp Clin Cancer Res 2003; 22:51-7. [PMID: 16767907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Gemcitabine is considered the golden standard treatment for unresectable pancreatic adenocarcinoma. Intra-arte-rial drug administration had shown a deep rationale with some interesting results. In a multicenter phase III trial, we compared gemcitabine given weekly with a combination of 5-fluoruracil, leucovorin, epirubicin, carboplatin (FLEC) administered intra-arteriously as first-line therapy in unresectable pancreatic adenocarcinoma. Patients were randomly assigned to receive gemcitabine at a dose of 1,000 mg/m2 over 30 minutes intravenously weekly for 7 weeks, followed by 1 week of rest, then weekly for 3 weeks every 4 weeks or 5-fluoruracil 1,000 mg/m2, leucovorin 100 mg/m2, epirubicin 60 mg/m2, carboplatin 300 mg/m2 infused bolus intra-arteriously at three-weekly interval for 3 times. The primary end point was overall survival, while time to treatment failure, response rate, clinical benefit response were secondary endpoints. Sixty-seven patients were randomly allocated gemcitabine and 71 were allocated FLEC intra-arterially. Patients treated with FLEC lived for significantly longer than patients on gemcitabine (p=.036). Survival at 1 year was increased from 21% in the gemcitabine group to 35% in the FLEC group. Median survival was 7.9 months in the FLEC group and 5.8 months in the gemcitabine group. Median time to treatment failure was longer with FLEC (5.3 vs 4.2 months for FLEC vs gemcitabine respectively; p=.013). Clinical benefit was similar in both groups (17.9% for gemcitabine and 26.7% for FLEC; p=NS). CT-scan partial response was similar in both group (5.9% for gemcitabine and 14% for FLEC; p=NS). Toxicity profiles were different. Compared with gemcitabine, FLEC regimen given intra-arteriously, improved survival in patient with unresectable pancreatic adenocarcinoma.
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Affiliation(s)
- M Cantore
- Oncological Department, USL 1, Massa e Carrara, Empoli.
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50
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Mambrini A, Fiorentini G, Zamagni D, Muttini M, Pennucci C, Caudana R, Cantore M. Intra-arterial chemiotherapy for invasive bladder cancer. J Exp Clin Cancer Res 2003; 22:21-3. [PMID: 16767901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Standard treatment for transitional cell carcinoma confined to the bladder is radical cystectomy that allow to obtain an overall 5-year disease-free survival rate only of 50-70%. It has been demonstrated that intra-arterial chemotherapy produces the same survival outcomes as radical cystectomy. This study aimed to evaluate the activity and toxicity of a bladder-sparing loco-regional treatment. Five patients with transitional cell carcinoma of the bladder (4 locally advanced and 1 pelvic relapse) were treated with doxorubycin 25 mg/m2, cisplatin 40 mg/m2 and methotrexate 50 mg/m2, all infused bolus via internal iliac arteries on day 1, every three weeks. We obtained 3 complete responses, 1 stable disease and 1 progression of disease. The treatment was well tolerated with a minimal hematological toxicity and no others major toxicity. Median disease free survival was 8 months (1-17), median overall survival was 22 months (2-55). This loco-regional regimen of chemotherapy is active and safe in locally advanced bladder cancer patients and permits a prolonged good quality of life regarding the maintenance of the physiological functions of the lower urinary tract.
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Affiliation(s)
- A Mambrini
- Oncological Department, USL 1 Massa e Carrara, Empoli.
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