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Slim N, Pacifico P, Passoni P, Tummineri R, Ronzoni M, Pedica F, Fiorino C, Deli A, Casadei Gardini A, Cascinu S, De Cobelli F, Aldrighetti L, Di Muzio N. PO-1212 Outcome of adjuvant hypofractionated radiotherapy concomitant to chemotherapy in bile duct carcinoma. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07663-5] [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: 11/16/2022]
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Broggi S, Gumina C, Mori M, Cattaneo G, Palmisano A, Di Chiara A, Ronzoni M, Slim N, De Cobelli F, Calandrino R, Rosati R, Di Muzio N, Fiorino C, Passoni P. PD-0539: Chemo-modulation of rectal cancer pathological response: prediction of an early regression index. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00561-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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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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Lonardi S, Pietrantonio F, Prete A, Messina M, Formica V, Corsi D, Cortesi E, Frassineti L, Zampino M, Ronzoni M, Scartozzi M, Casagrande M, Conca V, Bergamo F, Prisciandaro M, Intini R, Antista M, Paola D, Vettore V, Zagonel V. 402MO Final results of the CARACAS study: Randomized phase II trial of avelumab alone or with cetuximab for unresectable, locally advanced or metastatic squamous cell anal carcinoma progressed to at least one line of treatment. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.513] [Citation(s) in RCA: 12] [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] [Indexed: 11/29/2022] Open
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Patelli G, Paganoni S, Besana F, Codazzi F, Ronzoni M, Manini S, Remuzzi A. Preliminary detection of lung hypoperfusion in discharged Covid-19 patients during recovery. Eur J Radiol 2020; 129:109121. [PMID: 32540586 PMCID: PMC7280822 DOI: 10.1016/j.ejrad.2020.109121] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/06/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Gianluigi Patelli
- Department of Radiology, Bolognini Hospital - ASST Bergamo Est Company, 24068, Seriate, BG, Italy
| | - Silvia Paganoni
- Department of Radiology, Bolognini Hospital - ASST Bergamo Est Company, 24068, Seriate, BG, Italy
| | - Francesca Besana
- Department of Radiology, Bolognini Hospital - ASST Bergamo Est Company, 24068, Seriate, BG, Italy
| | - Fabiana Codazzi
- Department of Radiology, Bolognini Hospital - ASST Bergamo Est Company, 24068, Seriate, BG, Italy
| | | | | | - Andrea Remuzzi
- Department of Management, Information and Production Engineering, University of Bergamo, 24044, Dalmine, BG, Italy.
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Marmorino F, Rossini D, Lonardi S, Moretto R, Zucchelli G, Aprile G, Dell'Aquila E, Ratti M, Bergamo F, Masi G, Urbano F, Ronzoni M, Libertini M, Borelli B, Randon G, Buonadonna A, Allegrini G, Pella N, Ricci V, Boccaccino A, Latiano TP, Cordio S, Passardi A, Tamburini E, Boni L, Falcone A, Cremolini C. Impact of age and gender on the safety and efficacy of chemotherapy plus bevacizumab in metastatic colorectal cancer: a pooled analysis of TRIBE and TRIBE2 studies. Ann Oncol 2019; 30:1969-1977. [PMID: 31573612 DOI: 10.1093/annonc/mdz403] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The phase III TRIBE and TRIBE2 studies randomized metastatic colorectal cancer patients to first-line FOLFOXIRI/bevacizumab or a doublet (FOLFIRI or FOLFOX)/bevacizumab. The studies demonstrated a significant benefit from the triplet at the price of an increased incidence of chemotherapy-related adverse events (AEs). In both trials, males and females aged between 18 and 70 years with ECOG PS ≤2 and between 71 and 75 years with ECOG PS = 0 were eligible. We investigated the effect of FOLFOXIRI/bevacizumab versus doublets/bevacizumab according to age and gender. PATIENTS AND METHODS Subgroup analyses according to age (<70 versus 70-75 years) and gender were carried out for overall response rate (ORR), progression-free survival (PFS), and AE rates. RESULTS Of 1187 patients, 1005 (85%) were aged <70 years and 182 (15%) 70-75 years; 693 (58%) were males and 494 (42%) females. There was no evidence of interaction between age or gender and the benefit provided by the intensification of the upfront chemotherapy in terms of ORR and PFS, or the increased risk of experiencing G3/4 AEs. Elderly patients and females experienced higher rates of overall G3/4 AEs (73% versus 60%, P < 0.01 and 69% versus 57%, P < 0.01, respectively). Notably, in the FOLFOXIRI/bevacizumab subgroup, G3/4 diarrhea and febrile neutropenia occurred in 27% and 16% of elderly patients, respectively, while females reported high incidences of any grade nausea (67%) and vomiting (50%). CONCLUSIONS The improvements in terms of ORR and PFS of FOLFOXIRI/bevacizumab versus doublets/bevacizumab are independent of gender and age, with a similar relative increase in AEs among elderly patients and females. Initial dose reductions and possibly primary G-CSF prophylaxis should be recommended for patients between 70 and 75 years old treated with FOLFOXIRI/bevacizumab, and a careful management of antiemetic prophylaxis should be considered among females.
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Affiliation(s)
- F Marmorino
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa
| | - D Rossini
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa
| | - S Lonardi
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology - IRCCS, Padova
| | - R Moretto
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa
| | - G Zucchelli
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa
| | - G Aprile
- Department of Oncology, General and University Hospital, Udine; Department of Oncology, San Bortolo General Hospital, Azienda ULSS8 Berica, Vicenza
| | - E Dell'Aquila
- Department of Medical Oncology, Campus Biomedico University, Roma
| | - M Ratti
- Oncology Department, Oncology Unit, ASST of Cremona, Cremona
| | - F Bergamo
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology - IRCCS, Padova
| | - G Masi
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa
| | - F Urbano
- Department of Radiological Science, Oncology and Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Roma
| | - M Ronzoni
- Department of Oncology, Istituto Scientifico San Raffaele IRCSS, Milano
| | - M Libertini
- Medical Oncology Unit, Poliambulanza Foundation, Brescia
| | - B Borelli
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa
| | - G Randon
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - A Buonadonna
- Department of Medical Oncology, IRCCS CRO National Cancer Institute, Aviano
| | - G Allegrini
- Department of Medical Oncology, Unit of Medical Oncology, Livorno Hospital, Azienda Toscana Nord Ovest, Livorno
| | - N Pella
- Department of Oncology, General and University Hospital, Udine
| | - V Ricci
- Department of Oncology, S. Croce and Carle Teaching Hospital, Cuneo
| | - A Boccaccino
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa
| | - T P Latiano
- Oncology Unit, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo
| | - S Cordio
- Medical Oncology Unit, ARNAS Garibaldi Catania, Catania
| | - A Passardi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola
| | - E Tamburini
- Department of Medical Oncology, Card. G. Panico Hospital of Tricase, Tricase
| | - L Boni
- Clinical Trials Coordinating Center, Toscano Cancer Institute, University Hospital Careggi, Firenze, Italy
| | - A Falcone
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa
| | - C Cremolini
- Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa.
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Dell'Aquila E, Cremolini C, Zeppola T, Lonardi S, Bergamo F, Masi G, Stellato M, Marmorino F, Schirripa M, Urbano F, Ronzoni M, Tomasello G, Zaniboni A, Racca P, Buonadonna A, Allegrini G, Fea E, Di Donato S, Chiara S, Tonini G, Tomcikova D, Boni L, Falcone A, Santini D. Prognostic and predictive role of neutrophil/lymphocytes ratio in metastatic colorectal cancer: a retrospective analysis of the TRIBE study by GONO. Ann Oncol 2019; 29:924-930. [PMID: 29324972 DOI: 10.1093/annonc/mdy004] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Neutrophil/lymphocyte ratio (NLR), defined as absolute neutrophils count divided by absolute lymphocytes count, has been reported as poor prognostic factor in several neoplastic diseases but only a few data are available about unresectable metastatic colorectal cancer (mCRC) patients (pts). The aim of our study was to evaluate the prognostic and predictive role of NLR in the TRIBE trial. Patients and methods Pts enrolled in TRIBE trial were included. TRIBE is a multicentre phase III trial randomizing unresectable and previously untreated mCRC pts to receive FOLFOXIRI or FOLFIRI plus bevacizumab. A cut-off value of 3 was adopted to discriminate pts with low (NLR < 3) versus high (NLR ≥ 3) NLR, as primary analysis. As secondary analysis, NLR was treated as an ordinal variable with three levels based on terciles distribution. Results NLR at baseline was available for 413 patients. After multiple imputation at univariate analysis, patients with high NLR had significantly shorter progression-free survival (PFS) [hazard ratio (HR) 1.27 (95% CI 1.05-1.55), P = 0.017] and overall survival (OS) [HR 1.56 (95% CI 1.25-1.95), P < 0.001] than patients with low NLR. In the multivariable model, NLR retained a significant association with OS [HR 1.44 (95% CI 1.14-1.82), P = 0.014] but not with PFS [HR 1.18 (95% CI 0.95-1.46), P = 0.375]. No interaction effect between treatment arm and NLR was evident in terms of PFS (P for interaction = 0.536) or OS (P for interaction = 0.831). Patients with low [HR 0.84 (95% CI 0.64-1.08)] and high [HR 0.73 (95% CI 0.54-0.97)] NLR achieved similar PFS benefit from the triplet and consistent results were obtained in terms of OS [HR 0.83 (95% CI 0.62-1.12) for low NLR; HR 0.82 (95% CI 0.59-1.12) for high NLR]. Conclusion This study confirmed the prognostic role of NLR in mCRC pts treated with bevacizumab plus chemotherapy in the first line, showing the worse prognosis of pts with high NLR. The advantage of the triplet is independent of NLR at baseline.
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Affiliation(s)
- E Dell'Aquila
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - C Cremolini
- Department of Translational Research and New Technologies in Medicine and Surge, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy.
| | - T Zeppola
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - S Lonardi
- Department of Clinical and Experimental Oncolog, Medical Oncology Unit 1, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - F Bergamo
- Department of Clinical and Experimental Oncolog, Medical Oncology Unit 1, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - G Masi
- Department of Translational Research and New Technologies in Medicine and Surge, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - M Stellato
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - F Marmorino
- Department of Translational Research and New Technologies in Medicine and Surge, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - M Schirripa
- Department of Clinical and Experimental Oncolog, Medical Oncology Unit 1, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - F Urbano
- Department of Radiologica, Oncological and Pathological Sciences, Umberto I Policlinico di Roma, Rome, Italy
| | - M Ronzoni
- Medical Oncology, IRCCS San Raffaele, Milan, Italy
| | - G Tomasello
- S. C. Oncologia, ASST Ospedale di Cremona, Cremona, Italy
| | - A Zaniboni
- Department of Medical Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - P Racca
- SSD ColoRectal Cancer Unit-A.O.U. Department of Oncology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - A Buonadonna
- Division of Medical Oncology B, Centro di Riferimento Oncologico, Aviano, Italy
| | - G Allegrini
- Department of Oncology, Ospedale F. Lotti, Pontedera, Italy
| | - E Fea
- Department of Medical Oncology, Azienda Ospedaliera S Croce e Carle, Cuneo, Italy
| | - S Di Donato
- Department of Oncology, AUSL 4 Prato, Prato, Italy
| | - S Chiara
- Medical Oncology 2, Policlinico San Martino Hospital IRCCS per l'Oncologia, Genoa, Italy
| | - G Tonini
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - D Tomcikova
- Clinical Trials Coordinating Cente, Istituto Toscano Tumori, University Hospital Careggi, Florence, Italy
| | - L Boni
- Clinical Trials Coordinating Cente, Istituto Toscano Tumori, University Hospital Careggi, Florence, Italy
| | - A Falcone
- Department of Translational Research and New Technologies in Medicine and Surge, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - D Santini
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
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Dell’Aquila E, Rossini D, Stellato M, Bergamo F, Aprile G, Morano F, Intini R, Fea E, Ronzoni M, Libertini M, Buonadonna A, Fanchini L, Marcucci L, Maiello E, Marmorino F, Boccaccino A, Cordio S, Masi G, Falcone A, Santini D. Prognostic and predictive role of body mass index (BMI) in metastatic colorectal cancer (mCRC): A pooled analisys of TRIBE and TRIBE-2 studies by GONO. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.055] [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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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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Zucchelli G, Marmorino F, Rossini D, Aprile G, Casagrande M, Lonardi S, Murgioni S, Dell’Aquila E, Tomasello G, Moretto R, Antoniotti C, Borelli B, Urbano F, Ronzoni M, Zaniboni A, Manglaviti S, Buonadonna A, Ritorto G, Masi G, Allegrini G, Falcone A, Cremolini C. Impact of age and gender on safety and efficacy of first-line FOLFOXIRI/bevacizumab in mCRC: a pooled analysis of TRIBE and TRIBE2 studies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.012] [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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Rossini D, Sbrana A, Bergamo F, Manai C, Santini D, Ghidini M, Antoniotti C, Moretto R, Marmorino F, Urbano F, Ronzoni M, Noventa S, Randon G, Carlomagno C, Latiano T, Cordio S, Granetto C, Cremolini C, Falcone A, Antonuzzo A. Clinical impact of neutropenia and febrile neutropenia in metastatic colorectal cancer patients treated with FOLFOXIRI/bevacizumab: a pooled analysis of TRIBE and TRIBE2 studies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cremolini C, Antoniotti C, Lonardi S, Bergamo F, Cortesi E, Tomasello G, Moretto R, Ronzoni M, Racca P, Loupakis F, Zaniboni A, Tonini G, Buonadonna A, Marmorino F, Allegrini G, Granetto C, Masi G, Zagonel V, Sensi E, Fontanini G, Boni L, Falcone A. Primary tumor sidedness and benefit from FOLFOXIRI plus bevacizumab as initial therapy for metastatic colorectal cancer. Retrospective analysis of the TRIBE trial by GONO. Ann Oncol 2018; 29:1528-1534. [DOI: 10.1093/annonc/mdy140] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Dell'Aquila E, Pantano F, Rossini D, Stellato M, Lonardi S, Masi G, Schirripa M, Marmorino F, Antoniotti C, Murgioni S, Tomasello G, Ronzoni M, Racca P, Vincenzi B, Allegrini G, Urbano F, Buonadonna A, Banzi M, Tonini G, Cremolini C, Falcone A, Santini D. Development of a new clinical nomogram including velocity rate of disease progression to predict outcome in metastatic colorectal cancer patients treated with bevacizumab beyond progression: A subanalysis from tribe trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Arru M, Aldrighetti L, Gremmo F, Ronzoni M, Angeli E, Caterini R, Ferla G. Arterial Devices for Regional Hepatic Chemotherapy: Transaxillary versus Laparotomic Access. J Vasc Access 2018; 1:93-9. [PMID: 17638234 DOI: 10.1177/112972980000100305] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Intra-Arterial Hepatic Chemotherapy (IAHC) based on floxuridine (FUdR) infusion is an effective treatment for hepatic metastases from colorectal cancer. A percutaneously implanted intra-arterial device may overcome the surgical stress of the laparotomic placement allowing an increase in the number of patients treated by IAHC. The aim of the present study is the comparative analysis of surgical and percutaneous transaxillary approaches to implant the catheter into the hepatic artery (HA) for IAHC. Materials and Methods Between September 1993 and February 1999, 56 patients received an implantable infusion system [SynchroMed® (Medtronic, USA) or Port-a-cath® (Deltec, USA) connected to an external infusion pump (CADD®, Deltec, USA)] for IAHC. Twenty-eight patients (LPT group) underwent laparotomy to implant the catheter into the HA, the other 28 patients (PCT group) received a percutaneous catheter into the HA through a transaxillary percutaneous access. Indications for the laparotomic placement were: 1) synchronous metastases not suitable [technically unresectable or large (>40% of liver parenchyma) or multiple (> 3) metastases] for hepatic resection during colorectal surgery; 2) metachronous metastases treated by radical hepatic resection and subsequent adjuvant IAHC. Indications for percutaneous placement were: 1) metachronous metastases not suitable [see above] for hepatic resection; 2) metachronous metastases suitable for hepatic resection after neoadjuvant IAHC for tumor downstaging. All patients received IAHC based on continuous infusion of FUdR (dose escalation 0.15–0.30 mg/kg/day for 14 days every 28 days) plus dexamethasone 28 mg. For the purpose of the study, the LPT group and the PCT group were comparatively analyzed in terms of age, gender, primary diagnosis, vascular anatomy of HA, ligation/embolization of aberrant HA, previous intestinal or hepatic surgery, contextual systemic chemotherapy, concomitant diseases. Safety and efficacy of surgical and percutaneous transaxillary approaches were then comparatively analyzed in terms of number of IAHC cycles administered, device-related complications causing temporary or definitive suppression of IAHC, biological costs of the procedures (procedure-related complications, postoperative pain and hospitalization). LPT cases without concomitant surgical procedure other than catheter placement (Cath-LPT group - 10 cases) were also compared with the PCT group for the same end points of the study. Results LPT group and PCT group were comparable (p=n.s.) when evaluated for all the above listed variables. As for the end points of the study, mean postoperative hospitalization was 8.2±2.2 days in the LPT group and 1.8±0.7 days in the PCT group (p<0.0001), while mean analgesic requirements were 9.7±3.2 doses in the LPT group and 2±0.9 doses in the PCT group (p<0.0001). Mean number of IAHC cycles administered was 6.5±4.2 in the LPT group and 4.3±3.4 in the PCT group (p=0.038). Device-related complications causing temporary or definitive suppression of IAHC included catheter displacement in 10 cases (35.7%), HA thrombosis in 1 case (3.5%) and catheter occlusion in 1 case (3.5%) in the PCT group, while in the LPT group 1 case (3.5%) of catheter occlusion and 1 case (3.5%) of HA thrombosis occurred. The overall incidence of device-related complications causing temporary or definitive suppression of IAHC was 42.7% in the PCT group and 7.1% in the LPT group (p=0.005). Comparison of Cath-LPT group and the PCT group showed mean postoperative hospitalization of 5.5±0.7 days in the Cath-LPT group and 1.8±0.7 days in the PCT group (p<0.0001), and mean analgesic requirements of 8±3.1 doses in the Cath-LPT group and 2±0.9 in the PCT group (p<0.0001). Conclusions Surgically implanted indwelling catheters for IAHC present lower incidence of device-related complications than percutaneous transaxillary implanted catheters. In spite of its irreversibility and significant biological costs, surgical implant is still advised when laparotomy has to be performed for other contextual procedures, such as colorectal or hepatic resection, while percutaneous transaxillary catheter placement is indicated for palliative or neoadjuvant IAHC.
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Affiliation(s)
- M Arru
- Department of Surgery, Scientific Institute San Raffaele Hospital, Milan - Italy
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Aldrighetti L, Paganelli M, Arru M, Caterini R, Ronzoni M, Ferla G. Complications of Blind Placement Technique in 980 Subcutaneous Infusion Ports. J Vasc Access 2018; 1:28-32. [PMID: 17638219 DOI: 10.1177/112972980000100108] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose Subcutaneous Infusion Ports (SIPs) for prolonged venous access are useful tools for drug administration in a wide range of chronic diseases. An extensive use of these devices has to be balanced against the potential complications worsening the length and the quality of life of frequently compromised patients. The aim of the present study is the prospective evaluation of early and late complications of the technique for the blind placement of totally implantable devices for prolonged venous access. Methods Between April 1, 1991 and September 30, 1999, 980 SIPs were implanted in 967 patients. Thirteen patients received 2 SIPs. The surgical procedure, the catheter through peel-away technique after infraclavicular approach to the right or left subclavian vein, was performed without intraoperative fluoroscopy (blind placement technique) in the operating room under local anaesthesia. A postoperative chest radiography to rule out any procedure-related complications and to check the position of the catheter tip was obtained in all cases. For the purpose of the study, intraoperative complications as well as all SIP-related complications were recorded during the follow-up period and classified as major and minor complications. Results The study population consisted of 524 males/443 females, with a mean age of 56.3 ± 11.4 years (range 19–85 years). Primary diagnosis was malignancy in 916 patients (94.7%), acquired immunodeficiency syndrome (AIDS) in 44 patients (4.5%), and short gut syndrome secondary to subtotal small bowel resection in 2 cases (0.2%), others in 5 cases (0.5%). Perioperative complications were recorded in 12.9% of the 980 insertion procedures, including 77 cases of arterial puncture (7.8%) of the subclavian artery, 1 case of hemoptysis (without clinical and radiological evidence of pneumothorax) (0.1%), 23 cases of pneumothorax (2.3%), 20 of which (86.9%) required chest drainage, 10 cases of unsuccessful progression of the J-wire after the venepuncture (1%), 16 cases of catheter malposition (1.6%). As for the follow-up, 919 patients (95.0%) who had received 942 SIPs turned out to be suitable for long-term analysis, while 48 patients (5.0%) were excluded due to missing data. Seventy-seven SIPs (8.2%) were removed during the follow-up period, 13 of which received a second SIP. Long-term complications were recorded in 9.5% of the 942 SIPs, including mechanical complications (2.9%), infections (4.4%) and venous thrombosis (1.2%). Minor and major complication rates were 7.3% and 2.2% respectively. The overall incidence of SIP-related complications was 22.1%, including 44 major complications (4.5%) and 173 minor complications (17.6%). Conclusions Given the low rate of major complications, SIPs should be considered safe and effective devices, representing the first choice approach for prolonged venous access. Blind placement technique performed by full-trained operators yields adequate success rate to be suggested as a routine procedure.
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Affiliation(s)
- L Aldrighetti
- Department of Surgery, Scientific Institute H San Raffaele, Milano - 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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Ruzzo A, Galli F, Galli F, Rulli E, Lonardi S, Zagonel V, Ronzoni M, Ionta M, Pella N, Mucciarini C, Labianca R, Veltri E, Sozzi P, Barni S, Nicolini M, Biondi E, Bramati A, Turci D, Buscaglia M, Magnani M, Graziano F. Germline variants and clinical outcomes of high-risk stage II and stage III colon cancer patients treated with oxaliplatin and fluoropyrimidines adjuvant chemotherapy: a pharmacogenetic ancillary study to TOSCA trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.002] [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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Zaniboni A, Lonardi S, Labianca R, Di Bartolomeo M, Rosati G, Ronzoni M, Pella N, Banzi M, Zampino M, Pasini F, Marchetti P, Rimassa L, Maiello E, Bidoli P, Cinieri S, Barni S, Ciuffreda L, Beretta G, Frontini L, Rulli E, Sobrero A. FOLFOX4/XELOX in stage II–III colon cancer: early survival data of the Italian Three Or Six Colon Adjuvant (TOSCA) trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx421] [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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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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Gumina C, Slim N, Cattaneo G, De Nardi P, Canevari C, Ronzoni M, Fasolo A, Fiorino C, Perna L, Tamburini A, Rosati R, Passoni P, Di Muzio N. PO-0706: Assessing the impact of sentinel lymph-node and inguinal irradiation in patients with anal cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cremolini C, Antoniotti C, Loupakis F, Bergamo F, Ferrari L, Grande R, Tonini G, Masi G, Schirripa M, Bonotto M, Soldà C, Lucchesi S, rossini D, Corsi D, Ronzoni M, Llimpe FR, Fontanini G, Boni L, Zagonel V, Falcone A. Modified FOLFOXIRI (mFOLFOXIRI) plus cetuximab (cet), followed by cet or bevacizumab (bev) maintenance, in RAS/BRAF wt metastatic colorectal cancer (mCRC): The phase II randomized MACBETH trial by GONO. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.11] [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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Graziano F, Ruzzo A, Rulli E, Galli F, Galli F, Menghi M, Viti D, Giacomini E, Lonardi S, Ronzoni M, Massidda B, Pella N, Mucciarini C, Labianca R, Veltri E, Sozzi P, Barni S, Sobrero A, Frontini L, Magnani M. Dihydropyrimidine dehydrogenase (DPYD) gene polymorphisms profiling in colon cancer patients treated with adjuvant chemotherapy in the randomized phase III TOSCA trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw331.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rossini D, Casagrande M, Moretto R, Loupakis F, Cremolini C, Masi G, Borelli B, Lonardi S, Zagonel V, Aprile G, Ricci V, Grande R, Tomasello G, Ronzoni M, Allegrini G, Tonini G, Mancini M, Zaniboni A, Chiara S, Carlomagno C, Falcone A. Safety and efficacy of FOLFOXIRI with or without targeted agents as first-line treatment of selected elderly metastatic colorectal cancer patients: a pooled analysis of GONO studies. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.14] [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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Antoniotti C, Cremolini C, Loupakis F, Bergamo F, Garattini S, Grande R, Tonini G, Masi G, Schirripa M, Bonotto M, Rumanò L, Lucchesi S, Rossini D, Corsi D, Ronzoni M, Rojas Llimpe F, Fontanini G, Boni L, Zagonel V, Delliponti L, Falcone A. Modified FOLFOXIRI (mFOLFOXIRI) plus cetuximab (cet), followed by cet or bevacizumab (bev) maintenance, in RAS/BRAF wt metastatic colorectal cancer (mCRC): the phase II randomized MACBETH trial by GONO. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw331.01] [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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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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Casagrande M, Moretto R, Loupakis F, Cremolini C, Masi G, Borelli B, Lonardi S, Marsico Valentina A, Salvatore L, Rossini D, Ferrari L, Ricci V, Grande R, Tomasello G, Ronzoni M, Allegrini G, Tonini G, Mancini M, Zaniboni A, Chiara S, Carlomagno C, Falcone A. PD-009 Safety and efficacy of FOLFOXIRI with or without targeted agents as first-line treatment of selected elderly metastatic colorectal cancer patients: a pooled analysis of GONO studies. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.09] [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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Slim N, Gumina C, De Nardi P, Tamburini A, Canevari C, Ronzoni M, Bordogna G, Ricci V, Fiorino C, Rosati R, Di Muzio N, Passoni P. PO-0721: Impact of sentinel lymph-node biopsy on staging and treatment in patients with anal cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31971-5] [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: 11/30/2022]
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Cremolini C, Loupakis F, Masi G, Lonardi S, Granetto C, Mancini ML, Chiara S, Moretto R, Rossini D, Vitello S, Allegrini G, Tonini G, Bergamo F, Tomasello G, Ronzoni M, Buonadonna A, Bustreo S, Barbara C, Boni L, Falcone A. FOLFOXIRI or FOLFOXIRI plus bevacizumab as first-line treatment of metastatic colorectal cancer: a propensity score-adjusted analysis from two randomized clinical trials. Ann Oncol 2016; 27:843-9. [PMID: 26861604 DOI: 10.1093/annonc/mdw052] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/03/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND FOLFOXIRI plus bevacizumab is a valid option as upfront treatment for metastatic colorectal cancer (mCRC) patients. While several trials investigated the effect of combining bevacizumab with different chemotherapy regimens, including fluoropyrimidines monotherapy and oxaliplatin- or irinotecan-containing doublets, no randomized comparison assessing the impact of the addition of bevacizumab to FOLFOXIRI is available. PATIENTS AND METHODS A total of 122 mCRC patients received first-line FOLFOXIRI in the phase III trial by the GONO (FOLFOXIRI group) and 252 patients received first-line FOLFOXIRI plus bevacizumab in the TRIBE trial (FOLFOXIRI plus bevacizumab group). A propensity score-adjusted method was adopted to provide an estimation of the benefit from the addition of bevacizumab to FOLFOXIRI in terms of survival and activity parameters. RESULTS Patients in the FOLFOXIRI group had more frequently Eastern Cooperative Oncology Group performance status of one or two, high Köhne score, metachronous and liver-limited disease, had previously received adjuvant treatments and had their primary tumors resected. The median progression-free survival (PFS) was 12.3 months in the FOLFOXIRI plus bevacizumab group compared with 10.0 months in the FOLFOXIRI group {propensity score-adjusted hazard ratio (HR) 0.74 [95% confidence interval (CI) 0.59-0.94], P = 0.013}. This association was significant also in the multivariable model (P = 0.024). The median OS was 29.8 months in the FOLFOXIRI plus bevacizumab group compared with 23.6 months in the FOLFOXIRI group [propensity score-adjusted HR: 0.72 (95% CI 0.56-0.93), P = 0.014]. At the multivariable model, the addition of bevacizumab was still associated with significantly longer OS (P = 0.030). No significant differences in RECIST response rate (RR) [65.1% versus 55.7%; propensity score-adjusted odds ratio (OR): 1.29 (95% CI 0.81-2.05), P = 0.280], early RR [62.7% versus 57.8%; OR: 1.14 (95% CI 0.68-1.93), P = 0.619] and median depth of response (42.2% versus 53.8%, P = 0.259) were reported. CONCLUSIONS Though in the absence of a randomized comparison, the addition of bevacizumab to FOLFOXIRI provides significant benefit in PFS and OS, thus supporting the use of FOLFOXIRI plus bevacizumab as upfront treatment for mCRC patients. TRIALS' NUMBERS NCT01219920 and NCT00719797.
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Affiliation(s)
- C Cremolini
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa
| | - F Loupakis
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa
| | - G Masi
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa
| | - S Lonardi
- Unit of Medical Oncology 1, Istituto Oncologico Veneto, IRCSS, Padua
| | - C Granetto
- Unit of Medical Oncology, Azienda Sanitaria Ospedaliera Santa Croce e Carle, Cuneo
| | - M L Mancini
- Department of Medical Oncology, University of Rome La Sapienza, Rome
| | - S Chiara
- Department of Medical Oncology 2, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genoa
| | - R Moretto
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa
| | - D Rossini
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa
| | - S Vitello
- Unit of Oncology, Sant'Elia Hospital, Caltanissetta
| | - G Allegrini
- Unit of Medical Oncology, 'Felice Lotti' Hospital, Pontedera
| | - G Tonini
- Department of Medical Oncology, University Campus Biomedico, Rome
| | - F Bergamo
- Unit of Medical Oncology 1, Istituto Oncologico Veneto, IRCSS, Padua
| | - G Tomasello
- Division of Medicine and Medical Oncology, Azienda Istituti Ospitalieri, Cremona
| | - M Ronzoni
- Department of Oncology, 'San Raffaele' Hospital IRCSS, Milan
| | - A Buonadonna
- Division of Oncology, Centro di Riferimento Oncologico, Aviano
| | - S Bustreo
- ColoRectal Cancer Unit, Unit of Oncology 1, 'Molinette' Hospital, Città della Salute e della Scienza, Turin
| | - C Barbara
- Unit of Medical Oncology, Spedali Riuniti di Livorno, Livorno
| | - L Boni
- Clinical Trials Coordinating Center, Istituto Toscano Tumori, Florence, Italy
| | - A Falcone
- Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa
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Falcone A, Cremolini C, Antoniotti C, Lonardi S, Ronzoni M, Zaniboni A, Tonini G, Salvatore L, Masi G, Mezi S, Tomasello G, Carlomagno C, Allegrini G, Chiara S, D'Amico M, Granetto C, Lupi C, Sensi E, Fontanini G, Boni L, Loupakis F. FOLFOXIRI plus bevacizumab versus FOLFIRI plus bevacizumab as initial treatment for metastatic colorectal cancer (TRIBE study): updated survival results and final molecular subgroups analyses. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv335.02] [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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Cremolini C, Loupakis F, Antoniotti C, Lonardi S, Ronzoni M, Zaniboni A, Tonini G, Masi G, Chiara S, Carlomagno C, Salvatore L, Banzi M, Negri F, Marcucci L, Schirripa M, Barone C, Fontanini G, Borrelli N, Giordano M, Macerola E, Boni L, Falcone A. O-006 FOLFOXIRI plus bevacizumab versus FOLFIRI plus bevacizumab as initial treatment for metastatic colorectal cancer (TRIBE study): updated survival results and final molecular subgroups analyses. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv235.05] [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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Cremolini C, Loupakis F, Rossini D, Masi G, Salvatore L, Barbara C, Brunetti I, Antoniotti C, Granetto C, Cortesi E, Chiara S, Vitello S, Lonardi S, Ciuffreda L, Tomasello G, Ronzoni M, Buonadonna A, Tomcikova D, Boni L, Falcone A. Folfoxiri with or Without Bevacizumab (Bev) As First-Line Treatment of Metastatic Colorectal Cancer (Mcrc): a Propensity Score-Based Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Graziano F, Ruzzo A, Galli F, Giacomini E, Floriani I, Galli F, Rulli E, Lonardi S, Ronzoni M, Massidda B, Zagonel V, Pella N, Mucciarini C, Labianca R, Veltri E, Sozzi P, Barni S, Ricci V, Sobrero A, Magnani M. Pharmacogenetic Profiling for Toxicity of Oxaliplatin and Fluoropyrimidines. Final Report from an Ancillary Protocol to the Tosca (Three or Six Colon Adjuvant) Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.78] [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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Cremolini C, Loupakis F, Lonardi S, Tomasello G, Ronzoni M, Zaniboni A, Tonini G, Valsuani C, Chiara S, Boni C, Marcucci L, Negri F, Barone C, Vitello S, D'Amico M, Granetto C, Antoniotti C, Salvatore L, Fontanini G, Tomcikova D, Boni L, Falcone A. Subgroup Analyses in RAS Mutant, BRAF Mutant and “ALL WT” Metastatic Colorectal Cancer Patients Treated with Folfoxiri Plus Bevacizumab (BEV) or Folfiri Plus BEV in the Tribe Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu193.7] [Citation(s) in RCA: 3] [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: 12/16/2022] Open
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Slim N, Fiorino C, Passoni P, Ronzoni M, Ricci V, Di Palo S, Tamburini A, Iacovelli N, Calandrino R, Di Muzio N. PO-0696: Adaptive strategy in preoperative RT for rectal cancer with Tomotherapy: boosting the dose to the shrinking tumor. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33002-4] [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: 11/26/2022]
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Tamburini A, Orsenigo E, Di Palo S, Albarello L, Ronzoni M, Staudacher C. Long-term outcome of pathological complete response patients after neoadjuvant therapy for locally advanced rectal cancer. A single-center prospective trial. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.07.036] [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: 11/17/2022] Open
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Crea F, Fornaro L, Paolicchi E, Masi G, Frumento P, Loupakis F, Salvatore L, Cremolini C, Schirripa M, Graziano F, Ronzoni M, Ricci V, Farrar WL, Falcone A, Danesi R. An EZH2 polymorphism is associated with clinical outcome in metastatic colorectal cancer patients. Ann Oncol 2012; 23:1207-1213. [PMID: 21926398 DOI: 10.1093/annonc/mdr387] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [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: 12/12/2022] Open
Abstract
BACKGROUND Despite therapeutic innovations, metastatic colorectal cancer (mCRC) is still characterized by poor prognosis and few molecular markers predict the risk of progression. Polycomb group genes (PcGs) are epigenetic modifiers involved in tumor suppressor gene silencing. PcG member EZH2 mediates gene silencing through histone-H3 lysine-27 methylation. In colorectal cancer (CRC), EZH2 overexpression predicts shorter survival. Recently, four EZH2 single-nucleotide polymorphisms (SNPs) have been described. The present study was aimed at evaluating the correlation between EZH2 SNPs and outcome parameters in mCRC patients. PATIENTS AND METHODS DNA was extracted from blood samples of 110 mCRC patients treated with first-line 5-fluorouracil, folinic acid, irinotecan (FOLFIRI) and bevacizumab. Genotyping was carried out by real-time PCR. Genotype was used to predict objective response, progression-free survival (PFS) and overall survival (OS). EZH2 messenger RNA levels were evaluated on lymphocytes of a parallel cohort of 50 CRC patients. RESULTS One allelic variant (rs3757441 C/C versus C/T or T/T) was significantly associated with shorter PFS and OS (P < 0.01 and P < 0.05, respectively). At multivariate analysis, the same variant resulted an independent predictor of PFS and OS (P < 0.05). The C/C variant was associated with significantly higher EZH2 expression (P < 0.05). CONCLUSION An EZH2 SNP may be useful to predict clinical outcome in mCRC patients.
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Affiliation(s)
- F Crea
- Division of Pharmacology, Department of Internal Medicine, University of Pisa, Pisa.
| | - L Fornaro
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - E Paolicchi
- Division of Pharmacology, Department of Internal Medicine, University of Pisa, Pisa
| | - G Masi
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - P Frumento
- Unit of Biostatistics, Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - F Loupakis
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - L Salvatore
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - C Cremolini
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - M Schirripa
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - F Graziano
- Medical Oncology Unit, Department of Onco-Hematology, Azienda Ospedaliera S. Salvatore, Pesaro
| | - M Ronzoni
- Division of Medical Oncology, S. Raffaele Scientific Institute, Milano, Italy
| | - V Ricci
- Division of Medical Oncology, S. Raffaele Scientific Institute, Milano, Italy
| | - W L Farrar
- Cancer Stem Cell Section, Laboratory of Cancer Prevention, National Institute of Cancer-Frederick, Frederick, USA
| | - A Falcone
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - R Danesi
- Division of Pharmacology, Department of Internal Medicine, University of Pisa, Pisa
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Fornaro L, Crea F, Masi G, Paolicchi E, Loupakis F, Graziano F, Salvatore L, Ronzoni M, Ricci V, Cremolini C, Schirripa M, Danesi R, Falcone A. EZH2 polymorphism and benefit from bevacizumab in colorectal cancer: another piece to the puzzle. Ann Oncol 2012; 23:1370-1371. [PMID: 22383679 DOI: 10.1093/annonc/mds031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Fornaro
- Department of Oncology, Transplants and New Technologies in Medicine, Division of Medical Oncology, University of Pisa, Pisa.
| | - F Crea
- Department of Internal Medicine, Division of Pharmacology, University of Pisa, Pisa
| | - G Masi
- Department of Oncology, Transplants and New Technologies in Medicine, Division of Medical Oncology, University of Pisa, Pisa
| | - E Paolicchi
- Department of Internal Medicine, Division of Pharmacology, University of Pisa, Pisa
| | - F Loupakis
- Department of Oncology, Transplants and New Technologies in Medicine, Division of Medical Oncology, University of Pisa, Pisa
| | - F Graziano
- Medical Oncology Unit, Department of Onco-Hematology, Azienda Ospedaliera S. Salvatore, Pesaro
| | - L Salvatore
- Department of Oncology, Transplants and New Technologies in Medicine, Division of Medical Oncology, University of Pisa, Pisa
| | - M Ronzoni
- Division of Medical Oncology, S. Raffaele Scientific Institute, Milano, Italy
| | - V Ricci
- Division of Medical Oncology, S. Raffaele Scientific Institute, Milano, Italy
| | - C Cremolini
- Department of Oncology, Transplants and New Technologies in Medicine, Division of Medical Oncology, University of Pisa, Pisa
| | - M Schirripa
- Department of Oncology, Transplants and New Technologies in Medicine, Division of Medical Oncology, University of Pisa, Pisa
| | - R Danesi
- Department of Internal Medicine, Division of Pharmacology, University of Pisa, Pisa
| | - A Falcone
- Department of Oncology, Transplants and New Technologies in Medicine, Division of Medical Oncology, University of Pisa, Pisa
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Crea F, Fornaro L, Paolicchi E, Masi G, Frumento P, Loupakis F, Salvatore L, Cremolini C, Schirripa M, Graziano F, Ronzoni M, Ricci V, Farrar WL, Falcone A, Danesi R. An EZH2 polymorphism is associated with clinical outcome in metastatic colorectal cancer patients. Ann Oncol 2011. [PMID: 21926398 DOI: 10.1093/annonc/mdr387.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite therapeutic innovations, metastatic colorectal cancer (mCRC) is still characterized by poor prognosis and few molecular markers predict the risk of progression. Polycomb group genes (PcGs) are epigenetic modifiers involved in tumor suppressor gene silencing. PcG member EZH2 mediates gene silencing through histone-H3 lysine-27 methylation. In colorectal cancer (CRC), EZH2 overexpression predicts shorter survival. Recently, four EZH2 single-nucleotide polymorphisms (SNPs) have been described. The present study was aimed at evaluating the correlation between EZH2 SNPs and outcome parameters in mCRC patients. PATIENTS AND METHODS DNA was extracted from blood samples of 110 mCRC patients treated with first-line 5-fluorouracil, folinic acid, irinotecan (FOLFIRI) and bevacizumab. Genotyping was carried out by real-time PCR. Genotype was used to predict objective response, progression-free survival (PFS) and overall survival (OS). EZH2 messenger RNA levels were evaluated on lymphocytes of a parallel cohort of 50 CRC patients. RESULTS One allelic variant (rs3757441 C/C versus C/T or T/T) was significantly associated with shorter PFS and OS (P < 0.01 and P < 0.05, respectively). At multivariate analysis, the same variant resulted an independent predictor of PFS and OS (P < 0.05). The C/C variant was associated with significantly higher EZH2 expression (P < 0.05). CONCLUSION An EZH2 SNP may be useful to predict clinical outcome in mCRC patients.
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Affiliation(s)
- F Crea
- Division of Pharmacology, Department of Internal Medicine, University of Pisa, Pisa.
| | - L Fornaro
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - E Paolicchi
- Division of Pharmacology, Department of Internal Medicine, University of Pisa, Pisa
| | - G Masi
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - P Frumento
- Unit of Biostatistics, Institute of Environmental Health, Karolinska Institutet, Stockholm, Sweden
| | - F Loupakis
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - L Salvatore
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - C Cremolini
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - M Schirripa
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - F Graziano
- Medical Oncology Unit, Department of Onco-Hematology, Azienda Ospedaliera S. Salvatore, Pesaro
| | - M Ronzoni
- Division of Medical Oncology, S. Raffaele Scientific Institute, Milano, Italy
| | - V Ricci
- Division of Medical Oncology, S. Raffaele Scientific Institute, Milano, Italy
| | - W L Farrar
- Cancer Stem Cell Section, Laboratory of Cancer Prevention, National Institute of Cancer-Frederick, Frederick, USA
| | - A Falcone
- Division of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - R Danesi
- Division of Pharmacology, Department of Internal Medicine, University of Pisa, Pisa
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Ronzoni M, Manzoni M, Mariucci S, Loupakis F, Brugnatelli S, Bencardino K, Rovati B, Tinelli C, Falcone A, Villa E, Danova M. Circulating endothelial cells and endothelial progenitors as predictive markers of clinical response to bevacizumab-based first-line treatment in advanced colorectal cancer patients. Ann Oncol 2010; 21:2382-2389. [PMID: 20497963 DOI: 10.1093/annonc/mdq261] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite the consistent clinical results demonstrated by studies on anti-angiogenic drugs targeted against the vascular endothelial growth factor in metastatic colorectal cancer (mCRC) patients, no specific direct/indirect biomarker of their efficacy has been validated. In this field, circulating endothelial cells (CECs) and endothelial progenitor cells (CEPs) have recently been proposed as noninvasive biomarkers. PATIENTS AND METHODS The absolute numbers of CEPs, total CECs (tCECs) and their resting (rCECs) and activated subsets were evaluated by multiparameter flow cytometry in 40 mCRC patients at baseline and before the administration of the third and sixth course of a bevacizumab-based first-line treatment. Fifty healthy subjects were utilized as control. RESULTS The overall response rate was 80%, overall clinical benefit was 90% and median progression-free survival (PFS) was 13.8 months. In our patients, tCECs and rCECs were significantly increased compared with healthy subjects. The patients who achieved a radiological response showed, at baseline, a significant decrease of rCECs and a trend in decrease of tCECs in comparison with patients not achieving response. Finally, a baseline absolute number of tCEC and rCEC <40 cells/ml was evidenced in patients with a longer PFS. No correlation was found regarding CEP. CONCLUSIONS Our study suggests significant correlations between both tCEC and rCEC baseline levels and the antitumor efficacy of a bevacizumab-based combination therapy in mCRC patients, thus confirming that these biomarkers could be used in the clinical setting as an early predictor of tumor response.
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Affiliation(s)
- M Ronzoni
- Medical Oncology, Scientific Institute S. Raffaele, Milano.
| | | | | | - F Loupakis
- Medical Oncology 2, Department of Oncology, University Hospital of Pisa, Pisa, Italy
| | | | - K Bencardino
- Medical Oncology, Scientific Institute S. Raffaele, Milano
| | | | - C Tinelli
- Biometry and Clinical Epidemiology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia
| | - A Falcone
- Medical Oncology 2, Department of Oncology, University Hospital of Pisa, Pisa, Italy
| | - E Villa
- Medical Oncology, Scientific Institute S. Raffaele, Milano
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Falcone A, Loupakis F, Cupini S, Cortesi E, Buonadonna A, Tomasello G, Banzi M, Ronzoni M, Zaniboni A, Masi G. FOLFOXIRI plus bevacizumab (BV) versus FOLFIRI plus BV as first-line treatment of metastatic colorectal cancer (MCRC): Preliminary safety results of the phase III randomized TRIBE study by the Gruppo Oncologico Nord-Ovest (GONO). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3543] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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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Manzoni M, Rovati B, Ronzoni M, Loupakis F, Mariucci S, Ricci V, Gattoni E, Salvatore L, Tinelli C, Villa E, Danova M. Immunological Effects of Bevacizumab-Based Treatment in Metastatic Colorectal Cancer. Oncology 2010; 79:187-96. [DOI: 10.1159/000320609] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 07/27/2010] [Indexed: 11/19/2022]
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Passoni P, Ronzoni M, Fiorino C, Slim N, Bencardino K, Di Palo S, Tamburini A, Calandrino R, Staudacher C, Di Muzio N. Preoperative, Moderately Hypofractionated Radiotherapy with Image-guided Tomotherapy Concomitant to Chemotherapy in Rectal Adenocarcinoma: Early Results of a Phase II Study. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.631] [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: 11/29/2022]
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Tamburini A, Bencardino K, DiPalo S, Orsenigo E, Ronzoni M, Staudacher C. 6028 Prognostic value of pathological complete response after neoadjuvant therapy for locally advanced rectal cancer – a monoinstitutional experience. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71123-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Manzoni M, Rovati B, Delfanti S, Chatzileontiadou S, Bencardino K, Ronzoni M, Brugnatelli S, Luopakis F, Falcone A, Danova M. 6097 The recovery of circulating dendritic cells during anti-VEGF treatment is related to clinical outcome in advanced colorectal cancer patients. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71192-9] [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: 11/28/2022] Open
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Tamburini A, Castiglioni A, Bencardino K, Orsenigo E, Salandini M, Albarello L, Ronzoni M, Manfredi A, Staudacher C. 1108 Preliminary evidences for recruitment of innate responses to rectal cancer cell death elicited by neo-adjuvant radio-chemotherapy. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70401-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Loupakis F, Cremolini C, Perrone G, Stasi I, Salvatore L, Vincenzi B, Ruzzo A, Ronzoni M, Bencardino K, Falcone A. Amphiregulin (AR) expression in the prediction of benefit from cetuximab plus irinotecan in KRAS wild-type metastatic colorectal cancer (mCRC) patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
4021 Background: AR is an endogenous ligand of Epidermal Growth Factor Receptor (EGFR), whose binding is prevented in the presence of cetuximab. Methods: We retrospectively assessed KRAS mutational status and AR expression at immunohistochemistry (IHC) in 86 irinotecan-refractory EGFR-positive mCRC patients treated with cetuximab plus irinotecan. AR-IHC was performed on tissue sections from paraffin-embedded primary tumors. Specimens were defined AR-low or AR-high according to a score (range 0–300) obtained multiplying intensity (0 to 3+) by percentage of stained cells (0–100%). According to the results of a ROC analysis, we identified a cut-off value of 18. The association between AR-IHC and treatment outcome in terms of response rate (RR), PFS, and OS was investigated in the subgroup of KRAS wild-type patients. Results: Eighty-six consecutive patients were included. M/F = 44/42, median age = 67 (41–78), median number of previous lines of chemotherapy = 2 (1–5). Among 51 (59%) KRAS wild-type patients, 12 PRs and 1 CR were observed, for an overall RR of 25% (13/51). AR-IHC was high, low or unconclusive in 27, 22 and 2 cases respectively. AR-low patients reported a significantly worse RR (2/22, 9%) compared with AR-high (10/27, 37%) (p = 0.024) and a trend toward shorter PFS (3.5 vs 5.3 months, HR 0.88 [95%CI: 0.46–1.60], p = 0.628) and OS (8.8 vs 15.1 months, HR 0.60 [95%CI: 0.30–1.10], p = 0.106). Conclusions: These results underline the potential role of endogenous ligands in influencing the activity of anti-EGFR monoclonal antibodies. Absent or low AR expression at IHC may be related to resistance to cetuximab plus irinotecan. Further data regarding the prognostic impact of AR expression are needed. No significant financial relationships to disclose.
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Affiliation(s)
- F. Loupakis
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - C. Cremolini
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - G. Perrone
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - I. Stasi
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - L. Salvatore
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - B. Vincenzi
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - A. Ruzzo
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - M. Ronzoni
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - K. Bencardino
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
| | - A. Falcone
- Department of Oncology Azienda USL 6, Livorno, Italy; Surgical Pathology Campus Biomedico University, Roma, Italy; Medical Oncology Campus Biomedico University, Roma, Italy; Department of Biomolecular Sciences, University of Urbino, Urbino, Italy; Medical Oncology San Raffaele Scientific Institute, Milano, Italy; Department of Oncology, University of Pisa, Pisa, Italy
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Castiglioni A, Bencardino K, Tamburini AM, Monno A, Albarello L, Staudacher C, Ronzoni M, Doglioni C, Rovere-Querini P, Manfredi A. Characterization of innate responses elicited by neoadjuvant radio-chemotherapy for rectal cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15044] [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
e15044 Background: The neoadjuvant chemo-radiotherapy (CT-RT) has improved the treatment of locally advanced rectal cancer reducing the local recurrence. However a survival benefit has not been reached yet. In order to increase the rate of pathological complete remissions in our Institution we intensified both the CT schedule adding oxaliplatin to 5-FU and the RT program with tomotherapy. The aim of this study was to verify: whether the pattern of innate response elicited by the neoadjuvant CT-RT is heterogeneous among pts and whether this information can be used to identify which pts will benefit from the treatment. Methods: We collected samples of T3N+M0 rectal cancer pts before, during and after neoadjuvant CT-RT (3 cycles of oxaliplatin + 5-FU; 45 Gy). At each time point we characterized circulating monocytes by flow cytometry, infiltrating macrophages by immunoistochemistry (IHC) and selected inflammatatory molecules by ELISA.Results: We recruited so far 25 pts, of whom 10 have reached the surgery with three pathological complete remission and four down staging. No substantial changes were detectable in the number of circulating monocytes. In contrast we observed a clear expansion of CD14/CD86 and CD14/CD163 double positive subsets. This event was transient and apparently causally related to the treatment since it abated at the later time point. Moreover, it correlated with sensitivity to the treatment: 5/7 pts who underwent disease regression had an early and transitory increase of the number of CD14/CD86 and CD14/CD163 positive cells, which was absent or negligible in non responder pts. The IHC study revealed a massive tumoral infiltration by macrophages which displayed clear features of alternative M2 polarization as assessed by expression of the CD163 and 206 scavenger receptors. A subset of pts had elevated PTX3 and low CRP concentration at the onset of treatment. PTX3 concentration abated after the first CT cycle. Conclusions: These data suggest that neoadjuvant CT-RT modulates the cellular components of innate immune responses, that could represent valuable predictive factors. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | - A. Monno
- S. Raffaele Scientific Institute, Milan, Italy
| | | | | | - M. Ronzoni
- S. Raffaele Scientific Institute, Milan, Italy
| | - C. Doglioni
- S. Raffaele Scientific Institute, Milan, Italy
| | | | - A. Manfredi
- S. Raffaele Scientific Institute, Milan, Italy
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Tamburini A, Castiglioni A, Bencardino K, Orsenigo E, Russo V, Albarello L, Ronzoni M, Rovere Querini P, Manfredi A, Staudacher C. 274 POSTER Preliminary evidences for recruitment of innate responses to rectal cancer cell death elicited by neo-adjuvant radio-chemo therapy. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)72208-0] [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: 11/28/2022] Open
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Santoro A, Comandone A, Rimassa L, Granetti C, Lorusso V, Oliva C, Ronzoni M, Siena S, Zuradelli M, Mari E, Pressiani T, Carnaghi C. A phase II randomized multicenter trial of gefitinib plus FOLFIRI and FOLFIRI alone in patients with metastatic colorectal cancer. Ann Oncol 2008; 19:1888-93. [PMID: 18667394 DOI: 10.1093/annonc/mdn401] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gefitinib inhibits the epidermal growth factor receptor tyrosine kinase and preclinical studies indicate that it may enhance CPT-11 cytotoxicity. This randomized phase II trial investigates the feasibility and efficacy of gefitinib and 5-fluorouracil, folinic acid, irinotecan (FOLFIRI) in patients with metastatic colorectal cancer. PATIENTS AND METHODS Patients were randomized to FOLFIRI +/- gefitinib 250 mg daily p.o. Patients randomized to FOLFIRI + gefitinib without disease progression after 6 months continued to receive gefitinib alone until disease progression. RESULTS From October 2002 to September 2004, 100 patients were enrolled. Twenty-three patients (47.9%) in the FOLFIRI arm and 23 (45.1%) in the FOLFIRI + gefitinib arm experienced an objective response. The median progression-free survival and overall survival were 8.3 and 18.6 months in the FOLFIRI arm, and 8.3 and 17.1 months in the FOLFIRI + gefitinib arm, respectively. In the combination arm, grades 3-4 adverse events were experienced by 35 (67.3%) patients versus 25 patients (52.1%) in the FOLFIRI arm; 12 patients (23.1%) withdrew for an adverse event in the FOLFIRI + gefitinib arm and 5 (10.4%) in the FOLFIRI arm. CONCLUSIONS These data show that adding gefitinib to FOLFIRI does not improve the efficacy of FOLFIRI regimen. These disappointing results could be related to the high toxicity observed that led to significant dose reductions and delays.
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Affiliation(s)
- A Santoro
- Unità Operativa di Oncologia e Ematologia, Istituto Clinico Humanitas, Rozzano, Italy
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Rovati B, Manzoni M, Bencardino K, Ronzoni M, Mariucci S, Loupakis F, Gattoni E, Villa E, Falcone A, Danova M. The effect of bevacizumab plus chemotherapy on the immunological profile of advanced colorectal cancer patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14579] [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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