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Palassini E, Baldi GG, Sulfaro S, Barisella M, Bianchi G, Campanacci D, Fiore M, Gambarotti M, Gennaro M, Morosi C, Navarria F, Palmerini E, Sangalli C, Sbaraglia M, Trama A, Asaftei S, Badalamenti G, Bertulli R, Bertuzzi AF, Biagini R, Bonadonna A, Brunello A, Callegaro D, Cananzi F, Cianchetti M, Collini P, Comandini D, Curcio A, D'Ambrosio L, De Pas T, Dei Tos AP, Ferraresi V, Ferrari A, Franchi A, Frezza AM, Fumagalli E, Ghilli M, Greto D, Grignani G, Guida M, Ibrahim T, Krengli M, Luksch R, Marrari A, Mastore M, Merlini A, Milano GM, Navarria P, Pantaleo MA, Parafioriti A, Pellegrini I, Pennacchioli E, Rastrelli M, Setola E, Tafuto S, Turano S, Valeri S, Vincenzi B, Vitolo V, Ivanescu A, Paloschi F, Casali PG, Gronchi A, Stacchiotti S. Clinical recommendations for treatment of localized angiosarcoma: A consensus paper by the Italian Sarcoma Group. Cancer Treat Rev 2024; 126:102722. [PMID: 38604052 DOI: 10.1016/j.ctrv.2024.102722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/17/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
Angiosarcoma (AS) represents a rare and aggressive vascular sarcoma, posing distinct challenges in clinical management compared to other sarcomas. While the current European Society of Medical Oncology (ESMO) clinical practice guidelines for sarcoma treatment are applicable to AS, its unique aggressiveness and diverse tumor presentations necessitate dedicated and detailed clinical recommendations, which are currently lacking. Notably, considerations regarding surgical extent, radiation therapy (RT), and neoadjuvant/adjuvant chemotherapy vary significantly in localized disease, depending on each different site of onset. Indeed, AS are one of the sarcoma types most sensitive to cytotoxic chemotherapy. Despite this, uncertainties persist regarding optimal management across different clinical presentations, highlighting the need for further investigation through clinical trials. The Italian Sarcoma Group (ISG) organized a consensus meeting on April 1st, 2023, in Castel San Pietro, Italy, bringing together Italian sarcoma experts from several disciplines and patient representatives from "Sofia nel Cuore Onlus" and the ISG patient advocacy working group. The objective was to develop specific clinical recommendations for managing localized AS within the existing framework of sarcoma clinical practice guidelines, accounting for potential practice variations among ISG institutions. The aim was to try to standardize and harmonize clinical practices, or at least highlight the open questions in the local management of the disease, to define the best evidence-based practice for the optimal approach of localized AS and generate the recommendations presented herein.
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Affiliation(s)
- Elena Palassini
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
| | | | | | - Marta Barisella
- Department of Pathology, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Giuseppe Bianchi
- Department of Surgery, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Domenico Campanacci
- Department of Surgery, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Marco Fiore
- Department of Surgery, Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marco Gambarotti
- Department of Pathology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Massimiliano Gennaro
- Department of Surgery, Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Carlo Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Federico Navarria
- Department of Radiation Oncology, IRCCS Centro di Riferimento Oncologico di Aviano, Aviano, Pordenone, Italy
| | - Emanuela Palmerini
- Department of Medical Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudia Sangalli
- Department of Radiation Therapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marta Sbaraglia
- Department of Pathology, Università di Padova, Padova, Italy
| | - Annalisa Trama
- Department of Edidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Sebastian Asaftei
- Department of Pediatric Oncology, Ospedale Infantile Regina Margherita , Torino
| | - Giuseppe Badalamenti
- Department of Medical Oncology, Azienda Universitaria Policlinico Giaccone, Palermo, Italy
| | - Rossella Bertulli
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alexia Francesca Bertuzzi
- Department of Medical Oncology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Roberto Biagini
- Department of Oncological Orthopedics, IRCCS Istituto Nazionale Tumori Regina Elena - Istituti Fisioterapici Ospitalieri, Roma, Italy
| | - Angela Bonadonna
- Department of Medical Oncology, IRCCS Centro di Riferimento Oncologico di Aviano, Aviano, Pordenone, Italy
| | - Antonella Brunello
- Department of Medical Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Dario Callegaro
- Department of Surgery, Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Ferdinando Cananzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy; Sarcoma, Melanoma and Rare Tumors Surgery Unit, Humanitas Cancer Center, Department of Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | | | - Paola Collini
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Danila Comandini
- Department of Medical Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Annalisa Curcio
- Department of Surgery, Ospedale Morgagni e Pierantoni, Forlì, Italy
| | - Lorenzo D'Ambrosio
- Department of Medical Oncology, Ospedale S. Luigi, Orbassano, Torino, Italy
| | - Tommaso De Pas
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | | | - Virginia Ferraresi
- Sarcomas and Rare Tumors Departmental Unit, IRCCS Istituto Nazionale Tumori Regina Elena - Istituti Fisioterapici Ospitalieri, Roma, Italy
| | - Andrea Ferrari
- Department of Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alessandro Franchi
- Department of Pathology, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Anna Maria Frezza
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Elena Fumagalli
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Matteo Ghilli
- Breast Centre, Department of Oncology, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Daniela Greto
- Department of Radiation Therapy, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Giovanni Grignani
- Department of Medical Oncology, Azienda Ospedaliera Univerisitaria Città della Salute e della Scienza, Torino, Italy
| | - Michele Guida
- Department of Medical Oncology, IRCCS Istituto Tumori di Bari Giovanni Paolo II, Bari, Italy
| | - Toni Ibrahim
- Department of Medical Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Krengli
- Department of Radiation Therapy, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Roberto Luksch
- Department of Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Andrea Marrari
- Department of Medical Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Alessandra Merlini
- Department of Medical Oncology, Ospedale S. Luigi, Orbassano, Torino, Italy
| | | | - Piera Navarria
- Department of Radiation Therapy, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Maria Abbondanza Pantaleo
- Department of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna', University of Bologna, Bologna, Italy
| | | | - Ilaria Pellegrini
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Marco Rastrelli
- Department of Surgical Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy; Department of Surgery, Oncology and Gastroenterology (DISCOG), Università di Padova, Padova, Italy
| | - Elisabetta Setola
- Department of Medical Oncology, Istituto Europeo Oncologia, Milano, Italy
| | - Salvatore Tafuto
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori G. Pascale, Napoli, Italy
| | - Salvatore Turano
- Department of Medical Oncology, Azienda Ospedaliera S.S. Annunziata, Cosenza, Italy
| | - Sergio Valeri
- Department of Surgery, Università Campus Bio-Medico, Roma, Italy
| | - Bruno Vincenzi
- Department of Medical Oncology, Università Campus Bio-Medico, Roma, Italy
| | - Viviana Vitolo
- Department of Radiation Therapy, Centro Nazionale di Adroterapia Oncologica, Fondazione CNAO, Pavia, Italy
| | | | | | - Paolo Giovanni Casali
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alessandro Gronchi
- Department of Surgery, Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Silvia Stacchiotti
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Caputo R, Buono G, Piezzo M, Martinelli C, Cianniello D, Rizzo A, Pantano F, Staropoli N, Cangiano R, Turano S, Paris I, Nuzzo F, Fabi A, De Laurentiis M. Sacituzumab Govitecan for the treatment of advanced triple negative breast cancer patients: a multi-center real-world analysis. Front Oncol 2024; 14:1362641. [PMID: 38595817 PMCID: PMC11002149 DOI: 10.3389/fonc.2024.1362641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/22/2024] [Indexed: 04/11/2024] Open
Abstract
Objective The objective of this multicenter, observational, retrospective analysis was to evaluate the safety and efficacy of sacituzumab govitecan in metastatic triple-negative breast cancer (mTNBC) patients managed according to common clinical practice in Italy. Methods Data were retrieved by 7 sites. Triple-negative BC was defined by the lack of expression of estrogen receptor (ER <1%), progesterone receptor (PgR <1%) and human-epidermal growth factor receptor-2 (HER2 0, 1+, 2+ ISH-not amplified) according to standard ASCO-CAP criteria. Demographic and clinical characteristics were collected. Premedication, dose modifications and treatment schedule were based on the approved label of the product. Adverse events (AEs) were assessed according to NCI-CTCAE v5.0. Results Fifty-seven eligible patients who received sacituzumab govitecan for mTNBC were included. Median age was 53 years (range 25-75). Approximately 70% of patients had an initial diagnosis of TNBC. Median time from the diagnosis of metastatic BC to start of sacituzumab govitecan was 17 months (range 0-97) and median number of previous therapies was 3 (range 1-7). The most common sites of metastasis were lymph nodes (63.1% of patients), lung (57.9%), bone (50.8%) and liver (38.6%). Eight (14.0%) patients had a disease-free interval ≤12 months. A total of 32 (56.1%) deaths were observed and the median overall survival (OS) was 12.43 months (95% CI, 7.97 months-not reached). At a median follow-up of 10.6 months, 45 patients (78.9%) had progression and the median progression-free survival (PFS) was 4.9 months (95% CI, 3.7-7.1 months). Partial tumour response was observed in 19 patients (33.3%), stable disease in 16 (28.1%) and disease progression in 22 patients (38.6%). The most common treatment-related AEs were anemia (66.6% of patients), alopecia (66.6%), neutropenia (59.6%), nausea (42.1%) and diarrhea (38.6%). Neutropenia was the most common serious treatment-related AE: 21.0% and 8.7% of patients experienced grade 3 or 4 neutropenia, respectively. Twenty-two patients (38.6%) reduced the dose and 5.3% permanently discontinued treatment. Conclusion The results of this real-world analysis showed that both safety and efficacy of sacituzumab govitecan in mTNBC patients are consistent with that previously reported in regulatory trials. The use of premedication and supportive measures was associated with a satisfactory toxicity profile.
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Affiliation(s)
- Roberta Caputo
- Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori – IRCCS- “Fondazione G. Pascale", Naples, Italy
| | - Giuseppe Buono
- Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori – IRCCS- “Fondazione G. Pascale", Naples, Italy
| | - Michela Piezzo
- Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori – IRCCS- “Fondazione G. Pascale", Naples, Italy
| | - Claudia Martinelli
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Clinical and Translational Oncology, Scuola Superiore Meridionale (SSM), Naples, Italy
| | - Daniela Cianniello
- Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori – IRCCS- “Fondazione G. Pascale", Naples, Italy
| | - Alessandro Rizzo
- Medical Oncology Department, I.R.C.C.S. Istituto Tumori ”Giovanni Paolo II”, Bari, Italy
| | - Francesco Pantano
- Department of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Nicoletta Staropoli
- Medical Oncology and Translational Medical Oncology Units, Department of Experimental and Clinical Medicine, Magna Graecia University, AOU R. Dulbecco Catanzaro, Catanzaro, Italy
| | - Rodolfo Cangiano
- UOSD Oncologia PO Piedimonte Matese, ASL Caserta, Caserta, Italy
| | - Salvatore Turano
- Department of Oncohematology, UO Oncologia Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - Ida Paris
- Gynecologic Oncology, Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Nuzzo
- Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori – IRCCS- “Fondazione G. Pascale", Naples, Italy
| | - Alessandra Fabi
- Precision Medicine in Senology, Scientific Directorate – Department of Women and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michelino De Laurentiis
- Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori – IRCCS- “Fondazione G. Pascale", Naples, Italy
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Palassini E, Mir O, Grignani G, Vincenzi B, Gelderblom H, Sebio A, Valverde C, Baldi GG, Brunello A, Cardellino GG, Marrari A, Badalamenti G, Martin-Broto J, Ferraresi V, Libertini M, Turano S, Gataa I, Collini P, Tos APD, Gennaro M, Bini F, Provenzano S, Vullo SL, Mariani L, Le Cesne A, Casali PG. Systemic treatment in advanced phyllodes tumor of the breast: a multi-institutional European retrospective case-series analyses. Breast Cancer Res Treat 2022; 192:603-610. [PMID: 35150367 DOI: 10.1007/s10549-022-06524-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/16/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND We aimed at investigating outcome of systemic treatments in advanced breast PT. METHODS All cases of advanced breast PT treated with systemic treatments from 1999 to 2019, in one of the referral sarcoma centers involved in the study, were retrospectively reviewed. RESULTS 56 female patients were identified. Median age was 52 (range of 25-76) years. Patients received a median number of 2 systemic treatments (range of 1-4). Best responses according to RECIST were 1 (3.7%) CR, 11 (40.7%) PR, 6 (22.2%) SD, 9 (33.3%) PD with anthracyclines plus ifosfamide (AI); 2 (16.7%) PR, 4 (33.3%) SD, 6 (50.0%) PD with anthracycline alone; 3 (18.8%) PR, 4 (25.0%) SD, 9 (56.3%) PD with high-dose ifosfamide given as a continuous infusion (HD-IFX); 3 (20.0%) SD, 12 (80.0%) PD with a gemcitabine-based regimen (with 2 patients not evaluable); 1 (8.3%) PR, 2 (16.7%) SD, 9 (75.0%) PD with trabectedin (with 1 patient not evaluable); 1 (16.7%) PR, 1 (16.7%) SD, 4 (66.7%) PD with tyrosine-kinase inhibitors (TKI). The median PFS were 5.7 (IQR 2.5-9.1) months with AI; 3.2 (IQR 2.2-5.0) months with anthracycline alone; 3.4 (IQR 1.4-6.7) months with HD-IFX; 2.1 (IQR 1.4-5.2) months with gemcitabine-based chemotherapy; 1.8 (IQR 0.7-6.6) months with trabectedin; 3.4 (IQR 3.1-3.8) months with TKI. With a median follow-up of 35.3 (IQR 17.6-66.9) months, OS from the start of first-line systemic treatment was 15.2 (IQR 7.6-39.6) months. CONCLUSION In this series of advanced PT (to our knowledge, the largest reported so far), AI was associated with a high rate of responses, however, with a median PFS of 5.7 months. Other systemic treatments were poorly active.
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Affiliation(s)
- E Palassini
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - O Mir
- Department of Ambulatory Cancer Care, Sarcoma Group, Gustave Roussy, Villejuif, France
| | - G Grignani
- Division of Medical Oncology, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
| | - B Vincenzi
- Department of Medical Oncology, Campus Biomedico University, Rome, Italy
| | - H Gelderblom
- Department of Medical Oncology, LUMC - Leiden University Medical Center, Leiden, Netherlands
| | - A Sebio
- Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Valverde
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - G G Baldi
- Department of Medical Oncology, Ospedale "Santo Stefano", Prato, Italy
| | - A Brunello
- Department of Oncology, Oncology 1 Unit, Istituto Oncologico Veneto - IOV, IRCCS, Padua, Italy
| | - G G Cardellino
- Department of Oncology, Presidio "S. Maria della Misericordia" di Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - A Marrari
- Department of Oncology and Hematology, Humanitas Cancer Center Rozzano, Rozzano, Milan, Italy
| | - G Badalamenti
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - J Martin-Broto
- Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - V Ferraresi
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Libertini
- Department of Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - S Turano
- Department of Oncology, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - I Gataa
- Department of Ambulatory Cancer Care, Sarcoma Group, Gustave Roussy, Villejuif, France
| | - P Collini
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A P Dei Tos
- Department of Pathology, Azienda Ospedaliera Università Padova, Padua, Italy
| | - M Gennaro
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Bini
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Provenzano
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Lo Vullo
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Mariani
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Le Cesne
- Department of Ambulatory Cancer Care, Sarcoma Group, Gustave Roussy, Villejuif, France
| | - P G Casali
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Conforti S, Ceniti S, Conforti L, Turano S, Minardi S, Palazzo S. Targeted Therapy in Renal Carcinoma: A Case of Long-Term Effect with Complete Control of Toxicity. Tumori Journal 2018. [DOI: 10.1177/1778.19302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Silvia Ceniti
- Medical Oncology Unit, Mariano Santo Hospital, Cosenza
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Carlini M, Apa D, Spoletini D, Grieco M, Appetecchia M, Rota F, Palazzo S, Turano S. Management of Gastric Neuroendocrine Tumors. Updates Surg 2018. [DOI: 10.1007/978-88-470-3955-1_10] [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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Turano S, Manfredi C, Conforti S, Biamonte R, Rovito A, Filice A, Minardi S, Mastroianni C, Liguori V, De Simone R, Piattelli A, Iuvaro M, Toretti A, Palazzo S. The value of trabectedin in the treatment of soft tissue sarcoma: a monoinstitutional retrospective real-life study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx427.004] [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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Conforti S, Minardi S, Conforti L, Turano S, Bilotta S, Vilardo E, Palazzo S. Topical Application of a Galenical Formulation for the Management of Everolimus-Induced Mucositis in Patients with Metastatic Cancer: a Retrospective Study. Oncol Ther 2016; 4:275-286. [PMID: 28261655 PMCID: PMC5315064 DOI: 10.1007/s40487-016-0032-0] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Stomatitis is a common and potentially dose-limiting adverse event of the mammalian target of rapamycin (mTOR) inhibitor therapy. To minimize dose reductions or treatment delays that may affect therapeutic outcomes, management includes patient education, pain management strategies, and drug treatment. The aim of this study was to evaluate the effectiveness of a topically-applied galenical preparation to minimize the impact of everolimus-associated oral mucositis in patients with advanced cancer. METHODS Patients receiving everolimus plus exemestane for advanced breast cancer or everolimus alone for advanced renal cancer were eligible for inclusion. All patients were advised on procedures to maintain good oral hygiene and directed to use a dexamethasone-containing galenical preparation at the first signs of mucositis. Questionnaires were administered at baseline, and after cycles one, two, and three to evaluate the presence, duration, and intensity of oral mucositis. RESULTS Of the 19 patients included in the study (mean age 66 years; 16% male), mucositis developed in 10.5%, 47.4%, and 52.6% of patients after the first, second, and third cycles of everolimus, respectively. The median time to development of mucositis was 18.0 days, and the median time to mucositis resolution was 30.0 days. After the first, second, and third cycles of therapy, 5.3%, 10.5%, and 10.5% of patients required interruption of everolimus therapy; however, no dosage reductions for mucositis were necessary. CONCLUSIONS Patient education and the provision of an effective galenical preparation can minimize the effect of mTOR inhibitor-related mucositis.
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Turano S, Biamonte R, Zumpano E, Veltri P, Confessore G, Dattola F, Pellegrino I, Iaquinta P, Iusi M, De Stefano R, Romeo F, Palazzo S. ReCaTuR -Rare Cancer Network Calabria -“Implementing a software system based on showing of 3D stereoscopic imaging data”. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw343.09] [Citation(s) in RCA: 4] [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: 11/13/2022] Open
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Piattelli A, Biamonte R, Turano S, Manfredi C, Mastroianni C, De Simone R, Minardi S, Bartucci M, Marafioti L, Conforti S, Filice A, Liguori V, Loizzo M, Rovito A, Iuvaro M, Toretti A, Colistra E, Palazzo S. An Etiquette-Based Medicine Decalogue on the Professional style in the Multidisciplinary Unit (UVM) of Cosenza Hospital Oncology Department. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw342.18] [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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Palazzo S, Filice A, Mastroianni C, Biamonte R, Conforti S, Liguori V, Turano S, De Simone R, Rovito A, Manfredi C, Minardi S, Vilardo E, Loizzo M, Oriolo C. [Value-based cancer care. From traditional evidence-based decision making to balanced decision making within frameworks of shared values]. Recenti Prog Med 2016; 107:175-80. [PMID: 27093326 DOI: 10.1701/2218.23926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Clinical decision making in oncology is based so far on the evidence of efficacy from high-quality clinical research. Data collection and analysis from experimental studies provide valuable insight into response rates and progression-free or overall survival. Data processing generates valuable information for medical professionals involved in cancer patient care, enabling them to make objective and unbiased choices. The increased attention of many scientific associations toward a more rational resource consumption in clinical decision making is mirrored in the Choosing Wisely campaign against the overuse or misuse of exams and procedures of little or no benefit for the patient. This cultural movement has been actively promoting care solutions based on the concept of "value". As a result, the value-based decision-making process for cancer care should not be dissociated from economic sustainability and from ethics of the affordability, also given the growing average cost of the most recent cancer drugs. In support of this orientation, the National Comprehensive Cancer Network (NCCN) has developed innovative and "complex" guidelines based on values, defined as "evidence blocks", with the aim of assisting the medical community in making overall sustainable choices.
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Affiliation(s)
| | - Aldo Filice
- UOC di Oncologia Medica, PO dell'Annunziata, Cosenza
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Conforti S, Ceniti S, Conforti L, Turano S, Minardi S, Palazzo S. Targeted therapy in renal carcinoma: a case of long-term effect with complete control of toxicity. Tumori 2015; 100:e293-7. [PMID: 25688514 DOI: 10.1700/1778.19302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Although advances in imaging techniques have allowed earlier diagnosis of renal cell carcinoma (RCC) in recent decades, one-third of patients who have undergone radical resection of organ-confined disease will eventually develop metastases. The treatment of metastatic RCC was revolutionized by the advent of targeted therapy with tyrosine kinase inhibitors. We have followed seven patients with metastatic RCC who were treated with first-line pazopanib at our center. The case of one of these patients is described here in detail. The patient was first diagnosed with RCC in 1999 and metastases were detected in 2006 and 2012. Treatment with pazopanib at the standard dose of 800 mg/day for 29 months led to a partial response that persisted over time. Side effects (hypertension and painful mucositis) were successfully managed with supportive care at our oral therapy clinic. Early management of adverse events using a multidisciplinary approach is paramount to the favorable outcome of treatment with pazopanib and other targeted agents.
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Pastorelli D, Locatelli MA, Melotti B, Pisano C, Turano S, Mellino U, Provinciali N, Marchetti P, Dazzi C, Berretta M, Giordano A, Lorusso V. The Pan European Emesis Registry (PEER): a critical appraisal of the Italian experience. J Chemother 2013; 25:309-17. [DOI: 10.1179/1973947813y.0000000118] [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: 10/31/2022]
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Conforti S, Turano S, Minardi S, Locco C, Conforti L, Palazzo S. Improvement of quality of life in third-line chemotherapy with lapatinib in a case of metastatic breast cancer. Tumori 2013. [PMID: 24158085 DOI: 10.1700/1334.14824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We describe a case of a 72-year-old patient suffering from metastatic breast cancer. The disease had progressed slowly and was almost asymptomatic for a significant time. Toxicity, following third-line treatment with lapatinib, was not significant, and side effects were well controlled. The case is an excellent example of a chronic neoplastic disease in a patient who could be defined as "long-surviving".
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Conforti S, Turano S, Minardi S, Locco C, Conforti L, Palazzo S. Improvement of quality of life in third-line chemotherapy with lapatinib in a case of metastatic breast cancer. Tumori 2013; 99:e136-9. [DOI: 10.1177/030089161309900335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We describe a case of a 72-year-old patient suffering from metastatic breast cancer. The disease had progressed slowly and was almost asymptomatic for a significant time. Toxicity, following third-line treatment with lapatinib, was not significant, and side effects were well controlled. The case is an excellent example of a chronic neoplastic disease in a patient who could be defined as “long-surviving”.
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Affiliation(s)
| | | | | | - Claudio Locco
- Radiology Department, Mariano Santo Hospital, Cosenza
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15
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Mastroianni CM, Viscomi C, Ceniti S, De Simone R, Filice A, Gadaleta Caldarola G, Infusino S, Manfredi C, Rea A, Sandomenico C, Turano S, Serranò F, Condemi G, Cortese C, Prantera T, Palazzo S. Preferences of patients with advanced colorectal cancer for treatment with oral or intravenous chemotherapy. Patient 2012; 1:181-7. [PMID: 22272925 DOI: 10.2165/1312067-200801030-00005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND In recent years, patient-reported outcomes such as health-related quality of life have become important areas of clinician focus in general cancer management. Patients' preferences for, and/or satisfaction with, oral versus intravenous (IV) chemotherapy schedules may have a major impact on such outcomes. OBJECTIVE To evaluate preferences for oral or IV chemotherapy in patients with advanced colorectal cancer. METHODS A multicenter, randomized, crossover trial was conducted in 12 hospitals in Southern Italy, in which 22 patients with advanced colorectal cancer received one cycle of oral capecitabine ± irinotecan or oxaliplatin, followed by one cycle of an IV de Gramont or similar regimen (arm A), or the same regimens in reverse order (arm B). Patients were aged 50-70 years and 21% had a higher level of education (graduate or similar). Patients received oral capecitabine 3500 mg/m/day for 7 days (± irinotecan 180 mg/m or oxaliplatin 85 mg/m on day 1 only), followed by an IV de Gramont regimen ± irinotecan (FOLFIRI) or oxaliplatin (FOLFOX); or the two schedules administered in reverse order.The main outcome measure was patients' preferences for oral versus IV chemotherapy, as determined by a pre- and post-treatment therapy preference questionnaire (TPQ). RESULTS Before treatment, 75% of patients preferred oral therapy. Characteristics that patients considered to be important were that treatment should not interfere with daily activities (100% of patients) and should not cause fatigue (95%), diarrhea (76%), or painful mouth ulcers (76%); other factors considered important were the risk of infection and nausea (90%), and that treatment could be administered at home (65%). After receiving both chemotherapy schedules, only 45% of patients preferred oral therapy, while 55% preferred IV therapy. Among the latter, the most important characteristics influencing treatment choice were less nausea (66%), fewer mood effects (65%), the safety of hospital IV treatment (62%), less interference with family relationships (55%), less vomiting (55%), less interference with daily activities (50%), and less diarrhea (50%). Although the order in which patients received therapy did not influence treatment preference, significantly fewer patients with a lower rather than higher educational level preferred oral therapy (47% vs 80%; chi-square test = 9.9; p = 0.002). CONCLUSION These results suggest that there may be a correlation between educational level and the preference of patients with advanced colorectal cancer for oral or IV chemotherapy.
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Affiliation(s)
- Candida M Mastroianni
- 1 Mariano Santo Hospital, Cosenza, Italy 2 Siderno Hospital, Siderno, Italy 3 San Giovanni di Dio Hospital, Crotone, Italy
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Stacchiotti S, Palassini E, Sanfilippo R, Vincenzi B, Arena M, Bochicchio A, De Rosa P, Nuzzo A, Turano S, Morosi C, Dei Tos A, Pilotti S, Casali P. Gemcitabine in advanced angiosarcoma: a retrospective case series analysis from the Italian Rare Cancer Network. Ann Oncol 2012; 23:501-8. [DOI: 10.1093/annonc/mdr066] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Biamonte R, Turano S, Mastroianni C, Liguori V, De Simone R, Conforti S, Gadaleta-Caldarola G, Piattelli A, Iuvaro M, Palazzo S. Is the informed consent (IC) to treatment truly “informed”? The use of a comprehension check tool (CCT). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6128] [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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Turano S, Mastroianni C, Manfredi C, Biamonte R, Ceniti S, Liguori V, De Simone R, Conforti S, Filice A, Rovito A, Viscomi C, Patitucci G, Palazzo S. Advanced adult esthesioneuroblastoma successfully treated with cisplatin and etoposide alternated with doxorubicin, ifosfamide and vincristine. J Neurooncol 2009; 98:131-5. [DOI: 10.1007/s11060-009-0052-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2009] [Accepted: 10/26/2009] [Indexed: 11/30/2022]
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