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Economopoulou P, Kotoula V, Koliou GA, Papadopoulou K, Christodoulou C, Pentheroudakis G, Koutras A, Bafaloukos D, Papakostas P, Pectasides D, Kotsakis A, Razis E, Samantas E, Kalogeras KT, Economopoulos T, Fountzilas G. Abstract P2-08-20: Prognostic impact of SRC, CDKN1B and JAK2 expression in metastatic breast cancer patients treated with trastuzumab. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background-aim: SRC, CDKN1B and JAK2 play a crucial role in the coordination and facilitation of cell-signaling pathways controlling a wide range of cellular functions. In the present study, we investigated the prognostic significance and clinical utlity of these biomarkers in metastatic breast cancer (MBC) patients treated with trastuzumab (T). Methods: We assessed SRC, CDKN1B and JAK2 mRNA expression with qRT-PCR (Taqman-MGB assays) on 197 paraffin tumors. PIK3CA mutation status was previously assessed. Relapsed (RMBC) and de novo MBC (dnMBC) patients had received T for metastatic disease only. Tumors were centrally re-assessed for HER2 status. Results: Only 133/197 patients (67.5%) were found to be truly HER2(+). CDKN1B mRNA expression strongly correlated with SRC (rho = 0.71) and JAK2 (rho = 0.54); high CDKN1B was more frequent in RMBC compared to dnMBC (p = 0.001) and in PIK3CA wild-type tumors (p = 0.005). In HER2(+) patients, low CDKN1B conferred higher risk for progression (HR 1.58, 95% CI 1.08-2.32, p = 0.018). In HER2(-) patients, low SRC was associated with longer survival (HR 0.56, 95% CI 0.32-0.99, p = 0.045) and, as a trend, with increased progression-free survival (PFS) (p = 0.067). For PFS, in RMBC, we observed trends for unfavorable low CDKN1B (p = 0.068) and JAK2 (p = 0.086); similarly, in dnMBC for unfavorable low CDKN1B (p = 0.072). Low SRC showed a trend for better survival in RMBC (p = 0.087). Upon multivariable analyses, only PIK3CA mutations strongly predicted for unfavorable PFS in HER2(+) patients (HR 3.37, 95% CI 1.98-5.73, p < 0.001). Low CDKN1B and JAK2 mRNA expression remained unfavorable factors for PFS in dnMBC and RMBC patients (HR 2.36, 95% CI 1.01-5.48, p = 0.046 and HR 1.76, 95% CI 1.01-3.06, p = 0.047, respectively). Conclusions: Low CDKN1B and JAK2 mRNA expression were unfavorable prognosticators in a cohort of T-treated MBC patients previously unexposed to this agent, with distinct impact in de novo and RMBC. Our results highlight biological and clinical differences between de novo and RMBC and suggest that CDKN1B and JAK2, if validated, may serve as prognostic factors potentially implicated in T-resistance, which seems to be associated with distinct pathways in the two MBC settings.
Citation Format: Economopoulou P, Kotoula V, Koliou G-A, Papadopoulou K, Christodoulou C, Pentheroudakis G, Koutras A, Bafaloukos D, Papakostas P, Pectasides D, Kotsakis A, Razis E, Samantas E, Kalogeras KT, Economopoulos T, Fountzilas G. Prognostic impact of SRC, CDKN1B and JAK2 expression in metastatic breast cancer patients treated with trastuzumab [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-20.
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Affiliation(s)
| | - V Kotoula
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - G-A Koliou
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - K Papadopoulou
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | | | | | - A Koutras
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - D Bafaloukos
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - P Papakostas
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - D Pectasides
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - A Kotsakis
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - E Razis
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - E Samantas
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - KT Kalogeras
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | | | - G Fountzilas
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
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Gkirkas K, Bakou V, Spathis A, Kottaridi C, Kontsioti F, Kontos C, Papageorgiou S, Bouhla A, Papanikolaou N, Atta M, Ioannidou E, Roubakis C, Stamouli M, Economopoulos T, Dimitriadis G, Pappa V. P-024 Analysis of apoptosis and mitochondrial cytochrome C-oxidase gene mutations in bone marrow cells of patients with myelodysplastic syndromes. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70073-0] [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: 10/26/2022]
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Psyrri A, Kalogeras KT, Kronenwett R, Wirtz RM, Batistatou A, Bournakis E, Timotheadou E, Gogas H, Aravantinos G, Christodoulou C, Makatsoris T, Linardou H, Pectasides D, Pavlidis N, Economopoulos T, Fountzilas G. Prognostic significance of UBE2C mRNA expression in high-risk early breast cancer. A Hellenic Cooperative Oncology Group (HeCOG) Study. Ann Oncol 2011; 23:1422-7. [PMID: 22056852 DOI: 10.1093/annonc/mdr527] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The ubiquitin-proteasome system (UPS) plays a pivotal role in tumorigenesis. Components of the UPS have recently been implicated in breast cancer progression. In the present study, we sought to explore the prognostic and/or predictive significance of UBE2C messenger RNA (mRNA) expression on disease-free survival (DFS) and overall survival (OS) in high-risk operable breast cancer patients. METHODS Five hundred and ninety-five high-risk breast cancer patients were treated in a two-arm trial evaluating postoperative, dose-dense sequential chemotherapy with epirubicin followed by CMF (cyclophosphamide, methotrexate and 5-fluorouracil) with or without paclitaxel (Taxol). RNA was extracted from 313 formalin-fixed primary tumor tissue samples followed by one-step quantitative RT-PCR for assessment of mRNA expression of UBE2C. RESULTS High UBE2C mRNA expression was associated with poor DFS (Wald's P = 0.003) and OS (Wald's P = 0.005). High tumor grade, as well as high Ki67 protein expression, was more frequent in the high-expression group of UBE2C. Results of the Cox multivariate regression analysis revealed that high UBE2C mRNA expression remained an independent adverse prognostic factor for relapse (P = 0.037) and death (P = 0.05). CONCLUSIONS High UBE2C mRNA expression was found to be of adverse prognostic significance in high-risk breast cancer patients. These findings need to be validated in larger cohorts.
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Affiliation(s)
- A Psyrri
- Second Department of Internal Medicine, Attikon University Hospital, Athens.
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Kanelleas A, Liapi C, Katoulis A, Stavropoulos P, Avgerinou G, Georgala S, Economopoulos T, Stavrianeas NG, Katsambas A. The role of inflammatory markers in assessing disease severity and response to treatment in patients with psoriasis treated with etanercept. Clin Exp Dermatol 2011; 36:845-50. [PMID: 21790728 DOI: 10.1111/j.1365-2230.2011.04131.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Psoriasis is a chronic, systemic, inflammatory disease. Inflammatory markers are used in clinical practice to detect acute inflammation, and as markers of treatment response. Etanercept blocks tumour necrosis factor (TNF)-α, which plays a central role in the psoriatic inflammation process. AIM To reveal any possible association between disease severity [measured by Psoriasis Area and Severity Index (PASI)] and the inflammatory burden (measured by a group of inflammatory markers), before and after etanercept treatment. METHODS In total, 41 patients with psoriasis vulgaris, eligible for biological treatment with etanercept, were enrolled in the study. A set of inflammatory markers was measured, including levels of white blood cells and neutrophils, fibrinogen, ferritin, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), haptoglobin, ceruloplasmin and α1-antitrypsin, before and after 12 weeks of etanercept 50 mg twice weekly. RESULTS All markers were reduced after treatment (P < 0.001). PASI correlated with fibrinogen and hs-CRP. Of the 41 patients, 19 (46.3%) achieved reduction of 75% in PASI (PASI75). An increase in hs-CRP and ESR difference (values before minus values after treatment) was related to higher likelihood of achieving PASI75. CONCLUSIONS Inflammatory markers, particularly hs-CRP and to a lesser extent, fibrinogen and ESR, can be used to assist in assessing disease severity and response to treatment in patients with psoriasis. A combination of selected inflammatory factors (which we term the Index of Psoriasis Inflammation) in combination with PASI might reflect inflammatory status in psoriasis more accurately than each one separately.
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Affiliation(s)
- A Kanelleas
- Second Department of Dermatology and Venereology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece.
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Rampias T, Giagini A, Florou K, Gouveris P, Vaja E, Haralambakis N, Katsaounis P, Pectasides DG, Economopoulos T, Psyrri A. H-RAS and PIK3CA mutations and response to cetuximab in head and neck squamous cell carcinoma (HNSCC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5513] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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Vasilatou D, Pappa V, Kontos C, Kontsioti F, Papageorgiou S, Tsiotra P, Economopoulou C, Bakou V, Papageorgiou E, Economopoulos T, Dervenoulas J. 321 Analysis of let-7a, mir-17 and mir-20a microRNA expression in CD34+ bone marrow cells of patients with myelodysplastic syndromes. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70323-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: 11/30/2022]
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Papadopoulos A, Vrettos I, Kamposioras K, Anagnostopoulos F, Giannopoulos G, Pectasides D, Niakas D, Economopoulos T. Impact of cancer patients' disease awareness on their family members' health-related quality of life: a cross-sectional survey. Psychooncology 2011; 20:294-301. [DOI: 10.1002/pon.1731] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Psyrri D, Kronenwett R, Timotheadou E, Wirtz RM, Onyenadum A, Pentheroudakis GE, Papadimitriou CA, Razis E, Economopoulos T, Fountzilas G. Evaluation of the prognostic value of UBE2C mRNA levels in early breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pectasides D, Pectasides E, Papaxoinis G, Psyrri A, Pliarchopoulou K, Koumarianou A, Macheras A, Athanasas G, Xiros N, Economopoulos T. Carboplatin/gemcitabine alternating with carboplatin/pegylated liposomal doxorubicin and carboplatin/cyclophosphamide in platinum-refractory/resistant paclitaxel - pretreated ovarian carcinoma. Gynecol Oncol 2010; 118:52-7. [PMID: 20406710 DOI: 10.1016/j.ygyno.2010.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 03/03/2010] [Accepted: 03/06/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE In this phase II study the efficacy and toxicity of an alternating chemotherapy regimen was examined in platinum-resistant relapsed epithelial ovarian cancer (EOC) patients. METHODS Forty-five patients with platinum-refractory/resistant relapsed EOC, previously treated with carboplatin+paclitaxel+/-epirubicin were included. The regimen was consisted of gemcitabine 800 mg/m(2) (days 1+8) and carboplatin AUC 5, alternating with pegylated liposomal doxorubicin 30 mg/m(2) and carboplatin AUC 5, alternating with carboplatin AUC 5 and cyclophosphamide 600 mg/m(2), every 3 weeks for a total of 9 cycles. RESULTS Among 38 patients with measurable disease, 39.4% (95% CI: 23.2-55.7) responded (five complete response and 10 partial response), while 30 out of 40 (75%) patients assessable by CA125 criteria had a serological response. Responses were more frequent in patients with platinum-free interval (PFI) 3-6 months than in those with PFI 0-3 months, but this was not statistically-significant. After a median follow-up of 19.5 months (range, 1.0-37+ months) the median progression-free survival was 7.1 months (95% CI: 3.4-10.8) and the median survival (OS) was 18.8 months (95% CI: 15.6-22.0). For patients with PFI 0-3 months PFS was 4.3 (95% CI: 0.8-7.8) months, while for those with PFI 3-6 months PFS was 8.9 (95% CI: 5.3-12.4) months (p=0.062). The regimen was well-tolerated and the main grade 3-4 toxicity was myelosuppression, palmar-plantar erythrodysesthesia, allergy and fatigue. CONCLUSION This alternating regimen, including carboplatin, gemcitabine, liposomal doxorubicin and cyclophosphamide, is an active and well-tolerated treatment in platinum relapsed/refractory EOC patients.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine, Propaedeutic, Oncology Section, University of Athens, University General Hospital Attikon, Rimini 1, Haidari, Athens, Greece.
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Koumarianou A, Fountzilas G, Kosmidis P, Klouvas G, Samantas E, Kalofonos C, Pentheroudakis G, Economopoulos T, Pectasides D. Non small cell lung cancer in the elderly: clinico-pathologic, management and outcome characteristics in comparison to younger patients. J Chemother 2009; 21:573-83. [PMID: 19933050 DOI: 10.1179/joc.2009.21.5.573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
It is controversial whether non-small cell lung cancer (NSCLC) in the elderly constitutes a distinct clinico-biological entity compared to younger counterparts. As reported data are scant and discordant, we sought to analyze retrospectively the medical records of Hellenic NSCLC patients aged >70 years and compare them with those of age (70-45 years) and younger (<45 years) patients. Records were abstracted from the Hellenic Cooperative Oncology Group (HeCOG) cancer registry database. Presentation, management and outcome data of 417 elderly patients aged > or =70, 1374 age 70-45 years old and 115 patients aged < or =45 years old with histologically confirmed NSCLC managed from 1989 until 2004 were retrieved and compared. Elderly patients differed significantly in terms of presence of symptoms (p<0.001), including thoracic pain (p=0.003), dyspnea (p<0.001), cough (p<0.001) and fatigue (p<0.001), eastern Cooperative Oncology Group performance status (PS) 2-3 (p<0.001), and histological type (more commonly diagnosed with squamous cell carcinoma (p<0.002) and less frequently with adenocarcinoma). Although elderly patients had significantly higher rates of PS 2-3, they had significantly better median time to disease progression (TTP) compared to the younger counterpart (6.4 versus 4.3 months p=0.047). Overall survival (OS) was not significantly different between elderly and young patients (median OS 11.8 versus 11.5 months; p=0.6), but platinum-based chemotherapy and radiotherapy were variables associated favorably with TTP and survival in the elderly. This large retrospective series presents strong evidence that NSCLC constitutes a similar clinicopathologic entity in elderly and young individuals with discretely differing biological behavior and that elderly symptomatic patients should be considered for effective anticancer treatment whenever possible.
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Affiliation(s)
- A Koumarianou
- Second Department of Internal Medicine Propaedeutic, Attikon University Hospital, Athens University, Athens, Greece.
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Pectasides D, Psyrri A, Pliarchopoulou K, Floros T, Papaxoinis G, Skondra M, Papatsibas G, Macheras A, Athanasas G, Arapantoni-Datioti P, Economopoulos T. Gastric metastases originating from breast cancer: report of 8 cases and review of the literature. Anticancer Res 2009; 29:4759-4763. [PMID: 20032432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Breast cancer metastasis to the stomach is rare. It is very important to distinguish a breast cancer metastasis to the stomach from a primary gastric cancer on the basis of clinical, endoscopic, radiological and histopathological features, in order to administer the appropriate treatment. PATIENTS AND METHODS Eight patients with breast cancer metastasis to the stomach were identified in our database between 1995 and 2008. The clinicopathological data and outcome from the medical records of these patients were then reviewed. RESULTS The median age at initial breast cancer diagnosis was 59.5 years (range 44-75 years), while the median interval between the primary breast cancer and the gastric involvement was 41 months (range 2-82 months). The primary breast cancer histological subtype was mostly lobular carcinoma. All the biopsy specimens were estrogen receptor (ER), cytokeratin (CK) 7 and gross cystic disease fluid protein-15 (GCDFP-15) positive and CK-20 negative, while two of them (25%) were HER-2-neu positive. All the patients received chemotherapy and two of them were also treated with hormonal treatment. Two patients underwent surgical intervention, while one patient who had gastric involvement as the only metastatic site will proceed to surgical resection of the stomach. All these three patients were alive after 9, 39 and 44 months of follow-up, respectively. The response rate to chemotherapy was 50% (1 complete response [CR], 3 partial responses [PR]), and the median survival was 11 months (range, 1-44+ months). CONCLUSION Breast cancer metastasis to the stomach can be differentiated from primary gastric cancer by comparing the biopsies from the gastric metastasis with the original histological slides from the primary breast tumor. Appropriate systemic treatment for metastatic breast carcinoma is the preferred treatment, whereas surgical intervention should be reserved for palliation or may be indicated in cases of solitary resectable gastrointestinal tract metastases.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine, Attikon University Hospital, Rimini 1, Haidari, Athens, Greece.
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Pectasides D, Pectasides E, Papaxoinis G, Andreadis C, Papatsibas G, Fountzilas G, Pliarchopoulou K, Macheras A, Aravantinos G, Economopoulos T. Primary fallopian tube carcinoma: Results of a retrospective analysis of 64 patients. Gynecol Oncol 2009; 115:97-101. [DOI: 10.1016/j.ygyno.2009.06.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Revised: 06/14/2009] [Accepted: 06/17/2009] [Indexed: 11/24/2022]
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Papadopoulos A, Vrettos I, Kamposioras K, Giannopoulos G, Charitos D, Pectasides D, Niakas D, Economopoulos T. 3051 Health-related quality of life (HRQL) correlation between family members and cancer patients undergoing chemotherapy. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70650-0] [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: 10/20/2022] Open
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Kamposioras K, Papadopoulos A, Vrettos I, Giannopoulos G, Charitos D, Pectasides D, Niakas D, Economopoulos T. 3004 Disease awareness affects reversely health-related quality of life (HRQL) of cancer patients and their family members. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70603-2] [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: 10/20/2022] Open
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Eleutherakis-Papaiakovou V, Bamias A, Gika D, Simeonidis A, Pouli A, Anagnostopoulos A, Michali E, Economopoulos T, Zervas K, Dimopoulos MA. Renal failure in multiple myeloma: Incidence, correlations, and prognostic significance. Leuk Lymphoma 2009; 48:337-41. [PMID: 17325894 DOI: 10.1080/10428190601126602] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Renal failure (RF) is a common and severe complication of patients with multiple myeloma (MM). The purpose of our study was to assess the incidence of RF in a contemporary series of newly diagnosed patients with MM, its association with specific clinical and laboratory features, and its impact on patients' outcome. Over the last decade, 756 newly diagnosed symptomatic patients with MM were included in our database. Renal failure, defined as a serum creatinine >or= 2 mg/dl at the time of diagnosis, was seen in 21% of patients. Multiple parameters were associated with RF, but logistic regression analysis showed that RF was independently associated only with International Staging System and Bence Jones proteinuria. The presence of RF was associated with a trend for higher early death rate but with a similar response to primary therapy. The median survival of patients with RF was 19.5 months versus 40.4 months for patients without RF (p < 0.001). Several variables were associated with impaired survival by univariate analysis. When multivariate analysis was performed the independent variables were poor performance status, thrombocytopenia, advanced age, high LDH and elevated serum beta2 microglobulin but not high creatinine. When corrected for stage, renal failure had no impact on survival.
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Vrettos I, Papadopoulos A, Kamposioras K, Charitos D, Giannopoulos G, Pectasides D, Niakas D, Economopoulos T. Corrleation of health-related quality of life (HRQL) of cancer patients and the mental component parameters of their family members. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20619] [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
e20619 Background: It is widely experienced that health-related quality of life (HRQL) is greatly influenced in the family members of cancer patients. The aim of this study was to find the correlation of the HRQL parameters in cancer patients with the main mental component parameters of patients’ relatives. Methods: 122 cancer patients undergoing chemotherapy in our department (49 men and 73 women) of mean age 56.6 ±15.4 1SD and their 122 relatives that accompanied them (45 men and 77 women) of mean age 48.3 ±14.5 completed the validated SF-36 health survey by personal interview. The SF-36 health survey summarizes the functional health status and general health into eight scales with higher scores (0–100 range) reflecting better-perceived health. In this study, physical functioning (PF), role physical (RP), bodily pain (BP), general health perception (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) of the patients were correlated with the SF, RE, MH of their family members using the Spearman's test. Data analysis was performed with SPSS version 13.0 and correlations were considered statistically significant when p<0.05. Results: Table 1 summarizes the results of our study. Social Functioning and Mental Health of family members are highly correlated with the HRQL parameters of cancer patients. The RE does not seem to be affected. Conclusions: HRQL of cancer patients undergoing chemotherapy is highly correlated with the SF and the MH of their relatives. This observation highlights the need to develop more oriented supportive programs for both the patients and their family memebers. Abbreviations: PF = Physical Functioning, RP = Role Physical, BP = Bodily Pain, GH = General Health, VT = Vitality, SF = Social Functioning, RE = Role Emotional, MH = Mental Health; NS=Not Significant. * = 0.05. ** = 0.01. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- I. Vrettos
- Attikon University General Hospital, Athens, Greece; Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - A. Papadopoulos
- Attikon University General Hospital, Athens, Greece; Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - K. Kamposioras
- Attikon University General Hospital, Athens, Greece; Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - D. Charitos
- Attikon University General Hospital, Athens, Greece; Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - G. Giannopoulos
- Attikon University General Hospital, Athens, Greece; Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - D. Pectasides
- Attikon University General Hospital, Athens, Greece; Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - D. Niakas
- Attikon University General Hospital, Athens, Greece; Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - T. Economopoulos
- Attikon University General Hospital, Athens, Greece; Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
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Papadopoulos A, Vrettos I, Kamposioras K, Charitos D, Giannopoulos G, Pectasides D, Niakas D, Economopoulos T. Comparing health-related quality of life (HRQL) of cancer patients undergoing chemotherapy with family members in a tertiary hospital. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20535 Background: In Greece there is limited information concerning the HRQL of cancer patients undergoing chemotherapy. The aim of this study was to estimate and compare the HRQL of cancer patients and their relatives during the period of chemotherapy and to investigate potential differences in HRQL. Methods: 122 family members (45 men and 77 women) of mean age 48.3 ±14.5 and 122 cancer patients undergoing chemotherapy (49 men and 73 women) of mean age 56.6 ±15.4 1SD completed the SF-36 health survey by personal interview. The SF-36 health survey was used to evaluate and compare HRQL which contains eight scales measuring physical functioning (PF), role physical (RP), bodily pain (BP), general health perception (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH), with higher scores (0–100 range) reflecting better-perceived health. Two component summary scores capture the overall physical and mental health (Physical Component Summary or PCS and Mental Component Summary or MCS). Data analysis was performed with SPSS version 13.0 while statistical analysis was performed with Wilcoxon signed ranks test. Results: The table below summarizes the results of our study. Conclusions: Although the physical health was significantly higher in the family members as it was expected for a healthy population, the mental health and especially MCS was significantly lower from the cancer patients undergoing chemotherapy. It seems that medical condition of the patients affects severely the mental HRQL of family members. Supportive psychological programs for both the patients and the family members seem mandatory. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- A. Papadopoulos
- Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - I. Vrettos
- Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - K. Kamposioras
- Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - D. Charitos
- Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - G. Giannopoulos
- Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - D. Pectasides
- Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - D. Niakas
- Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
| | - T. Economopoulos
- Attikon Hospital, Hellenic Open University, Athens, Greece; Attikon University General Hospital, Athens, Greece; Hellenic Open University, Patras, Greece
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Kronenwett R, Stropp U, Briasoulis E, Gehrmann M, Razis E, Hennig G, Bafaloukos D, Wirtz RM, Economopoulos T, Fountzilas G. Utility of a multigene prognostic algorithm in combination with TP53 expression for prediction of benefit from adjuvant taxane-containing chemotherapy in node-positive breast cancer patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.593] [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
593 Background: Recently, we have shown that the Siemens Prognostic Score (SPS) based on mRNA expression of nine informative genes predicted outcome in node-positive (N+) patients with breast cancer (SABCS 2008, abstract 6044). The aim of this retrospective biomarker study was to examine the utility of the SPS in combination with TP53 expression to predict benefit from adjuvant taxane therapy. Methods: The 211 N+ patients included in this study were treated in the context of a randomized two-arm phase III study (E-T-CMF vs. E-CMF) investigating adjuvant dose-dense sequential chemotherapy with epirubicin (E) followed by CMF with or without paclitaxel (T). RNA was isolated from formalin-fixed, paraffin-embedded tissue samples, using a Siemens proprietary method, followed by kinetic one-step RT-PCR for assessment of mRNA expression of the nine SPS genes, TP53 and two normalization genes. The continuous SPS was calculated using a linear combination of expression values of the SPS genes. Patients were separated into a high- and low-risk group using a cutoff at the median of the SPS. Optimal cutoff for low or high TP53 expression was defined on the basis of a ROC curve in SPS high-risk patients. Distant metastasis-free survival (MFS) and overall survival (OS) were estimated by the Kaplan-Meier method and compared using the log-rank test. Results: For patients with high SPS or high TP53 expression, we observed a trend for a better MFS in the E-T-CMF arm (SPS: p = 0.18; HR = 0.66; TP53: p = 0.23; HR = 0.67; n = 211). Combining both parameters, patients with high SPS and high TP53 expression (n = 44) had a significantly better MFS following E-T-CMF compared to E-CMF (5-year MFS 80% vs. 40%, p = 0.003, HR = 0.21; OS: p = 0.09; HR = 0.34). On the other hand, patients with high SPS and low TP53 expression (n = 32) showed a trend for a worse outcome with E-T-CMF (MFS: p = 0.09; HR = 3.54; OS: p = 0.35, HR = 1.90). Conclusions: Our prognostic algorithm combined with TP53 mRNA expression predicts the benefit from the addition of paclitaxel to E-CMF and might be used for identification of patients who should be considered for adjuvant taxane therapy. This hypothesis needs to be confirmed in an independent clinical study. [Table: see text]
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Affiliation(s)
- R. Kronenwett
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - U. Stropp
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - E. Briasoulis
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - M. Gehrmann
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - E. Razis
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - G. Hennig
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - D. Bafaloukos
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - R. M. Wirtz
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - T. Economopoulos
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
| | - G. Fountzilas
- Siemens Healthcare Diagnostics, Cologne, Germany; Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece
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Pectasides D, Papaxoinis G, Fountzilas G, Aravantinos G, Bamias A, Pavlidis N, Kalofonos HP, Timotheadou E, Samantas E, Briasoulis E, Skarlos DV, Economopoulos T, Dimopoulos MA. Epithelial ovarian cancer in Greece: a retrospective study of 1,791 patients by the Hellenic Cooperative Oncology Group (HeCOG). Anticancer Res 2009; 29:745-751. [PMID: 19331231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The aim of this retrospective study was to present the epidemiological, pathological and clinical characteristics and treatment results of Greek women with epithelial ovarian cancer (EOC). PATIENTS AND METHODS From February 1976 to December 2006, 1,791 patients had been diagnosed, treated and followed up in the participating centers of the Hellenic Cooperative Oncology Group (HeCOG). Cox-regression analysis was carried out in order to identify possible prognostic factors. RESULTS The median age at diagnosis was 60 years. Seventy-five percent had a performance status (PS) of 0-1, 58.5% had a serous carcinoma, 36% had poorly differentiated tumors and 57% had International Federation of Gynecology and Obstetrics (FIGO) stage III disease. Approximately half of the patients had been subjected to a total abdominal hysterectomy, bilateral oophorectomy and omentectomy, and 80% of them had undergone optimal debulking surgery. Among 1,462 patients with advanced disease, 96% had received platinum-based chemotherapy, while platinum plus paclitaxel had been administered to two-thirds of them. Among 609 patients with known data for response, 34% had achieved a complete objective response (CR) and 30% a partial response (PR), resulting in an overall response rate (RR) of 64%. Performance status, FIGO stage and residual disease (RD) after cytoreductive surgery were the strongest prognostic factors for time-to-tumor progression (TTP) and for overall survival (OS), while age was found to be significant only for OS. The median TTP was 107 months (95% confidence interval (CI), 92-121 months) for patients with stages I-II, 17 months (95% CI, 15-18 months) for those with stages III-IV 96 months (95% CI, 58-133 months) for patients without RD and 17 months (95% CI, 15-18 months) for those with RD. Median OS had not been reached for the patients with stages I-II, while it was 40 months (95% CI, 37-43 months) for those with stages III-IV, 141 months (95% CI, 103-179 months) for patients without RD and 42 months (95% CI, 39-45 months) for those with RD. CONCLUSION There were no significant differences in patient characteristics or types of treatments administered in Greek women with EOC in comparison with those reported in the English literature.
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Affiliation(s)
- D Pectasides
- 2nd Department of Internal Medicine, Propaedeutic, Oncology Section, Attikon University Hospital, Rimini 1, Haidari, Athens, Greece.
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Pectasides D, Papaxoinis G, Nikolaou M, Valavanis C, Aravantinos G, Fountzilas G, Tamvakis N, Pectasides E, Lekka I, Arapantoni-Dadioti P, Zizi A, Ghiconti I, Economopoulos T. Analysis of 7 immunohistochemical markers in male germ cell tumors demonstrates the prognostic significance of p53 and MIB-1. Anticancer Res 2009; 29:737-744. [PMID: 19331230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Various prognostic factors have been investigated in order to predict the minority of male germ cell tumor (GCT) patients who will develop resistant disease. However, no prognostic system has been proven accurate. MATERIALS AND METHODS Paraffin-embedded tissue specimens, obtained from primary lesions during the initial diagnosis of 83 advanced chemotherapy-treated GCT male patients, were stained for 7 immunohistochemical markers: p53, bax, bcl-2, MIB-1, topoisomerase IIa, c-kit and COX-2. The percentage of positive cells for each marker was measured for each patient. Cox regression was used for the prognostic factor analysis. RESULTS All patients were followed for a median of 4 years. Nineteen patients had seminoma and 64 non-seminomatous GCT. In univariate analysis, only p53 (hazard ratio (HR) = 4.01, 95% confidence interval (CI) = 1.25-12.84, p = 0.019) and MIB-1 (HR = 3.16, 95% CI = 1.06-9.45, p = 0.039) were found to be prognostic for disease-specific survival. The best prognostic cut-off values of p53 and MIB-1 were 10% and 30% respectively. In multivariate analysis, these two markers obtained independent significance only when considered in combination (HR = 6.63, 95% CI = 1.40-31.41, p = 0.017, for patients with one or both markers above their cut-off), while the International Germ Cell Consensus Cancer Group (IGCCCG) risk was the most significant (HR = 7.99, 95% CI = 1.96-32.52, p = 0.004, for the high-risk group). However, the expression of these markers seemed to be significantly correlated with known prognostic factors. Nevertheless, we identified 34 patients of low IGCCCG risk expressing both markers below their cut-off with excellent survival. CONCLUSION Among 7 immunohistochemical markers, p53 and MIB-1 demonstrated prognostic significance. Their combination may contribute to improvement of the accuracy of the currently approved prognostic system (IGCCCG).
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine, Propaedeutic, Oncology Section, University of Athens, Attikon University Hospital, Haidari, Athens, Greece.
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Pectasides D, Pectasides E, Papaxoinis G, Skondra M, Gerostathou M, Karageorgopoulou S, Kamposioras C, Tountas N, Koumarianou A, Psyrri A, Macheras A, Economopoulos T. Testicular function in poor-risk nonseminomatous germ cell tumors treated with methotrexate, paclitaxel, ifosfamide, and cisplatin combination chemotherapy. ACTA ACUST UNITED AC 2009; 30:280-6. [PMID: 19136393 DOI: 10.2164/jandrol.108.006437] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Our objective was to investigate the impact of methotrexate, paclitaxel, ifosfamide, and cisplatin (M-TIP) on long-term fertility in poor-risk nonseminomatous germ cell tumors (NSGCT). Thirty patients with poor-risk NSGCT (median age, 29 years; range, 17-62 years) were treated with methotrexate 250 mg/m(2) with folinic acid rescue (day 1) and paclitaxel 175 mg/m(2) (day 1), followed by ifosfamide 1.2 g/m(2) and cisplatin 20 mg/m(2) (days 2-6). Treatment consisted of 4 cycles of M-TIP administered every 3 weeks. Twenty-one patients were continuously disease-free at a median follow-up of 5.3 years (range, 0.9-8.4 years). Sperm count and hormonal analyses were examined prechemotherapy (30 patients) and postchemotherapy (21 patients). Counts were classified as follows: lower than 1 x 10(6)/mL, azoospermia; 1-20 x 10(6)/mL, oligospermia (OS); higher than 20 x 10(6)/mL, normospermia (NS). Patients were followed for a median of 2.3 years (range, 0.9-3.8 years) postchemotherapy. The prechemotherapy median luteinizing hormone (LH) serum levels were slightly above the upper normal limit, whereas the serum levels of follicle-stimulating hormone (FSH) and testosterone (T) were within the reference interval. Eleven (52.3%) patients had NS prechemotherapy. Among the patients with NS, 72.7% still had NS following chemotherapy. Overall, 17 of 21 (80.9%; 33.3% OS and 47.6% NS) patients had recovery of spermatogenesis after treatment. The median FSH serum levels were significantly elevated at least 1 year postchemotherapy when compared with the pretreatment levels. Eighteen months after the completion of chemotherapy the median FSH levels had returned to the reference limits. Serum LH and T levels were unaffected by chemotherapy. Prior to chemotherapy 4 of 30 patients had fathered 5 children. Since completion of chemotherapy, 5 patients have fathered 5 children. The majority of men with poor-risk germ cell tumors who were treated with the M-TIP regimen demonstrated recovery spermatogenesis after treatment, and Leydig cell function was unaffected.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine, Propaedeutic, Oncology Section, University of Athens, Attikon University Hospital, Rimini 1, Haidari, Athens, Greece.
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Hadjidakis D, Androulakis I, Mylonakis A, Sfakianakis M, Raptis A, Papaefstathiou A, Economopoulos T, Raptis S. Diabetes in Postmenopause: Different Influence on Bone Mass According to Age and Disease Duration. Exp Clin Endocrinol Diabetes 2008; 117:199-204. [DOI: 10.1055/s-2008-1080921] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Economopoulos T, Matsopoulos GK, Asvestas PA, Gröndahl K, Gröndahl HG. Automatic correspondence using the enhanced hexagonal centre-based inner search algorithm for point-based dental image registration. Dentomaxillofac Radiol 2008; 37:185-204. [PMID: 18460572 DOI: 10.1259/dmfr/26553364] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES In this paper, the enhanced hexagonal centre-based inner search (EHCBIS) algorithm, for automatic point correspondence, is proposed for dental image registration. METHODS The presented algorithm is incorporated within a general registration scheme, which is based on extracting a set of candidate points on the reference image, finding their corresponding points in the image to be transformed (float image) using the proposed algorithm and applying a suitable geometrical transformation towards automatic registration. The performance of the proposed algorithm is evaluated against three well-known methods for automatic correspondence, the self-organizing maps, the automatic extraction of corresponding points and the trimmed iterative closest point method, in terms of registration accuracy. RESULTS Qualitative and quantitative results on registering 123 dental pairs show that the proposed algorithm outperforms the other methods for automatic correspondence with or without the presence of noise. CONCLUSIONS The EHCBIS method is capable of defining automatically corresponding points in dental image pairs. It can be incorporated within a general scheme for point-based registration of dental radiographs acquired with or without rigorous a priori standardization. The applied projective transformation provides a reliable model for registering intraoral radiographs. The methodology does not require any segmentation prior to alignment providing subtraction radiographs and fused images for clinical evaluation regarding the evolution of a disease or the response to a therapeutic scheme.
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Affiliation(s)
- T Economopoulos
- Institute of Communication and Computer Systems, Athens, Greece
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Psyrri A, Papageorgiou S, Economopoulos T. Primary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and management. Ann Oncol 2008; 19:1992-9. [PMID: 18647965 DOI: 10.1093/annonc/mdn525] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [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
Gastrointestinal lymphoma is the most common form of extranodal lymphoma, accounting for 30%-40% of cases. The most commonly involved site is the stomach (60%-75% of cases), followed by the small bowel, ileum, cecum, colon and rectum. The most common histological subtypes are diffuse large B-cell lymphoma (DLBCL) and marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT). Helicobacter pylori infection has been implicated in the pathogenesis of MALT gastric lymphoma, but its role in gastric diffuse large B-cell non-Hodgkin's lymphoma (NHL) is controversial. The therapeutic approach for patients with gastric NHL has been revised over the last 10 years. Conservative treatment with anthracycline-based chemotherapy alone or in combination with involved-field radiotherapy has replaced gastrectomy as standard therapy in cases with DLBCL. Additionally, MALT lymphomas are mainly treated with antibiotics alone, which can induce lasting remissions in those cases associated with H. pylori infection. Nevertheless, various therapeutic aspects for primary gastric lymphomas are still controversial and several questions remain unanswered. Among others, the role of rituximab, consolidation radiotherapy as well as H. pylori eradication in histological aggressive subtypes warrants better clarification.
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Affiliation(s)
- A Psyrri
- Second Department of Internal Medicine Propaedeutic, Athens University Medical School, University General Hospital Attikon, Haidari, Greece
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Kalofonos HP, Bamias A, Koutras A, Papakostas P, Basdanis G, Samantas E, Karina M, Misailidou D, Pisanidis N, Pentheroudakis G, Economopoulos T, Papadimitriou C, Skarlos DV, Pectasides D, Stavropoulos M, Bafaloukos D, Kardamakis D, Karanikiotis C, Vourli G, Fountzilas G. A randomised phase III trial of adjuvant radio-chemotherapy comparing Irinotecan, 5FU and Leucovorin to 5FU and Leucovorin in patients with rectal cancer: a Hellenic Cooperative Oncology Group Study. Eur J Cancer 2008; 44:1693-700. [PMID: 18639450 DOI: 10.1016/j.ejca.2008.05.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Revised: 05/26/2008] [Accepted: 05/29/2008] [Indexed: 01/15/2023]
Abstract
The primary objective was to compare the 3-year survival of rectal cancer patients randomised postoperatively to irinotecan (IRI), Leucovorin (LV) and bolus 5-fluorouracil (5FU) or LV-bolus 5FU with radiotherapy. Secondary objectives included disease-free survival, local relapse and toxicity. The study included 321 eligible patients. The treatment consisted of weekly administration of IRI 80 mg/m(2) intravenously (IV), LV 200 mg/m(2) and 5FU 450 mg/m(2) bolus (arm A) versus LV 200 mg/m(2) and 5FU 450 mg/m(2) IV bolus (arm B). One cycle included four infusions and treatment was continued for a total of six cycles. The first cycle was followed by pelvic irradiation plus 5FU. There were no differences between the arms in 3-year overall, disease-free and local relapse-free survival. Grades 3 and 4 toxicity was similar in both the arms with the exception of leucopaenia, neutropaenia and alopecia, which were higher in the IRI arm. IRI added to adjuvant radiochemotherapy with LV and bolus 5FU was not shown to improve survival, whereas the incidence of severe leucopaenia was significantly higher in the IRI arm.
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Affiliation(s)
- H P Kalofonos
- Department of Medicine, Division of Oncology, University Hospital, University of Patras Medical School, Rion 26504, Patras, Greece.
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Tsirigotis P, Triantafyllou K, Girkas K, Giannopoulou V, Ioannidou E, Chondropoulos S, Kalli T, Papaxoinis G, Pappa V, Papageorgiou E, Economopoulos T, Ladas SD, Dervenoulas J. Keratinocyte growth factor is effective in the prevention of intestinal mucositis in patients with hematological malignancies treated with high-dose chemotherapy and autologous hematopoietic SCT: a video-capsule endoscopy study. Bone Marrow Transplant 2008; 42:337-43. [DOI: 10.1038/bmt.2008.168] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Papageorgiou S, Psyrri A, Liakata E, Scorilas A, Rontogianni D, Kontos C, Argiriou P, Pappa V, Harhalakis N, Pectasides D, Economopoulos T. PIK3CA as a molecular target in mantle cell lymphoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8612] [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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Papadimitriou C, Wirtz RM, Economopoulos T, Samantas E, Papakostas P, Gogas H, Razis E, Lianos E, Aravantinos G, Fountzilas G. Differential EGFR and VEGFR mRNA expression in two subtypes of basal-like breast cancer identified by molecular classification. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22092] [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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Papaxoinis G, Fountzilas G, Rontogianni D, Dimopoulos M, Pavlidis N, Tsatalas C, Pectasides D, Xiros N, Economopoulos T. Low-grade mucosa-associated lymphoid tissue lymphoma: a retrospective analysis of 97 patients by the Hellenic Cooperative Oncology Group (HeCOG). Ann Oncol 2008; 19:780-6. [DOI: 10.1093/annonc/mdm529] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [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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Pectasides D, Iacovidou I, Psyrri A, Pectasides E, Papaxoinis G, Economopoulos T. Primary non-Hodgkin's lymphoma of the bladder: report of two cases and review of the literature. J BUON 2008; 13:277-279. [PMID: 18555478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Malignant lymphoma of the bladder is a rare entity which usually presents with nonspecific urologic symptoms such as dysuria, haematuria, nocturia and abdominal pain. Urologists should be familiar with the management of this disease as surgery alone often is not adequate treatment. We present herein 2 cases of non-Hodgkin's lymphoma (NHL) of the bladder and discuss their clinical-pathological features and management.
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Affiliation(s)
- D Pectasides
- 2nd Department of Internal Medicine, Oncology Section, University of Athens, Attikon University Hospital, Rimini 1, Haidari, Athens, Greece.
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Pectasides D, Xiros N, Papaxoinis G, Pectasides E, Sykiotis C, Koumarianou A, Psyrri A, Gaglia A, Kassanos D, Gouveris P, Panayiotidis J, Fountzilas G, Economopoulos T. Carboplatin and paclitaxel in advanced or metastatic endometrial cancer. Gynecol Oncol 2008; 109:250-4. [PMID: 18299146 DOI: 10.1016/j.ygyno.2008.01.028] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 01/09/2008] [Accepted: 01/23/2008] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the activity and toxicity of carboplatin and paclitaxel combination in advanced or recurrent endometrial carcinoma. METHODS Forty-seven eligible patients with measurable advanced or recurrent endometrial carcinoma were treated with carboplatin [area under the curve (AUC) 5] and paclitaxel 175 mg/m(2) every 3 weeks for 6-9 cycles or until disease progression or unacceptable toxicity. RESULTS There were 10 complete responses (CRs) (21%) and 19 partial responses (PRs) (41%) for an overall response rate (RR) of 62% (29 patients) (95% confidence interval [CI], 47-76%). The median progression-free survival (PFS) was 15 months (95% CI, 7.3-22.7 months) and the median overall survival (OS) was 25 months (95% CI, 19.0-31.0 months). No difference was found in RR and OS in patients with primary advanced disease and those with recurrent tumors. Similarly, no difference was found in PFS and OS for patients with serous/clear tumors and those with endometrioid tumors. Toxicity was generally mild except for myelotoxicity. Neutropenia grade 3/4 was recorded in 36% of patients and 6% experienced febrile neutropenia. One patient each developed grade 4 thrombocytopenia and anemia. Grade 3 sensory neuropathy was recorded in 6% of patients. CONCLUSION The combination of carboplatin and paclitaxel appears to have activity in advanced or recurrent endometrial carcinoma with an acceptable toxicity profile.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine, Propaedeutic, Oncology Section, University of Athens, Attikon University Hospital, Haidari, 1 Rimini, Athens, Greece.
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Pectasides D, Papaxoinis G, Fountzilas G, Aravantinos G, Pectasides E, Mouratidou D, Economopoulos T, Andreadis C. Adult granulosa cell tumors of the ovary: a clinicopathological study of 34 patients by the Hellenic Cooperative Oncology Group (HeCOG). Anticancer Res 2008; 28:1421-1427. [PMID: 18505090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Granulosa cell tumors (GCT) are rare malignant neoplasms of the ovaries with, usually, indolent biological behavior. PATIENTS AND METHODS The epidemiological, clinical and pathological features of 34 patients with adult GCT, from the registry of the HeCOG, were analyzed retrospectively for their prognostic significance. RESULTS The median age was 51 years with post- to premenopausal ratio=l.8 and median size of the tumor 10 cm. Forty-seven % had a low mitotic index (1-3 mitoses/10 high-power fields, HPFs) and 48% had International Federation of Obstetrics and Gynecology (FIGO) stage IA. After 34.5 months of median follow-up, the estimated 5-year and 10-year progression-free survival (PFS) was 78% and 65%, respectively, while both the 5- and 10-year overall survival (OS) was 89%. The stage and the presence of residual disease after surgery had prognostic significance for OS in the univariate analysis. Out of 19 patients whose disease was completely resected, the median disease-free survival (DFS) was 11 months. Only rupture of the tumor during surgery had prognostic significance for DFS in the univariate analysis. Seven out of 13 evaluable patients with unresectable disease responded to first-line chemotherapy (CT), 6 of them completely, while three patients responded to second-line chemotherapy. All the responders were retreated with platinum-based CT and one of them was platinum-insensitive. All the patients receiving second-line non-platinum CT developed progressive disease (PD). CONCLUSION The only curative treatment of GCT is complete surgical resection of all visible disease, while platinum-based CT is the most effective first-line, as well as second-line treatment.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine, Propaeduetic, Oncology Section, University of Athens, Attikon University Hospital, Haidari, Athens, Greece.
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Pectasides D, Papaxoinis G, Pectasides E, Galani H, Razi E, Katodrytis N, Fountzilas G, Economopoulos T. Merkel Cell Carcinoma of the Skin: A Retrospective Study of 24 Cases by the Hellenic Cooperative Oncology Group. Oncology 2008; 72:211-8. [DOI: 10.1159/000112944] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 07/04/2007] [Indexed: 11/19/2022]
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Economopoulou C, Pappa V, Kontsioti F, Papageorgiou S, Kapsimali V, Papasteriadi C, Economopoulou P, Papageorgiou E, Dervenoulas J, Economopoulos T. Analysis of apoptosis regulatory genes expression in the bone marrow (BM) of adult de novo Myelodysplastic Syndromes (MDS). Leuk Res 2008; 32:61-9. [PMID: 17597205 DOI: 10.1016/j.leukres.2007.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Revised: 04/04/2007] [Accepted: 04/06/2007] [Indexed: 11/22/2022]
Abstract
The aim of the present study was to examine caspases, granzyme B and bcl-2 family mRNA expression and the degree of apoptosis in the bone marrow (BM) of 46 Myelodysplastic Syndromes (MDS) and to correlate our findings with clinical parameters. The degree of apoptosis was determined by Annexin V, whereas expression of genes was determined using a multiprobe RNase Protection System. A positive correlation was found between caspases 8, 5, 3, 2, 1 and the level of apoptosis. bfl1 and mcl1 levels were significantly higher in patients with BM blasts >5%. Cases with ratio of bid expression >1 compared to normal pool were associated with IPSS values < or =1.
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Affiliation(s)
- C Economopoulou
- Attikon University Hospital, 2nd Propedeutic Clinic of Internal., 1 Rimini St., Athens, Haidari, Greece.
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Vlachogiannakos J, Kougioumtzian A, Triantos C, Viazis N, Sgouros S, Manolakopoulos S, Saveriadis A, Markoglou C, Economopoulos T, Karamanolis DG. Clinical trial: The effect of somatostatin vs. octreotide in preventing post-endoscopic increase in hepatic venous pressure gradient in cirrhotics with bleeding varices. Aliment Pharmacol Ther 2007; 26:1479-87. [PMID: 17919272 DOI: 10.1111/j.1365-2036.2007.03539.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatic venous pressure gradient (HVPG) increases significantly after endoscopic therapy in patients with bleeding oesophageal varices, which may precipitate further haemorrhage. Whether vasoactive drugs can suppress these changes remains unknown. AIM To investigate the efficacy of somatostatin when compared with octreotide in preventing the post-endoscopic increase in HVPG during acute bleeding and whether the changes affect outcome. METHODS Thirty-three cirrhotics with bleeding varices were randomized to receive somatostatin (n = 17) or octreotide (n = 16) under double-blind conditions, soon after their admission. HVPG measurements were performed before and immediately after endoscopic treatment. RESULTS In the somatostatin group, postendotherapy HVPG values did not change significantly when compared with pre-treatment values (18.9 vs. 17.2, P = 0.092). Conversely, in the octreotide group, HVPG increased significantly after endoscopy (18.2 vs. 20.8, P = 0.003). The probability of 6-week survival without treatment failure was significantly higher in the somatostatin group (P = 0.024). Post-endoscopic HVPG value was independently associated with 6-week failure. CONCLUSIONS Somatostatin, but not octreotide, effectively prevents the post-endoscopic increase in HVPG, which may be associated with low probability of treatment failure.
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Affiliation(s)
- J Vlachogiannakos
- 2nd Department of Gastroenterology, Evangelismos Hospital, Athens, Greece.
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Pectasides D, Samantas E, Fountzilas G, Briasoulis E, Kosmidis P, Skarlos D, Dimopoulos MA, Kalofonos HP, Economopoulos T, Syrigos K. Combination chemotherapy with cisplatin, etoposide and irinotecan in patients with extensive small-cell lung cancer: A phase II study of the Hellenic Co-operative Oncology Group. Lung Cancer 2007; 58:355-61. [PMID: 17698241 DOI: 10.1016/j.lungcan.2007.06.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Revised: 06/21/2007] [Accepted: 06/27/2007] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the efficacy and toxicity of cisplatin, etoposide and irinotecan as first-line treatment in patients with extensive small-cell lung cancer (E-SCLC). PATIENTS AND METHODS Chemo-naïve adult patients with a performance status (PS) of 0-2 and adequate organ function were eligible. Patients received cisplatin 20mg/m(2) i.v. daily for three consecutive days, etoposide 75mg/m(2) i.v. daily for three consecutive days and irinotecan 120mg/m(2) i.v. on day 2, every 21 days for six to eight cycles. Administration of G-CSF was given in the presence of febrile neutropenia and as a 5-day prophylaxis around the recorded nadir day in patients who developed grades 3-4 neutropenia. RESULTS Fifty-six patients were assessable. The median age was 62.2 years; 96.4% had PS 0-1, 33.5% had >3 metastatic sites. The overall response rate was 80.4% with 8 (14.3%) patients achieving a complete response. The median time to tumor progression was 7.8 months [95% confidence interval (CI), 7.1-8.6 months] with a median survival of 15.1 months [95% CI, 9.7-20.5 months] and 1-year survival rate of 56.5%. One patient died from toxicity. Grades 3-4 neutropenia occurred in 37.5% of patients, grades 3-4 thrombocytopenia occurred in 10.9% of patients and 11 (19.6%) patients developed febrile neutropenia. Grades 3-4 non-hematological toxicities were primarily nausea-vomiting 3.6%, diarrhea 7.1% and fatigue 3.6%. CONCLUSION This study strongly suggests that cisplatin, etoposide and irinotecan combination is very effective for the treatment of E-SCLC with good safety profile. The triplet regimen currently seems a promising regimen and has to be further explored in phase III trials.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine-Propaedeutic, Oncology Section, University General Hospital Attikon, Athens, Greece.
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Halvatsiotis PG, Stefanopoulou S, Kotanidou A, Orfanos S, Martinos C, Roussos C, Economopoulos T, Raptis SA. The relation of thyroid hormone levels and reduced insulin sensitivity to survival of patients with septic shock. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-984801] [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: 10/21/2022]
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Panagiotidou M, Tsiotra P, Economopoulos T, Raptis SA, Hatziagelaki E. Prevalence of anti-GAD65 in Greek population with type II diabetes mellitus. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-984776] [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: 10/21/2022]
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Economopoulou C, Psyrri A, Liakata E, Papageorgiou S, Economopoulou P, Kontsioti F, Pappa V, Economopoulos T. Contribution of constitutive activation of Akt to the pathogenesis of mantle cell lymphoma (MCL) independent of PTEN protein expression. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8101] [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
8101 Background: To determine whether the PI3K/Akt signaling pathway is involved in the pathogenesis of mantle cell lymphoma (MCL), we investigated the phosphorylation status of Akt in primary MCL cases and cell lines. We also sought to determine whether loss of the phosphatase PTEN is the mechanism of Akt activation in MCL. Methods: We evaluated the protein levels of Akt, phosphorylated Akt and PTEN in 15 primary MCL cases and 2 cell lines by immunoblotting Results: Akt was phosphorylated in 3 of 15 MCL cases and in 2 of 2 mantle cell lymphoma cell lines. PTEN protein was expressed in 15 of 15 primary mantle cell lymphoma cases and in 2 of 2 MCL cell lines. Conclusions: We conclude that constitutive activation of the PI3K/Akt pathway contributes to the pathogenesis of MCL. Loss of PTEN protein expression is not the responsible mechanism for Akt activation. Alternative mechanisms of Akt activation are being evaluated to identify markers predictive for response to PI3K/Akt inhibitors in MCL. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | | | | | | | - V. Pappa
- Attikon Hospital, Athens, Greece
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Papakostas P, Kalofonos HP, Pentheroudakis G, Timotheadou E, Papadimitriou C, Tsavdaridis D, Economopoulos T, Galani E, Bafaloukos D, Aravantinos G. Safety results of a phase III randomized trial of adjuvant treatment with 5- fluorouracil and folinic acid with or without irinotecan, in Dukes B2 and C colon cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4053 Background: The aim of our phase III study was to compare the effectiveness and the toxicity profile of 5-Fluorouracil (5- FU) + folinic acid (FA) + irinotecan (CPT-11) as adjuvant chemotherapy for resectable colon cancer (Dukes B2 and C) to that of 5-FU + FA which was considered the standard treatment. Since patients are still on follow-up regarding the primary endpoint, only safety results will be presented. Methods: Eligible patients received either 5-FU (450 mg/m2 bolus) + FA (200 mg/m2, 120 min infusion) + CPT- 11 (80 mg/m2, 90 min infusion) given 4 weeks on, two weeks off for a total of 6 treatment cycles (Arm A) or 5-FU (500 mg/m2 bolus) + FA (200 mg/m2, 120 min infusion) given 6 weeks on, two weeks off for a total of 4 treatment cycles (Arm B). Results: From January 1999 to September 2004, 910 patients (pts) were enrolled in this multi-center phase III trial. Safety data are available for 826 of the 910 pts, (415 in arm A and 411 in arm B). The total number of chemotherapy courses delivered was 8,906 (92%) in arm A and 8,775 (91%) in arm B, with median courses per patient 24 in both groups. Among patients who received treatment as randomized (403 in arm A and 398 in arm B), treatment was completed in 342 pts (82%) in arm A and in 341 pts (83%) in arm B. The number of patients who discontinued the treatment was 61 (15%) in arm A and 57 (14%) in arm B. Hospitalizations because of toxic effects happened in 37 pts (9%) in arm A and in 45 pts (11%) in arm B. Three deaths occurred in both arms. Use of G-CSF was more common in arm A (94 pts, 23%) than in arm B (38 pts, 9.5%) (p< 0.001). Significantly higher grade 3/4 neutropenia was observed in group A (11% in arm A and 3% in arm B, p< 0.001). Severe diarrhea was also frequently reported in both groups. Conclusions: These data show that both regimens have comparable and manageable toxicity profiles as adjuvant treatment in colon cancer. Severe neutropenia was more often seen in arm A. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | | | | | | | | | - E. Galani
- Hellenic Cooperative Oncology Group, Athens, Greece
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Tsirigotis P, Pappa V, Papageorgiou S, Kapsimali V, Giannopoulou V, Kaitsa I, Girkas K, Papageorgiou E, Stavrianeas N, Economopoulos T, Dervenoulas J. Extracorporeal photopheresis in combination with bexarotene in the treatment of mycosis fungoides and Sézary syndrome. Br J Dermatol 2007; 156:1379-81. [PMID: 17459033 DOI: 10.1111/j.1365-2133.2007.07901.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Economopoulou C, Pappa V, Kontsioti F, Kapsimali V, Tsirigotis P, Papageorgiou S, Giannopoulou V, Girkas K, Papageorgiou E, Dervenoulas J, Economopoulos T. P027 Analysis of cell cycle regulatory genes expression in the bone marrow of adult de novo myelodysplastic syndromes (MDS). Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70097-8] [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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Douzenis A, Michopoulos I, Economopoulos T, Lykouras L, Soldatos CR. Sublingual use of olanzapine in combination with alprazolam to treat agitation in a terminally ill patient receiving parenteral nutrition. Eur J Cancer Care (Engl) 2007; 16:289-90. [PMID: 17508951 DOI: 10.1111/j.1365-2354.2006.00735.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper reports the case of a 64-year-old man who was receiving parenteral nutrition after repeated operations due to stomach cancer. Olanzapine (orally disintegrating tablets) in combination with alprazolam was used successfully to relieve this terminally ill patient's anxiety and tension improving his relationship with his physicians and his daily life.
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Affiliation(s)
- A Douzenis
- Department of General Hospital Psychiatry, Athens University Medical School, Attikon Hospital, Athens, Greece.
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Koumarianou AA, Xiros N, Papageorgiou E, Pectasides D, Economopoulos T. Survival improvement of young patients, aged 16-23, with Hodgkin lymphoma (HL) during the last three decades. Anticancer Res 2007; 27:1191-7. [PMID: 17465262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The prognostic factors, treatments and outcomes of 55 young adults (16-23 years old) with Hodgkin lymphoma (HL) treated in the Second Department of Internal Medicine Propaedeutic, Medical Oncology Unit, Athens University, over the past 25 years, are reviewed. Patients were treated with the chemotherapy regimens available at each time period which were MOPP (Group A; 1978-1987), MOPP/ABVD (Group B; 1988-1993) and BEACOPP or ABVD (Group C; 1994-2003). The eligible patients, received radiotherapy (RT) according to treatment consensus. Additionally, the patients were retrospectively divided according to risk factors (abnormal erythrocyte sedimentation rate (ESR), bulky mediastinal disease, > 3 involved nodes and extranodal involvement) into low [stage I/II; five patients (9%)], intermediate [stage III with adverse prognostic factors; 18 patients (33%)] and high risk categories [stages IIB bulky and III/IV; 32 patients (58%)]. A total of 21 (38%) patients experienced relapse (three intermediate and 19 high risk). The 5-year survival and the 5-year event free survival (EFS) figures were Group A: 65% and 53%, Group B: 80% and 65%, Group C: 100% and 88.5%, respectively, the improvements between Group B and C were statistically significant (p = 0.04 and p = 0.005, respectively) among the three time periods. The overall survival (OS) and EFS differed significantly between intermediate and high risk categories (OS: p = 0.04, EFS: p = 0.005). The sequential use of RT did not influence OS and EFS but there was a trend of improvement with RT in the later periods. Survival of young patients with HL is significantly improving most probably due to improved chemotherapy treatment and understanding of the risk factors. Current controversial issues surrounding this disease, including the role of radiotherapy, positron emission tomography (PET), bone marrow biopsy and stem cell transplantation are discussed.
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Affiliation(s)
- A A Koumarianou
- Second Department of Internal Medicine Propaedeutic, Medical Oncology Unit, Attikon University Hospital, Athens University, Rimini 1, 12462 Athens, Greece.
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Psyrri A, Kountourakis P, Yu Z, Papadimitriou C, Markakis S, Camp RL, Economopoulos T, Dimopoulos MA. Analysis of p53 protein expression levels on ovarian cancer tissue microarray using automated quantitative analysis elucidates prognostic patient subsets. Ann Oncol 2007; 18:709-15. [PMID: 17220511 DOI: 10.1093/annonc/mdl479] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND p53 protein is regarded as a valuable prognostic marker in cancer with a potential use as a molecular target. Here, we sought to determine the prognostic value of p53 in ovarian cancer using a novel method of compartmentalized in situ protein analysis. PATIENTS AND METHODS A tissue array composed of 141 advanced stage ovarian cancers uniformly treated was constructed. For evaluation of p53 protein expression, we used an immunofluorescence-based method of automated in situ quantitative measurement of protein analysis (AQUA). RESULTS High nuclear p53 expression levels were associated with better outcome for overall survival (OS) (P = 0.0023) and disease-free survival (P = 0.0338) at 5-years. High cytoplasmic p53 expression levels were associated with better outcome for OS (P = 0.0002). In multivariable analysis, high nuclear and high cytoplasmic p53 level with International Federation of Gynecology and Obstetrics (FIGO) stage were the most significant predictor variables for OS and high nuclear p53 level with FIGO stage were the significant predictor variables for disease-free survival. CONCLUSIONS Assessment of the prognostic value of p53 protein levels using conventional immunohistochemistry is limited by the nonquantitative nature of the method. AQUA provides precise estimation of p53 protein levels and was able to elucidate the association of p53 protein levels and ovarian cancer prognosis.
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Affiliation(s)
- A Psyrri
- Department of Medical Oncology, Yale Cancer Center, New Haven, CT 06520, USA. diamando.psyrri@ yale.edu
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Fountzilas G, Papakostas P, Dafni U, Makatsoris T, Karina M, Kalogera-Fountzila A, Maniadakis N, Aravantinos G, Syrigos K, Bamias A, Christodoulou C, Economopoulos T, Kalofonos H, Nikolaou A, Angouridakis N, Stathopoulos G, Bafaloukos D, Pavlidis N, Daniilidis J. Paclitaxel and gemcitabine vs. paclitaxel and pegylated liposomal doxorubicin in advanced non–nasopharyngeal head and neck cancer. An efficacy and cost analysis randomized study conducted by the Hellenic Cooperative Oncology Group. Ann Oncol 2006; 17:1560-7. [PMID: 16790517 DOI: 10.1093/annonc/mdl151] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 11/14/2022] Open
Abstract
BACKGROUND The prognosis of patients with recurrent and/or metastatic head and neck cancer (HNC) is poor. Median survival of these patients following chemotherapy is in the range of 6 to 9 months. In the present randomized phase III trial we compared two new combinations containing new drugs with proven activity in phase II studies with patients with HNC. PATIENTS AND METHODS From November 1999 until November 2004, 166 eligible patients with HNC were enrolled in the study. They were treated with paclitaxel 175 mg/m(2) on day 1 and gemcitabine 1000 mg/m(2) on days 1 and 8 every 3 weeks (group A, 85 patients) or with paclitaxel, as in group A, and pegylated liposomal doxorubicin 40 mg/m(2) on day 1 every 4 weeks (group B, 81 patients). RESULTS There was no significant difference in response rate (20% versus 29%, P = 0.21), time to disease progression (median; 4.4 months versus 6.0 months, P = 0.09) and survival (median; 8.6 months versus 11.05 months, P = 0.25). Both regimens were generally well tolerated. The most frequently reported side effect, apart from alopecia, was neutropenia. Overall, there was no significant difference in severe toxicity between the two treatment arms. CONCLUSIONS The present study could not demonstrate a survival benefit with either regimen. Both treatments were well tolerated. Randomized studies comparing each of the two regimens with standard chemotherapy are warranted.
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Affiliation(s)
- G Fountzilas
- Department of Medical Oncology, Papageorgiou Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Macedonia, Greece.
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Pectasides D, Psyrri A, Pectasides M, Economopoulos T. Optimal therapy for platinum-resistant recurrent ovarian cancer: doxorubicin, gemcitabine or topotecan? Expert Opin Pharmacother 2006; 7:975-87. [PMID: 16722809 DOI: 10.1517/14656566.7.8.975] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Ovarian cancer is more fatal than all the other gynaecological malignancies combined. Although most patients respond to first-line combination chemotherapy, the vast majority (50-75%) of patients with advanced disease will relapse. The management of patients with recurrent ovarian cancer is based on their response profile to platinum: patients with platinum-sensitive disease can be rechallenged with platinum-based chemotherapy, whereas the management of patients with platinum-resistant or -refractory disease remains an area of active investigation. In this review, the data for second-line therapy in this latter group of patients will be summarised and recommendations for their optimal management will be made.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine, Athens University, Attikon University Hospital, Rimini 1, Haidari, Athens, Greece.
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Abstract
Merkel cell carcinoma (MCC) is a rare malignant cutaneous tumor of the elderly with rapidly growing skin nodules found predominantly on sun-exposed areas of the body. The vast majority of patients present with localized disease, while up to 30% have regional lymph node metastases. Despite local excision and the incidence of local recurrence, regional lymph node metastases and distant metastases is high and usually occurs within 2 years of primary diagnosis. The optimal treatment for patients with MCC remains unclear. The best outcome is achieved with multidisciplinary management including surgical excision of primary tumor with adequate margins and post-operative radiotherapy (RT) to control local and regional disease. Patients with regional nodal metastases should be treated with lymph node dissection plus RT. Adjuvant chemotherapy (CT) should be considered as part of the initial management. In case of metastatic disease CT based on regimens used for small-cell lung cancer is the standard treatment of care.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine, Oncology Section, University of Athens, Attikon University Hospital, Haidari, 1 Rimini, Athens, Greece.
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Economopoulos T, Asvestas PA, Matsopoulos GK, Grondahl K, Grondahl HG. Automatic correspondence using the enhanced hexagonal center-based inner search algorithm for point-based dental image registration. Conf Proc IEEE Eng Med Biol Soc 2006; 2006:1421-1424. [PMID: 17946045 DOI: 10.1109/iembs.2006.260676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In this paper a modified version of the center-based inner search algorithm, the enhanced hexagonal center-based inner search algorithm, for automatic point correspondence is proposed towards dental registration. The modified algorithm is incorporated within a general registration scheme which is based on extracting a set of candidate points on the reference image, finding their corresponding points in the other image (float image) using the proposed algorithm and applying an affine geometrical transformation towards automatic registration. The performance of the proposed algorithm is evaluated against a well-known method for automatic correspondence, in terms of the registration accuracy. Qualitative and quantitative results on registering 24 dental pairs showed that the proposed algorithm outperforms the other method for automatic correspondence.
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Affiliation(s)
- T Economopoulos
- Institute of Communication and Computer Systems, 9 Iroon Polytecneiou str. 15780, Athens, Greece
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Pectasides D, Gaglia A, Arapantoni-Dadioti P, Bobota A, Valavanis C, Kostopoulou V, Mylonakis N, Karabelis A, Pectasides M, Economopoulos T. HER-2/neu status of primary breast cancer and corresponding metastatic sites in patients with advanced breast cancer treated with trastuzumab-based therapy. Anticancer Res 2006; 26:647-53. [PMID: 16739334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND The aim of this prospective study was to investigate whether there were changes in HER-2/neu status in newly-developed metastatic lesions following treatment with trastuzumab in advanced breast cancer patients overexpressing HER-2/neu. The utility of serological assays for HER-2/neu in such patients was also studied. PATIENTS AND METHODS Sixteen patients with HER-2/neu-overexpressing tumors (15 were 3+ by immunohistochemistry (IHC) and one 2+ by IHC and positive by the chromogenic in situ hybridization (CISH) test) were included in the study. Fourteen patients underwent biopsy and 2 patients fine-needle aspiration (FNA) of newly-developed metastatic lesions following trastuzumab treatment. All samples were assayed for HER-2 by IHC and by the CISH test. Serial serum HER-2/neu (S-HER-2) levels were measured prior to (baseline values) and during trastuzumab-based treatment by enzyme-linked immunosorbent assay (ELISA) (cut-off point: 10 ng/ml) in all patients. The patients were divided into 2 groups: those with "altered HER-2/neu status" and those with "conserved HER-2/neu status" in the metastatic region. RESULTS Six out of the 16 (37%) ("altered HER-2/neu status") newly-developed metastatic lesions lost their HER-2/neu overexpression and scored 0 or +1 by IHC or negative on the CISH test, while in the remaining cases (10/16, 62.5%) ("conserved HER-2/neu status"), the HER-2/neu status was unchanged (+3 by IHC or a positive CISH test). Baseline S-HER-2 levels were elevated in 5 out of 16 patients (3 of "altered HER-2/neu status", 2 of "conserved HER-2/neu status"). The serum HER-2 (S-HER-2) levels declined and returned within the normal ranges in all these 5 patients as a response to trastuzumab treatment. Following the disease progression, the S-HER-2 levels of the 3 patients with "altered HER-2/neu status" remained normal, while those of 2 with "conserved HER-2/neu status" increased. There was no statistically significant difference in the number of chemotherapeutic treatments or the median time of treatment with trastuzumab or chemotherapy between the 2 groups. Time to tumor progression (TTP) was significantly shorter in the "altered HER-2/neu status" patients (median TTP for "altered HER-2/neu status": 9.5 months, and for "conserved HER-2/neu status": 12 months; p <0.001). CONCLUSION These data suggest that, for most patients with metastatic breast cancer treated with trastuzumab, the HER-2/neu expression as measured by IHC and/or CISH in newly-developed metastatic lesions was unchanged. However, a remarkable percentage of cases lost HER-2/neu overexpression. It is not clear whether this finding implies resistance or sensitivity to trastuzumab.
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Affiliation(s)
- D Pectasides
- Second Department of Internal Medicine-Propaedeutic, Oncology Section, Attikon University Hospital, Athens, Greece.
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