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Andrini E, Lamberti G, Mazzoni F, Riccardi F, Bonetti A, Follador A, Giardina D, Genova C, Guaitoli G, Frassoldati A, Brighenti M, Colantonio I, Pasello G, Ficorella C, Cinieri S, Tiseo M, Gelsomino F, Tognetto M, Rihawi K, Ardizzoni A. EP14.01-006 CeLEBrATE: Phase II trial of CarbopLatin, Etoposide, Bevacizumab and Atezolizumab in Patients with exTEnsive-Stage SCLC-GOIRC-01-2019. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Novello S, Torri V, Grohe C, Kurz S, Serke M, Wehler T, Meyer A, Ladage D, Geissler M, Colantonio I, Cauchi C, Stoelben E, Ceribelli A, Kropf-Sanchen C, Valmadre G, Borra G, Schena M, Morabito A, Santo A, Gregorc V, Chiari R, Reck M, Schmid-Bindert G, Folprecht G, Griesinger F, Follador A, Pedrazzoli P, Bearz A, Caffo O, Dickgreber N, Irtelli L, Wiest G, Monica V, Porcu L, Manegold C, Scagliotti G. Corrigendum to “International Tailored Chemotherapy Adjuvant (ITACA) trial, a phase III multicenter randomized trial comparing adjuvant pharmacogenomic-driven chemotherapy versus standard adjuvant chemotherapy in completely resected stage II-IIIA non-small-cell lung cancer”. Ann Oncol 2022; 33:454. [DOI: 10.1016/j.annonc.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Novello S, Torri V, Grohe C, Kurz S, Serke M, Wehler T, Meyer A, Ladage D, Geissler M, Colantonio I, Cauchi C, Stoelben E, Ceribelli A, Kropf-Sanchen C, Valmadre G, Borra G, Schena M, Morabito A, Santo A, Gregorc V, Chiari R, Reck M, Schmid-Bindert G, Folprecht G, Griesinger F, Follador A, Pedrazzoli P, Bearz A, Caffo O, Dickgreber NJ, Irtelli L, Wiest G, Monica V, Porcu L, Manegold C, Scagliotti GV. International Tailored Chemotherapy Adjuvant (ITACA) trial, a phase III multicenter randomized trial comparing adjuvant pharmacogenomic-driven chemotherapy versus standard adjuvant chemotherapy in completely resected stage II-IIIA non-small-cell lung cancer. Ann Oncol 2021; 33:57-66. [PMID: 34624497 DOI: 10.1016/j.annonc.2021.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/05/2021] [Accepted: 09/26/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Several strategies have been investigated to improve the 4% survival advantage of adjuvant chemotherapy in early-stage non-small-cell lung cancer (NSCLC). In this investigator-initiated study we aimed to evaluate the predictive utility of the messenger RNA (mRNA) expression levels of excision repair cross complementation group 1 (ERCC1) and thymidylate synthase (TS) as assessed in resected tumor. PATIENTS AND METHODS Seven hundred and seventy-three completely resected stage II-III NSCLC patients were enrolled and randomly assigned in each of the four genomic subgroups to investigator's choice of platinum-based chemotherapy (C, n = 389) or tailored chemotherapy (T, n = 384). All anticancer drugs were administered according to standard doses and schedules. Stratification factors included stage and smoking status. The primary endpoint of the study was overall survival (OS). RESULTS Six hundred and ninety patients were included in the primary analysis. At a median follow-up of 45.9 months, 85 (24.6%) and 70 (20.3%) patients died in arms C and T, respectively. Five-year survival for patients in arms C and T was of 65.4% (95% CI (confidence interval): 58.5% to 71.4%) and 72.9% (95% CI: 66.5% to 78.3%), respectively. The estimated hazard ratio (HR) was 0.77 (95% CI: 0.56-1.06, P value: 0.109) for arm T versus arm C. HR for recurrence-free survival was 0.89 (95% CI: 0.69-1.14, P value: 0.341) for arm T versus arm C. Grade 3-5 toxicities were more frequently reported in arm C than in arm T. CONCLUSION In completely resected stage II-III NSCLC tailoring adjuvant chemotherapy conferred a non-statistically significant trend for OS favoring the T arm. In terms of safety, the T arm was associated with better efficacy/toxicity ratio related to the different therapeutic choices in the experimental arm.
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Affiliation(s)
- S Novello
- Department of Oncology at San Luigi Hospital, University of Torino, Orbassano (Torino), Italy.
| | - V Torri
- Laboratory of Methodology for Clinical Research, Oncology Department at Instituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - C Grohe
- Department of Respiratory Diseases, Evangelische Lungenklinik Berlin, Berlin, Germany
| | - S Kurz
- Evangelische Lungenklinik Berlin, Berlin, Germany
| | - M Serke
- Thorax Center Clinic for Haematology, Oncology, Pulmonology and Palliative Medicine, Evangelisches Krankenhaus Hamm, Hamm, Germany
| | - T Wehler
- Thorax Center Clinic for Haematology, Oncology, Pulmonology and Palliative Medicine, Evangelisches Krankenhaus Hamm, Hamm, Germany
| | - A Meyer
- Department of Pneumology, Maria Hilf Hospital, Moenchengladbach, Germany
| | - D Ladage
- Department of Pneumology, Maria Hilf Hospital, Moenchengladbach, Germany
| | - M Geissler
- Esslingen Cancer Center Department of Oncology, Gastroenterology and Infectious Diseases Klinikum Esslingen, Esslingen, Germany
| | - I Colantonio
- Division of Oncology, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy
| | - C Cauchi
- Division of Oncology, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy
| | - E Stoelben
- Lung Clinic, Cologne-Merheim Hospital, Cologne, Germany
| | - A Ceribelli
- Division of Clinical Oncology A, Istituto Nazionale Regina Elena per lo Studio e la Cura dei Tumori, Rome, Italy
| | - C Kropf-Sanchen
- Department of Pulmonology, Internal Medicine II, University of Ulm, Ulm, Germany
| | - G Valmadre
- Division of Clinical Oncology, Ospedale di Sondalo, Sondrio, Italy
| | - G Borra
- Division of Clinical Oncology, AOU Maggiore della Carità, Novara, Italy
| | - M Schena
- Division of Clinical Oncology I, AOU Città della Salute e della Scienza, Turin, Italy
| | - A Morabito
- Division of Clinical Oncology and Thoracic Pneumology, IRCCS Fondazione Pascale, Naples, Italy
| | - A Santo
- Complex Operative Unit of Oncology - Gruppo Interdisciplinare Veronese Oncologia Polmonare (GIVOP), Verona, Italy
| | - V Gregorc
- Division of Clinical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - R Chiari
- Division of Clinical Oncology, Azienda Ospedaliera di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - M Reck
- Oncology Department, LungenClinic Grosshansdorf, Grosshansdorf, Germany
| | - G Schmid-Bindert
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - G Folprecht
- University Hospital Carl Gustav Carus Medical Department I Dresden, Dresden, Germany
| | - F Griesinger
- Clinic for Haematology and Oncoloy, Medizinischer Campus Universität Oldenburg, Oldenburg, Germany
| | - A Follador
- Department of Oncology, Presidio Ospedaliero Universitario Santa Maria della Misericordia, Azienda Sanitaria Universitaria Integrata Friuli Centrale, Udine, Italy
| | - P Pedrazzoli
- Oncology Division, University Hospital Santa Maria della Misericordia AOU Friuli Centrale, Udine, Italy
| | - A Bearz
- Division of Clinical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
| | - O Caffo
- Division of Clinical Oncology, Ospedale Santa Chiara, Trento, Italy
| | - N J Dickgreber
- Department for Respiratory Medicine and Thoracic Oncology, Klinikum Rheine - Mathias-Spital, Rheine, Germany
| | - L Irtelli
- Oncology Clinic, Policlinico SS. Annunziata, Chieti, Italy
| | - G Wiest
- Asklepios Cancer Center Hamburg, Asklepios Klinikum Harburg, Hamburg, Harburg, Germany
| | - V Monica
- Department of Oncology at San Luigi Hospital, University of Torino, Orbassano (Torino), Italy
| | - L Porcu
- Laboratory of Methodology for Clinical Research, Oncology Department at Instituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - C Manegold
- Department of Surgery, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - G V Scagliotti
- Department of Oncology at San Luigi Hospital, University of Torino, Orbassano (Torino), Italy
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Mazza F, Scarnecchia E, Turello D, Gorla A, Venturino M, Colantonio I, Bianchi A, Gianello L, Colmo M, Melloni G. P04.02 Efficacy of Multidisciplinary Team-Based Evaluation of Patients With Suspicious Pulmonary Lesions. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.272] [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: 11/27/2022]
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Novello S, Monica V, Serke M, Grohe C, Meyer A, Geissler M, Colantonio I, Stoelben E, Cecere F, Schutte W, Schumann C, Valmadre G, Borra G, Schena M, Morabito A, Santo A, Chiari R, Gregorc V, Reck M, Manegold C, Griesinger F, Follador A, Ferrari A, Bearz A, Caffo O, Dickgreber N, Irtelli L, Wiest G, Sotoparra H, Spatafora M, Righi L, Torri V, Porcu L, Arizio F, Scagliotti G. PS01.04 International Tailored Chemotherapy Adjuvant Trial : ITACA Trial. Final Results. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Capelletto E, Osman G, Morabito A, Chiari R, Grossi F, Tiseo M, Di Costanzo F, Delmonte A, Romano G, Misino A, Scotti V, Gregorc V, Pisconti S, Bonomi M, Del Conte A, Ciuffreda L, Colantonio I, Bria E, Ricciardi S, Manzo A, Metro G, Morelli A, Critelli R, Stura I, Migliaretti G, Novello S. P2.04-84 NSCLC Survival Expectancy for Patients Treated with Docetaxel/Nintedanib in the SENECA Trial and Previous Immunotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Passiglia F, Capelletto E, Grossi F, Bidoli P, Galetta D, Follador A, Valmadre G, Defferrari C, Caffo O, Bearz A, Colantonio I, Gregorc V, Scotti V, Cognetti F, Cordero L, Arizio F, Novello S, Torri V, Scagliotti G. The elderly patient individualized chemotherapy (EPIC) trial, a study for an aged population of non-small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Morelli A, Migliorino M, Morabito A, Chiari R, Grossi F, Bordi P, Di Costanzo F, Delmonte A, Romano G, Misino A, Scotti V, Gregorc V, Pisconti S, Ceresoli G, Del Conte A, Colantonio I, Ciuffreda L, Capelletto E, Stura I, Novello S. Safety of nintedanib plus docetaxel in advanced non-squamous NSCLC (nsNSCLC) patients: The preliminary results of the SENECA (second-line nintedanib in non-small cell lung cancer) trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gelsomino F, Tiseo M, Barbieri F, Riccardi F, Cavanna L, Frassoldati A, Delmonte A, Longo L, Dazzi C, Cinieri S, Colantonio I, Tognetto M, Baldari D, Tofani L, Ardizzoni A. Phase II study of NAB-paclitaxel in sensitive and refractory relapsed SCLC (NABSTER TRIAL). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy298.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Fea E, Vanella P, Miraglio E, Cauchi C, Colantonio I, Denaro N, Di Costanzo G, Garrone O, Granetto C, Occelli M, Ricci V, Vandone A, Merlano M. Metronomic oral cyclophosphamide (CTX) in patients (pts) with heavily pretreated metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw334.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Roila F, Ruggeri B, Ballatori E, Fatigoni S, Caserta C, Licitra L, Mirabile A, Ionta MT, Massidda B, Cavanna L, Palladino MA, Tocci A, Fava S, Colantonio I, Angelelli L, Ciuffreda L, Fasola G, Zerilli F. Aprepitant versus metoclopramide, both combined with dexamethasone, for the prevention of cisplatin-induced delayed emesis: a randomized, double-blind study. Ann Oncol 2015; 26:1248-1253. [PMID: 25743855 DOI: 10.1093/annonc/mdv132] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 02/19/2015] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND A combination of aprepitant, a 5-HT3 receptor antagonist (r.a.), and dexamethasone is recommended for the prophylaxis of cisplatin-induced nausea and vomiting in the acute phase, and aprepitant + dexamethasone (A + D) in the delayed phase. The aim of this study was to verify if A + D is superior to metoclopramide plus dexamethasone (M + D) in preventing delayed emesis in cancer patients receiving the same prophylaxis for acute emesis. PATIENTS AND METHODS A randomized double-blind study comparing A + D versus M + D was completed in previously untreated cancer patients. Before chemotherapy, all patients were treated with intravenous palonosetron 0.25 mg and dexamethasone 12 mg, and oral aprepitant 125 mg. On day 2-4, patients randomly received oral dexamethasone 8 mg plus aprepitant 80 mg once daily (days 2-3) or metoclopramide 20 mg four times daily plus dexamethasone 8 mg bid. Primary endpoint was rate of complete response (no vomiting, no rescue treatment) in day 2-5 after chemotherapy. RESULTS Due to difficulty in the accrual of patients, 303 of the 480 planned patients were enrolled, 284 were fully evaluable, 147 receiving A + D, 137 M + D. Day 1 results were similar in both arms. On day 2-5, complete response rate was not significantly different (80.3% with A + D versus 82.5% with M + D, P < 0.38, respectively), and all secondary endpoints were also similar (complete protection, total control, no vomiting, no nausea, and score of Functional Living Index-Emesis; P < 0.24). Adverse events incidence was not significantly different between the two treatments. CONCLUSIONS In cancer patients submitted to cisplatin-based chemotherapy, receiving the same antiemetic prophylaxis for acute emesis, A + D is not superior to M + D in preventing delayed emesis, and both treatments present similar toxicity. CLINICALTRIALSGOV NUMBER NCT00869310.
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Affiliation(s)
- F Roila
- Medical Oncology Division, 'S. Maria' Hospital, Terni.
| | - B Ruggeri
- Clinical Governance, ASUR Marche, Ascoli Piceno
| | - E Ballatori
- Internal Medicine and Public Health, University of L'Aquila, Spinetoli
| | - S Fatigoni
- Medical Oncology Division, 'S. Maria' Hospital, Terni
| | - C Caserta
- Medical Oncology Division, 'S. Maria' Hospital, Terni
| | - L Licitra
- Medical Oncology, National Cancer Institute, Milano
| | - A Mirabile
- Medical Oncology, National Cancer Institute, Milano
| | - M T Ionta
- Medical Oncology II, University Hospital, Cagliari
| | - B Massidda
- Medical Oncology II, University Hospital, Cagliari
| | - L Cavanna
- Medical Oncology, Piacenza Hospital, Piacenza
| | | | - A Tocci
- Medical Oncology, Azienda Ospedaliera di Legnano, Legnano
| | - S Fava
- Medical Oncology, Azienda Ospedaliera di Legnano, Legnano
| | - I Colantonio
- Medical Oncology, Santa Croce e Carle Hospital, Cuneo
| | - L Angelelli
- Medical Oncology, ASUR Marche, Ascoli Piceno
| | - L Ciuffreda
- Medical Oncology, Molinette Hospital, Torino
| | - G Fasola
- Medical Oncology, University Hospital S. Maria della Misericordia, Udine
| | - F Zerilli
- Medical Oncology, S. Antonio Abate Hospital, Trapani, Italy
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Viti A, Bertolaccini L, Russi E, Merlano M, Colantonio I, Terzi A. 201 * CLINICAL IMPACT OF RADICAL LOCO-REGIONAL SURGERY IN SYNCHRONOUS OLIGOMETASTATIC NON-SMALL-CELL LUNG CANCER. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vavala T, Novello S, Grossi F, Misino A, Cortinovis D, Valmadre G, Meoni G, Caffo O, Follador A, Bearz A, Trenta P, Gregorc V, Defferrari C, Cordero L, Colantonio I, Torri V, Monica V, Papotti M, Scagliotti G. A Randomized Phase III Multicenter Trial of Customized Chemotherapy Versus Standard of Care for 1St Line Treatment of Elderly Patients with Advanced Non-Small-Cell Lung Cancer (Nsclc): the Elderly Patient Individualized Chemotherapy (Epic) Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Denaro N, Russi EG, Colantonio I, Adamo V, Merlano MC. The role of antiangiogenic agents in the treatment of head and neck cancer. Oncology 2012; 83:108-16. [PMID: 22777379 DOI: 10.1159/000339542] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 05/02/2012] [Indexed: 01/25/2023]
Abstract
Despite progress in the treatment of locally advanced head and neck squamous cell cancer (HNSCC), the prognosis remains dismal and 5-year survival does not exceed 40%. In metastatic and recurrent disease, in spite of the introduction of cetuximab in combination with platinum and fluorouracil, the median overall survival rate remains lower than 11 months. There are many possible reasons for these disappointing results including acquired drug resistance and tumor hypoxia. Angiogenesis plays an important role in HNSCC development and proliferation. Promising preclinical results with antiangiogenic therapies have engendered a number of clinical trials, but so far there have not been any conclusive results on the value of such treatments. This paper aims to review the role of angiogenesis in head and neck cancer and to suggest future perspectives.
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Affiliation(s)
- N Denaro
- Department of Oncology, Santa Croce e Carle General Hospital, Cuneo, Italy.
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Ardizzoni A, Boni L, Tiseo M, Vincent A, Passalacqua R, Camerini A, Labianca R, Genestreti G, Zanelli F, Ciuffreda L, Di Costanzo F, De Marinis F, Crinò L, Santo A, Pazzola A, Barbieri F, Zilembo N, Colantonio I, Tibaldi C, Smit EF. Pemetrexed versus pemetrexed plus carboplatin in pretreated patients with advanced non-small cell lung cancer (NSCLC): Pooled analysis of two randomized trials. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7555] [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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Gasco M, Vivenza D, Monteverde M, Lattanzio L, Colantonio I, Natoli G, Miraglio E, Comino A, Syed N, Crook T, Merlano MC, Lo Nigro C. MDM2 309 single nucleotide polymorphisms (SNP) and clinical outcome in patients with advanced squamous cell carcinoma of head and neck (SCCHN). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5509] [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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Novello S, Scagliotti G, Torri V, Monica V, Papotti M, Grohe C, Valmadre G, Bria E, Colantonio I, Serke MH, Stoelben E, Geissler M, Schena M, Santo A, Alabiso O, Schumann C, Manegold C. International tailored chemotherapy adjuvant trial: ITACA trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e17514] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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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Merlano M, Russi E, Benasso M, Corvò R, Colantonio I, Vigna-Taglianti R, Vigo V, Bacigalupo A, Numico G, Crosetto N, Gasco M, Lo Nigro C, Vitiello R, Violante S, Garrone O. Cisplatin-based chemoradiation plus cetuximab in locally advanced head and neck cancer: a phase II clinical study. Ann Oncol 2010; 22:712-717. [PMID: 20810547 DOI: 10.1093/annonc/mdq412] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Intensification of chemoradiation for advanced head and neck squamous cell carcinoma (HNSCC) is unlikely due to toxicity. Cetuximab combined either with radiotherapy or with chemotherapy showed favourable toxic profile with positive results in both combinations. Therefore, cetuximab could intensify chemoradiation without worsening toxicity. We conducted a phase II study of chemoradiation and cetuximab. PATIENTS AND METHODS Eligible patients had stage III-IV M0 HNSCC. Treatment consisted of three cycles of cisplatin (20 mg/m(2)/day × 5 days) and fluorouracil (200 mg/m(2)/day × 5 days) rapidly alternated to three split courses of radiotherapy up to 70 Gy and concurrent weekly cetuximab. The primary end point of the study was complete response (CR) rate. Secondary end points were toxicity, progression-free survival (PFS) and overall survival (OS). RESULTS Fourty-five patients were enrolled: median age was 56 years, 38 had stage IV disease and 40 nodal involvement. CR occurred in 32 patients (71%). PFS and OS was 21+ months and 32.6+, respectively. Acute grade 3-4 toxic effects were in the expected range, but grade 3 radiodermatitis occurred in 33 patients. CONCLUSIONS The combination of cetuximab, cisplatin, fluorouracil and radiotherapy leads to a very high proportion of CR and it is feasible with toxic effects similar to those expected by radiochemotherapy. The only unexpected toxicity was skin toxicity: grade 3 radiodermatitis occurred in 73% of the patients.
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Affiliation(s)
| | - E Russi
- Department of Radiation Therapy, S. Croce General Hospital, Cuneo
| | - M Benasso
- Department of Medical Oncology, La Spezia General Hospital, La Spezia
| | - R Corvò
- Department of Radiation Therapy, National Institute for Cancer Research, Genoa
| | | | | | - V Vigo
- Department of Medical Oncology, La Spezia General Hospital, La Spezia
| | - A Bacigalupo
- Department of Radiation Therapy, National Institute for Cancer Research, Genoa
| | - G Numico
- Department of Medical Oncology, Aosta General Hospital, Aosta
| | | | - M Gasco
- Department of Medical Oncology
| | | | | | - S Violante
- Clinical Trials Office, Department of Medical Oncology, S. Croce General Hospital, Cuneo, Italy
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Colantonio I, Russi E, Numico G, Cipolat M, Mattiot VP, Vitiello R, Merlano M. 8579 Re-irradiation with Cetuximab in relapsed squamous cell carcinoma of the head and neck (HNC). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71670-2] [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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Numico G, Occelli M, Fea E, Granetto C, Di Costanzo G, Colantonio I, Gasco M, Garrone O, Polla V, Merlano M. Survival prediction and frequency of anticancer treatment (ACT) near the end of life in patients hospitalized due to acute conditions (AC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20558] [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
e20558 Background: Recent literature suggests that ACT near the end of life is increasingly common. Although the reason is complex, we hypothesize that AC impair the formulation of prognosis. The PaP score was shown to predict 1-month survival for terminally ill pts. Its application to pts with AC is object of debate. We evaluated the frequency of ACT near the end of life and assessed the value of PaP score and of other clinical parameters in predicting survival in pts with AC. Methods: All pts admitted due to AC in a Department of Medical Oncology in a 9-month period were included. Pts and disease features (site of primary, stage of disease, disease control), previous and current ACT, cause of admission (diagnosis without a previous history of cancer; treatment-related toxicity; cancer- related symptoms) were assessed. The PaP score was calculated using physicians’ survival prediction, Performance Status (PS), anorexia and dyspnea, total WBC and lymphocyte percentage. Results: 208 pts were evaluated: local disease 24%, advanced 76%; ACT 60%, off-treatment 40%; disease controlled 9%, non controlled 91%; cause of admission: diagnosis 19%, toxicity 17%; symptoms 64%. PaP score: group A 78%, B 18%, C 4%. Overall, median survival was 19 weeks (95% I.C. 13,3 to 24,6) and 12-week survival was 59,6%. Of the pts admitted during ACT 11% died within 4 weeks and 32% within 12 weeks. Among the 39 pts died within 4 weeks, 33% were on ACT. Cause of admission, disease control, treatment, and PaP score predicted 12-week survival in the multivariate analysis. However, only PS < 30, and PaP group B and C identified pts with a 12-week survival lower than 30%. Conclusions: ACT in the last period of life is common. During AC only a minority of pts has such a dismal prognosis that treatment withdrawal is justified. The potential reversibility of AC renders prognostic measures inadequate to make treatment decisions. No significant financial relationships to disclose.
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Affiliation(s)
- G. Numico
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - M. Occelli
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - E. Fea
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - C. Granetto
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - G. Di Costanzo
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - I. Colantonio
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - M. Gasco
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - O. Garrone
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - V. Polla
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
| | - M. Merlano
- Ospedale Regionale della Valle d'Aosta, Aosta, Italy; Ospedale S.Croce e Carle, Cuneo, Italy
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Gasco M, Syed N, Coley H, Colantonio I, Merlano M, Crook T, Crook T. Novel genes mediating cisplatin resistance in head and neck cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e22135] [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
e22135 Background: Chemo-radiotherapy with cisplatin-based regimens offers the possibility of cure to a subset of patients with surgically non-resectable squamous carcinomas of the head and neck (HNSCC), but outcome is frequently limited by acquired drug resistance. We have sought novel genes mediating cisplatin resistance in HNSCC. Methods: We derived in vitro cisplatin resistant variants of the HN5 HNSCC cell line and performed micro-array anaylsis to identify differentially expressed genes. Differences in gene expression were confirmed by qPCR and /or western blotting. Methylation-dependent transcriptional silencing of down-regulated genes was studied by bisulphate sequencing and methylation specific PCR. Selected genes were further analysed in a cohort of stage III and IV HNSCC patients treated with cisplatin-based chemo-radiotherapy. Results: We have identified a panel of genes in which changes in expression occur with acquisition of cisplatin resistance both in vitro and, some cases, in vivo. Up-regulated genes include TAOK1, BZW1 and RECQL, whereas down-regulated genes include FAM83D, PAFAH1B2, DLL1, ABPA1 and FH. Conclusions: We report the identification of a novel panel of genes which function as determinants of cisplatin sensitivity. Analysis of expression and/or epigenetic regulation of these genes may have clinical utility in prediction of patients likely to respond to highly toxic combined modality chemo-radiotherapy. No significant financial relationships to disclose.
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Affiliation(s)
- M. Gasco
- S.Croce General Hospital, Cuneo, Italy; Charing Cross Hospital, London, United Kingdom; University of Surrey, Giuldford, United Kingdom
| | - N. Syed
- S.Croce General Hospital, Cuneo, Italy; Charing Cross Hospital, London, United Kingdom; University of Surrey, Giuldford, United Kingdom
| | - H. Coley
- S.Croce General Hospital, Cuneo, Italy; Charing Cross Hospital, London, United Kingdom; University of Surrey, Giuldford, United Kingdom
| | - I. Colantonio
- S.Croce General Hospital, Cuneo, Italy; Charing Cross Hospital, London, United Kingdom; University of Surrey, Giuldford, United Kingdom
| | - M. Merlano
- S.Croce General Hospital, Cuneo, Italy; Charing Cross Hospital, London, United Kingdom; University of Surrey, Giuldford, United Kingdom
| | - T. Crook
- S.Croce General Hospital, Cuneo, Italy; Charing Cross Hospital, London, United Kingdom; University of Surrey, Giuldford, United Kingdom
| | - T. Crook
- S.Croce General Hospital, Cuneo, Italy; Charing Cross Hospital, London, United Kingdom; University of Surrey, Giuldford, United Kingdom
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Numico G, Anfossi M, Bertelli G, Russi E, Cento G, Silvestris N, Granetto C, Di Costanzo G, Occelli M, Fea E, Garrone O, Gasco M, Colantonio I, Merlano M. The process of truth disclosure: an assessment of the results of information during the diagnostic phase in patients with cancer. Ann Oncol 2009; 20:941-5. [PMID: 19150944 DOI: 10.1093/annonc/mdn709] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Surveys carried out in Mediterranean countries demonstrated very low rates of awareness of both diagnosis and prognosis among cancer patients. In our institution, a long-term training program aimed at improving communication skills among all physicians interacting with cancer patients was conducted. We report here the results of an extensive assessment of patients' awareness conducted after the first training period. PATIENTS AND METHODS In a 2-year period, after every first visit of patients with a histological diagnosis of cancer, oncologists elicited perception of the patients and completed a structured questionnaire focusing on the understanding of the diagnosis and prognosis. Our data are thus a photograph of the results of the informative process conducted during the diagnostic phase. RESULTS Among the enrolled 649 patients, 79.3% were aware of their diagnosis; factors significantly associated with higher levels of awareness were age younger than 70 and referral from surgery (versus internal medicine). Knowledge about the palliative or curative aims of future treatments (a surrogate sign of prognostic consciousness) was evident in 55.2%. CONCLUSIONS Compared with historical data, our results show a high level of comprehension of the diagnosis of malignancy, probably due to the extensive training effort together with the method chosen for assessment.
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Affiliation(s)
- G Numico
- Medical Oncology Unit, Regional Hospital of the Aosta Valley, Aosta, Italy.
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Colantonio I, Numico G, Crosetto N, Lo Nigro C, Merlano M. P42 Treatment of locally advanced head-and-neck squamous carcinomas with chemotherapy alternated to radiation and Cetuximab (ALTERCC Phase II study). EJC Suppl 2007. [DOI: 10.1016/s1359-6349(08)70045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Merlano MC, Numico G, Russi EG, Benasso M, Colantonio I, Vigna Taglianti R, Lanzilotta L, Vigo V, Bacigalupo A. Cetuximab (C-mab) and chemo-radiation (CT-RT) for loco-regional advanced squamous cell carcinoma of the head and neck (HNC): A phase II study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.6043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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
6043 Background: C-mab is a monoclonal antibody targeting EGFR. C-mab combined with radiotherapy (RT) improved loco- regional control and overall survival over RT alone in HNC pts (Bonner 2006). Prior data of C-mab and CT-RT (Pfister 2006) were encouraging but the trial was stopped due to an excess of severe toxicities, suggesting the need for a less toxic scheduling. For these reasons we evaluate the safety and activity of C-mab combined with alternating CT-RT in HNC pts. Methods: The primary end-point is C.R. rate. The optimal two stage design was used: the calculated sample size is 45 pts. Eligible pts have locally advanced, measurable, untreated, stage III/IV HNC (excluding nasopharynx). Chemotherapy (CT) consists of Cis-PT 20 mg/m2/day and bolus 5Fu 200 mg/m2/day from day 1 to 5, repeated on days 22 and 43. RT, 2 Gy/day, 5 days a week, is given in the pauses between the chemotherapy courses and after the last CT week, up to a total dose of 70 Gy. Results: From 10/2005 to 12/2006 24 pts were enrolled: median age 59 (49–75); median ECOG P.S. 0 (0–1); Stage IV 73%; N1–3 86%; EGFR >80% cells: 55%; EGFR 3+: 91%; most pts had hypopharynx cancer, only 1 had oral cavity tumor. Toxicity is evaluable on 20 pts (4 ongoing). Grade 3–4 toxicities included febrile neutropenia (20%), diarrhea (20%), hypomagnesaemia (10%), mucositis (60%). Unexpected skin toxicity, starting as desquamating moist dermatitis and confined at the irradiated field, occurred in 18/20 pts, usually during the second part of the treatment. Acute colon diverticulitis with perforation (1 pt), gastric perforation (1 pt), fatal myocardial infarction (1 pt) and arterial thrombosis (1 pt) also occurred. Responses, evaluated 3 months after the treatment, are available for the first 16 pts. Objective responses were observed in all them (11 CR + 5 PR). Two PRs were then rendered disease free with salvage surgery. At a maximum follow-up of 15 months, 16/20 pts are alive and 16/20 progression free. Conclusions: This trial showed a skin toxicity not previously reported in other experiences of C-mab combined with RT or CT-RT. Preliminary activity data seems to confirm the Pfister experience. No significant financial relationships to disclose.
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Affiliation(s)
- M. C. Merlano
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
| | - G. Numico
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
| | - E. G. Russi
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
| | - M. Benasso
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
| | - I. Colantonio
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
| | - R. Vigna Taglianti
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
| | - L. Lanzilotta
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
| | - V. Vigo
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
| | - A. Bacigalupo
- S. Croce General Hospital, Cuneo, Italy; National Cancer Institute, Genoa, Italy
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Merlano MC, Numico G, Colantonio I, Garrone O, Gasco M, Russi E, Vigna Taglianti R, Granetto C, Di Costanzo G. AlteRCC phase I-II trial: Alternating radiotherapy and chemotherapy plus cetuximab in advanced head and neck cancer (HNC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.15515] [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
15515 Background: Pfister (ASCO 2003) added Cetuximab (C) to CT/RT to evaluate toxicity and activity of this combination in advanced HNC. The trial was early stopped due to an excess of toxicity including on treatment deaths. However, the treated pts achieved an excellent long term. Results: 76% of them were alive and disease free at 24 months. Therefore, a new, less toxic scheduling of CT/RT and C is highly attractive. Alternating CT/RT (ACR) may be less toxic than concurrent CT/RT (Haffty 2000; Merlano 2003). Therefore we designed a phase I-II trial, scheduling finding, combining ACR and C. Methods: The ACR regimen consists of cisplatin 20 mg/m2 and 5FU 200 mg/m2 days 1 to 5, weeks 1, 4 and 7; and RT, 2 Gy/day, days 1 to 5, weeks 2–3, 5–6, 8–10 to a total dose of 66 Gy. ACR remains unchanged during both phase I and phase II part of the study, whereas C is given to the first 6 pts (phase I, step I) weekly only in the weeks when RT is delivered. If no limiting toxicity is observed, C is combined also with CT, in a second group of six pts (phase I step II). If again no limiting toxicity is recorded, the trial will be continued as a phase II study (optimal two-stage design, 21+24 pts, Simon 1989). Results: At the time of the present report, the phase I step I is completed and 3 pts in phase I step II are on-going. All the pts had HNC stage IVa (8 pts) or stage III (1 pt). Two pts had disease recurrence after prior surgery, while the others had previously untreated cancers. All the tumors over-expressed EGFr (+++), but the percentage of cells expressing EGFr ranges between 10 to 100% (median 70%), One episode of neutropenic fever occurred in one pt enrolled in phase I step II. All the pts developed chemoradiation expected toxicities, including stomatitis and dysphagia requiring TPN. The only unexpected toxicity was a moist desquamation occurring within the irradiated field which was observed in all but one pts at a cumulative RT dose of 50–66 Gy. This toxicity did not interfere with ACR treatment but C was stopped until recovery. Recovery occurred in 5–7 days. Four pts out of the 6 evaluable for response, reached a complete response; the two remaining achieved a PR. One of them underwent surgical removal of a residual nodal mass without complications. Conclusions: The update of the AlteRCC trial will be presented. [Table: see text]
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Affiliation(s)
| | - G. Numico
- St. Croce General Hospital, Cuneo, Italy
| | | | - O. Garrone
- St. Croce General Hospital, Cuneo, Italy
| | - M. Gasco
- St. Croce General Hospital, Cuneo, Italy
| | - E. Russi
- St. Croce General Hospital, Cuneo, Italy
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Gasco M, Syed N, Smith P, Numico G, Colantonio I, Garrone O, Granetto C, Di Costanzo G, Merlano M, Crook T. A multi-gene algorithm as predictor of response to chemo-radiotherapy in head and neck cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10086] [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
10086 Background: Chemo-radiotherapy results in clinical cure for stage III/IV head and neck cancer in approximately 40% of cases, with significant treatment-associated morbidity and mortality. Molecular genetic factors predictive of treatment outcome would clearly be of value in selection of patients with highest probability of response. We have analysed the structure and epigenetic regulation of specific genes as possible predictors of outcome to chemo-radiotherapy. The genes analyzed were: p53 (single nucleotide polymorphism (SNP) and mutation), MDM2 (SNP), Chfr (methylation), CRABP1 (methylation). Methods: 84 patients with locally advanced head and neck cancer receiving cisplatin-based chemo-radiotherapy were studied. SNP genotypes were determined by direct sequencing of DNA from normal tissue. Acquired mutations in p53 and aberrant methylation in the CpG islands of specific genes were analyzed by direct sequencing and methylation-specific PCR. Results: There were 6 treatment-related deaths in 84 patients, all occurring in cases with germ-line haplotype p53 72 Arg/Arg, MDM2 309T/T. At the time of analysis, 39/84 (46%) patients had progressed or died, with median time to progression or death = 17.3 months. Complete response was more common in patients whose genetic/epigenetic profile was p53 72 Arg/Arg wild type, MDM2 309 G/G, Chfr methylated, CRABP1 methylated, compared to the profile p53 72 Arg/Arg mutant, MDM2 309 T/T, Chfr unmethylated, CRABP1 unmethylated (91% vs 46%, log rank p = 0.002). Progression-free survival was significantly longer for patients with the profile p53 72 Arg/Arg wild type, MDM2 309 G/G, Chfr methylated, CRABP1 methylated, compared to those with p53 72 Arg/Arg mutant, MDM2 309 T/T, Chfr unmethylated, CRABP1 unmethylated (% surviving progression-free at 2 years = 74% vs 36%, p = 0.001). Overall survival was significantly longer in patients with the profile p53 72 Arg/Arg wild type, MDM2 309 G/G, Chfr methylated, CRABP1 methylated compared to those with p53 72 Arg/Arg mutant, MDM2 309 T/T, Chfr unmethylated, CRABP1 unmethylated (% surviving at 2 years = 88% vs 40%, p = 0.0004). Conclusions: Genetic and epigenetic parameters influence the toxicity and clinical outcome of chemo-radiotherapy in head and neck cancer. No significant financial relationships to disclose.
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Affiliation(s)
- M. Gasco
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - N. Syed
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - P. Smith
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - G. Numico
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - I. Colantonio
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - O. Garrone
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - C. Granetto
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - G. Di Costanzo
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - M. Merlano
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
| | - T. Crook
- S.Croce General Hospital, Cuneo, Italy; Institute of Cancer Research, London, United Kingdom
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Numico G, Colantonio I, Heouaine A, Occelli M, Fea E, Russi EG, Vigna Taglianti R, Lanzillotta L, Merlano MC. Compassionate treatment (CTr) with re-irradiation, carboplatin (Cb) and Cetuximab (C) in very advanced head and neck cancer (HNC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.13153] [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
13153 Background: Extremely locally advanced HNC is a dramatic clinical situation, causing pain, repeated infections, speech and swallowing impairmen, malnutrition and cosmetic disasters. Re-irradiation may partially palliate some pt, but the low dose of radiation that can safely be delivered limits this approach. Recently the combination of C and radiation has shown improvement of clinical outcome over radiation alone. Methods: We started a CTr with re-irradiation concurrent with Cb and C in pts with heavily symptomatic, pretreated HNC. CTr consisted of: RT (30 Gy) 2 Gy/d, 5 d/week given every other week; Cb AUC 6 d 1, 22 and 43; C, 400 mg/m2 loading dose and 250 mg/m2 maintenance, weekly until day 43 (6 administrations). Results: From January 04 to June 05, 8 pts pre-treated with surgery (6 pts), radiation (8) and chemotherapy (6) entered the CTr. All pts but one had bulky soft tissue invasion and 2 had skin ulceration. One had only bulky nodal relapse. One pt died after the 2nd week due to pneumonia. The other pts had a fast response to CTr: within 5–7 d from the start of therapy they reached a clinical benefit (major or complete pain relief, improvement of swallowing and/or neck movements) and subsequently a rapid tumor shrinkment. All pts achieved an objective response (complete response in 2). No significant local or systemic toxicity occurred in any of the pts, but a mild skin rush. The first 4 pts did not receive further treatment after CTr. These pts showed tumor re-growth within 4–6 weeks from the end of treatment. However one of them underwent salvage surgery and is alive and disease free 14 months after CTr. The 3 other pts received maintenance treatment with weekly C until disease progression. One of them died due to cancer unrelated causes without PD 11 weeks after RT. The 2nd pt developed PD during RT. The 3rd pt is progression-free and alive at 30 weeks from the end of RT. Overall, TTP of the 7 pts ranges between 2 and 7+ months (median 3); survival from the end of RT ranges between 3 and 14+ months (median 7+). Conclusions: CTr with re-irradiation, Cb and C seems feasible even in this poor prognosis, very advanced HNC. No additional toxicity was recorded by adding C. Palliation was achieved in almost all pts and the results deserve further investigations. No significant financial relationships to disclose.
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Affiliation(s)
- G. Numico
- S.Croce General Hospital, Cuneo, Italy
| | | | | | | | - E. Fea
- S.Croce General Hospital, Cuneo, Italy
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Schena M, Barone C, Birocco N, Dongiovanni D, Numico G, Colantonio I, Bertetto O. Weekly cisplatin paclitaxel and continuous infusion fluorouracil in patients with recurrent and/or metastatic head and neck squamous cell carcinoma: a phase II study. Cancer Chemother Pharmacol 2004; 55:271-6. [PMID: 15592837 DOI: 10.1007/s00280-004-0875-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2004] [Accepted: 06/28/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cisplatin, paclitaxel and 5-fluorouracil (5-FU) have demonstrated significant activity in patients with advanced squamous head and neck cancer (HNSCC) despite relevant toxicity. A weekly administration of cisplatin and paclitaxel with continuous infusion of 5-FU could offer a better toxicity profile without affecting dose intensity or treatment outcome. We evaluated the toxicity and the activity of weekly cisplatin/paclitaxel with continuous infusion 5-FU in patients with recurrent and/or metastatic HNSCC. METHODS A total of 44 patients were studied. Treatment consisted of two 6-week cycles with weekly cisplatin 20 mg/m2 and paclitaxel 60 mg/m2 and daily continuous infusion 5-FU 200 mg/m2 from day 1 to 42. Patients were evaluated for toxicity and response. RESULTS 40 out of 44 patients were evaluable for response. After two cycles we observed seven complete responses (16%) and 12 partial responses (27%), with a 43% (95% CI 28-58%) overall response rate. Stable disease was seen in 13 patients (29%) and progressive disease in 12 patients (27%). Toxicity was mild in treated patients: we observed less than 10% of grade 3/4 hematological and gastroenteric toxicity. CONCLUSIONS A weekly schedule of cisplatin and paclitaxel associated with continuous infusion 5-FU showed low toxicity in the treatment of advanced HNSCC while significant activity was conserved.
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Affiliation(s)
- M Schena
- Department of Medical Oncology, Azienda Ospedaliera San Giovanni Battista, Via Cherasco 15, 10126, Turin, Italy.
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Gasco M, Sullivan A, Smith P, Farrell P, Numico G, Colantonio I, Merlano M, Crook T. Transcriptional silencing of Fanconi anaemia genes and clinical outcome in head and neck cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Gasco
- S. Croce General Hospital, Cuneo, Italy; Ludwig Institute for Cancer Research, London, United Kingdom
| | - A. Sullivan
- S. Croce General Hospital, Cuneo, Italy; Ludwig Institute for Cancer Research, London, United Kingdom
| | - P. Smith
- S. Croce General Hospital, Cuneo, Italy; Ludwig Institute for Cancer Research, London, United Kingdom
| | - P. Farrell
- S. Croce General Hospital, Cuneo, Italy; Ludwig Institute for Cancer Research, London, United Kingdom
| | - G. Numico
- S. Croce General Hospital, Cuneo, Italy; Ludwig Institute for Cancer Research, London, United Kingdom
| | - I. Colantonio
- S. Croce General Hospital, Cuneo, Italy; Ludwig Institute for Cancer Research, London, United Kingdom
| | - M. Merlano
- S. Croce General Hospital, Cuneo, Italy; Ludwig Institute for Cancer Research, London, United Kingdom
| | - T. Crook
- S. Croce General Hospital, Cuneo, Italy; Ludwig Institute for Cancer Research, London, United Kingdom
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Festa V, Greco R, Giugno G, Celoria P, Mormile C, Colantonio I, Di Ciero M. [Cystic lymphangioma. Review of the literature and cases contribution]. MINERVA CHIR 1987; 42:1419-25. [PMID: 3320812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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