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Leonetti A, Perrone F, Puntoni M, Maglietta G, Bordi P, Bria E, Vita E, Gelsomino F, De Giglio A, Gelibter A, Siringo M, Mazzoni F, Caliman E, Genova C, Bertolini F, Guaitoli G, Passiglia F, Delcuratolo MD, Montrone M, Cerea G, Pasello G, Roca E, Belluomini L, Cecere FL, Guida A, Manzo A, Adamo V, Rastelli F, Bulotta A, Citarella F, Toschi L, Zoratto F, Cortinovis DL, Berardi R, Follador A, Carta A, Camerini A, Salerno F, Silva RR, Baldini E, Cortellini A, Brighenti M, Santoni M, Malorgio F, Caminiti C, Tiseo M. Real-world outcomes of Italian patients with advanced non-squamous lung cancer treated with first-line pembrolizumab plus platinum-pemetrexed. Eur J Cancer 2024; 202:114006. [PMID: 38489861 DOI: 10.1016/j.ejca.2024.114006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE The aim of this multi-center, retrospective/prospective cohort observational study was to evaluate outcomes in routine clinical practice of first-line chemo-immunotherapy with cis/carboplatin, pemetrexed and pembrolizumab in patients with advanced non-squamous non-small cell lung cancer (NSCLC) in 33 Italian centers. METHODS The outcome measure was to evaluate overall survival (OS) in a real-world patient population. Secondary endpoints were: progression-free survival (PFS), objective response rate (ORR), duration of response (DoR) and incidence of treatment-related adverse events (AEs). RESULTS 1068 patients were enrolled at the time of data cut-off (January 31st, 2023), and 812 (76.0%) belonged to the retrospective cohort. Median age was 66 years (27-85), ECOG PS was ≥ 2 in 91 (8.6%) patients; 254 (23.8%) patients had brain metastases at baseline; 38 (3.6%) patients had tumor with PD-L1 expression ≥ 50%. After a median follow-up of 17.0 months (95% CI, 16.1-17.9), median OS was 16.1 months (95% CI, 14.4-18.8) and PFS was 9.9 months (95% CI, 8.8-11.2). Median DoR (n = 493) was 14.7 months (95% CI, 13.6-17.1). ORR was 43.4% (95% CI, 40.4-46.4). Any-grade AEs occurred in 636 (59.6%) patients and grade ≥ 3 in 253 (23.7%) patients. Most common grade ≥ 3 AEs were neutropenia (6.3%) and anemia (6.3%). CONCLUSIONS First-line chemo-immunotherapy was effective and tolerable in this large, real-world Italian study of patients with advanced non-squamous NSCLC. Our results were in line with the KEYNOTE-189 registration study, also considering the low number of PD-L1 ≥ 50% patients included in our study.
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Affiliation(s)
| | - Fabiana Perrone
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
| | - Matteo Puntoni
- Clinical & Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - Giuseppe Maglietta
- Clinical & Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - Paola Bordi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Emilio Bria
- UOSD Oncologia Toraco-Polmonare, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Medical Oncology, Department of Traslational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuele Vita
- UOSD Oncologia Toraco-Polmonare, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Medical Oncology, Department of Traslational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Gelsomino
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea De Giglio
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alain Gelibter
- Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Marco Siringo
- Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | | | - Enrico Caliman
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Carlo Genova
- Academic Oncology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - Federica Bertolini
- Division of Medical Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Giorgia Guaitoli
- Division of Medical Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Francesco Passiglia
- Department of Oncology, University of Turin, AOU San Luigi Gonzaga, Orbassano, Turin, Italy
| | | | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Giulio Cerea
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giulia Pasello
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Elisa Roca
- Thoracic Oncology - Lung Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Lorenzo Belluomini
- Medical Oncology, Department of Medicine, University of Verona Hospital Trust, Verona, Italy
| | | | - Annalisa Guida
- Department of Medical Oncology, St. Mary's Hospital, Terni, Italy
| | - Anna Manzo
- Thoracic Medical Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Vincenzo Adamo
- Medical Oncology Unit, Azienda Ospedaliera Papardo, Messina, Italy
| | - Francesca Rastelli
- Medical Oncology, AST (Azienda Sanitaria Territoriale) of Ascoli Piceno, Ascoli Piceno, Italy
| | - Alessandra Bulotta
- Department of Oncology, Istituto di Ricerca a Carattere Scientifico (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Fabrizio Citarella
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Luca Toschi
- IRCCS Humanitas Clinical and Research Center - Humanitas Cancer Center, Rozzano, Milan, Italy
| | | | - Diego Luigi Cortinovis
- SC Medical Oncology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy; Medicine and Surgery Department, University of Milano Bicocca, Milan, Italy
| | - Rossana Berardi
- Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Alessandro Follador
- Medical Oncology Unit San Daniele - Tolmezzo, ASUFC Azienda Sanitaria Universitaria Friuli Centrale, Italy
| | - Annamaria Carta
- Pathology and Oncology Unit, Businco Oncological Hospital, Cagliari, Italy
| | - Andrea Camerini
- Medical Oncology, Versilia Hospital, Azienda USL Toscana Nord Ovest, Lido di Camaiore, Italy
| | - Flavio Salerno
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Rosa Rita Silva
- Department of Oncology, ASUR Marche, Area Vasta 2, Fabriano, Italy
| | | | - Alessio Cortellini
- Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Roma, Italy; Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, UK
| | | | | | | | - Caterina Caminiti
- Clinical & Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - Marcello Tiseo
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
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Bonomi M, Spada D, Baiocchi GL, Celotti A, Brighenti M, Grizzi G. Targeting HER2 in Gastroesophageal Adenocarcinoma: Molecular Features and Updates in Clinical Practice. Int J Mol Sci 2024; 25:3876. [PMID: 38612688 PMCID: PMC11011631 DOI: 10.3390/ijms25073876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/23/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Gastroesophageal adenocarcinoma (GEA) is one of the principal causes of death related to cancer globally. Human epidermal growth factor receptor 2 (HER2) is a tyrosine kinase receptor which is found to be overexpressed or amplified in approximately 20% of GEA cases. In GEA, the identification of HER2-positive status is crucial to activate a specific anti-HER2 targeted therapy. The landmark ToGA trial demonstrated the superiority of adding trastuzumab to platinum-based chemotherapy, becoming the first-line standard of treatment. However, unlike breast cancer, the efficacy of other anti-HER2 drugs, such as lapatinib, pertuzumab, and T-DM1, has failed to improve outcomes in advanced and locally advanced resectable GEA. Recently, the combination of trastuzumab with pembrolizumab, along with chemotherapy, and the development of trastuzumab deruxtecan, with its specific bystander activity, demonstrated improved outcomes, renewing attention in the treatment of this disease. This review will summarise historical and emerging therapies for the treatment of HER2-positive GEA, with a section dedicated to the HER2 molecular pathway and the use of novel blood biomarkers, such as circulating tumour DNA and circulating tumour cells, which may be helpful in the future to guide treatment decisions.
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Affiliation(s)
- Maria Bonomi
- Oncology Unit, ASST Cremona, 26100 Cremona, Italy; (M.B.); (D.S.); (M.B.)
| | - Daniele Spada
- Oncology Unit, ASST Cremona, 26100 Cremona, Italy; (M.B.); (D.S.); (M.B.)
| | - Gian Luca Baiocchi
- Department of Surgery, ASST Cremona, 26100 Cremona, Italy; (G.L.B.); (A.C.)
| | - Andrea Celotti
- Department of Surgery, ASST Cremona, 26100 Cremona, Italy; (G.L.B.); (A.C.)
| | - Matteo Brighenti
- Oncology Unit, ASST Cremona, 26100 Cremona, Italy; (M.B.); (D.S.); (M.B.)
| | - Giulia Grizzi
- Oncology Unit, ASST Cremona, 26100 Cremona, Italy; (M.B.); (D.S.); (M.B.)
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Prelaj A, Ganzinelli M, Provenzano L, Mazzeo L, Viscardi G, Metro G, Galli G, Agustoni F, Corte CMD, Spagnoletti A, Giani C, Ferrara R, Proto C, Brambilla M, Dumitrascu AD, Inno A, Signorelli D, Pizzutilo EG, Brighenti M, Biello F, Bennati C, Toschi L, Russano M, Cortellini A, Catania C, Bertolini F, Berardi R, Cantini L, Pecci F, Macerelli M, Emili R, Bareggi C, Verderame F, Lugini A, Pisconti S, Buzzacchino F, Aieta M, Tartarone A, Spinelli G, Vita E, Grisanti S, Trovò F, Auletta P, Lorenzini D, Agnelli L, Sangaletti S, Mazzoni F, Calareso G, Ruggirello M, Greco GF, Vigorito R, Occhipinti M, Manglaviti S, Beninato T, Leporati R, Ambrosini P, Serino R, Silvestri C, Zito E, Pedrocchi ACL, Miskovic V, de Braud F, Pruneri G, Lo Russo G, Genova C, Vingiani A. APOLLO 11 Project, Consortium in Advanced Lung Cancer Patients Treated With Innovative Therapies: Integration of Real-World Data and Translational Research. Clin Lung Cancer 2024; 25:190-195. [PMID: 38262770 DOI: 10.1016/j.cllc.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Despite several therapeutic efforts, lung cancer remains a highly lethal disease. Novel therapeutic approaches encompass immune-checkpoint inhibitors, targeted therapeutics and antibody-drug conjugates, with different results. Several studies have been aimed at identifying biomarkers able to predict benefit from these therapies and create a prediction model of response, despite this there is a lack of information to help clinicians in the choice of therapy for lung cancer patients with advanced disease. This is primarily due to the complexity of lung cancer biology, where a single or few biomarkers are not sufficient to provide enough predictive capability to explain biologic differences; other reasons include the paucity of data collected by single studies performed in heterogeneous unmatched cohorts and the methodology of analysis. In fact, classical statistical methods are unable to analyze and integrate the magnitude of information from multiple biological and clinical sources (eg, genomics, transcriptomics, and radiomics). METHODS AND OBJECTIVES APOLLO11 is an Italian multicentre, observational study involving patients with a diagnosis of advanced lung cancer (NSCLC and SCLC) treated with innovative therapies. Retrospective and prospective collection of multiomic data, such as tissue- (eg, for genomic, transcriptomic analysis) and blood-based biologic material (eg, ctDNA, PBMC), in addition to clinical and radiological data (eg, for radiomic analysis) will be collected. The overall aim of the project is to build a consortium integrating different datasets and a virtual biobank from participating Italian lung cancer centers. To face with the large amount of data provided, AI and ML techniques will be applied will be applied to manage this large dataset in an effort to build an R-Model, integrating retrospective and prospective population-based data. The ultimate goal is to create a tool able to help physicians and patients to make treatment decisions. CONCLUSION APOLLO11 aims to propose a breakthrough approach in lung cancer research, replacing the old, monocentric viewpoint towards a multicomprehensive, multiomic, multicenter model. Multicenter cancer datasets incorporating common virtual biobank and new methodologic approaches including artificial intelligence, machine learning up to deep learning is the road to the future in oncology launched by this project.
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Affiliation(s)
- Arsela Prelaj
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy; Electronic, Information e Bio-engeenering, Politecnico di Milano, Milan, Italy
| | - Monica Ganzinelli
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Leonardo Provenzano
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy.
| | - Laura Mazzeo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Giuseppe Viscardi
- Oncology Department, Ospedale Monaldi, Azienda Ospedaliera Dei Colli, Napoli, Italy
| | - Giulio Metro
- Oncology Unit, Azienda Ospedaliera Santa Maria della Misercordia, Perugia, Italy
| | - Giulia Galli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Agustoni
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carminia Maria Della Corte
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Andrea Spagnoletti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Claudia Giani
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Roberto Ferrara
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Claudia Proto
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Marta Brambilla
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Andra Diana Dumitrascu
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Alessandro Inno
- Oncology Department, IRCCS Ospedale Sacro Cuore don Calabria, Verona, Italy
| | - Diego Signorelli
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | | | - Federica Biello
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Chiara Bennati
- Oncology Unit, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Luca Toschi
- Oncology Department, Istituto Clinico Humanitas IRCCS, Milan, Italy
| | - Marco Russano
- Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy; Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, United Kingdom
| | - Alessio Cortellini
- Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Chiara Catania
- Oncology Department, Humanitas Gavazzeni, Bergamo, Italy
| | | | - Rossana Berardi
- Clinica Oncologica, Università Politecnica delle Marche, AOU delle Marche, Ancona, Italy
| | - Luca Cantini
- Clinica Oncologica, Università Politecnica delle Marche, AOU delle Marche, Ancona, Italy
| | - Federica Pecci
- Clinica Oncologica, Università Politecnica delle Marche, AOU delle Marche, Ancona, Italy
| | - Marianna Macerelli
- Medical Oncology Unit, Azienda Ospedaliero-Universitaria Santa Maria Della Misericordia, Udine, Italy
| | - Rita Emili
- Oncology Unit, Ospedale Santa Maria della Misericordia, Urbino, Italy
| | - Claudia Bareggi
- Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Antonio Lugini
- Oncology Unit, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | | | | | - Michele Aieta
- Oncology Unit, IRCCS CROB, Rionero in Vulture, Italy
| | | | | | - Emanuele Vita
- Oncology Department, Policlinico Universitario Fondazione "A.Gemelli" IRCCS, Rome, Italy
| | - Salvatore Grisanti
- Medical Oncology Unit, ASST Spedali Civili di Breascia, University of Brescia, Brescia, Italy
| | - Francesco Trovò
- Electronic, Information e Bio-engeenering, Politecnico di Milano, Milan, Italy
| | - Pietro Auletta
- IPOP onlus - Associazione Insieme per i Pazienti di Oncologia Polmonare, Milan, Italy
| | - Daniele Lorenzini
- Pathology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Luca Agnelli
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Sabina Sangaletti
- Sperimental Oncology and Molecular Medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | | | - Giuseppina Calareso
- Radiology Department, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Margherita Ruggirello
- Radiology Department, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | | | - Raffaella Vigorito
- Radiology Department, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Mario Occhipinti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Sara Manglaviti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Teresa Beninato
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Rita Leporati
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Paolo Ambrosini
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Roberta Serino
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Cecilia Silvestri
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Emanuela Zito
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | | | - Vanja Miskovic
- Electronic, Information e Bio-engeenering, Politecnico di Milano, Milan, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Giancarlo Pruneri
- Pathology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Giuseppe Lo Russo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Carlo Genova
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Andrea Vingiani
- Pathology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
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Ramella S, Morabito A, Silipigni S, Russo A, Capelletto E, Rossi S, Leonetti A, Montrone M, Facilissimo I, Romano G, Stasi I, Ceresoli G, Gridelli C, Lugini A, Pilotto S, Tagliaferri P, Bria E, Canova S, Rijavec E, Borghetti P, Brighenti M, Carta A, Ciuffreda L, Giusti R, Macerelli M, Verderame F, Zanelli F, Berardi R, Gregorc V, Sergi C, Vattemi E, Manglaviti S, Piovano P, Olmetto E, Borra G, Gori S, Aieta M, Bertolini A, Cecere F, Pasello G, Rocco D, Zulian M, Roncari B, Novello S. EP06.01-006 Multidisciplinary Team during the COVID-19 Pandemic: The BE-PACIFIC Italian Observational Study Analysis. J Thorac Oncol 2022. [PMCID: PMC9452007 DOI: 10.1016/j.jtho.2022.07.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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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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Andrini E, Lamberti G, Mazzoni F, Riccardi F, Bonetti A, Follador A, Artioli F, Genova C, Barbieri F, Frassoldati A, Brighenti M, Colantonio I, Pasello G, Ficorella C, Cinieri S, Tiseo M, Gelsomino F, Tognetto M, Rihawi K, Ardizzoni A. A phase II, open-label, single-arm trial of carboplatin plus etoposide with bevacizumab and atezolizumab in patients with extended-stage small-cell lung cancer (CeLEBrATE study): background, design and rationale. Future Oncol 2022; 18:771-779. [PMID: 35068173 DOI: 10.2217/fon-2021-1027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Based on improved survival from the addition of PD-L1 inhibitors in phase III trials, the combination of immunotherapy and platinum-doublet chemotherapy has become the new standard treatment for extended-stage small-cell lung cancer (ES-SCLC). Furthermore, the antiangiogenetic agent bevacizumab showed a longer progression-free survival by targeting VEGF that has pleiotropic effects, including immunosuppressive ones. We, therefore, hypothesized that targeting angiogenesis would improve the efficacy of chemoimmunotherapy. The CeLEBrATE trial is an open-label, multicenter, phase II study designed to assess the efficacy and safety of the combination of carboplatin and etoposide plus bevacizumab and atezolizumab in treatment-naive patients with ES-SCLC. The primary end point is overall survival rate at 1 year, while secondary end points include overall response rate, progression-free survival and toxicity.
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Affiliation(s)
- Elisa Andrini
- Department of Experimental, Diagnostic & Specialty Medicine (DIMES), University of Bologna, Bologna 40138, Italy
| | - Giuseppe Lamberti
- Department of Experimental, Diagnostic & Specialty Medicine (DIMES), University of Bologna, Bologna 40138, Italy
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Francesca Mazzoni
- Medical Oncology Unit, University Hospital Careggi, Firenze 50134, Italy
| | | | - Andrea Bonetti
- Department of Oncology, Mater Salutis Hospital, Legnago 37045, Italy
| | - Alessandro Follador
- Department of Oncology, University Hospital Santa Maria Della Misericordia, Udine 33100, Italy
| | - Fabrizio Artioli
- Oncology & Palliative Care Units, Civil Hospital Carpi, USL, Carpi 41012, Italy
| | - Carlo Genova
- Academic Oncology Unit, IRCCS Ospedale Policlinico San Martino, Genoa 16132, Italy
- Department of Internal Medicine & Medical Specialties (DiMI), Università degli Studi di Genova, Genoa 16132, Italy
| | - Fausto Barbieri
- Division of Medical Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena 41125, Italy
| | - Antonio Frassoldati
- Department of Oncology, Azienda Ospedaliero Universitaria di Ferrara-Arcispedale Sant'Anna, Ferrara 44124, Italy
| | | | - Ida Colantonio
- Medical Oncology Unit, Hospital of Cuneo, Cuneo 12100, Italy
| | - Giulia Pasello
- Department of Surgery, Oncology & Gastroenterology, University of Padova, Padova 35122, Italy
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova 35122, Italy
| | - Corrado Ficorella
- Department of Biotechnological & Applied Clinical Sciences, St Salvatore Hospital, University of L'Aquila, L'Aquila 67100, Italy
| | - Saverio Cinieri
- Department of Oncology, Medical Oncology & Breast Unit, Antonio Perrino Hospital, Brindisi 72100, Italy
| | - Marcello Tiseo
- Department of Medicine & Surgery, University of Parma & Medical Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma 43126, Italy
| | - Francesco Gelsomino
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Michele Tognetto
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Karim Rihawi
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Andrea Ardizzoni
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
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7
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Ratti M, Procopio G, Guadalupi V, Grizzi G, Bonomi M, Saleri J, Gobbi A, Marchi R, Pogliacomi G, Donati G, Nazzari M, Bacciocchini N, Brighenti M, Perrucci B, Giganti M, Panni S, Donini M, Curti A, Gregorc V, Passalacqua R. 1610P Delivery of ONCOlogic care at HOME: Ready for “ONCOHOME”. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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8
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Passalacqua R, Ratti M, Pan A, Testa S, Molteni A, Tonoli S, Faliva A, Mainardi E, Saleri J, Gobbi A, Nanni N, Bacciocchini N, Donati G, Marchi R, Cattaneo M, Gnocchi N, Grizzi G, Brighenti M, Maglietta G, Caminiti C. 1646TiP Efficacy of SARS-CoV-2 vaccination in cancer patients during treatment: A prospective observational study (ANTICOV trial). Ann Oncol 2021. [PMCID: PMC8454316 DOI: 10.1016/j.annonc.2021.08.1639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Brighenti M, Govindasamy-Lucey S, Jaeggi JJ, Johnson ME, Lucey JA. Effect of substituting whey cream for sweet cream on the textural and rheological properties of cream cheese. J Dairy Sci 2021; 104:10500-10512. [PMID: 34334199 DOI: 10.3168/jds.2021-20338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/20/2021] [Accepted: 06/07/2021] [Indexed: 11/19/2022]
Abstract
In the manufacture of cream cheese, sweet cream and milk are blended to prepare the cream cheese mix, although other ingredients such as condensed skim milk and skim milk powder may also be included. Whey cream (WC) is an underutilized fat source, which has smaller fat droplets and slightly different chemical composition than sweet cream. This study investigated the rheological and textural properties of cream cheeses manufactured by substituting sweet cream with various levels of WC. Three different cream cheese mixes were prepared: control mix (CC; 0% WC), cream cheese mixes containing 25% WC (25WC; i.e., 75% sweet cream), and cream cheese mixes with 75% WC (75WC; i.e., 25% sweet cream). The CC, 25WC, and 75WC mixes were then used to manufacture cream cheeses. We also studied the effect of WC on the initial step in cream cheese manufacture (i.e., the acid gelation process monitored using dynamic small amplitude rheology). Acid gels were also prepared with added denatured whey proteins or membrane proteins/phospholipids (PL) to evaluate how these components affected gel properties. The rheological, textural, and sensory properties of cream cheeses were also measured. The WC samples had significantly higher levels of PL and insoluble protein compared with sweet cream. An increase in the level of WC reduced the rate of acid gel development, similar to the effect of whey phospholipid concentrate added to mixes. In cream cheese, an increase in the level of added WC resulted in significantly lower storage modulus values at temperatures <20°C. Texture results, obtained from instrumental and sensory analyses, showed that high level of WC resulted in significantly lower firmness or hardness values and higher stickiness compared with cream cheeses made with 25WC or CC cream cheeses. The softer, less elastic gels or cheeses resulting from the use of high levels of WC are likely due to the presence of components such as PL and proteins from the native milk fat globule membrane. The use of low levels of WC in cream cheese did not alter the texture, whereas high levels of WC could be used if manufacturers want to produce more spreadable products.
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Affiliation(s)
- M Brighenti
- Department of Food Science, University of Wisconsin, Madison 53706
| | - S Govindasamy-Lucey
- Wisconsin Center for Dairy Research, University of Wisconsin, Madison 53706.
| | - J J Jaeggi
- Wisconsin Center for Dairy Research, University of Wisconsin, Madison 53706
| | - M E Johnson
- Wisconsin Center for Dairy Research, University of Wisconsin, Madison 53706
| | - J A Lucey
- Department of Food Science, University of Wisconsin, Madison 53706; Wisconsin Center for Dairy Research, University of Wisconsin, Madison 53706
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10
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Laganà M, Gurizzan C, Roca E, Cortinovis D, Signorelli D, Pagani F, Bettini A, Bonomi L, Rinaldi S, Berardi R, Filetti M, Giusti R, Pilotto S, Milella M, Intagliata S, Baggi A, Cortellini A, Soto Parra H, Brighenti M, Petrelli F, Bennati C, Bidoli P, Garassino MC, Berruti A. High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone Metastases. Front Oncol 2020; 10:588862. [PMID: 33282740 PMCID: PMC7689017 DOI: 10.3389/fonc.2020.588862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives The prevalence of Skeletal Related Adverse Events (SREs) in EGFR mutated non-small cell lung cancer (NSCLC) patients with bone metastases, treated with modern tyrosine kinase inhibitors (TKIs), has been scarcely investigated. Materials and Methods We retrospectively evaluated the data of EGFR mutated NSCLC patients with bone metastases treated with TKIs in 12 Italian centers from 2014 to 2019, with the primary aim to explore type and frequency of SREs. Results Seventy-seven out of 274 patients enrolled (28%) developed at least one major SRE: 55/274 (20%) bone fractures, 30/274 (11%) spinal cord compression, 5/274 (2%) hypercalcemia. Median time to the onset of SRE was 3.63 months. Nine patients (3%) underwent bone surgery and 150 (55%) radiation therapy on bone. SREs were more frequently observed within the 12 months from TKI start than afterwards (71 vs 29%, p 0.000). Patient Performance Status and liver metastases where independently associated with the risk of developing SREs. Median TKI exposure and overall survival were 11 and 28 months, respectively. Bone resorption inhibitors were associated with a lower risk of death (HR 0.722, 95% CI: 0.504–1.033, p = 0.075) although not statistically significant at multivariate analysis. Conclusion Bone metastatic NSCLC patients with EGFR mutated disease, treated with EGFR TKIs, have a relatively long survival expectancy and are at high risk to develop SREs. The early SRE occurrence after the TKI start provides the rationale to administer bone resorption inhibitors.
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Affiliation(s)
- Marta Laganà
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - Cristina Gurizzan
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - Elisa Roca
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | | | - Diego Signorelli
- Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Filippo Pagani
- Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Anna Bettini
- Medical Oncology, ASST Papa Giovanni XXIII di Bergamo, Bergamo, Italy
| | - Lucia Bonomi
- Medical Oncology, ASST Papa Giovanni XXIII di Bergamo, Bergamo, Italy
| | - Silvia Rinaldi
- Medical Oncology, Ospedali Riuniti di Ancona, Ancona, Italy
| | | | - Marco Filetti
- Medical Oncology, Azienda Ospedaliero Universitaria S. Andrea di Roma, Roma, Italy
| | - Raffaele Giusti
- Medical Oncology, Azienda Ospedaliero Universitaria S. Andrea di Roma, Roma, Italy
| | - Sara Pilotto
- Medical Oncology, Università degli studi di Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Michele Milella
- Medical Oncology, Università degli studi di Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Salvatore Intagliata
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - Alice Baggi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | | | - Hector Soto Parra
- Medical Oncology, Policlinico Vittorio Emanuele di Catania, Catania, Italy
| | | | | | - Chiara Bennati
- Ospedale Santa Maria delle Croci di Ravenna, Ravenna, Italy
| | - Paolo Bidoli
- Medical Oncology, Ospedale S. Gerardo di Monza, Monza, Italy
| | | | - Alfredo Berruti
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
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11
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Cortellini A, Dingemans AMC, Arrieta O, Baena J, Brighenti M, Felip E, Garassino MC, Garrido P, Genova C, Grosso F, Horn L, Huang LC, Van Meerbeeck J, Peters S, Nadal E, Rogado J, Shyr Y, Tiseo M, Torri V, Trama A, Wakelee H, Whisenant JG, Viscardi G, Barlesi F, Popat S. Abstract S12-03: Thoracic cancers international COVID-19 collaboration (TERAVOLT): Small-cell lung cancer and other rare thoracic malignancies. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.covid-19-s12-03] [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: At the last update of the TERAVOLT registry, patients with thoracic malignancies and COVID-19 showed a high mortality rate (35.5% overall and 31% due to COVID-19) compared to the general population and to other solid tumors. Major determinants of mortality were age, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), and previous administration of chemotherapy. No cancer-specific data are available with respect to small-cell lung cancer (SCLC) and other rare thoracic malignancies.
Methods: TERAVOLT is an international, multicenter observational registry launched to collect data on patients with thoracic malignancies diagnosed with COVID-19 infection. Risk factors for hospitalization and mortality were identified by Wilcoxon rank sum tests (continuous variables) or χ2 tests (categorical variables). Here we present the subgroup analyses of SCLC and other rare thoracic malignancies, including malignant pleural mesothelioma (MPM), thymic carcinoma/thymoma, and carcinoid/neuroendocrine lung tumors.
Results: As of June 4th, 2020, a total of 581 patients with COVID-19 and thoracic cancers have been entered; among them, 66 (11%) were SCLC, 22 (4%) were MPM, 18 (3%) were thymic carcinoma/thymoma, 12 (2%) were carcinoid/neuroendocrine lung tumors, and 442 (76%) NSCLC; 21 were an unknown type. Among SCLC patients, 54% were > 65 years old, 56% were males, 98% were current/former smokers, 31% had an ECOG-PS ≥ 2, 67% had stage IV disease, 82% were on current oncologic treatment at the COVID-19 diagnosis, and 58% were receiving chemotherapy alone or in combination with immune checkpoint inhibitors. Among other non-NSCLC patients, 56% were > 65 years old, 56% were males, 69% were current/former smokers, 24% had an ECOG-PS ≥ 2, 50% had stage IV disease, 52% were on current oncologic treatment at the COVID-19 diagnosis, and 37% were receiving chemotherapy alone or in combination with immune checkpoint inhibitors. Overall, 79.7% of the patients required hospitalization, 15.4% were admitted to an ICU, and 39.8% died (36.2% due to COVID-19). Among SCLC patients, 74.2% required hospitalization, 14.3% were admitted to an ICU, and 42.2% died (37.5% due to COVID-19). Among SCLC patients, age > 65 years old (p=0.81), gender (p=0.71), smoking status (p=1.0), ECOG-PS ≥ 2(p=0.17), disease stage of IV (p=0.37), and having received chemotherapy alone or with checkpoint inhibitors (p=0.84) were not associated with mortality.
Conclusions: This analysis confirmed that patients with thoracic malignancies have a high mortality and risk for hospitalization due to COVID-19 overall. SCLC patients showed the highest mortality rate among thoracic cancer patients.
Citation Format: Alessio Cortellini, Anne-Marie C. Dingemans, Oscar Arrieta, Javier Baena, Matteo Brighenti, Enriqueta Felip, Marina Chiara Garassino, Pilar Garrido, Carlo Genova, Federica Grosso, Leora Horn, Li-Ching Huang, Jan Van Meerbeeck, Solange Peters, Ernest Nadal, Jacobo Rogado, Yu Shyr, Marcello Tiseo, Valter Torri, Annalisa Trama, Heather Wakelee, Jennifer G Whisenant, Giuseppe Viscardi, Fabrice Barlesi, Sanjay Popat. Thoracic cancers international COVID-19 collaboration (TERAVOLT): Small-cell lung cancer and other rare thoracic malignancies [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S12-03.
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Affiliation(s)
- Alessio Cortellini
- 1Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, L'Aquila, AQ, Italy,
| | - Anne-Marie C. Dingemans
- 2Erasmus University Medical Center, Rotterdam, University Maastricht, Maastricht, Rotterdam, The Netherlands,
| | - Oscar Arrieta
- 3Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico,
| | - Javier Baena
- 4Hospital Universitario 12 de Octubre, Madrid, Spain,
| | | | - Enriqueta Felip
- 6Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain,
| | | | - Pilar Garrido
- 8Medical Oncology Department, Hospital Universitario Ramón y Cajal, IRYCIS and CIBERONC, Madrid, Spain,
| | - Carlo Genova
- 9IRCCS Ospedale Policlinico San Martino, Genova, Italy,
| | - Federica Grosso
- 10Azienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy,
| | - Leora Horn
- 11Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN,
| | - Li-Ching Huang
- 12Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN,
| | | | - Solange Peters
- 14Oncology Department, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland,
| | - Ernest Nadal
- 15Thoracic Oncology Unit, Department of Medical Oncology, Catalan Institute of Oncology, Hospitalet, Barcelona, Spain,
| | - Jacobo Rogado
- 16Medical Oncology Department, Hospital Universitario Infanta Leonor, Madrid, Spain,
| | - Yu Shyr
- 11Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN,
| | - Marcello Tiseo
- 17Medical Oncology Unit, University Hospital of Parma, Department of Medicine and Surgery, University of Parma, Parma, Italy,
| | - Valter Torri
- 18Laboratory of Clinical Research Methodology, Oncology Department, "Mario Negri" Institute of Pharmacological Researches-IRCCS, Milan, Italy,
| | - Annalisa Trama
- 7Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy,
| | - Heather Wakelee
- 19Stanford Cancer Institute, Stanford University, Stanford, CA,
| | | | | | - Fabrice Barlesi
- 20Gustave Roussy Institute, Villejuif, Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France,
| | - Sanjay Popat
- 21Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
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12
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Bonomi M, Maltese M, Brighenti M, Muri M, Passalacqua R. Tocilizumab for COVID-19 Pneumonia in a Patient With Non-Small-cell Lung Cancer Treated With Chemoimmunotherapy. Clin Lung Cancer 2020; 22:e67-e69. [PMID: 32952047 PMCID: PMC7448773 DOI: 10.1016/j.cllc.2020.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/28/2020] [Accepted: 08/18/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Maria Bonomi
- Department of Oncology, ASST Cremona, Cremona, Italy.
| | - Mariangela Maltese
- Department of Oncology, ASST Cremona, Cremona, Italy; Department of Oncology, Azienda Ospedaliera Papardo, Messina, Italy
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13
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Brighenti M, Govindasamy-Lucey S, Jaeggi J, Johnson M, Lucey J. Behavior of stabilizers in acidified solutions and their effect on the textural, rheological, and sensory properties of cream cheese. J Dairy Sci 2020; 103:2065-2076. [DOI: 10.3168/jds.2019-17487] [Citation(s) in RCA: 7] [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] [Received: 08/22/2019] [Accepted: 11/19/2019] [Indexed: 11/19/2022]
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14
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Petrelli F, Signorelli D, Ghidini M, Ghidini A, Pizzutilo EG, Ruggieri L, Cabiddu M, Borgonovo K, Dognini G, Brighenti M, De Toma A, Rijavec E, Garassino MC, Grossi F, Tomasello G. Association of Steroids use with Survival in Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis. Cancers (Basel) 2020; 12:cancers12030546. [PMID: 32120803 PMCID: PMC7139305 DOI: 10.3390/cancers12030546] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 12/21/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) can elicit toxicities by inhibiting negative regulators of adaptive immunity. Sometimes, management of toxicities may require systemic glucocorticoids. We performed a systematic review and meta-analysis of published studies to evaluate the correlation between steroids use, overall survival (OS), and progression-free survival (PFS) in cancer patients treated with ICIs. Publications that compared steroids with non-steroid users in cancer patients treated with ICIs from inception to June 2019 were identified by searching the EMBASE, PubMed, SCOPUS, Web of Science, and Cochrane Library databases. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Patients (studies, n = 16; patients, n = 4045) taking steroids were at increased risk of death and progression compared to those not taking steroids (HR = 1.54, 95% CI: 1.24-1.91; p = 0.01 and HR = 1.34, 95% CI: 1.02-1.76; p = 0.03, respectively). The main negative effect on OS was associated with patients taking steroids for supportive care (HR = 2.5, 95% CI 1.41-4.43; p < 0.01) or brain metastases (HR = 1.51, 95% CI 1.22-1.87; p < 0.01). In contrast, steroids used to mitigate adverse events did not negatively affect OS. In conclusion, caution is needed when steroids are used for symptom control. In these patients, a negative impact of steroid use was observed for both OS and PFS.
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Affiliation(s)
- Fausto Petrelli
- Medical Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy; (M.C.); (K.B.)
- Correspondence: ; Tel.: +39-036-3424-420; Fax: +39-036-3424-380
| | - Diego Signorelli
- Thoracic Oncology, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (D.S.); (A.D.T.); (M.C.G.)
| | - Michele Ghidini
- Medical Oncology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy; (M.G.); (E.R.); (F.G.)
| | - Antonio Ghidini
- Medical Oncology Unit, Casa di Cura Igea, 20126 Milano, Italy;
| | - Elio Gregory Pizzutilo
- Medical Oncology Unit, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (E.G.P.); (L.R.); (G.T.)
| | - Lorenzo Ruggieri
- Medical Oncology Unit, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (E.G.P.); (L.R.); (G.T.)
| | - Mary Cabiddu
- Medical Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy; (M.C.); (K.B.)
| | - Karen Borgonovo
- Medical Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy; (M.C.); (K.B.)
| | | | | | - Alessandro De Toma
- Thoracic Oncology, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (D.S.); (A.D.T.); (M.C.G.)
| | - Erika Rijavec
- Medical Oncology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy; (M.G.); (E.R.); (F.G.)
| | - Marina Chiara Garassino
- Thoracic Oncology, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (D.S.); (A.D.T.); (M.C.G.)
| | - Francesco Grossi
- Medical Oncology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy; (M.G.); (E.R.); (F.G.)
| | - Gianluca Tomasello
- Medical Oncology Unit, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (E.G.P.); (L.R.); (G.T.)
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15
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Donini M, Brighenti M, Giganti MO, Panni S, Perrucci B, Pizzo C, Gerevini F, Foramitti M, Marchi G, Potenzoni M, Prati A, Quarta M, Benecchi L, del Boca C, Passalacqua R. Two sequential dose-dense regimens of CGP, followed by MVAC in patients with metastatic urothelial carcinoma (mUC): A single institution, explorative trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e16023] [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
e16023 Background: Currently, cisplatin, gemcitabine, paclitaxel (CGP) and MVAC are the most active chemotherapy regimens in mUC. We tested the hypothesis that two sequential non-cross-resistant, dose-dense (DD) regimens may target different cancer cells, avoid drug resistance, and improve response rate. Methods: This is a single institution, explorative trial. The aim is to evaluate the incremental benefit of the two regimens in terms of complete response and long term survival. We treat all consecutive, chemo-naïve mUC patients with 4 cycles of CGP dose-dense every 14 days followed by 4 cycles of MVAC every 14 days. In all cycles we used Pegfilgrastim 6 mg on day 3. Pts were evaluated with CT scan at the baseline, after 4 cycles, at the end of chemotherapy and then every 3 months for 2 years and 6 months thereafter. Results: From 2007 to 2018, 67 consecutive pts were included. Male were 82%; median age 66 years (33-83); Bajorin risk factors was 0 in 31%, 1 in 52%, 2 in 16%. The majority of pts were hospitalized for three days during chemotherapy and received hydration and supportive therapy. After the first 4 cycles of CGP, we observed 7% CR, 46% PR, 31% SD, and 12% PD. After the 4 sequential cycles of MVAC DD we observed a global 25% of CR, 33% PR, 10% SD, and 24% PD. Median TTP was 8.2 months (95% CI, 7.3-10.1) and median OS was 18 months (95% CI, 10.8-26.1). 5 pts are still alive after more than 30 months and maintaining complete response. Main grade 3–4 toxicity included anemia 27%, asthenia 23%, neutropenia 19% (febrile 7%), thrombocytopenia 13%. Conclusions: The sequential use of these two DD regimens is active and leads to an increased number of complete response and possible longer survival. A randomized trial is needed to confirm our results.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Andrea Prati
- Urology Division, Ospedale Vaio Fidenza, Parma, Italy
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16
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Grizzi G, Petrelli F, Ghidini M, Ghidini A, Ratti M, Panni S, Cabiddu M, Ghilardi M, Borgonovo K, Parati MC, Barni S, Tomasello G, Passalacqua R, Berruti A, Brighenti M. Immune-related adverse events (irAEs) and survival in solid tumors treated with immune checkpoint inhibitors (ICIs): A systematic review and meta-analysis. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14130] [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
e14130 Background: irAEs are autoimmune-toxic effects associated with ICIs used for treatment of advanced solid tumors. The correlation of these irAEs with survival is presently unknown. The objective of this meta-analysis is to assess the outcome of cancer patients treated with ICIs who develop irAEs. Methods: Two independent reviewers selected prospective or retrospective studies from PubMed, EMBASE, and the Cochrane library database from their inception to November 2018. Studies were selected if: 1) they reported correlation of irAEs (any) with outcome, 2) they included patients with solid tumors; 3) they included treatment with anti-PD-(L)1 or anti-CTLA-4 agents, 4) patients had no previous history of autoimmune disorders, 5) they were published in English language, and 6) they provided availability of adequate data to calculate hazard ratios (HRs) or odds ratios (ORs) and 95% confidence intervals (CIs). Data were pooled using HRs for overall survival (OS) or progression-free survival (PFS) or ORs for overall response rate (ORR) of irAEs vs no irAEs according to fixed or random effect model. HRs for OS (the primary outcome measure) were pooled to provide an aggregate value. Hazard ratio for PFS and ORs for ORR were secondary endpoints. Results: A total of 29 studies for a total of 4242 patients treated with ICIs were selected. Patients who developed irAEs presented a reduced risk of death (HR = 0.52, p < .001). Similarly, the occurrence of irAEs was associated with a reduced risk of progression (HR = 0.51, p < .001). The combined odds of response was 4.87 (p < .001). Conclusions: In patients treated with ICIs, irAEs predict survival and response. Although this correlation cannot be fully explained, it may be related to the strongest T cell activation. Patients showing any form of irAEs can be informed about the positive prognostic effect, and physicians can detect patients with favorable outcome to ICIs.
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Affiliation(s)
- Giulia Grizzi
- Oncology Unit, Oncology Department, ASST of Cremona, Cremona, Italy
| | | | - Michele Ghidini
- Oncology Unit, Oncology Department, ASST of Cremona, Cremona, Italy
| | | | - Margherita Ratti
- Oncology Unit, Oncology Department, ASST of Cremona, Cremona, Italy
| | | | | | | | | | | | | | | | | | - Alfredo Berruti
- Medical Oncology, University of Brescia, Spedali Civili Hospital, Brescia, Italy
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Brighenti M, Govindasamy-Lucey S, Jaeggi JJ, Johnson ME, Lucey JA. Effects of processing conditions on the texture and rheological properties of model acid gels and cream cheese. J Dairy Sci 2018; 101:6762-6775. [PMID: 29753471 DOI: 10.3168/jds.2018-14391] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/27/2018] [Indexed: 11/19/2022]
Abstract
Manufacture of cream cheese involves the formation of an initial acid-induced gel made from high-fat milk, followed by a series of processing steps including shearing, heating, and dewatering that complete the conversion of the acid gel into a complex cheese product. We investigated 2 critical parameters for their effect on the initial gel: homogenization pressure (HP) of the high-fat cheese milk, and fermentation temperature (FT). The impact of a low (10 MPa) and high (25 MPa) HP, and low (20°C) and high (26°C) FT were investigated for their effects on rheological and textural properties of acid-induced gels. Intact acid gels were sheared and heated to 80°C, and then their rheological properties were analyzed to help understand the effect of shearing/heating processes on the gel characteristics. The effect of HP on fat globule size distribution and the amount of protein not involved in emulsion droplets (i.e., in the bulk phase) were also studied. For cream cheese trials, a central composite experimental design was used to explore the effect of these 2 parameters (HP and FT) on the texture, rheology, and sensory properties of experimentally manufactured cream cheese. Storage modulus (G') and hardness values of cream cheeses were obtained from small amplitude oscillatory rheology tests and texture profile analysis, respectively. Quantitative spectrum descriptive sensory analysis was also performed. Consistency of acid gels (measured using a penetration test) increased with an increase in FT and with an increase in HP. Although stiffer acid-induced gels were formed at high FT, after the heating and shearing processes the apparent viscosity of the samples formed at high FT was lower than those formed at low FT. For the cream cheeses, significant prediction models were obtained for several rheological and textural attributes. The G' values at 8°C, instrumental hardness, and sensory firmness attributes were significantly correlated (r > 0.84); all these attributes significantly decreased with an increase in FT, and HP was not a significant parameter in the prediction models developed for these attributes. Significant interactions were observed between the HP and FT terms for these prediction models. Higher HP increased the amount of protein adsorbed at interface of fat globules but decreased bulk phase protein content (which may be important for crosslinking this gelled emulsion system). At higher FT temperature, coarser gel networks were likely formed. The combined effect of a coarser acid gel network at high FT, and less bulk phase casein available for crosslinking the acidified emulsion gel with an increase in HP, could have contributed to the lower stiffness/firmness observed in cream cheese made under conditions of both high FT and high HP. Stickiness of cream cheese greatly increased under conditions of high FT and high HP, whereas the sensory attributes cohesiveness of mass and difficulty to dissolve decreased. This study helped to better understand the complex relationships between the initial acid-induced gel phase and properties of the (final) cream cheese.
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Affiliation(s)
| | | | - J J Jaeggi
- Center for Dairy Research, University of Wisconsin, Madison 53706
| | - M E Johnson
- Center for Dairy Research, University of Wisconsin, Madison 53706
| | - J A Lucey
- Department of Food Science, Madison 53706; Center for Dairy Research, University of Wisconsin, Madison 53706
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Grigiante M, Brighenti M. An improved predictive model to determine the thermal degradation of lignocellulosic materials at low temperature (Torrefaction) ranges. Bioresour Technol 2018; 256:431-437. [PMID: 29477081 DOI: 10.1016/j.biortech.2018.01.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/14/2018] [Accepted: 01/15/2018] [Indexed: 06/08/2023]
Abstract
This study introduces an improved computational procedure to determine the thermal degradation of biomasses when submitted to a torrefaction process. The novelty consists in integrating a summative kinetic model approach with an enhanced finite difference scheme. This is achieved by defining timing updated parameters to account for both the extent of conversion and the evolution of the fibers composition. As main result, the proposed method enhances the exploitation of the summative assumption considering that the predictive accuracy of the model sets within 5% as maximum error. Furthermore, the adopted discrete approach contributes to generalize the TGA set up going beyond the conventional heating programs usually limited to isothermal and constant heating rate constrains. Due to these constitutive improvements, the proposed computational approach looks promising for investigations involving both kinetic analysis and thermal processes design including torrefaction.
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Affiliation(s)
- M Grigiante
- University of Trento, Department of Civil, Environmental and Mechanical Engineering, Via Mesiano 77 38123, Trento, Italy.
| | - M Brighenti
- University of Trento, Department of Civil, Environmental and Mechanical Engineering, Via Mesiano 77 38123, Trento, Italy
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Brighenti M, Tiseo M. Is there still room for anti-angiogenic agents in small cell lung cancer? Transl Cancer Res 2018. [DOI: 10.21037/tcr.2018.03.23] [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: 11/06/2022]
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20
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Petrelli F, Maltese M, Tomasello G, Conti B, Borgonovo K, Cabiddu M, Ghilardi M, Ghidini M, Passalacqua R, Barni S, Brighenti M. Clinical and Molecular Predictors of PD-L1 Expression in Non-Small-Cell Lung Cancer: Systematic Review and Meta-analysis. Clin Lung Cancer 2018. [PMID: 29530732 DOI: 10.1016/j.cllc.2018.02.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Clinicopathologic and molecular characteristics of non-small-cell lung cancers (NSCLCs) associated with a strong expression of programmed death ligand 1 (PD-L1+ in > 5% of cells) have not been well elucidated. Expression of PD-L1 is a poor prognostic factor, but NSCLCs with higher levels of PD-L1 have greater benefit when treated with immunotherapy. We have performed a systematic review to synthesize the available evidence regarding clinicopathologic and molecular variables associated with PD-L1 expression in NSCLC. PubMed, EMBASE, SCOPUS, Web of Science and Cochrane Library databases were searched for relevant articles assessing predictors of PD-L1 expression in > 5% cells. Data were reported as odds ratio (OR) of events. Fifty-two studies (for a total of 5066 PD-L1+ out of 13,279 NSCLC patients) were included in this meta-analysis. Factors associated with PD-L1 expression were: smoking status (OR 5.48; 95% confidence interval (CI) 2.8-10.4; P < .001), male gender (OR 4.8; 95% CI 3.2-7.2; P < .001), adenocarcinoma histology (OR 2.75; 95% CI, 1.5-4.8; P < .001), Epidermal growth factor receptor (EGFR) wild type (OR 4.83; 95% CI, 2.1-11.1; P < .001), ALK mutation negative (OR 388.6; 95% CI, 222.5-678.7; P < .001), ROS mutation negative (OR 1904.8; 95% CI, 630-5757; P < .001), and KRAS wild type (OR 19.8; 95% CI, 7.6-51.6; P < .001). Conversely higher pT stages (OR 0.16; 95% CI, 0.04-0.7; P = .01), pN+ stages (OR 0.29; 95% CI, 0.17-0.5; P < .001) are inversely associated with PD-L1 expression in > 5% cells. Expression of PD-L1 is more common in male smokers, with adenocarcinoma histology and not carriers of EGFR/ALK/ROS/KRAS mutations. These data could be useful to screening of PD-L1 expression and to select patients for immunotherapy.
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Affiliation(s)
- Fausto Petrelli
- Department of Oncology, Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy.
| | - Mariangela Maltese
- Department of Oncology, Oncology Unit, ASST Ospedale di Cremona, Cremona, Italy
| | - Gianluca Tomasello
- Department of Oncology, Oncology Unit, ASST Ospedale di Cremona, Cremona, Italy
| | - Barbara Conti
- Department of Surgery, Surgical Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - Karen Borgonovo
- Department of Oncology, Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - Mary Cabiddu
- Department of Oncology, Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - Mara Ghilardi
- Department of Oncology, Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - Michele Ghidini
- Department of Oncology, Oncology Unit, ASST Ospedale di Cremona, Cremona, Italy
| | - Rodolfo Passalacqua
- Department of Oncology, Oncology Unit, ASST Ospedale di Cremona, Cremona, Italy
| | - Sandro Barni
- Department of Oncology, Oncology Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - Matteo Brighenti
- Department of Oncology, Oncology Unit, ASST Ospedale di Cremona, Cremona, Italy
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Chiesa MD, Buti S, Tomasello G, Negri F, Buononato M, Brunelli A, Lazzarelli S, Brighenti M, Donati G, Passalacqua R. A Pilot Phase ii Study of Chemotherapy with Oxaliplatin, Folinic acid, 5-Fluorouracil and Irinotecan in Metastatic Gastric Cancer. Tumori 2018; 93:244-7. [PMID: 17679458 DOI: 10.1177/030089160709300303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 11/15/2022]
Abstract
Aims and background Previous phase II studies have reported that combinations of oxaliplatin, folinic acid and 5-fluorouracil or irinotecan, folinic acid and 5-fluorouracil are associated with good efficacy and an acceptable safety profile in metastatic gastric cancer. The aim of this study was to evaluate chemotherapy with oxaliplatin, folinic acid, 5-fluorouracil and irinotecan (COFFI regimen) in metastatic gastric cancer. Methods Patients received oxaliplatin (85 mg/m2 d 1), irinotecan (140 mg/m2 d 1), and L-folinic acid (200 mg/m2 d 1) followed by 5-fluorouracil bolus (400 mg/m2 d 1) and then 5-fluorouracil (2,400 mg/m2 48-h continuous infusion), every 14 days. Results Seventeen patients with metastatic gastric cancer were enrolled. Eight patients were pretreated for advanced disease. Of the 9 chemo-naïve patients, 8 were evaluated for response (1 patient was lost to follow-up): one complete response, 5 partial responses and 2 progressions of disease occurred, giving an overall response rate, at intention-to-treat analysis, of 67%. Of the 8 pretreated patients, 6 were evaluated for response (2 patients had nonmeasurable disease): one partial response, 2 disease stabilizations and 3 progressions of disease occurred, giving an overall response rate, at intention-to-treat analysis, of 12%. Median progression-free and overall survival in chemo-naïve patients were 8.2 and 10.2 months, respectively, and in pretreated patients 2.7 and 3 months. Grade 3-4 neutropenia occurred in 55% of chemo-naïve patients. Thrombocytopenia, and anemia were observed in 18% and 29%, respectively. Grade 3 nausea/vomiting occurred in 12% and grade 3 diarrhea in 6%. Conclusions The COFFI regimen is active and well tolerated, therefore phase III studies are warranted.
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Affiliation(s)
- Matteo Dalla Chiesa
- Medical Oncology, 2Surgery Division, Azienda Istituti Ospitalieri di Cremona, Cremona, Italy.
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Tomasello G, Chiesa MD, Buti S, Brighenti M, Negri F, Rovere RK, Martinotti M, Buononato M, Brunelli A, Lazzarelli S, Donati G, Passalacqua R. Dose-dense Chemotherapy in Metastatic Gastric Cancer with a Modified Docetaxel-Cisplatin-5-Fluorouracil Regimen. Tumori 2018; 96:48-53. [DOI: 10.1177/030089161009600108] [Citation(s) in RCA: 7] [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: 11/17/2022]
Abstract
Aims and background Previous studies have reported that in early breast cancer, lymphomas and advanced bladder cancer, dose-dense chemotherapy may be more effective than conventional treatments. In metastatic gastric cancer, chemotherapy with docetaxel, cisplatin and 5-fluorouracil (TCF) q3w is very active, and, even though there is no international consensus on the subject, it is the regimen of choice of many European centers as first-line chemotherapy in this subset of patients. Based on these studies, we tested for the first time the feasibility and activity of an intensified dose-dense TCF regimen (q2w) modifying the 5-fluorouracil infusion with l-folinic acid/5-fluorouracil according to the “De Gramont regimen”. Methods and study design Patients with histologically confirmed measurable metastatic gastric cancer, ECOG performance status ≤1, and not previously treated for advanced disease received docetaxel, 85 mg/m2 (75 mg/m2 after the first 6 patients, 70 mg/m2 after the 19th patient) on day 1, cisplatin, 75 mg/m2 on day 1 (60 mg/m2 after the 19th patient), l-folinic acid, 100 mg/m2 on days 1 and 2, followed by 5-fluorouracil, 400 mg/m2 bolus on days 1 and 2 and then 600 mg/m2 as a 22-h continuous infusion on days 1 and 2, every 14 days, plus pegfilgrastim, 6 mg on day 3. Patients aged ≥65 years received the same schedule with a dose reduction of 30%. Results Thirty-two consecutive patients were enrolled (63% male, 37% female); median age, 64 years (range, 40–81). A median of 4 cycles (range, 1–7) per patient was administered. Eleven of 32 patients (34%) required a dose reduction, mostly for hematological grade III-IV toxicity and severe asthenia. Twelve patients (38%) completed the first 4 cycles of therapy within 7 weeks, thereby finishing without delay the initially planned dose-density schedule. Twenty-eight patients were evaluated for response (1 early suspension after the first cycle because of toxicity, 3 deaths before response evaluation due to progression of disease). There were 3 complete responses (9%), 15 partial responses (47%), 7 stable disease (22%) and 3 progression of disease (9%), for an overall response rate, by intention to treat, of 56% (95% CI, 39–73). The most frequent grade 3–4 toxicities were: neutropenia (53%), thrombocytopenia (34%), anemia (16%) febrile neutropenia (22%), asthenia (38%) and diarrhea (19%). Median time to progression was 9.1 months (95% CI, 6.0–12.2); median overall survival was 10.1 months (95% CI, 8.8–12.2). Conclusions A dose-dense TCF regimen in metastatic gastric cancer is feasible, with activity comparable to previous results achieved with epirubicin-based chemotherapy and TCF q3wk in terms of overall survival and time to progression, and deserves to be further tested in randomized phase III studies.
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Affiliation(s)
- Gianluca Tomasello
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Matteo Dalla Chiesa
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Sebastiano Buti
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Matteo Brighenti
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Federica Negri
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Rodrigo Kraft Rovere
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Mario Martinotti
- Surgery Division, Azienda Istituti
Ospitalieri di Cremona, Cremona, Italy
| | - Massimo Buononato
- Surgery Division, Azienda Istituti
Ospitalieri di Cremona, Cremona, Italy
| | - Antonio Brunelli
- Surgery Division, Azienda Istituti
Ospitalieri di Cremona, Cremona, Italy
| | - Silvia Lazzarelli
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Gianvito Donati
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Rodolfo Passalacqua
- Medical Oncology Division, Azienda
Istituti Ospitalieri di Cremona, Cremona, Italy
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Migliorino M, Gelibter A, Grossi F, Fagnani D, Bordi P, Franchina T, Turci D, Di Lauro L, Cascinu S, Calabro L, Brighenti M, Tedde N, Bearz A, Giusti S, Vasile E, Surico G, Cartenì G, Marchetti P, Verderame F, Melotti B. Use of nivolumab in elderly patients with advanced non-squamous NSCLC: Results from the Italian expanded access program (EAP). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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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Brighenti M, Petrelli F, Barni S, Conti B, Sarti E, Ratti M, Panni S, Passalacqua R, Bersanelli M. Radical treatment of oligometastatic non-small cell lung cancer: Ready for prime time? Eur J Cancer 2017; 79:149-151. [DOI: 10.1016/j.ejca.2017.04.008] [Citation(s) in RCA: 5] [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] [Received: 02/10/2017] [Revised: 03/18/2017] [Accepted: 04/07/2017] [Indexed: 01/11/2023]
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Maltese M, Panni S, Lazzarelli S, Brighenti M, Negri F, Ratti M, Giganti MO, Passalacqua R. High baseline lymphocyte count is a predictive biomarker of prolonged time to progression in patients with advanced solid tumors receiving checkpoint inhibitors. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e14532] [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
e14532 Background: Biomarkers predicting response to checkpoint inhibitor are needed to better select patients most likely to benefit from treatment. We observed that baseline absolute lymphocyte count (ALC) can predict durable responses to anti-PD-1 antibodies in various malignancies. Methods: This is a retrospective analysis of patients with advanced solid tumors treated with anti-PD-1 antibodies. Pembrolizumab was given at 2 mg/kg every 3 weeks, Nivolumab at 3 mg/kg every 2 weeks. Peripheral ALC and absolute neutrophil count (ANC) from routine safety labs were collected at baseline, cycle 4 and cycle 8. Evaluation of response was based on irRECIST. Neutrophil lymphocyte ratio [NLR = ANC/ALC] was stratified by ≤4 or > 4. The lymphocyte count cutoff was 1000/mm3. Time to progression (TTP) and overall survival (OS) were estimated with the Kaplan-Meier method. Differences between groups were estimated with the log rank test. Results: We have retrospectively evaluated 40 patients with unresectable stage III/IV Non Small Cell Lung Cancer (squamous n. 17; 42.5%, adenocarcinoma n. 7; 17.5%), Malignant Melanoma (n.11; 27.5%), Renal Cell Carcinoma (n.5; 12.5%) treated with anti-PD-1 antibodies. 6 pts (15%) received treatment as 1st line, 14 pts (35%) as 2nd line, 20 pts (15%) as ≥ 3rd line. We observed a 29% partial response (PR), 31% stable disease (SD) and 40% progressive disease (PD). The overall response rate (ORR) was 29% [I.C. 95% 13-42]. Median TTP was 5.5 months [IC 95% 3.3-NR]. Median OS was not reached. Pts with baseline ALC ≥1000/mm3 had significantly longer TTP (median value not reached), compared with those who had ALC < 1000/mm3 (median TTP 2.8 months), p = 0.01. There was also a trend for longer TTP in patients with NLR < 4 vs ≥4 (4.9 vs 10.5 months, p 0.44). Conclusions: In our observation baseline ALC ≥1000/mm3 is a predictive biomarker of prolonged TTP in patients treated with anti-PD-1 antibodies. The potential predictive value of this test should be prospectively validated.
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Tiseo M, Boni L, Ambrosio F, Camerini A, Baldini E, Cinieri S, Brighenti M, Zanelli F, Defraia E, Chiari R, Dazzi C, Tibaldi C, Turolla GM, D'Alessandro V, Zilembo N, Trolese AR, Grossi F, Riccardi F, Ardizzoni A. Italian, Multicenter, Phase III, Randomized Study of Cisplatin Plus Etoposide With or Without Bevacizumab as First-Line Treatment in Extensive-Disease Small-Cell Lung Cancer: The GOIRC-AIFA FARM6PMFJM Trial. J Clin Oncol 2017; 35:1281-1287. [PMID: 28135143 DOI: 10.1200/jco.2016.69.4844] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Considering promising results in phase II studies, a randomized phase III trial was designed to assess the efficacy of adding bevacizumab to first-line cisplatin plus etoposide for treatment of extensive-disease (ED) small-cell lung cancer (SCLC). Patients and Methods Treatment-naive patients with ED-SCLC were randomly assigned to receive either cisplatin plus etoposide (arm A) or the same regimen with bevacizumab (arm B) for a maximum of six courses. In the absence of progression, patients in arm B continued bevacizumab alone until disease progression or for a maximum of 18 courses. The primary end point was overall survival (OS). Results Two hundred four patients were randomly assigned and considered in intent-to-treat analyses (103 patients in arm A and 101 patients in arm B). At a median follow-up of 34.9 months in arm A and arm B, median OS times were 8.9 and 9.8 months, and 1-year survival rates were 25% and 37% (hazard ratio, 0.78; 95% CI, 0.58 to 1.06; P = .113), respectively. A statistically significant effect of bevacizumab on OS in patients who received maintenance was seen (hazard ratio, 0.60; 95% CI, 0.40 to 0.91; P = .011). Median progression-free survival times were 5.7 and 6.7 months in arm A and arm B, respectively ( P = .030). Regarding hematologic toxicity, no statistically significant differences were observed; for nonhematologic toxicity, only hypertension was more frequent in arm B (grade 3 or 4, 1.0% v 6.3% in arms A v B, respectively; P = .057). Conclusion The addition of bevacizumab to cisplatin and etoposide in the first-line treatment of ED-SCLC had an acceptable toxicity profile and led to a statistically significant improvement in progression-free survival, which, however, did not translate into a statistically significant increase in OS. Further research with novel antiangiogenic agents, particularly in the maintenance setting, is warranted.
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Affiliation(s)
- Marcello Tiseo
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Luca Boni
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Francesca Ambrosio
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Andrea Camerini
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Editta Baldini
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Saverio Cinieri
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Matteo Brighenti
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Francesca Zanelli
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Efisio Defraia
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Rita Chiari
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Claudio Dazzi
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Carmelo Tibaldi
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Gianni Michele Turolla
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Vito D'Alessandro
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Nicoletta Zilembo
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Anna Rita Trolese
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Francesco Grossi
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Ferdinando Riccardi
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
| | - Andrea Ardizzoni
- Marcello Tiseo, Azienda Ospedaliero-Universitaria, Parma; Luca Boni, Clinical Trials Coordinating Center, Istituto Toscano Tumori, Azienda Ospedaliero-Universitaria Careggi, Firenze; Francesca Ambrosio and Ferdinando Riccardi, Azienda Ospedaliera di Rilievo Nazionale Cardarelli, Napoli; Andrea Camerini, Ospedale della Versilia, Lido di Camaiore; Editta Baldini and Carmelo Tibaldi, Ospedale San Luca, Lucca; Saverio Cinieri, Ospedale Perrino, Brindisi; Matteo Brighenti, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona; Francesca Zanelli, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Santa Maria Nuova, Reggio Emilia; Efisio Defraia, Ospedale Businco, Cagliari; Rita Chiari, Azienda Ospedaliero-Universitaria, Perugia; Claudio Dazzi, Ospedale Santa Maria delle Croci, Ravenna; Gianni Michele Turolla, Ospedale Civile Umberto I, Lugo di Romagna; Vito D'Alessandro, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Nicoletta Zilembo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; Anna Rita Trolese, Ospedale Mater Salutis di Legnago, Legnago; Francesco Grossi, Azienda Ospedaliera Universitaria San Martino IST-Istituto Nazionale per la Ricerca sul Cancro, Genova; and Andrea Ardizzoni, Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna, Italy
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Tiseo M, Boni L, Ambrosio F, Camerini A, Baldini E, Cinieri S, Zanelli F, Defraia E, Brighenti M, Crinò L, Dazzi C, Tibaldi C, Turolla G, D'Alessandro V, Zilembo N, Trolese A, Grossi F, Riccardi F, Ardizzoni A. Italian multicenter phase III randomized study of cisplatin-etoposide with or without bevacizumab as first-line treatment in extensive stage small cell lung cancer (SCLC): GOIRC-AIFA FARM6PMFJM trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw331.03] [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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Toppo L, Tomasello G, Liguigli W, Lazzarelli S, Tanzi G, Ghidini M, Perrucci B, Brighenti M, Ratti M, Panni S, Giganti MO, Donini M, Rovatti M, Maglietta G, Ranieri V, Grassia R, Iiritano E, Iezzi ELISA, Caminiti C, Passalacqua R. Modified dose-dense taxotere cisplatin fluorouracil regimen (mTCF-dd) in a large cohort of patients (pts) with metastatic or locally advanced non-squamous gastroesophageal cancer (GEC). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e15552] [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)
- Laura Toppo
- SC Oncologia, Ospedale di Cremona, Cremona, Italy
| | | | | | | | - Giulia Tanzi
- SC Anatomia Patologica, Ospedale di Cremona, Cremona, Italy
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Tiseo M, Boni L, Ambrosio F, Camerini A, Baldini E, Cinieri S, Zanelli F, Defraia E, Brighenti M, Crino L, Dazzi C, Tibaldi C, Turolla GM, D'Alessandro V, Zilembo N, Trolese AR, Grossi F, Riccardi F, Ardizzoni A. Italian multicenter phase III randomized study of cisplatin-etoposide with or without bevacizumab as first-line treatment in extensive stage small cell lung cancer (SCLC): GOIRC-AIFA FARM6PMFJM trial. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.8513] [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)
- Marcello Tiseo
- Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Luca Boni
- Clinical Trial Coordinating Center, AOU Careggi, Istituto Toscano Tumori, Firenze, Italy
| | | | | | | | | | - Francesca Zanelli
- Department of Oncology and Advanced Technologies, Operative Unit of Oncology, Azienda S. Maria Nuova / IRCCS, Modena, Italy
| | | | | | - Lucio Crino
- Clinical Oncology, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Claudio Dazzi
- Medical Oncology Unit, S.Maria delle Croci Hospital, Ravenna, Italy
| | - Carmelo Tibaldi
- Istituto Toscano Tumori, Department of Medical Oncology, Civil Hospital of Livorno, Livorno, Italy
| | - Gianni Michele Turolla
- Oncologia Medica, Ospedale Civile Umberto I, Lugo di Romagna, Italy, Lugo Di Romagna, Italy
| | - Vito D'Alessandro
- IRCCS Ospedale Casa Sollievo della Sofferenza , San Giovanni Rotondo, Italy
| | | | - Anna Rita Trolese
- Department of Oncology, Mater Salutis Hospital-AULSS 21 della Regione Veneto, Legnago, Italy
| | - Francesco Grossi
- Lung Cancer Unit, IRCCS AOU San Martino - IST - Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
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Morabito A, Brandes A, Sibau A, Ciuffreda L, Favaretto A, Cappuzzo F, Santoro A, Vasile E, Brighenti M, Ferraù F, Giordano P, Tiseo M, Soria J, Felip E, Lu S, Goss G, Gadgeel S, Georgoulias V, Chand V, Ardizzoni A. Afatinib vs erlotinib as second-line therapy of patients with advanced SCC of the lung following platinum-based chemotherapy: OS analysis from the global phase III trial LUX-Lung 8 (LL8). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv343.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
MicroRNAs (miRNAs) are a class of small non-protein coding RNAs that modulate important cellular functions via their post-transcriptional regulation of messenger RNAs (mRNAs). Recent evidences from multiple tumor types and model systems implicate miRNA dysregulation as a common mechanism of tumorigenesis, cancer progression and resistance to therapy. Several miRNAs are dysregulated in cancers and a single miRNA can have multiple targets involved in different oncogenic pathways. MET, the tyrosine kinase receptor for hepatocyte growth factor (HGF), has a central role in lung cancer development and in acquired resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors; it has been predicted and shown to be the target gene of multiple miRNAs, which play a crucial role in controlling its activity in a stimulatory or inhibitory sense. In this review we will focus on the most important and recent studies about the role of miRNAs in the control of MET expression, reporting also the progress made using miRNAs for therapy of lung cancer.
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Passalacqua R, Giganti MO, Brighenti M, Perrucci B, Donini M, Negri F, Tomasello G, Toppo L, Liguigli W, Poli R, Ratti M, Benecchi L, Prati A, Arnaudi R, Potenzoni M, Panni S, Lazzarelli S. Optimizing chemotherapy in patients with metastatic transitional-cell carcinoma: High rate of complete response with two sequential dose-dense regimens of cisplatin, gemcitabine, paclitaxel, followed by MVAC. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.7_suppl.303] [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
303 Background: Currently, cisplatin, gemcitabine, paclitaxel (CGP) and MVAC are the most active regimens in transitional-cell carcinoma (TCC). We tested the hypothesis that two sequential non-cross-resistant, dose-dense (DD) regimens may target different cancer cells, avoid drug resistance, and improve response rate. Methods: This is a phase II, single institutional trial, including patients (pts) with bladder, renal pelvis, or ureteral TCC. Primary end point was the rate of complete response (CR) after two sequential DD regimens. Primary analysis was carried out in the intention to treat (ITT) population.Patients with histological diagnosis of TCC, PS 0–2 (ECOG), adequate organ function and no previous systemic regimens were treated with 4 cycles of CGP DD followed by 4 cycles of M-VAC DD. All received peg-filgrastim after chemotherapy. Pts were evaluated with CT scan at the baseline, after 4 cycles, at the end of chemotherapy and then every 3 months for 2 years and 6 months thereafter. Results: 44 consecutive pts followed in the same oncology institution were included. Males were 73%; median age was 66 years; median PS ECOG was 1; Bajorin risk factors was 0 in 36%, 1 in 48%, 2 in 16%. After the first 4 cycles of CGP DD, we observed 6.8% CR, 43.2% PR, 38.6% SD, and 11.4% PD. After the 4 sequential cycles of M-VAC DD, we observed a global 27.3% of CR, 15.9% of PR, 18.2% of SD, and 13.6% of PD. Median TTP was 9.66 months (95% CI, 6.7-13) and median OS was 18.6 months (95% CI, 12-30). Main grade 3–4 toxicity included asthenia (26%), anemia (26%), neutropenia (9.5%), febrile (7%), thrombocytopenia (12%), and neurological toxicity (5%). No toxic deaths were seen. After a median follow up of 50 months, 4 of 12 patients who obtained a complete response are free of disease since more than 3 years. Conclusions: This sequential use of these two DD regimens leads to a 4-fold increase in CR, an increase in survival, and a possible cure for some patients. A phase III trial is warranted.
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Affiliation(s)
| | | | | | | | | | | | | | - Laura Toppo
- Istituti Ospitalieri di Cremona, Cremona, Italy
| | | | | | | | | | - Andrea Prati
- Urology Division, Ospedale Vaio Fidenza, Parma, Italy
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Tomasello G, Liguigli W, Poli R, Lazzarelli S, Brighenti M, Negri F, Curti A, Martinotti M, Olivetti L, Rovatti M, Donati G, Passalacqua R. Efficacy and tolerability of chemotherapy with modified dose-dense TCF regimen (TCF-dd) in locally advanced or metastatic gastric cancer: final results of a phase II trial. Gastric Cancer 2014; 17:711-7. [PMID: 24282019 DOI: 10.1007/s10120-013-0317-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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] [Received: 05/22/2013] [Accepted: 11/10/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND We previously studied a dose-dense TCF (TCF-dd) regimen demonstrating its feasibility and an activity comparable to epirubicin-based chemotherapy and TCF q3w in terms of overall survival and time to progression (TTP). We report here the final results of a phase II study of chemotherapy with a modified TCF-dd regimen in locally advanced or metastatic gastric cancer (MGC). METHODS AND STUDY DESIGN Patients with histologically confirmed measurable MGC, not previously treated for advanced disease, received docetaxel 70 mg/m(2) day 1, cisplatin 60 mg/m(2) day 1, l-folinic acid 100 mg/m(2) days 1 and 2, followed by 5-fluorouracil (5-FU) 400 mg/m(2) bolus days 1 and 2, and then 600 mg/m(2) as a 22-h continuous infusion days 1 and 2, every 14 days, plus pegfilgrastim 6 mg on day 3. Patients aged ≥65 years received the same schedule with a dose reduction of 30 %. RESULTS Study duration: December 2007-November 2010. Forty-six consecutive patients were enrolled (78 % male, 22 % female; median age, 66 years, range, 38-76 years; ECOG PS: 0, 48 %, 1, 46 %). Primary endpoint was overall response rate (ORR). A median of four cycles (range, one to six) was administered. Forty-three patients were evaluated for response (93.5 %) and all for toxicity: 3 complete response (CR), 25 partial response (PR), 10 stable disease (SD), and 5 progressive disease (PD) were observed, for an ORR by intention to treat (ITT) of 61 % (95 % CI 47-75). Median overall survival (OS) was 17.63 months (95 % CI, 13.67-20.67); median progression-free survival was 8.9 months (95 % CI, 6.5-13.4). Twenty-one patients (46.0 %) were treated at full doses without any delay, thus respecting the dose-dense criterion. Most frequent grade 3-4 toxicities were neutropenia (20 %), leukopenia (4 %), thrombocytopenia (2 %), anemia (2 %), febrile neutropenia (6 %), asthenia (22 %), diarrhea (4 %), nausea/vomiting (11 %), and hypokalemia (6 %). Overall, TCF-dd was shown to be safe. CONCLUSIONS The TCF-dd regimen in locally advanced or MGC is confirmed to be feasible and very active and needs to be further tested in randomized studies.
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Affiliation(s)
- Gianluca Tomasello
- Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Viale Concordia 1, 26100, Cremona, Italy,
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Bersanelli M, Buti S, Camisa R, Brighenti M, Lazzarelli S, Mazza G, Passalacqua R. Gefitinib plus interleukin-2 in advanced non-small cell lung cancer patients previously treated with chemotherapy. Cancers (Basel) 2014; 6:2035-48. [PMID: 25271833 PMCID: PMC4276955 DOI: 10.3390/cancers6042035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 08/21/2014] [Accepted: 09/15/2014] [Indexed: 01/05/2023] Open
Abstract
The activation of lymphocytes by gefitinib treatment has been described. In this phase II pilot trial, we explored the possible synergism between IL-2 and gefitinib for non-small cell lung cancer (NSCLC) treatment. From September, 2003, to November, 2006, 70 consecutive patients with advanced, progressive NSCLC, previously treated with chemotherapy, received oral gefitinib 250 mg daily. The first 39 patients received gefitinib alone (G group). The other 31 also received subcutaneous IL-2 (GIL-2 group): 1 MIU/m2 (Million International Unit/m2)twice a day on Days 1 and 2, once a day on Days 3, 4, 5 every week for four consecutive weeks with a four-week rest period. Median follow-up was 25.2 months. Grade 3–4 toxicity of gefitinib was represented by skin rash (7%), asthenia/anorexia (6%) and diarrhea (7%); patients treated with IL-2 showed grade 2–3 fever (46%), fatigue (21%) and arthralgia (13%). In the GIL-2 group and G-group, we respectively observed: an overall response rate of 16.1% (6.4% complete response) and 5.1% (only partial response); a disease control rate of 41.9% and 41%; a median time to progression of 3.5 (CI 95% = 3.2–3.8) and 4.1 (CI 95% = 2.6–5.7) months; a median overall survival of 20.1 (CI 95% = 5.1–35.1) and 6.9 (CI 95% = 4.9–8.9) months (p = 0.002); and an actuarial one-year survival rate of 54% and 30%. Skin toxicity (p < 0.001; HR = 0.29; CI 95% = 0.16–0.54) and use of IL-2 (p < 0.001; HR = 0.33; CI 95% = 0.18–0.60) were independently associated with improvement of survival. In this consecutive, non-randomized, series of advanced NSCLC patients, the use of IL-2 increased the efficacy of gefitinib.
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Affiliation(s)
- Melissa Bersanelli
- Oncology Unit, University Hospital of Parma, Via Gramsci, 14, 43126 Parma, Italy.
| | - Sebastiano Buti
- Oncology Unit, University Hospital of Parma, Via Gramsci, 14, 43126 Parma, Italy.
| | - Roberta Camisa
- Oncology Unit, University Hospital of Parma, Via Gramsci, 14, 43126 Parma, Italy.
| | - Matteo Brighenti
- Oncology Unit, Azienda Istituti Ospitalieri di Cremona, Largo Priori, 1, 26100 Cremona, Italy.
| | - Silvia Lazzarelli
- Oncology Unit, Azienda Istituti Ospitalieri di Cremona, Largo Priori, 1, 26100 Cremona, Italy.
| | - Giancarlo Mazza
- Radiology Division, Spedali Civili di Brescia, P.le Spedali Civili,1, 25123 Brescia, Italy.
| | - Rodolfo Passalacqua
- Oncology Unit, Azienda Istituti Ospitalieri di Cremona, Largo Priori, 1, 26100 Cremona, Italy.
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Bronzetti G, Patrizi A, Giacomini F, Savoia F, Raone B, Brighenti M, Bonvicini M, Neri I, Gargiulo GD. A PHACES syndrome unmasked by propranolol interruption in a tetralogy of Fallot patient: case report and extensive review on new indications of beta blockers. Curr Med Chem 2014; 21:3153-64. [PMID: 24606509 DOI: 10.2174/0929867321666140304094345] [Citation(s) in RCA: 2] [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] [Received: 05/19/2013] [Revised: 06/16/2013] [Accepted: 12/15/2013] [Indexed: 11/22/2022]
Abstract
Infantile hemangiomas (IHs) are the most common benign tumors of infancy and usually they don't require specific therapy. In 10-20% of cases IHs are able to generate complication and medical/surgical intervention is needed. For many decades standard treatment consisted in oral or intralesional corticosteroids until Leaute-Labreze and colleagues published the first report on the efficacy of propranolol for cutaneous infantile hemangiomas in 2008. IHs can be sometimes part of complex syndrome. Here we report the case of a patient with tetralogy of Fallot operated at 5 month of age who stopped propranolol treatment for hypoxic spells and unusually developed facial and subglottic IHs configuring the diagnosis of PHACES syndrome (posterior fossa brain malformations, hemangioma, arterial anomalies, cardiac defects and/or aortic coarctation, ocular anomalies and sternal defects). To our knowledge this is the first report in the international literature of a delayed appearance of an infantile hemangioma involving the skin and the airways (PHACES syndrome). The pathophysiological explanation relies on the mechanism of action of propranolol which seems to act initially with vasoconstriction, down-regulating proangiogenetic factors and inducing endothelial cell apoptosis. Many decades since their introduction β-blockers are useful in a growing group of diseases. The pleiotropic effect of β-adrenoceptors antagonists is not yet deeply understood, residing in neurohormonal regulation systems and angiogenesis and proving to be an effective treatment from cardiovascular to oncological illnesses.
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Affiliation(s)
| | | | | | | | | | | | | | | | - G D Gargiulo
- Clinica Dermatologica, via Massarenti 1, 40138, Bologna, Italy.
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Passalacqua R, Buti S, Tomasello G, Longarini R, Brighenti M, Dalla Chiesa M. Immunotherapy options in metastatic renal cell cancer: where we are and where we are going. Expert Rev Anticancer Ther 2014; 6:1459-72. [PMID: 17069530 DOI: 10.1586/14737140.6.10.1459] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The treatment of renal cell carcinoma is rapidly changing as a result of recent evidence concerning the efficacy of biological drugs, antiangiogenetic agents and signal-transduction inhibitors. This paper will provide a critical overview of the use of immunotherapy in renal cell carcinoma and review the available data concerning the efficacy of interferons, interleukin-2 and other forms of immunological treatment, particularly allogenic transplantation and vaccines. Moreover, it will focus on the new mechanisms of regulation of the immune system with a better understanding of the interaction between host and tumor, the role of T regulatory cells, heat-shock proteins and vaccines. The mechanism of action and the results obtained in renal cell carcinoma using the new molecular targeted drugs will be examined, along with the possibility of using immunotherapy combined with the new biological agents. Future research will not only need to make every effort to optimize the use of the new molecules and to define their efficacy precisely, but also to consider how to integrate these drugs with the traditional immunotherapy.
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Affiliation(s)
- Rodolfo Passalacqua
- Istituti Ospitalieri, Department of Internal Medicine, Medical Oncology Division, Viale Concordia 1, 26100, Cremona, Italy.
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Brighenti M, Panni S, Perrucci B, Maltese M, Liguigli W, Tomasello G, Poli R, Negri F, Ratti M, Donini M, Toppo L, del Boca C, Benecchi L, Prati A, Martens D, Potenzoni M, Passalacqua R. Rate of durable complete remission (CR) using two sequential, dose-dense regimens of cisplatin, gemcitabine, paclitaxel (CGP) followed by m-VAC in patients with metastatic urothelial cancer (mUC). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e15502] [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
e15502 Background: mUC is a chemotherapy sensitive tumor. Currently, CGP and MVAC are the most active regimens in this setting. According to Norton and Simon hypothesis, the administration of two sequential non cross-resistant, dose-dense chemotherapy regimens may target different cancer cells, avoid drug resistance, improve response rate and CR. Methods: Patients with histological diagnosis of mUC, PS 0–2 (ECOG), adequate organ function and no previous systemic regimens were treated with 4 cycles of CGP dose-dense (Gemcitabine 1000 mg/m2 d 1, Paclitaxel 140 mg/m2 d 1, Cisplatin 70 mg/m2 d 2 plus PegFilgrastim 6 mg on day 3, every 2 weeks) followed by 4 cycles of M-VAC (Methotrexate 30 mg/m2 d 1,Vinblastine 3 mg/m2 d 2, Doxorubicin 30 mg/m2 d 2, Cisplatin 70 mg/m2 d 2 plus Pegfilgrastim 6 mg on day 3 every 2 weeks). All were evaluated with CT scan at the baseline, after 4 cycles, at the end of chemotherapy and then every 3 months for two years and 6 months thereafter. Metastatic sites included retroperitoneal nodes, lung, liver and bone. Results: From January 2007, 35 consecutive pts followed in the same oncology institution were included. Male were 74%; median age 65 years; median PS ECOG was 1; Bajorin risk factors was 0 in 37%, 1 in 43%, 2 in 20%. All pts were hospitalized for three days and received chemotherapy with hydration and supportive therapy. After the first 4 cycles of CGP we observed 14.3% CR, 48.6% PR, 22.9% SD and 14.3% PD. After the 4 sequential cycles of M-VAC we observed a global 37.1% of CR, 25.7% of PR, 8.6% of SD and 28.6% of PD. Median TTP was 9.9 months ( 95 % CI, 7.53-14.83) and median OS was 24.27 months ( 95 % CI, 10.03-38.43). Main grade 3–4 toxicity included asthenia ( 27%), anemia (21%), neutropenia (12 %), febrile (9%), thrombocytopenia (9%) and peripheral neuropathy (6 %). After a median follow up of 33 months, 6 of 13 patients who obtained a complete response are free of disease. Conclusions: These data confirm that the sequential use of this two dose-dense regimens is very active and 17 % of patients maintained a CR status.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Laura Toppo
- Istituti Ospitalieri di Cremona, Cremona, Italy
| | | | | | - Andrea Prati
- Urology division, Ospedale Vaio Fidenza, Parma, Italy
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Tomasello G, Liguigli W, Poli R, Ratti M, Toppo L, Brighenti M, Maltese M, Perrucci B, Panni S, Negri F, Lazzarelli S, Colombi C, Curti A, Donini M, Martinotti M, Rovatti M, Passalacqua R. Final analysis of efficacy and safety of dose-dense chemotherapy with modified TCF regimen (TCF-dd) in elderly patients (pts) with metastatic gastric cancer (MGC). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e15086] [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
e15086 Background: Gastric cancer is more common in elderly pts with its highest incidence around the seventh decade of life. Most oncologists are reluctant to treat this population with the most active polichemotherapy combinations because of safety concerns. Subgroup analyses of elderly pts enrolled in European studies show limited and conflicting data.We previously reported on the feasibility and high activity of a dose-dense TCF regimen (Tomasello 2010). This is a retrospective analysis of efficacy and safety of this schema in the elderly pts subgroup (≥ 65 years). Methods: From Nov 2004 to Jan 2013, 119 consecutivepts with MGC, PS 0-2, not previously treated, received Docetaxel 70 mg/m2 d1, Cisplatin 60 mg/m2 d1, l-Folinic Acid 100 mg/m2 d1-2, followed by 5-FU 400 mg/m2 bolus d1-2, and then 600 mg/m222 h c.i. d1-2, every 2 weeks, plus Pegfilgrastim 6 mg on day 3. Pts aged ≥ 65 years (60) received the same schedule with doses reducted by 30%. Results: Overall pts characteristics: 76% male, 24% female; median age: 65, range 31-81. A median of 4 cycles was administered. 102 pts were evaluable for response (86%) and all for toxicity. In pts aged ≥ 65 y, we observed 5 CR (8%), 26 PR (43%), 10 SD (17%) and 7 PD (12%); in younger pts: 3 CR (5%), 32 PR (54%), 9 SD (15%) and 10 PD (17%); ORR by ITT was 56% (95% CI 45-64). Median OS was 11,2 months (95% CI 9,4-14,1); in elderly and younger pts was 11,2 (95% CI 7,3-15,1) and 11,8 (95% CI 9,2-16,2), respectively. Out of 48 evaluable pts aged ≥ 65 years, 24 (50%) were treated at full doses without any delay. In the elderly most frequent grade 3-4 toxicities were: neutropenia (13%, p<0.0001), leucopenia (7%), thrombocytopenia (18%), anemia (3%, p=0.02), febrile neutropenia (8%), asthenia (27%), diarrhea (10%), nausea/vomiting (10%) and hypokalemia (17%); in the younger: neutropenia (56%), leucopenia (31%), thrombocytopenia (22%), anemia (15%), febrile neutropenia (15%), asthenia (41%), diarrhea (15%), nausea/vomiting (22%) and hypokalemia (20%). Conclusions: This study shows that elderly pts can be safely treated with a TCF-dd regimen with a 30% dose reduction achieving similar efficacy results as younger pts with lesser toxicity.
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Affiliation(s)
| | | | | | | | - Laura Toppo
- Istituti Ospitalieri di Cremona, Cremona, Italy
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Toppo L, Tomasello G, Liguigli W, Ratti M, Poli R, Negri F, Curti A, Vismarra M, Maltese M, Delfrate R, Donini M, Colombi C, Brighenti M, Panni S, Perrucci B, Lazzarelli S, Passalacqua R. Efficacy and safety of dose-dense modified TCF regimen (TCF-dd) in metastatic or locally advanced gastroesophageal cancer (GEC). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.4112] [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
4112 Background: TCF is a standard first line option for GEC. The Norton-Simon hypothesis suggests that chemotherapy efficacy can be enhanced by decreasing intervals between cycles. We previously reported on the high activity of TCF-dd in GEC (Tomasello 2010). The aim of this study is to investigate the efficacy and safety of this intensified dose-dense regimen in a single-center large cohort of patients (pts). Methods: 150 pts with measurable or evaluable GEC, PS 0-2, with adequate organ function, treated in our center from 2004 to 2012 received TCF-dd: Docetaxel (60-85 mg/m2 d 1), Cisplatin (50-75 mg/m2 d 1), l-Folinic Acid (100 mg/m2 d 1-2), 5-FU (400 mg/m2 bolus d 1-2, and 600 mg/m2 as a 22 h continuous infusion d 1-2), plus Pegfilgrastim 6 mg d 3, every 14 days. Pts aged ≥ 65 years received the same schedule with a dose reduction by 30%. Analysis was based on the intention to treat population. Results: At a median follow-up of 44 months, 128 pts were evaluable for response, all for survival. Median age 65 (range 31-81), M:F 112:38. 17 pts (11%) with locally advanced inoperable GEC, 133 pts (89%) with metastatic GEC. Metastatic sites: liver 40%, peritoneum 31%, bone 14%, lung 12%. A median of 4 cycles (range 1-7) per patient was administered. 33% required a dose reduction. 33% were treated without any delay. 10 CR, 74 PR, 24 SD and 20 PD were observed, for an ORR of 66% (95% CI 57-74). Median OS was 13 months (95% CI 9.7-14.2). Most frequent grade 3/4 toxicities: neutropenia (34%), asthenia (28%), thrombocytopenia (17%), hypokalemia (16%), diarrhea (11%), febrile neutropenia (10%), anemia (9%), and stomatitis (4%). 11 pts (7%) [7 metastatic, 4 locally advanced] became operable after TCF-dd and underwent surgery. We identified 12 metastatic pts (8%) with overall survival > 3 years and 7 (5%) still maintaining a long lasting CR at the time of the current analysis. Conclusions: TCF-dd in GEC is very active and may be an option for conversion therapy. Toxicity can be relevant and requires a careful monitoring.
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Affiliation(s)
- Laura Toppo
- Istituti Ospitalieri di Cremona, Cremona, Italy
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Tomasello G, Liguigli W, Poli R, Negri F, Brighenti M, Toppo L, Curti A, Lazzarelli S, Panni S, Donini M, Maltese M, Ratti M, Passalacqua R. Sequential chemotherapy with dose-dense docetaxel, cisplatin, folinic acid and 5-fluorouracil (TCF-dd) followed by oxaliplatin, folinic acid, 5-fluorouracil, and irinotecan (COFFI) in locally advanced or metastatic gastric cancer (MGC). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.4097] [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
4097 Background: MGC is a chemosensitive tumour. According to the Norton-Simon hypothesis, a reduction of tumor burden could best be achieved by shortening the interval between the cycles, and the resistance might be overcome by switching from initial chemotherapy to a new, non cross-resistant one. We previously reported on the high efficacy of a new strategy using 2 sequential, non cross-resistant chemotherapy regimens in MGC (Cancer Chemother Pharmacol 11 Jan; 67 (1): 41-8). Aim of this study is to evaluate this therapeutic approach in a larger case series. Methods: 43 patients (pts) treated at our centre from November 04 to April 11 were included. All pts were chemo-naïve and received 4 cycles of TCF-dd (see reference above for doses) every 2 weeks. Subsequently and irrespective of their response, they received 4 cycles of COFFI (see reference above ) every 2 weeks. In both regimens pegfilgrastim 6 mg sc on day 3 was included. Results: Median age: 63; 74% male. PS 0-1. After the first regimen (TCF-dd) 43 pts were evaluable for response.We registered 3 CR, 27 PR, 7 SD, 5 PD and 1 not evaluable for an ORR at ITT of 70% (95% CI, 58-85). All pts proceeded to the second regimen (COFFI) and 40 pts were evaluable for response. The 3 CR observed after TCF-dd were maintained. Among the 27 pts with PR after TCF-dd, 2 achieved CR, 14 improved the response, 6 maintained PR, 3 progressed. Among the 7 pts with SD after TCF-dd, 1 achieved CR, 3 achieved PR, 2 progressed and 1 is not valuable. Among the 5 pts with PD after TCF-dd, 1 achieved CR, 4 achieved RP. After COFFI we observed 5 CR, 21 PR, 9 SD and 5 PD. The ORR in the 40 pts was 60% (95% CI, 50-80). Considering both regimen ORR was 93%. mTTP was 12.1 months (95% CI, 8,1-16,2). mOS was 16.1 months (95% CI, 12.7-21.6). At Dec '11, 4 out of 8 pts who achieved CR are alive and disease free. Most frequent G3-4 toxicities were: astenia (32%), neutropenia (35%), anemia (14%), neurotoxicity (21%). Conclusions: The study confirms that a sequential dose-dense strategy using TCF-dd followed by COFFI is feasible and highly effective and deserves to be tested in a randomized study which is on going.
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Affiliation(s)
| | | | | | | | | | - Laura Toppo
- Istituti Ospitalieri di Cremona, Cremona, Italy
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Barni S, Labianca R, Verso M, Gasparini G, Bonizzoni E, Mandala M, Brighenti M, Petrelli F, Bianchini C, Perrone T, Agnelli G. Khorana risk score: Is the body mass index a predictable factor for thromboembolism in European countries? A retrospective analysis. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e19612] [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
e19612 Background: Five variables (site of cancer, platelet count, haemoglobin level, leukocyte count, and body mass index-BMI) define the Khorana risk score (KS), predicting the high (≥ 3), the moderate (1-2) and the low (0) risk of thromboembolic events (TEs) in cancer outpatients. Nadroparin has been demonstrated to reduce the incidence of TEs by about 50% in cancer outpatients receiving chemotherapy (PROTECHT study) and patients receiving chemotherapy including gemcitabine, platinum analogues or their combination are at higher risk of TEs. Methods: 378 patients enrolled in the PROTECHT study didn’t receive thromboprophylaxis (placebo group) and were evaluable for the KS. The aim of this retrospective analysis was to assess the distribution of the five KS variables and if the replacing of BMI variable, in the KS, with a chemotherapy variable (administration of platinum compound or gemcitabine added 1point and their association 2points) in a PROTECHT score (PrS) could better predict high risk patients. A receiver operating characteristic (ROC) curve has been used to assess the accuracy of both scores. Results: Among patients the five KS variables were distributed as follow: 15% of stomach/pancreas cancer (2points), 33% with lung/gynecologic cancer (1point), 24% with platelet count of ≥350x10^9/L, 7.9% hemoglobin <10g/dL , 14.3% leukocyte count >11x10^9/L (1point each variable) and only 1.3% with BMI ≥ 35 (1point). 15 TEs occurred in the 378 pts, below the TEs distribution according to KS and PrS (see table). The area under the ROC curve was larger with PrS in comparison with KS (0.70 and 0.65 respectively). Conclusions: BMI ≥ 35 seems not to be a predictable factor for TEs in European cancer patients and the use of a chemotherapy variable could be more useful to identify patient at high risk of TE. A formal study is needed to evaluate which score could have a higher predictability to identify high risk patients for TEs. [Table: see text]
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Affiliation(s)
- Sandro Barni
- Treviglio and Caravaggio Hospital, Division of Medical Oncology, Treviglio, Italy
| | - Roberto Labianca
- Oncology Department, Ospedali Riuniti di Bergamo, Bergamo, Italy
| | | | | | - Erminio Bonizzoni
- Institute of Medical Statistics and Biometry, University of Milan, Milan, Italy
| | | | | | | | | | - Tania Perrone
- Scientific Department, Italfarmaco, Cinisello Balsamo, Italy
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Buti S, Donini M, Lazzarelli S, Brighenti M, Passalacqua R. A new modified sunitinib schedule for metastatic renal cell cancer (mRCC): A pilot study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.5_suppl.471] [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
471 Background: Oral sunitinib administration at 50 mg daily given for 4 weeks followed by 2 weeks off treatment (4+2 schedule) is a standard first line for mRCC treatment. About 20% of patients had to discontinue treatment permanently and 50% of patients are forced to reduce the doses due to adverse events [Motzer RJ, J Clin Oncol. 2009]. A meta-analysis showed that increase exposure to sunitinib is associated with improved clinical outcome [Houk BE, Cancer Chemother Pharmacol. 2010]. Methods: This is a pilot study in which consecutive mRCC patients admitted to our hospital who had at least a grade 2 toxicity with sunitinib, were switched to a modified schedule maintaining the same dose-intensity of 4+2 schedule: starting on Monday, 1 tablet (50 mg) a day for 5 consecutive days a week for 5 weeks and 1 tablet per day on days 1, 3 and 5 in the sixth week (28 tablets in 6 weeks), until disease progression. Primary end points were toxicity changes assessment and schedule feasibility, secondary end point was overall progression free survival (PFS). Results: Eight nephrectomized patient were enrolled: 6 males; median age 61; 37% good, 50% intermediate and 13% poor MSKCC risk; 3 patient pretreated; 6 clear cell histologies, 1 papillary and 1 undifferentiated histotypes. Median time from start therapy to switch was 7.4 months (range 1.4-16.1). Treatment delays and dose reductions were reduced from 50% to 25% and from 37% to 12% of patients respectively. The table shows the toxicity changes: there were no new toxicities. PFS was 16.3 months (CI 95% 5.6-23.4). Conclusions: This new modified schedule requires and deserves further studies. [Table: see text]
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Affiliation(s)
- Sebastiano Buti
- Istituti Ospitaleri di Cremona, Cremona, Italy; Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Maddalena Donini
- Istituti Ospitaleri di Cremona, Cremona, Italy; Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Silvia Lazzarelli
- Istituti Ospitaleri di Cremona, Cremona, Italy; Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Matteo Brighenti
- Istituti Ospitaleri di Cremona, Cremona, Italy; Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Rodolfo Passalacqua
- Istituti Ospitaleri di Cremona, Cremona, Italy; Istituti Ospitalieri di Cremona, Cremona, Italy
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Barni S, Labianca R, Agnelli G, Bonizzoni E, Verso M, Mandalà M, Brighenti M, Petrelli F, Bianchini C, Perrone T, Gasparini G. Chemotherapy-associated thromboembolic risk in cancer outpatients and effect of nadroparin thromboprophylaxis: results of a retrospective analysis of the PROTECHT study. J Transl Med 2011; 9:179. [PMID: 22013950 PMCID: PMC3220644 DOI: 10.1186/1479-5876-9-179] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 10/20/2011] [Indexed: 11/14/2022] Open
Abstract
Background Cancer patients receiving chemotherapy are at increased risk of thrombosis. Nadroparin has been demonstrated to reduce the incidence of venous and arterial thrombotic events (TEs) by about 50% in cancer outpatients receiving chemotherapy. The aims of this retrospective analysis were to evaluate the thromboembolic risk and the benefit of thromboprophylaxis according to type of chemotherapy. Methods Cancer outpatients were randomly assigned to receive subcutaneous injections of nadroparin or placebo. The incidence of symptomatic TEs was assessed according to the type of chemotherapy. Results were reported as risk ratios with associated 95% CI and two-tailed probability values. Results 769 and 381 patients have been evaluated in the nadroparin and placebo group, respectively. In the absence of thromboprophylaxis, the highest rate of TEs was found in patients receiving gemcitabine- (8.1%) or cisplatin-based chemotherapy (7.0%). The combination of gemcitabine and cisplatin or carboplatin increased the risk to 10.2%. Thromboprophylaxis reduced TE risk by 68% in patients receiving gemcitabine; with a further decrease to 78% in those receiving a combination of gemcitabine and platinum. Conclusions This retrospective analysis confirms that patients undergoing chemotherapy including gemcitabine, platinum analogues or their combination are at higher risk of TEs. Our results also suggest that outpatients receiving chemotherapy regimens including these agents might achieve an increased benefit from thromboprophylaxis with nadroparin. Clinical Trial registration number: NCT 00951574
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Affiliation(s)
- Sandro Barni
- Oncology Department, San Filippo Neri Hospital, via Martinotti 20, Rome, 00135, Italy
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Labianca R, Gasparini G, Barni S, Verso M, Bonizzoni E, Brighenti M, Mandala M, Petrelli F, Bianchini C, Perrone T, Agnelli G. Prediction of venous thromboembolism in ambulatory patients with cancer receiving chemotherapy: An expanded thromboembolic risk score model. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19551] [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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Dalla Chiesa M, Poli R, Tomasello G, Lazzarelli S, Buti S, Brighenti M, Negri F, Curti A, Auzzani A, Passalacqua R. Dose-dense chemotherapy (CT) with modified dose-dense TCF regimen (TCF-dd) in metastatic gastric cancer (MGC): Update of a phase II study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4142] [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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Passalacqua R, Buti S, Brighenti M, Rivoltini L, Castelli C, Camisaschi C, Simonelli C, Lo Re G, Mattioli R, Lazzarelli S. Final results of a dose-finding phase II trial with a triple combination therapy in metastatic renal cell cancer (mRCC): Bevacizumab (B) plus immunotherapy (IT) plus chemotherapy (C) (BIC), antitumor effects, and variations of circulating T-regulatory cells (TREG). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4615] [Citation(s) in RCA: 2] [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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Passalacqua R, Brighenti M, Naldi N, Potenzoni D, Monica B, Fumagalli M, Lazzarelli S, Caminiti C. Long-term effects of a program of bladder preservation using chemotherapy plus radiotherapy in muscle invasive bladder cancer (BC). Analysis of biologic predictive factors and health-related quality of life (QOL). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16014] [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
e16014 Background: Long-term effects of a combined approach of transurethral resection (TUR) plus chemotherapy (CT) and pelvic radiotherapy (RT) in terms of bladder preservation, survival, QOL are largely unknown. Moreover we investigated whether p53, Ki67, bcl-2, c-erbB-2 protein expression predict the achievement of a complete response (CR). Methods: From March 1994 to June 2000, 75 pts with muscle invasive BC were treated with a bladder sparing approach including an initial TUR, 3 cycles of CT (cisplatin + 5- FU) alternating with pelvic RT (40 Gy). At the response evaluation, pts with biopsy proven residual disease were considered incomplete responders (IR) and underwent immediate cystectomy. Pts with CR were treated with two additional CT cycles plus a bladder RT boost (20- 24 Gy). Paraffin embedded blocks of the primary tumors were collected and Ki67, p53, bcl-2 and c-erbB-2 protein expression were evaluated in a blind fashion. The Expanded Prostate Cancer Index Composite (EPIC) scores for urinary function, (especially storage, voiding symptoms and bowel function) was used to explore QOL in bladder preserved and compared with a group of matched patients treated by radical cystectomy only. Results: Median age was 67 yrs (range 42–80); T2a-T2b: 42%; T3a-T3b: 47%; T4a: 11%; G3: 88%; hydronephrosis: 32%. Overall, 56 (74.7%) pts achieved a CR and the achievement of a CR was significantly related to lower T stage (p= 0.002), high Ki67 (p=0.001), absence of hydronephrosis (p= 0.007) and high p53 overexpression (p=0.007). Multivariate analysis showed that only a low T stage (p=0.002) and high p53 expression (p=0.043) predict the obtaining of a CR. At 5 years of follow-up, 44 (59%) were alive and in 33 of them (75%) bladder was preserved; after 10-years 28 (37.3%) were alive and in 23 of them (82%) bladder was preserved. Analysis of QOL scores is ongoing. Conclusions: This approach induces a long term survival similar to radical cystectomy with a high rate of bladder preservation and represents a valid treatment for muscle invasive BC. Overexpression of p53 is a predictive marker for the obtaining of CR and for bladder preservation. No significant financial relationships to disclose.
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Affiliation(s)
- R. Passalacqua
- Istituti Ospitalieri, Cremona, Italy; University Hospital, Parma, Italy; Urology Division, Fidenza, Italy; Urology Division, Guastalla Hospital, Italy
| | - M. Brighenti
- Istituti Ospitalieri, Cremona, Italy; University Hospital, Parma, Italy; Urology Division, Fidenza, Italy; Urology Division, Guastalla Hospital, Italy
| | - N. Naldi
- Istituti Ospitalieri, Cremona, Italy; University Hospital, Parma, Italy; Urology Division, Fidenza, Italy; Urology Division, Guastalla Hospital, Italy
| | - D. Potenzoni
- Istituti Ospitalieri, Cremona, Italy; University Hospital, Parma, Italy; Urology Division, Fidenza, Italy; Urology Division, Guastalla Hospital, Italy
| | - B. Monica
- Istituti Ospitalieri, Cremona, Italy; University Hospital, Parma, Italy; Urology Division, Fidenza, Italy; Urology Division, Guastalla Hospital, Italy
| | - M. Fumagalli
- Istituti Ospitalieri, Cremona, Italy; University Hospital, Parma, Italy; Urology Division, Fidenza, Italy; Urology Division, Guastalla Hospital, Italy
| | - S. Lazzarelli
- Istituti Ospitalieri, Cremona, Italy; University Hospital, Parma, Italy; Urology Division, Fidenza, Italy; Urology Division, Guastalla Hospital, Italy
| | - C. Caminiti
- Istituti Ospitalieri, Cremona, Italy; University Hospital, Parma, Italy; Urology Division, Fidenza, Italy; Urology Division, Guastalla Hospital, Italy
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Brighenti M, Govindasamy-Lucey S, Lim K, Nelson K, Lucey J. Characterization of the Rheological, Textural, and Sensory Properties of Samples of Commercial US Cream Cheese with Different Fat Contents. J Dairy Sci 2008; 91:4501-17. [DOI: 10.3168/jds.2008-1322] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Passalacqua R, Buti S, Rivoltini L, Castelli C, Camisaschi C, Simonelli C, Lo Re G, Mattioli R, Mazza G, Brighenti M, Lazzarelli S. Bevacizumab (B) plus low-doses immunotherapy (IT) plus chemotherapy (CT) (BIC) in metastatic renal cell cancer (mRCC): Antitumor effects and variations of T-regulatory cells (Treg) and other T lymphocytes subsets. A study of the Italian Oncology Group for Clinical Research (GOIRC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5121] [Citation(s) in RCA: 2] [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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Dalla Chiesa M, Tomasello G, Buti S, Negri F, Brighenti M, Lazzarelli S, Auzzani A, Curti A, Martinotti M, Passalacqua R. High efficacy of sequential chemotherapy (CT) with dose-dense modified TCF regimen (TCF-DD) followed by CT with oxaliplatin, folinic acid (FA), 5-fluorouracil (5-FU) and irinotecan (COFFI) in metastatic gastric cancer (MGC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4570] [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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