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Scarpa A, Ralli M, De Bonis E, Troisi D, Montanino A, Viola P, Chiarella G, Gioacchini FM, Cavaliere M, Cassandro E, Cassandro C. Pharmacological, surgical and diagnostic innovations in Meniere's disease: a review. Transl Med UniSa 2021. [PMID: 34447713 PMCID: PMC8370534 DOI: 10.37825/2239-9747.1009] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Meniere's disease is an inner ear disorder characterized by the presence of endolymphatic hydrops in the inner ear and symptomatology of recurrent and debilitating vertigo attacks, tinnitus, aural fullness, and fluctuating sensorineural hearing loss. Although many therapeutic options for MD have been proposed during years, no consensus has been reached by the scientific community. In the last decade, many therapeutic options have been proposed, as intratympanic steroid, intratympanic gentamicin, and intravenous glycerol. Recently, the role of the antisecretory factor in the diet of MD patients have been investigated. Surgery is recommended for intractable MD; some authors proposed new approaches including transcanal endoscopic infracochlear vestibular neurectomy, new marsupiliazation technique in sac surgery, and tenotomy of the stapedius and tensor tympani muscles.
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Affiliation(s)
- A Scarpa
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - M Ralli
- Department of Sense Organs, Sapienza University Rome, Rome, Italy; Center for Hearing and Deafness, University at Buffalo, Buffalo, NY 14214, USA
| | - E De Bonis
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - D Troisi
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - A Montanino
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - P Viola
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - G Chiarella
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - F M Gioacchini
- Ear, Nose, and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - M Cavaliere
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - E Cassandro
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - C Cassandro
- Surgical Sciences Department, University of Turin, Turin, Italy
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Camerini A, Morabito A, Montanino A, Bernabé R, Grossi F, Ramlau R, Ciuleanu TE, Ceresoli GL, Pasello G, de Marinis F, Bosch-Barrera J, Laundreau P, Gautier S, Ta Thanh Minh C, Kowalski D. Metronomic oral vinorelbine in previously untreated advanced non-small-cell lung cancer patients unfit for platinum-based chemotherapy: results of the randomized phase II Tempo Lung trial. ESMO Open 2021; 6:100051. [PMID: 33611164 PMCID: PMC7903063 DOI: 10.1016/j.esmoop.2021.100051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 12/27/2022] Open
Abstract
Background To assess the efficacy and safety of a metronomic schedule of oral vinorelbine (mVNR) in advanced non-small-cell lung cancer (NSCLC) in patients unfit for platinum-based combination chemotherapy. Patients and methods This was a multicenter, prospective, randomized, open-label phase II study in treatment-naive patients with TNM stage IIIB/IV NSCLC. Patients received mVNR at a fixed dose of 50 mg × 3 or standard schedule 60-80 mg/m2 weekly until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS) without grade 4 toxicity (G4PFS; NCI-CTC v4). Main secondary objectives were safety, disease control rate (DCR) without grade 4 toxicity (G4DCR), DCR, PFS, overall survival (OS) and quality of life (QoL). Results A total of 167 patients were included, 83 and 84 patients in the mVNR and standard arms, respectively. The median G4PFS was 4.0 months [95% confidence interval (CI): 2.6-4.3] and 2.2 months (95% CI: 1.5-2.9), hazard ration (HR) = 0.63 (95% CI: 0.45-0.88), P = 0.0068 in favor of metronomic arm; G4DCR was 45.8% and 26.8% in the mVNR and standard arms, respectively. Grade 3-4 treatment-related adverse events were less frequent in the mVNR arm (25.3% versus 54.4%) mainly owing to a reduction in all grades (15.7% versus 51.9%) and grade 3-4 neutropenia (10.8% versus 42%). PFS was 4.3 (95% CI: 3.3-5.1) and 3.9 months (95% CI: 2.8-5.2) in mVNR and standard arms, respectively. No difference in median OS was observed. QoL was comparable between arms. Conclusions Metronomic oral vinorelbine significantly prolonged median G4PFS in advanced NSCLC patients unfit for platinum combinations as first-line treatment. It was associated with a clear reduction in toxicity and may be considered as an important option in this challenging population. First-line oral vinorelbine prolonged PFS without grade 4 toxicity in platinum-unfit patients with advanced NSCLC. Metronomic oral vinorelbine is associated with a clear reduction of grade 3-4 toxicities (mainly hematological ones). Metronomic oral vinorelbine allows home treatment and easy tailoring of the treatment according to patient tolerance.
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Affiliation(s)
- A Camerini
- Medical Oncology Department, Versilia Hospital, Lido di Camaiore, Italy.
| | - A Morabito
- Thoracic Medical Oncology, Istituto Nazionale Tumori, "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | - A Montanino
- Thoracic Medical Oncology, Istituto Nazionale Tumori, "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | - R Bernabé
- Medical Oncology Department, Hospital Virgen del Rocio, Institute for Biomedical Research, Seville, Spain
| | - F Grossi
- Division of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - R Ramlau
- Oncology Department, Poznan University of Medical Sciences, Poland
| | - T-E Ciuleanu
- Oncology Institute "Pr Dr Ion Chiricuta", Cluj-Napoca, Romania
| | - G-L Ceresoli
- Oncology Department, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - G Pasello
- Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - F de Marinis
- Thoracic Oncology Division, European Institute of Oncology, IRCCS, Milan, Italy
| | - J Bosch-Barrera
- Lung Cancer Unit, Catalan Institute of Oncology, Hospital Universitari Dr Josep Trueta, Girona, Spain
| | - P Laundreau
- Medical Affairs Oncology, Pierre Fabre Médicament, Boulogne, France
| | - S Gautier
- IRPF, Pierre Fabre Médicament, Toulouse, France
| | - C Ta Thanh Minh
- Medical Affairs Oncology, Pierre Fabre Médicament, Boulogne, France
| | - D Kowalski
- Lung Cancer and Chest Tumours Department, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Scarpa A, Ralli M, De Bonis E, Troisi D, Montanino A, Viola P, Chiarella G, Gioacchini FM, Cavaliere M, Cassandro E, Cassandro C. Pharmacological, Surgical and Diagnostic Innovations in Meniere's Disease: A Review. Transl Med UniSa 2020; 23:48-52. [PMID: 33457323 PMCID: PMC8370534] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
PURPOSE To investigate literature about pharmacological, surgical, and diagnostic innovations for Meniere's Disease (MD). SUMMARY Meniere's disease is an inner ear disorder characterized by the presence of endolymphatic hydrops in the inner ear and symptomatology of recurrent and debilitating vertigo attacks, tinnitus, aural fullness, and fluctuating sensorineural hearing loss. Although many therapeutic options for MD have been proposed during years, no consensus has been reached by the scientific community. In the last decade, many therapeutic options have been proposed, as intratympanic steroid, intratympanic gentamicin, and intravenous glycerol. Recently, the role of the antisecretory factor in the diet of MD patients have been investigated. Surgery is recommended for intractable MD; some authors proposed new approaches including transcanal endoscopic infracochlear vestibular neurectomy, new marsupiliazation technique in sac surgery, and tenotomy of the stapedius and tensor tympani muscles.
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Affiliation(s)
- A Scarpa
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - M Ralli
- Department of Sense Organs, Sapienza University Rome, Rome, Italy; Center for Hearing and Deafness, University at Buffalo, Buffalo, NY 14214, USA
| | - E De Bonis
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - D Troisi
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - A Montanino
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - P Viola
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - G Chiarella
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - F M Gioacchini
- Ear, Nose, and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - M Cavaliere
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - E Cassandro
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - C Cassandro
- Surgical Sciences Department, University of Turin, Turin, Italy
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Angelillo M, Montanino A, Pandolfi A. On the Connection Between Geometry and Statically Determined Membrane Stresses in the Human Cornea. J Biomech Eng 2020; 142:975394. [PMID: 31518389 DOI: 10.1115/1.4044742] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/08/2019] [Indexed: 11/08/2022]
Abstract
Under the action of the intraocular pressure (IOP), the human cornea is stressed and deforms acquiring a quasi-spherical configuration. If the stressed configuration is known, and the cornea is regarded as a membrane, disregarding flexural behaviors with an equilibrium analysis only is possible to estimate the distribution of the average stress across the thickness. In the cornea, the action of the intraocular pressure is supported by collagen fibrils, immersed into an elastin-proteoglycan matrix, and organized in a very precise architecture to provide the necessary confinement and transparency to the light. With the goal of understanding the static consequences of shape modifications due to pathological dilatation (ectasia), we present a simplified stress analysis of the human cornea modeled as a membrane. A numerical investigation over 40 patient-specific corneas (20 normal and 20 ectatic) is carried out to establish a relationship between the physiological geometry and the distribution of the membrane stresses, and to assess the possibility to obtain information on the stress state based on topographic images only. Comparative analyses reveal that, with respect to normal corneas, in ectatic corneas the pattern of the principal stress lines is modified markedly showing a deviation from the hypothetical dominant orientation of the collagen fibrils. The rotation of the principal stress with respect to the fibril orientation can be thought as responsible of the transmission of a large amount of shear stresses onto the elastin-proteoglycan matrix. The anomalous loading of the matrix could be correlated to the evolution of time-dependent shape modifications leading to ectasia.
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Affiliation(s)
- M Angelillo
- Civil and Environmental Engineering Department, Universita' degli Studi di Salerno, Fisciano 84084, Italy
| | - A Montanino
- Civil and Environmental Engineering Department, Politecnico di Milano, Milano 20133, Italy
| | - A Pandolfi
- Civil and Environmental Engineering Department, Politecnico di Milano, Milano 20133, Italy
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Camerini A, Morabito A, Montanino A, Bernabe Caro R, Grossi F, Ramlau R, Ciuleanu TE, Ceresoli G, Pasello G, de Marinis F, Bosch-Barrera J, Landreau P, Gautier S, Ta Thanh Minh C, Kowalski D. Second-line treatment after first-line vinorelbine in advanced platinum unfit NSCLC patients: An exploratory analysis of randomized Tempo-Lung trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437.035] [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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Kowalski D, Morabito A, Montanino A, Bernabé R, Grossi F, Ramlau R, Ciuleanu TE, Ceresoli G, Pasello G, de Marinis F, Bosch Barrera J, Landreau P, Gautier S, Ta Thanh Minh C, Camerini A. Final results of randomized phase II trial of metronomic vs weekly oral vinorelbine (OV) as first-line chemotherapy (CT) in advanced NSCLC patients unfit to platinum-based CT (P-CT): Tempo-Lung. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Piccirillo M, Morabito A, Maione P, Luciani A, Cavanna L, Bonanno L, Piazza E, Leo S, Cinieri S, Morgillo F, Burgio M, Bilancia D, Rosetti F, Montanino A, Manzo A, Arenare L, Signoriello S, Gallo C, Perrone F, Gridelli C. Effect on quality of life (QOL) of adding cisplatin to single-agent first-line chemotherapy in elderly patients with advanced non-small cell lung cancer (NSCLC): A joint analysis of the multicentre, randomized, phase 3 MILES-3 and MILES-4 studies. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Normanno N, Rachiglio A, Lambiase M, Fenizia F, Iannaccone A, Chicchinelli N, Morabito A, Montanino A, Rocco G, Galetta D, Montagna E, Crinò L, Ludovini V, Vincenzi B, Barletta E, Pinto C, Ferraù F, Botti G, Piccirillo M, Perrone F. Tumor heterogeneity affects the activity of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in EGFR mutant non-small cell lung cancer (NSCLC) patients (pts). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Montanino A, Fortunato A, Angelillo M. A new simplified methodology for studying the coupled fluid-structure interaction in a weakened basilar artery. Int J Numer Method Biomed Eng 2016; 32:e02752. [PMID: 26446301 DOI: 10.1002/cnm.2752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 04/07/2015] [Accepted: 09/30/2015] [Indexed: 06/05/2023]
Abstract
In this paper, we study the fluid-structure interaction in a weakened basilar artery. The aim is to study how the wall shear stress changes in space and time because of the weakening, because spatial and temporal changes are thought to be possible causes of aneurysm and vascular deseases. The arterial wall, in its natural configuration, is modeled as a hyperelastic cylinder, inhomogeneous along its axis, in order to simulate the axis-symmetric weakening. The fluid is studied exploiting a recent approach for quasi-one-dimensional flows in slowly varying ducts, which allows to write the averaged equations of mass and energy balance on the basis of the velocity profile in a straight duct. The unknowns are the wall pressure, the average velocity, and the wall radial displacement. The problem is solved in two parts: first, the stationary non-linear coupled problem is solved, and an intermediate configuration is obtained. Then, we study the variation of the basic unknowns about the intermediate configuration, considering time dependence over the cardiac cycles. The results suggest that, with a 10% reduction of the main elastic modulus, the shear stress in the weakened zone changes its sign and doubles the maximum stress value detected in the healthy zone. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- A Montanino
- Dipartimento di Ingegneria Civile ed Architettura (DICAr), Università degli Studi di Pavia, Pavia, Italy
- Centro di Simulazione Numerica Avanzata (CeSNA), Istituto Universitario di Studi Superiori (IUSS), Pavia, Italy
| | - A Fortunato
- Dipartimento di Ingegneria Civile (DiCiv), Università degli Studi di Salerno, Fisciano, SA, Italy
| | - M Angelillo
- Dipartimento di Ingegneria Civile (DiCiv), Università degli Studi di Salerno, Fisciano, SA, Italy
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Normanno N, Morabito A, Novello S, Cortinovis D, Migliorino M, Pinto C, Pasquale R, Montanino A, Capelletto E, Tonini G, Bidoli P, Galetta D, Ricciardi S, Milella M, Melotti B, Romano G, Crinò L. Circulating-free tumor DNA as a surrogate for determination of EGFR status: the Italian experience within the ASSESS study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv343.03] [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: 11/12/2022] Open
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Perrone F, Nuzzo F, Di Rella F, Gravina A, Iodice G, Labonia V, Landi G, Pacilio C, Rossi E, De Laurentiis M, D'Aiuto M, Botti G, Forestieri V, Lauria R, De Placido S, Tinessa V, Daniele B, Gori S, Colantuoni G, Barni S, Riccardi F, De Maio E, Montanino A, Morabito A, Daniele G, Di Maio M, Piccirillo M, Signoriello S, Gallo C, de Matteis A. Weekly docetaxel versus CMF as adjuvant chemotherapy for older women with early breast cancer: final results of the randomized phase III ELDA trial. Ann Oncol 2015; 26:675-682. [DOI: 10.1093/annonc/mdu564] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vavala T, Follador A, Tiseo M, Galetta D, Montanino A, Martelli O, Caffo O, Piovano P, Cortinovis D, Zilembo N, Casartelli C, Banna G, Colombo D, Barzelloni M, Rijavec E, Cecere F, Bria E, Lazzari C, Rossi A, Novello S. Be-Positive: Beyond Progression After Tyrosine Kinase Inhibitor in Egfr-Positive Non-Small Cell Lung Cancer (Nsclc) Patients. Preliminary Results from a Multicenter Italian Observational Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.57] [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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Sandomenico C, Costanzo R, Carillio G, Piccirillo MC, Montanino A, Di Maio M, Rocco G, Normanno N, Perrone F, Morabito A. Bevacizumab in non small cell lung cancer: development, current status and issues. Curr Med Chem 2012; 19:961-71. [PMID: 22214464 DOI: 10.2174/092986712799320673] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 10/25/2011] [Accepted: 10/26/2011] [Indexed: 11/22/2022]
Abstract
Bevacizumab is a monoclonal antibody directed against Vascular Endothelial Growth Factor (VEGF). Evidence about its efficacy in addition to first-line chemotherapy in non-small-cell-lung-cancer (NSCLC) has been produced by two large randomized phase III clinical trials (ECOG 4599 and AVAiL), conducted in a clinically selected population with non-squamous histology and without major risk factors for bleeding. In the ECOG 4599 trial, the addition of bevacizumab (15 mg/kg) to carboplatin plus paclitaxel produced a statistically significant and clinically relevant improvement in overall survival (OS), that was the primary endpoint of the trial (12.3 months vs 10.3 months, HR 0.79; p=0.003). Furthermore, patients receiving bevacizumab showed a significant improvement in progression-free survival (PFS) and in objective response rates. Treatment with bevacizumab was well tolerated by the majority of patients, but was still associated with increased risk of clinically significant bleeding (4.4% vs 0.7%, p0.001). In the AVAiL trial the addition of bevacizumab (at the dose of 7.5 and 15 mg/kg) to cisplatin plus gemcitabine produced a small improvement in PFS, but no differences in OS. Information from retrospective analysis and two large observational studies (SAIL and ARIES) have confirmed the safety profile of first-line bevacizumab with a wide range of chemotherapy partners, but whether its efficacy is comparable when combined with the different regimens is still unknown. The identification of predictive factors of efficacy would be relevant for the optimal use of the drug, but to date we have no conclusive data in this direction.
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Affiliation(s)
- C Sandomenico
- Thoraco-Pulmonary Department, National Cancer Institute, Naples, Italy
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De Laurentiis M, Criscitiello C, Giuliano M, Giordano A, Cianniello D, Montanino A, Falato C, Caputo R, Stanzione B, De Placido S. Taxane-based adjuvant therapy for early breast cancer (EBC): A meta-analysis of the predictive effect of ER and HER2 status. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e11025] [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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