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Bogani G, Ditto A, Chiappa V, Pinelli C, Sonetto C, Raspagliesi F. Primary conization overcomes the risk of developing local recurrence following laparoscopic radical hysterectomy in early stage cervical cancer. Int J Gynaecol Obstet 2020; 151:43-48. [PMID: 32511745 DOI: 10.1002/ijgo.13260] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/06/2019] [Accepted: 06/02/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate whether primary conization might overcome the risk of local dissemination in patients undergoing laparoscopic radical hysterectomy. METHODS Consecutive data of 262 patients with early stage cervical cancer were retrieved: 88 women had conization followed by radical hysterectomy. A propensity-matched comparison (1:1) was carried out in order to compare laparoscopy and open surgery. Accumulating data highlighted that minimally invasive surgery has been associated with higher recurrence rates and worse overall survival than open surgery in women with early stage cervical cancer. RESULTS Data of 35 paired patients (total 70 patients) were analyzed. No between-group differences in baseline, disease, and pathological variables were observed. Patients undergoing laparoscopy correlated with lower blood loss (50 [range 30-100] vs 150 [range 50-500] mL; P<0.001) and shorter length of stay (3 ± 0.8 vs 5.4 ± 1.4 days; P<0.001) compared to open surgery. One local recurrence was observed per group (P=1.00). Type of surgical approach did not influence site of recurrence (P=1.00) or survival outcomes, in terms of 10-year disease-free (P=0.549, log-rank test) and overall survivals (P=0.615, log-rank test). CONCLUSIONS The data show that primary conization might overcome the risk of local recurrence after laparoscopic radical hysterectomy in early stage cervical cancer. Further prospective evidence is needed.
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Affiliation(s)
- Giorgio Bogani
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Antonino Ditto
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Valentina Chiappa
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Ciro Pinelli
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Cristina Sonetto
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Buttigliero C, Tucci M, Sonetto C, Vignani F, Di Stefano RF, Pisano C, Turco F, Lacidogna G, Guglielmini P, Numico G, Scagliotti GV, Di Maio M. Prognostic role of early PSA drop in castration resistant prostate cancer patients treated with abiraterone acetate or enzalutamide. MINERVA UROL NEFROL 2020; 72:737-745. [PMID: 32284527 DOI: 10.23736/s0393-2249.20.03708-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Previous studies demonstrated a predictive value of prostate-specific antigen (PSA) kinetics for treatment outcome. Our retrospective study evaluates the prognostic role of early PSA drop in metastatic castration resistant prostate cancer (mCRPC) patients receiving abiraterone acetate (AA) or enzalutamide (E). METHODS All mCRPC patients treated with AA or E at the San Luigi Hospital in Orbassano between 2010 and 2018 and at the Ordine Mauriziano Hospital in Turin between 2014 and 2018 were included in this retrospective study. Only patients with an early PSA (measured 28-60 days after the beginning of the treatment) were included in the analysis. Patients were divided in early responders and non-early responders according to early PSA response (drop≥50% from baseline). Univariate and multivariate analyses for progression free survival (PFS) and overall survival (OS) were performed. RESULTS Of 144 patients with early PSA value, 61 (42.4%) patients received E (docetaxel-naïve 42, post-docetaxel 19) and 83 (57.6%) received AA (docetaxel-naïve 44, post-docetaxel 39). Seventy-five (52.1%) patients achieved early PSA drop. In docetaxel-naïve setting (N.=86), median PFS was 14.9 (with early PSA drop) vs. 8.8 months (without early PSA drop, P=0.001). In post-docetaxel setting (N.=58) median PFS was 11.9 vs. 4.5 months (P<0.001). Globally, median PFS was 14.9 vs. 6.3 months in patients with and without early PSA drop, respectively (P<0.001). In docetaxel-naïve setting, patients with early PSA drop had a median OS of 39.5 vs. 18.8 months (P=0.12). In post-docetaxel setting median OS was 29.6 vs. 10.7 months (P=0.01). Comprehensively, median OS was 31.9 vs. 16.3 (P=0.002) in patients with and without early PSA drop, respectively. At multivariate analysis, early PSA drop confirmed an independent association with PFS (HR 0.21; 95% CI: 0.12-0.38, P<0.001) and OS (HR 0.25; 95% CI: 0.12-0.50, P<0.001). CONCLUSIONS mCRPC patients treated with AA or E, in docetaxel-naïve or post-docetaxel setting, with early PSA drop had significantly better OS and PFS.
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Affiliation(s)
- Consuelo Buttigliero
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Marcello Tucci
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy -
| | - Cristina Sonetto
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Francesca Vignani
- Division of Medical Oncology, Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - Rosario F Di Stefano
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Chiara Pisano
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Fabio Turco
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Gaetano Lacidogna
- Division of Medical Oncology, Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - Pamela Guglielmini
- Unit of Oncology, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Gianmauro Numico
- Unit of Oncology, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Giorgio V Scagliotti
- Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Massimo Di Maio
- Division of Medical Oncology, Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
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Lombardi P, Marandino L, De Luca E, Zichi C, Reale ML, Pignataro D, Di Stefano RF, Ghisoni E, Mariniello A, Trevisi E, Leone G, Muratori L, La Salvia A, Sonetto C, Leone F, Aglietta M, Novello S, Scagliotti GV, Perrone F, Di Maio M. Quality of life assessment and reporting in colorectal cancer: A systematic review of phase III trials published between 2012 and 2018. Crit Rev Oncol Hematol 2020; 146:102877. [PMID: 31981880 DOI: 10.1016/j.critrevonc.2020.102877] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 07/21/2019] [Revised: 12/09/2019] [Accepted: 01/17/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In this study, our aim was to describe quality of life (QoL) prevalence and heterogeneity in QoL reporting in colorectal cancer phase III trials. METHODS We included all phase III trials evaluating anticancer drugs in colorectal cancer patients published between 2012 and 2018 by 11 major journals. RESULTS Out of the 67 publications identified, in 41 (61.2 %) QoL was not listed among endpoints. Out of 26 primary publications of trials including QoL among endpoints, QoL results were not reported in 10 (38.5 %). Overall, no QoL data were available in 51/67 (76.1 %) primary publications. In particular, in the metastatic setting, QoL data were not available in 12/18 (66.7 %) trials with primary endpoint overall survival, and in 20/29 (69.0 %) trials with other primary endpoints. CONCLUSIONS QoL was absent in a high proportion of recently published phase III trials in colorectal cancer, even in trials of second or further lines, where attention to QoL should be particularly high.
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Affiliation(s)
- Pasquale Lombardi
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Laura Marandino
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Emmanuele De Luca
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Clizia Zichi
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Maria Lucia Reale
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Daniele Pignataro
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Rosario F Di Stefano
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Eleonora Ghisoni
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Annapaola Mariniello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Elena Trevisi
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Leonardo Muratori
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Anna La Salvia
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Francesco Leone
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Massimo Aglietta
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Giorgio V Scagliotti
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Francesco Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale"-IRCCS, Napoli, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy.
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Marandino L, La Salvia A, Sonetto C, De Luca E, Pignataro D, Zichi C, Di Stefano RF, Ghisoni E, Lombardi P, Mariniello A, Reale ML, Trevisi E, Leone G, Muratori L, Marcato M, Bironzo P, Novello S, Aglietta M, Scagliotti GV, Perrone F, Di Maio M. Deficiencies in health-related quality-of-life assessment and reporting: a systematic review of oncology randomized phase III trials published between 2012 and 2016. Ann Oncol 2019; 29:2288-2295. [PMID: 30304498 DOI: 10.1093/annonc/mdy449] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Quality of life (QoL) is a relevant end point and a topic of growing interest by both scientific community and regulatory authorities. Our aim was to review QoL prevalence as an end point in cancer phase III trials published in major journals and to evaluate QoL reporting deficiencies in terms of under-reporting and delay of publication. All issues published between 2012 and 2016 by 11 major journals were hand-searched for primary publications of phase III trials in adult patients with solid tumors. Information about end points was derived from paper and study protocol, when available. Secondary QoL publications were searched in PubMed. In total, 446 publications were eligible. In 210 (47.1%), QoL was not included among end points. QoL was not an end point in 40.1% of trials in the advanced/metastatic setting, 39.7% of profit trials and 53.6% of non-profit trials. Out of 231 primary publications of trials with QoL as secondary or exploratory end point, QoL results were available in 143 (61.9%). QoL results were absent in 37.6% of publications in the advanced/metastatic setting, in 37.1% of profit trials and 39.3% of non-profit trials. Proportion of trials not including QoL as end point or with missing QoL results was relevant in all tumor types and for all treatment types. Overall, 70 secondary QoL publications were found: for trials without QoL results in the primary publication, probability of secondary publication was 12.5%, 30.9% and 40.3% at 1, 2 and 3 years, respectively. Proportion of trials not reporting QoL results was similar in trials with positive results (36.5%) and with negative results (39.4%), but the probability of secondary publication was higher in positive trials. QoL is not included among end points in a relevant proportion of recently published phase III trials in solid tumors. In addition, QoL results are subject to significant under-reporting and delay in publication.
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Affiliation(s)
- L Marandino
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, Candiolo Cancer Institute, FPO, IRCCS, Candiolo, Italy
| | - A La Salvia
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - C Sonetto
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - E De Luca
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy
| | - D Pignataro
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - C Zichi
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy
| | - R F Di Stefano
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - E Ghisoni
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, Candiolo Cancer Institute, FPO, IRCCS, Candiolo, Italy
| | - P Lombardi
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, Candiolo Cancer Institute, FPO, IRCCS, Candiolo, Italy
| | - A Mariniello
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - M L Reale
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - E Trevisi
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - G Leone
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - L Muratori
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - M Marcato
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy
| | - P Bironzo
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - S Novello
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - M Aglietta
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, Candiolo Cancer Institute, FPO, IRCCS, Candiolo, Italy
| | - G V Scagliotti
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - F Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale"-IRCCS, Napoli, Italy
| | - M Di Maio
- Department of Oncology, University of Turin, Turin, Italy; Division of Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy.
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Lorusso D, Ferrandina G, Colombo N, Pignata S, Pietragalla A, Sonetto C, Pisano C, Lapresa MT, Savarese A, Tagliaferri P, Lombardi D, Cinieri S, Breda E, Sabatucci I, Sabbatini R, Conte C, Cecere SC, Maltese G, Scambia G. Carboplatin-paclitaxel compared to Carboplatin-Paclitaxel-Bevacizumab in advanced or recurrent endometrial cancer: MITO END-2 - A randomized phase II trial. Gynecol Oncol 2019; 155:406-412. [PMID: 31677820 DOI: 10.1016/j.ygyno.2019.10.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [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: 08/14/2019] [Revised: 10/10/2019] [Accepted: 10/12/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Increased Vascular Endothelial Growth Factor Receptor (VEGF) expression in endometrial cancer (EC) is associated with a poor prognosis. Preliminary clinical data reported Bevacizumab effectiveness in EC both as single agent and in combination with chemotherapy. METHODS In a phase II trial, patients with advanced (FIGO stage III-IV) or recurrent EC were randomized to receive Carboplatin-Paclitaxel standard dose for 6-8 cycles vs Carboplatin-Paclitaxel and Bevacizumab 15 mg/kg in combination with chemotherapy and maintenance until disease progression or unacceptable toxicity. The primary endpoint was progression free survival (PFS). RESULTS 108 patients were randomized; PFS (10.5 vs 13.7 months, HR 0.84 p = 0.43), overall response rate (ORR 53.1% vs 74.4%) and overall survival (OS) (29.7 vs 40.0 months, HR 0.71 p = 0.24) resulted in a non-significant increase in Bevacizumab treated patients. The PFS increase became significant when an exploratory analysis with the Breslow test was used. Moreover, patients treated with Bevacizumab experienced a significant increase in 6-month disease control rate (70.4% vs 90.7%). Cardiovascular events were more frequent in the experimental arm ("de novo" grade ≥2 hypertension 21% vs 0% and grade ≥2 thromboembolic events 11% vs 2% in the Bevacizumab vs standard treatment arm, respectively). CONCLUSIONS Bevacizumab combined with chemotherapy in the treatment of advanced/recurrent EC failed to demonstrate a significant increase in PFS in the MITO END-2 trial. Nevertheless, these preliminary data suggests some effectiveness of the antiangiogenic agent which merits further exploration in a larger population with a better molecular characterization.
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Affiliation(s)
- D Lorusso
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - G Ferrandina
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Woman, Child and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - N Colombo
- Gynecologic Oncology Program, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of medicine and surgery, University of Milan-Bicocca, Milan, Italy
| | - S Pignata
- Department of Oncology, Fondazione Pascale National Cancer Institute, Naples, Italy
| | - A Pietragalla
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Sonetto
- Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan, Italy
| | - C Pisano
- Department of Oncology, Fondazione Pascale National Cancer Institute, Naples, Italy
| | - M T Lapresa
- Gynecologic Oncology Program, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Savarese
- Department of Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - P Tagliaferri
- Department of Oncology, Magna Grecia University, Catanzaro, Italy
| | - D Lombardi
- Department of Oncology, CRO, Aviano, Italy
| | - S Cinieri
- Department of Oncology, Di Summa-Perrino Hospital, Brindisi, Italy
| | - E Breda
- Department of Oncology, Fatebenefratelli Hospital, Rome, Italy
| | - I Sabatucci
- Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan, Italy
| | - R Sabbatini
- Department of Oncology, University of Modena and Reggio Emilia, Italy
| | - C Conte
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S C Cecere
- Department of Oncology, Fondazione Pascale National Cancer Institute, Naples, Italy
| | - G Maltese
- Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan, Italy
| | - G Scambia
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Woman, Child and Public Health, Catholic University of the Sacred Heart, Rome, Italy
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Reale ML, De Luca E, Lombardi P, Marandino L, Zichi C, Pignataro D, Ghisoni E, Di Stefano RF, Mariniello A, Trevisi E, Leone G, Muratori L, La Salvia A, Sonetto C, Bironzo P, Aglietta M, Novello S, Scagliotti GV, Perrone F, Di Maio M. Quality of life analysis in lung cancer: A systematic review of phase III trials published between 2012 and 2018. Lung Cancer 2019; 139:47-54. [PMID: 31734586 DOI: 10.1016/j.lungcan.2019.10.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 08/17/2019] [Revised: 10/20/2019] [Accepted: 10/23/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES We previously reported that quality of life (QoL) is not included among trial endpoints and QoL results are underreported in a significant proportion of phase III oncology trials. Here we describe QoL adoption, reporting and methodology of QoL analysis in lung cancer trials. MATERIALS AND METHODS We selected all primary publications of lung cancer phase III trials assessing anticancer drugs published between 2012 and 2018 by 11 major journals. RESULTS 122 publications were included. In 39 (32.0%) publications, QoL was not listed among endpoints: in 10/17 (58.8%) early stage/locally advanced NSCLC, in 15/54 (27.8%) first-line of advanced NSCLC; in 10/41 (24.4%) second and further lines of advanced NSCLC, in 4/10 (40.0%) SCLC. Proportion of trials not including QoL was similar over time: 32.9% publications in 2012-2015 vs. 30.6% in 2016-2018. Out of 83 trials including QoL among endpoints, QoL results were absent in 36 primary publications (43.4%). Proportion of trials without QoL results in primary publication increased over time (30.6% 2012-2015 vs. 61.8% 2016-2018, p = 0.005). Overall, QoL data were not available in 75/122 (61.5%) primary publications, due to the absent endpoint or unpublished results. QoL data were lacking in 48/68 (70.6%) publications of trials with overall survival as primary endpoint, 27/54 (50.0%) with other primary endpoints and 28/54 (51.9%) publications with a positive result. For trials including QoL among endpoints but lacking QoL results in primary publication, probability of secondary publication was 6.3%, 30.1% and 49.8% after 1, 2 and 3 years respectively, without evidence of improvement comparing 2012-2015 vs. 2016-2018. CONCLUSION QoL is not assessed or published in many phase III lung cancer trials, a setting where QoL value should be highly considered, due to high symptom burden and generally limited life expectancy. Timely inclusion of results in primary publications is worsening in recent years.
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Affiliation(s)
- Maria Lucia Reale
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Emmanuele De Luca
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Pasquale Lombardi
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Laura Marandino
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Clizia Zichi
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Daniele Pignataro
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Eleonora Ghisoni
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Rosario F Di Stefano
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Annapaola Mariniello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Elena Trevisi
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Leonardo Muratori
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Anna La Salvia
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Paolo Bironzo
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Massimo Aglietta
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Giorgio V Scagliotti
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Francesco Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale"-IRCCS, Napoli, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy.
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7
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Reale M, De Luca E, Lombardi P, Marandino L, Zichi C, Pignataro D, Ghisoni E, Di Stefano R, Mariniello A, Trevisi E, Leone G, Muratori L, La Salvia A, Sonetto C, Bironzo P, Aglietta M, Novello S, Scagliotti G, Perrone F, Di Maio M. OA07.07 Quality of Life (QoL) Analysis in Lung Cancer: A Systematic Review of Phase III Trials Published Between 2012 and 2018. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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8
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Marandino L, De Luca E, Zichi C, Lombardi P, Reale ML, Pignataro D, Di Stefano RF, Ghisoni E, Mariniello A, Trevisi E, Leone G, Muratori L, La Salvia A, Sonetto C, Buttigliero C, Tucci M, Aglietta M, Novello S, Scagliotti GV, Perrone F, Di Maio M. Quality-of-Life Assessment and Reporting in Prostate Cancer: Systematic Review of Phase 3 Trials Testing Anticancer Drugs Published Between 2012 and 2018. Clin Genitourin Cancer 2019; 17:332-347.e2. [PMID: 31416754 DOI: 10.1016/j.clgc.2019.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 05/24/2019] [Revised: 07/06/2019] [Accepted: 07/15/2019] [Indexed: 01/20/2023]
Abstract
Quality of life (QoL) is not included among the end points in many studies, and QoL results are underreported in many phase 3 oncology trials. We performed a systematic review to describe QoL prevalence and heterogeneity in QoL reporting in recently published prostate cancer phase 3 trials. A PubMed search was performed to identify primary publications of randomized phase 3 trials testing anticancer drugs in prostate cancer, issued between 2012 and 2018. We analyzed QoL inclusion among end points, presence of QoL results, and methodology of QoL analysis. Seventy-two publications were identified (15 early-stage, 20 advanced hormone-sensitive, and 37 castration-resistant prostate cancer [CRPC]). QoL was not listed among study end points in 23 studies (31.9%) (40.0% early stage, 40.0% advanced hormone sensitive, and 24.3% CRPC). QoL results were absent in 15 (30.6%) of 49 primary publications of trials that included QoL among end points. Overall, as a result of absent end point or unpublished results, QoL data were lacking in 38 (52.8%) primary publications (53.3% early stage, 55.0% in advanced hormone sensitive, and 51.4% in CRPC). The most commonly used QoL tools were Functional Assessment of Cancer Therapy-Prostate (FACT-P) (21, 53.8%) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) (14, 35.9%); most common methods of analysis were mean changes or mean scores (28, 71.8%), time to deterioration (14, 35.9%), and proportion of patients with response (10, 25.6%). In conclusion, QoL data are lacking in a not negligible proportion of recently published phase 3 trials in prostate cancer, although the presence of QoL results is better in positive trials, especially in CRPC. The methodology of QoL analysis is heterogeneous for type of instruments, analysis, and presentation of results.
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Affiliation(s)
- Laura Marandino
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Emmanuele De Luca
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy
| | - Clizia Zichi
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy
| | - Pasquale Lombardi
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Maria Lucia Reale
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Daniele Pignataro
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Rosario F Di Stefano
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Eleonora Ghisoni
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Annapaola Mariniello
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Elena Trevisi
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Leonardo Muratori
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Anna La Salvia
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Consuelo Buttigliero
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Marcello Tucci
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Massimo Aglietta
- Department of Oncology, University of Turin, at Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Giorgio V Scagliotti
- Department of Oncology, University of Turin, at San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Francesco Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale"-IRCCS, Naples, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, at Ordine Mauriziano Hospital, Turin, Italy.
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Lombardi P, Marandino L, De Luca E, Zichi C, Pignataro D, Di Stefano R, Ghisoni E, Mariniello A, Reale M, Trevisi E, Gianmarco L, Muratori L, La Salvia A, Sonetto C, Leone F, Aglietta M, Novello S, Scagliotti G, Perrone F, Di Maio M. Quality of life assessment and reporting in colorectal cancer: a systematic review of phase 3 trials published between 2012 and 2018. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Bossi P, Botta L, Bironzo P, Sonetto C, Musettini G, Sbrana A, Di Giannantonio V, Locati LD, Di Maio M, Antonuzzo A. Systematic Review of adverse events reporting in clinical trials leading to approval of targeted therapy and immunotherapy. Future Oncol 2019; 15:2543-2553. [DOI: 10.2217/fon-2018-0772] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Reporting toxicities of targeted therapies (TTs) and immunotherapy in oncology requires special attention. Materials & methods: We identified TTs and immunotherapies approved by the US FDA for solid malignancies in the adult population. Publications were reviewed according to a 24-point score based on the Consolidated Standards of Reporting Trials guidance. Results: We identified 81 trials (>45,000 patients). The experimental drug was studied as single agent in 51% of the cases; setting of disease was mainly (95%) advanced/metastatic. Lowest scores in adverse event (AE) description regarded: reporting recurrent/late toxicities and duration of the AEs (>90%), time of occurrence and indication of all-grade AEs (>75%). Conclusion: Suboptimal reporting of AEs in trials leading to approval of TTs and immunotherapy was shown. Improving AE descriptions should be a priority in ongoing trials.
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Affiliation(s)
- Paolo Bossi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili and University of Brescia, Italy
| | - Laura Botta
- Department of Epidemiological and Molecular Medicine Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Paolo Bironzo
- AOU S Luigi Gonzaga, Orbassano, Turin & Department of Oncology, University of Turin, Turin, Italy
| | - Cristina Sonetto
- AOU S Luigi Gonzaga, Orbassano, Turin & Department of Oncology, University of Turin, Turin, Italy
| | - Gianna Musettini
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Andrea Sbrana
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Valerio Di Giannantonio
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Laura D Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Massimo Di Maio
- Ordine Mauriziano Hospital, Turin & Department of Oncology, University of Turin, Turin, Italy
| | - Andrea Antonuzzo
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
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11
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Bogani G, Matteucci L, Tamberi S, Ditto A, Sabatucci I, Murgia F, Arcangeli V, Maltese G, Comerci G, Stefanetti M, Sonetto C, Calareso G, Marchiano A, Chiappa V, Lorusso D, Raspagliesi F. RECIST 1.1 criteria predict recurrence-free survival in advanced ovarian cancer submitted to neoadjuvant chemotherapy. Eur J Obstet Gynecol Reprod Biol 2019; 237:93-99. [PMID: 31029972 DOI: 10.1016/j.ejogrb.2019.04.007] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/06/2019] [Accepted: 04/07/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Neoadjuvant chemotherapy plus interval debulking surgery is growing treatment strategy for advanced ovarian cancer patients with unresectable disease. Here, we aimed to assess predictors of surgical unresectability and survival of patients submitted to neoadjuvant chemotherapy plus interval debulking surgery. METHODS Data of consecutive 193 patients undergoing neoadjuvant chemotherapy plus interval debulking surgery were retrospectively evaluated in four Italian oncologic centers. RECIST 1.1 guidelines were used to assess response to neoadjuvant chemotherapy. Survival outcomes were evaluated using Kaplan-Meier and Cox proportional hazard models. RESULTS Overall, 155 (80.3%) and 38 (19.7%) patients had optimal and non-optimal cytoreduction at the time of interval debulking surgery. Via multivariate analysis, age (OR: 2.87 (95%CI: 1.29, 6.36) per 10-year increase) and radiological response to neoadjuvant chemotherapy (OR: 48.1 (95%CI: 6.33, 365.3)) impact on the inability to perform a complete cytoreduction. Patients having complete or partial response experienced a significant better disease-free survival than patients having stable or progressive disease at radiological examination (median disease-free survival 16.8 vs. 11.0 months; HR: 0.42 (95%CI: 0.09, 0.78); p = .001). Radiological response did not predict for overall survival (p = .719). CONCLUSIONS RECIST1.1 response criteria might be helpful to predict surgical resectability and disease-free survival of advanced stage ovarian cancer patients undergoing neoadjuvant chemotherapy plus interval debulking surgery.
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Affiliation(s)
- Giorgio Bogani
- Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | | | | | - Antonino Ditto
- Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - Ilaria Sabatucci
- Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - Ferdinando Murgia
- Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
| | | | - Giuseppa Maltese
- Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | - Giuseppe Comerci
- Obstetrics and Gynecology, Ospedale S. Maria delle Croci, Ravenna, Italy
| | | | - Cristina Sonetto
- Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
| | | | - Alfonso Marchiano
- Department of Radiology, IRCCS National Cancer Institute, Milan, Italy
| | | | - Domenica Lorusso
- Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy
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12
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Marandino L, La Salvia A, Sonetto C, De Luca E, Pignataro D, Zichi C, Di Stefano RF, Ghisoni E, Lombardi P, Mariniello A, Reale ML, Trevisi E, Leone G, Muratori L, ButtIgliero C, Tucci M, Aglietta M, Scagliotti GV, Perrone F, Di Maio M. Quality-of-life (QoL) assessment and reporting in prostate cancer: A systematic review of phase III trials published between 2012 and 2016. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
219 Background: We previously reported that QoL is not included among endpoints and QoL results are significantly underreported in a high proportion of recently published phase III trials in oncology. In this study our aim was to describe QoL prevalence and heterogeneity in QoL reporting in prostate cancer (PC) phase III trials. Methods: Whole database included all primary publications (P) of phase III trials evaluating anticancer drugs published between 2012 and 2016 by 11 major journals. For this analysis, we extracted the subset of PC trials. We analyzed QoL inclusion among endpoints, presence of QoL results and methodology of QoL analysis. Results: 35 P were identified (21 in castration-resistant [CRPC], 9 in advanced hormone sensitive [aHSPC], incl. both metastatic and biochemical relapsed, and 5 in earlier stages). In 13 (37.1%) QoL was not listed among study endpoints: 7/21 (33.3%) in CRPC, 3/9 (33.3%) in aHSPC, and 3/5 (60%) in earlier stages. Out of 22 primary P of trials including QoL among endpoints, QoL results were not reported in 9 (40.9%). Overall, no QoL data were available in 22/35 (62.9%) primary P (61.9% in CRPC, 44.4% in aHSPC and 100% in earlier disease). QoL data were not available in 15/25 (60%) trials with overall survival (OS) as primary endpoint, and in 7/10 (70%) trials with other primary endpoints. QoL data were not available in 7/16 (43.8%) trials with a positive result (25% in CRPC, 40% in aHSPC, 100% in earlier stages). In 18 trials with available QoL results (incl. secondary publications), most common QoL tools were FACT-P (11, 61.1%) and EORTC QLQ-C30 (6, 33.3%). Common methods of analysis were mean changes (6, 33.3%), mean scores over time (6, 33.3%), time to deterioration (6, 33.3%) and proportion of responders (3, 16.7%). QoL analysis was focused on the impact of toxicity in 10 cases (mostly in earlier stages), and on disease symptoms in 10 cases (mostly in CRPC). Conclusions: QoL is absent in a high proportion of recently published phase III trials in PC, although presence of QoL results is better in positive trials, especially in CRPC. Methodology of QoL analysis is heterogeneous in terms of type of instruments, analysis and presentation of results.
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Affiliation(s)
- Laura Marandino
- Department of Oncology, University of Turin; Candiolo Cancer Institute - FPO- IRCCS, Candiolo (TO), Italy
| | - Anna La Salvia
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Emmanuele De Luca
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Daniele Pignataro
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Clizia Zichi
- Department of Oncology, University of Turin; Ordine Mauriziano Hospital, Torino, Italy
| | - Rosario F Di Stefano
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Eleonora Ghisoni
- Department of Oncology, University of Turin; Candiolo Cancer Institute - FPO- IRCCS, Candiolo (TO), Italy
| | - Pasquale Lombardi
- Department of Oncology, University of Turin; Candiolo Cancer Institute - FPO- IRCCS, Candiolo (TO), Italy
| | - Annapaola Mariniello
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Maria Lucia Reale
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Elena Trevisi
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Leonardo Muratori
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Consuelo ButtIgliero
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Marcello Tucci
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Massimo Aglietta
- Department of Oncology, University of Turin; Candiolo Cancer Institute - FPO- IRCCS, Candiolo (TO), Italy
| | - Giorgio V. Scagliotti
- Department of Oncology, University of Turin; San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Francesco Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale"-IRCCS, Napoli, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin; Ordine Mauriziano Hospital, Torino, Italy
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13
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Marandino L, La Salvia A, Sonetto C, De Luca E, Pignataro D, Zichi C, Di Stefano RF, Ghisoni E, Lombardi P, Mariniello A, Reale ML, Trevisi E, Leone G, Muratori L, Marcato M, Bironzo P, Aglietta M, Scagliotti GV, Perrone F, Di Maio M. Biases in assessment and reporting of health-related quality of life (QoL): A systematic review of oncology randomized phase III trials published between 2012 and 2016. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18719] [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 Marandino
- Department of Oncology, University of Turin, Fondazione del Piemonte per l’Oncologia - IRCCS, Candiolo (TO), Italy
| | - Anna La Salvia
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Emmanuele De Luca
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Daniele Pignataro
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Clizia Zichi
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Rosario F Di Stefano
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Eleonora Ghisoni
- Department of Oncology, University of Turin, Fondazione del Piemonte per l’Oncologia - IRCCS, Candiolo (TO), Italy
| | - Pasquale Lombardi
- Department of Oncology, University of Turin, Fondazione del Piemonte per l’Oncologia - IRCCS, Candiolo (TO), Italy
| | - Annapaola Mariniello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Maria Lucia Reale
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Elena Trevisi
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Leonardo Muratori
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Maddalena Marcato
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Paolo Bironzo
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | - Massimo Aglietta
- Department of Oncology, University of Turin, Fondazione del Piemonte per l’Oncologia - IRCCS, Candiolo (TO), Italy
| | - Giorgio V. Scagliotti
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | | | - Massimo Di Maio
- Department of Oncology, University of Turin; Ordine Mauriziano Hospital, Torino, Italy
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14
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Zichi C, Tampellini M, Tucci M, Sonetto C, Baratelli C, Brizzi MP, Scagliotti GV. FOLFOX activity in a rare case of metastatic colonic adenocarcinoma of the tongue: a case report. BMC Cancer 2018; 18:470. [PMID: 29699528 PMCID: PMC5918988 DOI: 10.1186/s12885-018-4395-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 04/17/2018] [Indexed: 11/30/2022] Open
Abstract
Background Adenocarcinomas of the oral cavity are rare neoplasms, and only four cases of primary colonic adenocarcinoma of the tongue have ever been described in literature. Very few information about chemotherapy sensitiveness of this type of neoplasia is available, with only one regimen that showed some activity in a metastatic patient. Case presentation We describe the case of a patient bearing a metastatic colonic adenocarcinoma of the tongue submitted to a first-line chemotherapy with oxaliplatin, 5-fluorouracil and folinic acid (FOLFOX regimen). After chemotherapy the patient obtained the complete disappearance of the primitive neoplasia located in the body of the tongue, and a tumor size reduction > 50% of liver and lung metastases. Conclusions This case demonstrated the activity of the combination of oxaliplatin and 5-fluorouracil in this very rare neoplasia. The FOLFOX regimen might be considered either in advanced and especially in the neoadjuvant setting, when the reduction of the primary tumor is highly needed.
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Affiliation(s)
- Clizia Zichi
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Marco Tampellini
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043 Orbassano, Turin, Italy.
| | - Marcello Tucci
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Cristina Sonetto
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Chiara Baratelli
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Maria P Brizzi
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Giorgio V Scagliotti
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
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15
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Brizzi MP, La Salvia A, Tampellini M, Sonetto C, Volante M, Scagliotti GV. Efficacy and safety of everolimus treatment in a hemodialysis patient with metastatic atypical bronchial carcinoid: case report and literature review. BMC Cancer 2018; 18:311. [PMID: 29558899 PMCID: PMC5861646 DOI: 10.1186/s12885-018-4205-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/09/2018] [Indexed: 12/03/2022] Open
Abstract
Background Everolimus was recently approved for the treatment of neuroendocrine tumors. However, its efficacy and tolerability in hemodialysis patients with end-stage renal disease is not established. Case presentation We describe the case of a 47-year-old man with end-stage renal disease who received everolimus plus Lanreotide for 9 months for the management of metastatic atypical bronchial carcinoid. Conclusions Everolimus is a treatment option for hemodialysis patients with metastatic atypical bronchial carcinoid. Based on our case report and review of literature, Everolimus does not require any dose reductions and is overall well tolerated in hemodialysis patients.
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Affiliation(s)
- M P Brizzi
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
| | - A La Salvia
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - M Tampellini
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - C Sonetto
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - M Volante
- Department of Medical Oncology and Pathology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
| | - G V Scagliotti
- Medical Oncology, Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Turin, Italy
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16
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Baratelli C, Zichi C, Di Maio M, Brizzi MP, Sonetto C, Scagliotti GV, Tampellini M. A systematic review of the safety profile of the different combinations of fluoropyrimidines and oxaliplatin in the treatment of colorectal cancer patients. Crit Rev Oncol Hematol 2018; 122:21-29. [DOI: 10.1016/j.critrevonc.2017.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 09/29/2017] [Accepted: 12/12/2017] [Indexed: 11/27/2022] Open
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17
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Baratelli C, Tampellini M, Di Maio M, Ottone A, Brizzi MP, Forti L, Alabiso I, Sonetto C, Alabiso O, Scagliotti GV. MMC/UFT/LV in refractory colorectal cancer: phase II study and analysis of predictive variables of progression. Int J Clin Oncol 2017; 23:281-286. [PMID: 28956178 DOI: 10.1007/s10147-017-1195-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 09/17/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND The treatment of refractory metastatic colorectal cancer (rmCRC) and the lack of predictive variables are matters of debate. PATIENTS AND METHODS We conducted a multicentre phase II trial assessing the disease control rate (DCR) of the combination of tegafur/uracil and mitomycin C in rmCRC. The number of previous lines of chemotherapy, carcinoembryonic antigen (CEA) levels, progression-free survival of the last chemotherapy regimen (PPFS), and the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio at the time of study entry were evaluated as indicators of early progression. RESULTS We enrolled 42 patients. The combination was well tolerated with a DCR of 26.2% and median overall survival of 6.9 months. Low CEA levels, PPFS >6 months and low NLR were significantly associated with better prognosis. CONCLUSION The study failed its primary endpoint. However, some putative indicators of early progressive patients have been described.
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Affiliation(s)
- Chiara Baratelli
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
| | - Marco Tampellini
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
| | - Massimo Di Maio
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
| | - Azzurra Ottone
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
| | - Maria Pia Brizzi
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
| | - Laura Forti
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
| | - Irene Alabiso
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
| | - Cristina Sonetto
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy.
| | - Oscar Alabiso
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
| | - Giorgio Vittorio Scagliotti
- Division of Medical Oncology, Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Regione Gonzole 10, Orbassano, 10043, Turin, Italy
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Cremolini C, Antoniotti C, Pietrantonio F, Berenato R, Tampellini M, Baratelli C, Salvatore L, Marmorino F, Borelli B, Nichetti F, Bironzo P, Sonetto C, Bartolomeo MD, de Braud F, Loupakis F, Falcone A, Maio MD. Surrogate Endpoints in Second-Line Trials of Targeted Agents in Metastatic Colorectal Cancer: A Literature-Based Systematic Review and Meta-Analysis. Cancer Res Treat 2017; 49:834-845. [PMID: 27857020 PMCID: PMC5512363 DOI: 10.4143/crt.2016.249] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 10/18/2016] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate progression-free survival (PFS) and objective response rate (ORR) as surrogate endpoints of overall survival (OS) in modern clinical trials investigating the efficacy of targeted agents in the second-line treatment of metastatic colorectal cancer (mCRC). MATERIALS AND METHODS A systematic search of literature pertaining to randomized phase II and III trials evaluating targeted agents as second-line treatments for mCRC was performed. The strength of the correlation between both PFS and ORR and OS was assessed based on the Pearson's correlation coefficient (R) and the coefficient of determination (R2). RESULTS Twenty trials, including a total of 7,571 patients, met the search criteria. The median duration of post-progression survival (PPS) was 7.6 months. The median differences between experimental and control arms were 0.65 months (range, -2.4 to 3.4) for the median PFS and 0.7 months (range, -5.8 to 3.9) for the median OS. PFS and ORR showed moderate (R=0.734, R2=0.539, p < 0.001) and poor correlation (R=0.169, R2=0.029, p=0.476) with OS, respectively. No differences between anti-angiogenic agents and other drugs were evident. CONCLUSION Targeted agents investigated in the second-line treatment of mCRC provided minimal PFS gains translating into modest OS improvements. Considering both the moderate correlation between PFS and OS and the short duration of PPS, the OS should remain the preferred primary endpoint for randomized clinical trials in the second-line treatment of mCRC.
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Affiliation(s)
- Chiara Cremolini
- Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Carlotta Antoniotti
- Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Filippo Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosa Berenato
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marco Tampellini
- Department of Oncology, University of Turin, A.O.U. San Luigi Gonzaga, Turin, Italy
| | - Chiara Baratelli
- Department of Oncology, University of Turin, A.O.U. San Luigi Gonzaga, Turin, Italy
| | - Lisa Salvatore
- Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Federica Marmorino
- Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Beatrice Borelli
- Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Federico Nichetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Bironzo
- Department of Oncology, University of Turin, A.O.U. San Luigi Gonzaga, Turin, Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin, A.O.U. San Luigi Gonzaga, Turin, Italy
| | - Maria Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fotios Loupakis
- Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Alfredo Falcone
- Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, A.O. Ordine Mauriziano, Turin, Italy
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Tampellini M, Di Maio M, Baratelli C, Anania L, Brizzi MP, Sonetto C, La Salvia A, Scagliotti GV. Treatment of Patients With Metastatic Colorectal Cancer in a Real-World Scenario: Probability of Receiving Second and Further Lines of Therapy and Description of Clinical Benefit. Clin Colorectal Cancer 2017; 16:372-376. [PMID: 28465170 DOI: 10.1016/j.clcc.2017.03.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/16/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND The optimal therapeutic strategy for metastatic colorectal cancer patients is still a matter of debate. There are no prognostic variables indicating how many lines individual patients ought to receive, and whether later lines could be effective even when earlier ones were not. PATIENTS AND METHODS We retrospectively collected data from 420 consecutive patients with metastatic colorectal cancer at our institution, describing the proportion of patients who received second or later lines of therapy and the chance of a line of treatment being active when the previous line was not. For each line of treatment, we defined clinical benefit as the probability of not having had evidence of disease progression 6 months after the start of chemotherapy. RESULTS Of the 373 patients with disease progression after first-line chemotherapy (1L), 277 received a second line (2L) (probability of being submitted to a 2L (P(2L)) = 74.3%): 143 (63.3%) of 226 received a 3L (P(3L)), and 56 (45.9%) of 122 were submitted to a 4L (P(4L)). Joint probabilities were: 2L 74.3%, 3L 47.0%, and 4L 21.6%. A total of 298 (71.5%) of 417 patients had a clinical benefit with 1L; 134 (48.6%) of 276 with 2L; 50 (35.2%) of 142 with 3L; and 12 (25.0%) of 48 with 4L. Taking all these data together, 31% of the patients who experienced early progression at 1L had the chance to have a clinical benefit with any further lines. CONCLUSION Our study demonstrated that of 4 patients submitted to a 1L, about 3 will receive a 2L, about 2 a 3L, and nearly 1 a 4L. Later lines could be beneficial even though earlier ones were not.
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Affiliation(s)
- Marco Tampellini
- Department of Oncology, University of Torino, AOU San Luigi di Orbassano, Orbassano, Italy.
| | | | | | - Lorenzo Anania
- Department of Oncology, University of Torino, AOU San Luigi di Orbassano, Orbassano, Italy
| | - Maria Pia Brizzi
- Department of Oncology, University of Torino, AOU San Luigi di Orbassano, Orbassano, Italy
| | - Cristina Sonetto
- Department of Oncology, University of Torino, AOU San Luigi di Orbassano, Orbassano, Italy
| | - Anna La Salvia
- Department of Oncology, University of Torino, AOU San Luigi di Orbassano, Orbassano, Italy
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Tampellini M, Benedetto S, Rubatto E, Baratelli C, DI Scipio F, Pirro E, Brizzi MP, Sonetto C, DI Maio M, Berta GN, Scagliotti GV. Bioequivalence of Branded and Generic Oxaliplatin: From Preclinical Assessment to Clinical Incidence of Hypersensitivity Reactions. Anticancer Res 2016; 36:5163-5170. [PMID: 27798876 DOI: 10.21873/anticanres.11086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 09/01/2016] [Accepted: 09/22/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Generic anticancer drugs represent an opportunity in terms of cost savings but there are some concerns about their tolerability. The safety profiles of generic versus branded oxaliplatin formulations have never been studied in detail. PATIENTS AND METHODS We tested in vitro concentrations, stability and efficacy of branded versus generic oxaliplatin formulations, then we retrospectively collected data about hypersensitivity reactions (HSR) of 427 colorectal cancer patients treated with oxaliplatin-based regimens. RESULTS No significant difference in oxaliplatin concentration or time-dependent antiproliferative activity between branded and generic oxaliplatin was detected. The incidence of HSR was 12.1% (33/273 patients) in those treated with branded and 9.8% (15/154 patients) in those treated with generic oxaliplatin (p=0.46). The occurrence of grade III-IV HSRs and severe HSRs leading to oxaliplatin discontinuation were comparable. CONCLUSION No difference between generic and branded formulations of oxaliplatin were demonstrated in preclinical nor in clinical settings. Generic oxaliplatin can be considered a safe alternative to branded formulation.
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Affiliation(s)
- Marco Tampellini
- Division of Medical Oncology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Simone Benedetto
- Division of Medical Oncology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Elena Rubatto
- Division of Medical Oncology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Chiara Baratelli
- Division of Medical Oncology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Federica DI Scipio
- Division of Pharmacology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Elisa Pirro
- Division of Pharmacology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Maria Pia Brizzi
- Division of Medical Oncology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Cristina Sonetto
- Division of Medical Oncology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Massimo DI Maio
- Division of Medical Oncology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
| | - Giovanni Nicolao Berta
- Division of Pharmacology, University of Torino, Department of Oncology, S. Luigi Hospital, Turin, Italy
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Sonetto C, Baratelli C, Brizzi M, Di Maio M, Scagliotti G, Tampellini M. Pharmacological bioquivalence of branded and generic oxaliplatin: from preclinical assessment to clinical incidence of hypersensitivity reactions in patients with colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bossi P, Botta L, Bironzo P, Sonetto C, Musettini G, Sbrana A, Di Giannantonio V, Locati L, Di Maio M, Antonuzzo A. Systematic review of adverse events reporting in clinical trials leading to approval of targeted therapy and immunotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw366.05] [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: 11/14/2022] Open
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Antonuzzo A, Bossi P, Botta L, Bironzo P, Sonetto C, Musettini G, Sbrana A, Di Giannantonio V, Locati L, Di Maio M. Systematic review of adverse events reporting in clinical trials leading to approval of targeted therapy and immunotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.11] [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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Sonetto C, Baratelli C, Brizzi M, Di Maio M, Scagliotti G, Tampellini M. Phase ii study of mytomicin-c plus uft/lv in patients with metastatic colorectal cancer refractory to standard chemotherapy. subgroup analysis of predictive variables in discriminating early progressors. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.49] [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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25
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Tampellini M, La Salvia A, Baratelli C, Di Scipio F, Pirro E, Brizzi M, Sonetto C, Di Maio M, Berta G, Scagliotti G. Preclinical assessment of the bioequivalence of branded and generic oxaliplatin and incidence of hypersensitivity reactions in patients with advanced colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Brizzi M, Baratelli C, Di Maio M, Sonetto C, Bironzo P, La Salvia A, Scagliotti G, Tampellini M. Treatment of patients with metastatic colorectal cancer in a real-word scenario: probability of being submitted and clinical benefit of second and further lines of therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.25] [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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27
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Chiara B, Zichi C, Di Maio M, Sonetto C, Brizzi M, Scagliotti G, Tampellini M. A systematic review of the safety profile of bolus, continuous infusion of 5-fu and capecitabine in combination with oxaliplatin in the treatment of colorectal cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.35] [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: 11/14/2022] Open
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28
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Baratelli C, Sonetto C, Benedetto S, Rubatto E, Di Scipio F, Pirro E, Brizzi Maria P, Di Maio M, Berta Giovanni N, Scagliotti Giorgio V, Tampellini M. P-202 Preclinical assessment of the bioequivalence of branded and generic oxaliplatin and incidence of hypersensitivity reactions in patients with advanced colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.194] [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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Abstract
INTRODUCTION Anti-angiogenetic agents are currently the standard of care in metastatic CRC patients. Bevacizumab, aflibercept, regorafenib and recently ramucirumab have significantly improved both progression-free and overall survival in different lines of treatment. Since bevacizumab's approval, a number of novel anti-VEGF agents have been tested in preclinical and clinical models. AREAS COVERED This review is focused on the most recent clinical results of novel agents targeting VEGF and its receptors with a major focus on those investigated recently in clinical trials. EXPERT OPINION In the last 15 years, a number of new anti-angiogenetic agents have been tested. Unfortunately, most of them have demonstrated unacceptable toxicities or failed to show activity. When tested as single agents, encouraging preliminary results were reported with fruquintinib, famitinib, and nintedanib. Interesting novel mechanisms of action are also being explored: VGX-100 is a monoclonal antibody (mAb) which binds to VEGF-C, inhibiting activation of VEGFR-2 and VEGFR-3 when combined with bevacizumab; tanibirumab is a mAb which binds to VEGFR-2 and vanucizumab is a bispecific mAb binding both to VEGF-A and Angiopoietin-2. Data about the combination of these agents with chemotherapy are very encouraging, even though preliminary. However, the definition of specific predictive biomarkers remains a priority.
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Affiliation(s)
- M Tampellini
- a University of Turin , Department of Oncology, AOU San Luigi di Orbassano , Torino , Italy
| | - C Sonetto
- a University of Turin , Department of Oncology, AOU San Luigi di Orbassano , Torino , Italy
| | - G V Scagliotti
- a University of Turin , Department of Oncology, AOU San Luigi di Orbassano , Torino , Italy
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Brizzi MP, Sonetto C, Tampellini M, Di Maio M, Volante M, Scagliotti GV. Unusual paraneoplastic neurological syndrome secondary to a well differentiated pancreatic neuroendocrine tumor: a case report and review of the literature. BMC Cancer 2015; 15:914. [PMID: 26582328 PMCID: PMC4652398 DOI: 10.1186/s12885-015-1923-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/01/2015] [Accepted: 11/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Paraneoplastic neurological syndrome (PNS) is a heterogeneous group of disorders affecting any part of the nervous system, in a patient affected by cancer. PNS is estimated to occur in 0.01 to 8% of cancer patients, with higher incidence in those with small cell lung cancer, gynecological tumours or hematological disease. Paraneoplastic cerebellar degeneration (PCD) is the most common PNS, but it has never been reported in patients with pancreatic well-differentiated neuroendocrine tumours. CASE PRESENTATION A 61-year-old man presented with an unusual PNS and absence of circulating neural auto-antibodies. Subsequently, contrast-enhanced computed tomography revealed a large pancreatic mass, together with multiple liver metastases, histologically diagnosed as a well-differentiated neuroendocrine tumor. Initial treatment with long-acting somatostatin analogue (octreotide LAR) and prednisone achieved a biochemical response (reduction of chromogranin A level) and a radiological disease control, but patient experienced only a brief improvement of neurological symptoms. Seven months after the onset of the symptoms, he died from neurological impairment. CONCLUSIONS PNS can be associated with metastatic non-functioning well-differentiated pancreatic neuroendocrine tumors. These tumors may be unresponsive to treatment with somatostatin analogues and an early neurological treatment should be considered for the optimal management of these uncommon cases.
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Affiliation(s)
- Maria Pia Brizzi
- Medical Oncology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,University of Turin, Department of Oncology, Pathology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
| | - Cristina Sonetto
- Medical Oncology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,University of Turin, Department of Oncology, Pathology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
| | - Marco Tampellini
- Medical Oncology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,University of Turin, Department of Oncology, Pathology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
| | - Massimo Di Maio
- Medical Oncology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,University of Turin, Department of Oncology, Pathology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
| | - Marco Volante
- University of Turin, Department of Oncology, Pathology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
| | - Giorgio V Scagliotti
- Medical Oncology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,University of Turin, Department of Oncology, Pathology, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy. .,Department of Oncology, University of Turin, Azienda Ospedaliera Universitaria San Luigi, Regione Gonzole 10, 10043, Orbassano, Torino, Italy.
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Ponzetti A, Sonetto C, Spadi R, Pinta F, Fanchini L, Zanini M, Ciuffreda L, Racca P. Clinical characteristics of a series of patients with prolonged clinical benefit after anti-EGFR treatment in metastatic colorectal cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.24] [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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Senetta R, Duregon E, Sonetto C, Spadi R, Mistrangelo M, Racca P, Chiusa L, Munoz FH, Ricardi U, Arezzo A, Cassenti A, Castellano I, Papotti M, Morino M, Risio M, Cassoni P. YKL-40/c-Met expression in rectal cancer biopsies predicts tumor regression following neoadjuvant chemoradiotherapy: a multi-institutional study. PLoS One 2015; 10:e0123759. [PMID: 25875173 PMCID: PMC4398550 DOI: 10.1371/journal.pone.0123759] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/21/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Neoadjuvant chemo-radiotherapy (CRT) followed by surgical resection is the standard treatment for locally advanced rectal cancer, although complete tumor pathological regression is achieved in only up to 30% of cases. A clinicopathological and molecular predictive stratification of patients with advanced rectal cancer is still lacking. Here, c-Met and YKL-40 have been studied as putative predictors of CRT response in rectal cancer, due to their reported involvement in chemoradioresistance in various solid tumors. MATERIAL AND METHODS A multicentric study was designed to assess the role of c-Met and YKL-40 expression in predicting chemoradioresistance and to correlate clinical and pathological features with CRT response. Immunohistochemistry and fluorescent in situ hybridization for c-Met were performed on 81 rectal cancer biopsies from patients with locally advanced rectal adenocarcinoma. All patients underwent standard (50.4 gy in 28 fractions + concurrent capecitabine 825 mg/m2) neoadjuvant CRT or the XELOXART protocol. CRT response was documented on surgical resection specimens and recorded as tumor regression grade (TRG) according to the Mandard criteria. RESULTS A significant correlation between c-Met and YKL-40 expression was observed (R = 0.43). The expressions of c-Met and YKL-40 were both significantly associated with a lack of complete response (86% and 87% of c-Met and YKL-40 positive cases, p< 0.01 and p = 0.006, respectively). Thirty of the 32 biopsies co-expressing both markers had partial or absent tumor response (TRG 2-5), strengthening their positive predictive value (94%). The exclusive predictive role of YKL-40 and c-Met was confirmed using a multivariate analysis (p = 0.004 and p = 0.007 for YKL-40 and c-Met, respectively). TRG was the sole morphological parameter associated with poor outcome. CONCLUSION c-Met and YKL-40 expression is a reliable predictor of partial/absent response to neoadjuvant CRT in rectal cancer. Targeted therapy protocols could take advantage of prior evaluations of c-MET and YKL-40 expression levels to increase therapeutic efficacy.
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Affiliation(s)
- Rebecca Senetta
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Cristina Sonetto
- SSCVD Colorectal Cancer Unit, City of Health and Science Hospital of Turin, Turin, Italy
| | - Rossella Spadi
- SSCVD Colorectal Cancer Unit, City of Health and Science Hospital of Turin, Turin, Italy
| | - Massimiliano Mistrangelo
- Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - Patrizia Racca
- SSCVD Colorectal Cancer Unit, City of Health and Science Hospital of Turin, Turin, Italy
| | - Luigi Chiusa
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | - Alberto Arezzo
- Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - Adele Cassenti
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Mario Morino
- Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, University of Turin, Turin, Italy
| | - Mauro Risio
- Candiolo Cancer Institute—FPO (Fondazione del Piemonte per l'0ncologia), IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Candiolo, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
- * E-mail:
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Isella C, Terrasi A, Bellomo SE, Petti C, Galatola G, Muratore A, Mellano A, Senetta R, Cassenti A, Sonetto C, Inghirami G, Trusolino L, Fekete Z, De Ridder M, Cassoni P, Storme G, Bertotti A, Medico E. Stromal contribution to the colorectal cancer transcriptome. Nat Genet 2015; 47:312-9. [PMID: 25706627 DOI: 10.1038/ng.3224] [Citation(s) in RCA: 439] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 01/28/2015] [Indexed: 12/19/2022]
Abstract
Recent studies identified a poor-prognosis stem/serrated/mesenchymal (SSM) transcriptional subtype of colorectal cancer (CRC). We noted that genes upregulated in this subtype are also prominently expressed by stromal cells, suggesting that SSM transcripts could derive from stromal rather than epithelial cancer cells. To test this hypothesis, we analyzed CRC expression data from patient-derived xenografts, where mouse stroma supports human cancer cells. Species-specific expression analysis showed that the mRNA levels of SSM genes were mostly due to stromal expression. Transcriptional signatures built to specifically report the abundance of cancer-associated fibroblasts (CAFs), leukocytes or endothelial cells all had significantly higher expression in human CRC samples of the SSM subtype. High expression of the CAF signature was associated with poor prognosis in untreated CRC, and joint high expression of the stromal signatures predicted resistance to radiotherapy in rectal cancer. These data show that the distinctive transcriptional and clinical features of the SSM subtype can be ascribed to its particularly abundant stromal component.
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Affiliation(s)
- Claudio Isella
- 1] Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy. [2] Department of Oncology, University of Torino, Candiolo, Italy
| | - Andrea Terrasi
- Department of Oncology, University of Torino, Candiolo, Italy
| | - Sara Erika Bellomo
- 1] Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy. [2] Department of Oncology, University of Torino, Candiolo, Italy
| | - Consalvo Petti
- Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy
| | - Giovanni Galatola
- Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy
| | - Andrea Muratore
- Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy
| | - Alfredo Mellano
- Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy
| | - Rebecca Senetta
- Department of Medical Science, University of Torino, Torino, Italy
| | - Adele Cassenti
- Department of Medical Science, University of Torino, Torino, Italy
| | | | - Giorgio Inghirami
- Department of Molecular Biotechnology and Health Science, Center for Experimental Research and Medical Studies, University of Torino, Torino, Italy
| | - Livio Trusolino
- 1] Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy. [2] Department of Oncology, University of Torino, Candiolo, Italy
| | - Zsolt Fekete
- Institute of Oncology Prof. Dr. Ion Chiricuta, Cluj, Romania
| | - Mark De Ridder
- Department of Radiotherapy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Paola Cassoni
- Department of Medical Science, University of Torino, Torino, Italy
| | - Guy Storme
- Department of Radiotherapy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Andrea Bertotti
- 1] Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy. [2] Department of Oncology, University of Torino, Candiolo, Italy
| | - Enzo Medico
- 1] Candiolo Cancer Institute, Fondazione Piemontese per l'Oncologia'Istituto di Ricovero e Cura a Carattere Scientifico (FRO-IRCCS), Candiolo, Italy. [2] Department of Oncology, University of Torino, Candiolo, Italy
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Pinta F, Ponzetti A, Spadi R, Fanchini L, Zanini M, Mecca C, Sonetto C, Ciuffreda L, Racca P. Pilot clinical trial on the efficacy of prophylactic use of vitamin K1-based cream (Vigorskin) to prevent cetuximab-induced skin rash in patients with metastatic colorectal cancer. Clin Colorectal Cancer 2013; 13:62-7. [PMID: 24332355 DOI: 10.1016/j.clcc.2013.10.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [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: 05/25/2013] [Revised: 09/27/2013] [Accepted: 10/02/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cetuximab is an effective option for the treatment of metastatic colorectal cancer in the first and subsequent lines of treatment; among its side effects, acneiform skin rash is one of the major causes of treatment delay, reduction, or interruption, with a negative effect on quality of life. No effective strategy to prevent skin rash induced by epidermal growth factor receptor inhibitors is available; however, encouraging results have come from vitamin K1, phytomenadione, applied as a topical formulation. Available studies have been conducted in heterogeneous populations and are mainly focused on the use of vitamin K1-based cream for the treatment, rather than the prophylaxis, of acneiform rash. PATIENTS AND METHODS Forty-one consecutive patients from a single center all affected by metastatic colorectal cancer and receiving cetuximab, alone or combined with chemotherapy, applied vitamin K1-based cream to prevent the occurrence of acneiform skin rash. The cream was applied twice a day on the face and trunk from the first day of administration of cetuximab. RESULTS The application of the cream was well tolerated. No grade 4 rash was reported. The proportion of grade 3 skin rash in the first 8 weeks of treatment in this population was 15%, at the lower limit of values reported in the literature, and the proportion of patients with grade 2 rash was reduced (22.5%). CONCLUSION This experience confirms available data in a homogeneous population, suggesting a possible benefit of topical vitamin K1 as prophylaxis for cetuximab-induced skin rash in patients with metastatic colorectal cancer.
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Affiliation(s)
- Francesco Pinta
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy
| | - Agostino Ponzetti
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy.
| | - Rosella Spadi
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy
| | - Laura Fanchini
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy
| | - Marcello Zanini
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy
| | - Caterina Mecca
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy
| | - Cristina Sonetto
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy
| | - Libero Ciuffreda
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy
| | - Patrizia Racca
- Colorectal Cancer Unit, Medical Oncology 1 Division, San Giovanni Battista Hospital, Turin, Italy
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