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Chi KN, Sandhu S, Smith MR, Attard G, Saad M, Olmos D, Castro E, Roubaud G, Pereira de Santana Gomes AJ, Small EJ, Rathkopf DE, Gurney H, Jung W, Mason GE, Dibaj S, Wu D, Diorio B, Urtishak K, Del Corral A, Francis P, Kim W, Efstathiou E. Niraparib plus abiraterone acetate with prednisone in patients with metastatic castration-resistant prostate cancer and homologous recombination repair gene alterations: second interim analysis of the randomized phase III MAGNITUDE trial. Ann Oncol 2023; 34:772-782. [PMID: 37399894 PMCID: PMC10849465 DOI: 10.1016/j.annonc.2023.06.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Patients with metastatic castration-resistant prostate cancer (mCRPC) and BRCA alterations have poor outcomes. MAGNITUDE found patients with homologous recombination repair gene alterations (HRR+), particularly BRCA1/2, benefit from first-line therapy with niraparib plus abiraterone acetate and prednisone (AAP). Here we report longer follow-up from the second prespecified interim analysis (IA2). PATIENTS AND METHODS Patients with mCRPC were prospectively identified as HRR+ with/without BRCA1/2 alterations and randomized 1 : 1 to niraparib (200 mg orally) plus AAP (1000 mg/10 mg orally) or placebo plus AAP. At IA2, secondary endpoints [time to symptomatic progression, time to initiation of cytotoxic chemotherapy, overall survival (OS)] were assessed. RESULTS Overall, 212 HRR+ patients received niraparib plus AAP (BRCA1/2 subgroup, n = 113). At IA2 with 24.8 months of median follow-up in the BRCA1/2 subgroup, niraparib plus AAP significantly prolonged radiographic progression-free survival {rPFS; blinded independent central review; median rPFS 19.5 versus 10.9 months; hazard ratio (HR) = 0.55 [95% confidence interval (CI) 0.39-0.78]; nominal P = 0.0007} consistent with the first prespecified interim analysis. rPFS was also prolonged in the total HRR+ population [HR = 0.76 (95% CI 0.60-0.97); nominal P = 0.0280; median follow-up 26.8 months]. Improvements in time to symptomatic progression and time to initiation of cytotoxic chemotherapy were observed with niraparib plus AAP. In the BRCA1/2 subgroup, the analysis of OS with niraparib plus AAP demonstrated an HR of 0.88 (95% CI 0.58-1.34; nominal P = 0.5505); the prespecified inverse probability censoring weighting analysis of OS, accounting for imbalances in subsequent use of poly adenosine diphosphate-ribose polymerase inhibitors and other life-prolonging therapies, demonstrated an HR of 0.54 (95% CI 0.33-0.90; nominal P = 0.0181). No new safety signals were observed. CONCLUSIONS MAGNITUDE, enrolling the largest BRCA1/2 cohort in first-line mCRPC to date, demonstrated improved rPFS and other clinically relevant outcomes with niraparib plus AAP in patients with BRCA1/2-altered mCRPC, emphasizing the importance of identifying this molecular subset of patients.
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Affiliation(s)
- K N Chi
- University of British Columbia, BC Cancer-Vancouver Center, Vancouver, Canada.
| | - S Sandhu
- Peter MacCallum Cancer Center, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - M R Smith
- Massachusetts General Hospital Cancer Center, Boston, USA; Harvard Medical School, Boston, USA
| | - G Attard
- University College London Cancer Institute, London, UK; University College London Hospitals, London, UK
| | - M Saad
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - D Olmos
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid
| | - E Castro
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - G Roubaud
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | | | - E J Small
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco
| | - D E Rathkopf
- Memorial Sloan Kettering Cancer Center, New York, USA; Weill Cornell Medicine, New York, USA
| | - H Gurney
- Macquarie University, Macquarie Park, Australia
| | - W Jung
- Keimyung University Dongsan Hospital, Daegu, South Korea
| | - G E Mason
- Janssen Research & Development, LLC, Spring House
| | - S Dibaj
- Janssen Research & Development, LLC, San Diego
| | - D Wu
- Janssen Research & Development, LLC, Los Angeles
| | - B Diorio
- Janssen Research & Development, LLC, Titusville
| | - K Urtishak
- Janssen Research & Development, LLC, Spring House
| | | | - P Francis
- Janssen Research & Development, LLC, Bridgewater
| | - W Kim
- Janssen Research & Development, LLC, Los Angeles
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Tang C, Sherry A, Haymaker C, Bathala T, Liu S, Fellman B, Aparicio A, Zurita-Saavedra A, Chun S, Reddy J, Efstathiou E, Wang J, Pilie P, Reuben A, Kovitz C, Kumar R, Chapin B, Gomez D, Wistuba I, Corn P. Addition of Metastasis-Directed Therapy to Intermittent Hormone Therapy for Oligometastatic Prostate Cancer (EXTEND): A Multicenter, Randomized Phase II Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Oudard S, Bevans K, Attard G, Efstathiou E, Flaig T, Franke F, Goodman O, De Giorgi U, Pieczonka C, Yeruva K, De Porre P, Brookman-May S, Dibaj S, Wu D, Mundle S, McCarthy S, Steuber T, Suzuki H, Rathkopf D, Saad F. 584P Health-related quality of life (HRQoL) in ACIS: A phase III trial of apalutamide with abiraterone acetate and prednisone (APA + AAP) vs AAP in metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Hahn A, Tidwell R, Surasi D, Msaouel P, Efstathiou E, Zurita-Saavedra A, Tu SM, McQuade J, Fogelman D, Starbuck M, Subudhi S, Corn P, Pilie P, Aparicio A, Logothetis C. 669P Body composition and clinical outcomes in men with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Gillessen S, Omlin A, Attard G, de Bono JS, Efstathiou E, Fizazi K, Halabi S, Nelson PS, Sartor O, Smith MR, Soule HR, Akaza H, Beer TM, Beltran H, Chinnaiyan AM, Daugaard G, Davis ID, De Santis M, Drake CG, Eeles RA, Fanti S, Gleave ME, Heidenreich A, Hussain M, James ND, Lecouvet FE, Logothetis CJ, Mastris K, Nilsson S, Oh WK, Olmos D, Padhani AR, Parker C, Rubin MA, Schalken JA, Scher HI, Sella A, Shore ND, Small EJ, Sternberg CN, Suzuki H, Sweeney CJ, Tannock IF, Tombal B. Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015. Ann Oncol 2019; 30:e3. [PMID: 27141017 DOI: 10.1093/annonc/mdw180] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chi K, Rathkopf D, Attard G, Smith M, Efstathiou E, Olmos D, Small E, Lee J, Sieber P, Dunshee C, Ricci D, Simon J, Zhao X, Kothari N, Cheng S, Sandhu S. A phase III randomized, placebo-controlled, double-blind study of niraparib plus abiraterone acetate and prednisone versus abiraterone acetate and prednisone in patients with metastatic prostate cancer (NCT03748641). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Smith M, Sandhu S, Kelly W, Scher H, Efstathiou E, Lara P, Yu E, George D, Chi K, Saad F, Summa J, Freedman J, Mason G, Zhu E, Ricci D, Simon J, Cheng S, Fizazi K. Pre-specified interim analysis of GALAHAD: A phase II study of niraparib in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) and biallelic DNA-repair gene defects (DRD). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.043] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [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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Efstathiou E, Terras A, Kopanakis N, Andreadakis G, Prodromidou A, Manikis P, Spiliotis J. Local recurrence rate after resection of low rectal cancer: short-term outcomes of a single center. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.411] [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] Open
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Efstathiou E, Terras A, Kopanakis N, Andreadakis G, Prodromidou A, Manikis P, Spiliotis J. The role of a diverting ileostomy in patients with low rectal cancer treated with a low anterior resection. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.412] [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: 12/01/2022] Open
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Fizazi K, Hussain M, Saad F, Shore N, De Giorgi U, Efstathiou E, Ferreira U, Ivashchenko P, Madziarska K, Al-Adhami M, Modelska K, Phung D, Steinberg J, Sternberg C. A phase III, randomized, double-blind, placebo (PBO)-controlled study of enzalutamide (ENZA) in men with nonmetastatic (M0) castration-resistant prostate cancer (CRPC): Results of PROSPER by age and region. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gillessen S, Schmid S, Beltran H, Almeida D, Mehra N, Lavaud P, Morales Barrera R, Pignataro D, Castro Marcos E, Conteduca V, Efstathiou E, Le H, Pezaro C, Suzuki H, Zivi A, Klingbiel D, Omlin A. Platinum-based therapy in men with metastatic castration resistant prostate (mCRPC) with or without DNA repair defects: A multicentre retrospective analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sakellakis M, Ramachandran S, Efstathiou E, Mao X, Hoang A, Navone N, Logothetis C, Titus M. PO-259 Identification of a clinically meaningful site-specific steroid roadmap in prostate cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.774] [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: 11/03/2022] Open
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Efstathiou E. The case for ‘successfully’ treating hormone naïve metastatic prostate cancer. Ann Oncol 2018; 29:1084-1086. [DOI: 10.1093/annonc/mdy122] [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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Pezaro C, Omlin A, Mastris K, Attard G, Beer T, Chi K, Chowdhury S, Davis I, Drake C, de Bono J, Efstathiou E, Gravis G, Higano C, Hussain M, James N, Logothetis C, Morgans A, Parker C, Ryan C, Saad F, Sartor O, Small E, Sternberg C, Sweeney C, Tannock I, Tombal B, Gillessen S. Precision, complexity and stigma in advanced prostate cancer terminology: it is time to move away from ‘castration-resistant’ prostate cancer. Ann Oncol 2017; 28:1692-1694. [DOI: 10.1093/annonc/mdx312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Efstathiou E, Tsikkinis A, Wen S, Tapia ELN, Hoang A, Aparicio A, Tu SM, Rangel G, Troncoso P, Corn P, Araujo J, Logothetis C. Abiraterone acetate (AA) followed by randomization to dasatinib (D) or sunitinib malate (S) in metastatic castrate resistant prostate cancer (mCRPC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.11] [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: 11/14/2022] Open
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de Wit R, Fizazi K, Efstathiou E, Dittamore R, Hitier S, Pantel K, Sternberg C, Tombal B, Wülfing C, de Bono J. CARD: A randomized phase 4 trial comparing cabazitaxel and an androgen receptor (AR)-targeted agent in men with metastatic castration-resistant prostate cancer (mCRPC) progressing after docetaxel and an alternative AR-targeted agent. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw372.50] [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: 11/13/2022] Open
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Polychronidis A, Tsaroucha AK, Karayiannakis AJ, Perente S, Efstathiou E, Simopoulos C. Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy. J Int Med Res 2016; 33:360-3. [PMID: 15938598 DOI: 10.1177/147323000503300312] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report a case of delayed perforation of the large bowel because of thermal injury during a laparoscopic cholecystectomy. A 78-year-old male with symptomatic cholelithiasis underwent a difficult laparoscopic cholecystectomy because of multiple adhesions resulting from two previous cholecystitis episodes. The patient recovered well after surgery and was discharged on post-operative day 2. On postoperative day 10, the patient returned to the hospital with peritonitis. An exploratory laparotomy revealed perforation of the wall of the hepatic flexure of the large bowel, which was centred in a necrotic area 1 cm in diameter. The perforation was sutured and a temporary ileostomy performed, which was closed at a later date. The patient was doing well at a 10-month follow-up review. A delayed rupture of any part of the bowel after laparoscopic surgery can be potentially fatal if not treated during an emergency exploratory laparotomy, even if the clinical signs are not severe.
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Affiliation(s)
- A Polychronidis
- Second Department of Surgery, Democritus University of Thrace, Alexandroupolis, Greece
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Spiliotis J, Argiriou E, Vafias E, Manou V, Vaos N, Datsis A, Efstathiou E. Re-admissions for delayed complications after cytoreductive surgery and HIPEC. Acta Chir Belg 2016; 116:96-100. [PMID: 27385296 DOI: 10.1080/00015458.2016.1165019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Peritoneal metastasis (PM) is currently treated with the complex procedure of cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS + HIPEC). This procedure presents high morbidity and mortality rates, but they have only been examined in the immediate post-operative period. The aim of our study is to present, describe and analyze the post-operative events, secondary to a cytoreductive surgery and HIPEC procedure that occurs after the patients' discharge from the hospital. PATIENTS AND METHODS We examine retrospectively 219 patients who were discharged from our hospital from the initial 230 patients with PM, who were operated on from August 2005 to August 2015 and underwent CRS and HIPEC. Complications are investigated from the patient's discharge date until the 90th post-operative day, and are categorized with the Clavien-Dindo classification. RESULTS We identified 17 patients (7.8%) who developed late complications. No major differences in patient characteristics were identified between this group of 17 patients and the rest, apart from a slightly higher PCI (23.5 vs. 22.3). Mean length of stay at the re-admission was 11.7 days. 5 of the patients (29.4%) had to be re-operated on, whereas we found a mortality of 11.8% (2/17 patients). The most common complications involved abdominal abscesses (17.6%), ureteral strictures (17.6%) and enterocutaneous fistulae (17.6%). CONCLUSION Our study highlights the late complications following CRS plus HIPEC procedures, that occur after the patient's discharge from the hospital, an issue that has not been investigated thoroughly yet and may have serious impact on the post-operative quality of life. The role of adjuvant chemotherapy following CRS and HIPEC procedures in the onset of such complications appears to be important and needs further investigation.
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Angelergues A, Bellmunt J, Efstathiou E, Gonzalez I, Gyftaki R, Delanoy N, Ozguroglu M, Flechon A, Guillot A, Le Moulec S, Castellano D, Esteban E, Munarriz J, Campos Balea B, Ardavanis A, Stefanou D, Oudard S. 2538 Response to cabazitaxel in patients with metastatic castrationresistant prostate cancer (mCRPC) poorly responding to docetaxel. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31357-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Oudard S, Angelergues A, Efstathiou E, Gonzalez I, Gyftaki R, Delanoy N, Ozguroglu M, Flechon A, Guillot A, Le Moulec S, Castellano D, Esteban E, Munarriz J, Campos Balea B, Ardavanis A, Stefanou D, Bellmunt J. 2541 Updated results of the FLAC European database of metastatic castration resistant prostate cancer (mCRPC) patients (pts) treated with life extending therapies in post-docetaxel (D) setting. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31360-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gillessen S, Omlin A, Attard G, de Bono JS, Efstathiou E, Fizazi K, Halabi S, Nelson PS, Sartor O, Smith MR, Soule HR, Akaza H, Beer TM, Beltran H, Chinnaiyan AM, Daugaard G, Davis ID, De Santis M, Drake CG, Eeles RA, Fanti S, Gleave ME, Heidenreich A, Hussain M, James ND, Lecouvet FE, Logothetis CJ, Mastris K, Nilsson S, Oh WK, Olmos D, Padhani AR, Parker C, Rubin MA, Schalken JA, Scher HI, Sella A, Shore ND, Small EJ, Sternberg CN, Suzuki H, Sweeney CJ, Tannock IF, Tombal B. Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015. Ann Oncol 2015; 26:1589-604. [PMID: 26041764 PMCID: PMC4511225 DOI: 10.1093/annonc/mdv257] [Citation(s) in RCA: 234] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 12/18/2022] Open
Abstract
The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management. The successful registration of several drugs for castration-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion, and not based on a critical review of the available evidence, are presented. The various recommendations carried differing degrees of support, as reflected in the wording of the article text and in the detailed voting results recorded in supplementary Material, available at Annals of Oncology online. Detailed decisions on treatment as always will involve consideration of disease extent and location, prior treatments, host factors, patient preferences as well as logistical and economic constraints. Inclusion of men with APC in clinical trials should be encouraged.
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Affiliation(s)
- S Gillessen
- Department of Oncology/Haematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - A Omlin
- Department of Oncology/Haematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - G Attard
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - J S de Bono
- Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - E Efstathiou
- Department of Genitourinary Medical Oncology, MD Anderson Cancer Centre, Houston Department of Genitourinary Medical Oncology, David H. Koch Centre, The University of Texas M. D. Anderson Cancer Centre, Houston, USA Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
| | - S Halabi
- Department of Biostatistics and Bioinformatics, Duke University, Durham
| | - P S Nelson
- Division of Human Biology, Fred Hutchinson Cancer Research Centre, Seattle
| | - O Sartor
- Tulane Cancer Centre, Tulane University, New Orleans
| | - M R Smith
- Massachusetts General Hospital Cancer Centre, Boston
| | - H R Soule
- Prostate Cancer Foundation, Santa Monica, USA
| | - H Akaza
- Research Centre for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - T M Beer
- Oregon Health & Science University Knight Cancer Institute, Portland
| | - H Beltran
- Department of Medicine, Weill Cornell Medical College, New York
| | - A M Chinnaiyan
- Michigan Centre for Translational Pathology, Department of Pathology Department of Urology, Comprehensive Cancer Centre Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, USA
| | - G Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - I D Davis
- Monash University and Eastern Health, Eastern Health Clinical School, Box Hill, Australia
| | - M De Santis
- Cancer Research Centre, University of Warwick, Warwick, UK Ludwig Boltzmann Institute for Applied Cancer Research, Kaiser Franz Josef-Spital, Vienna, Austria
| | - C G Drake
- Johns Hopkins Sidney Kimmel Cancer Center and The Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - R A Eeles
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - S Fanti
- Department of Nuclear Medicine, Policlinico S. Orsola, University of Bologna, Bologna, Italy
| | - M E Gleave
- Urological Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - A Heidenreich
- Klinik und Poliklinik für Urologie, RWTH University Aachen, Aachen, Germany
| | - M Hussain
- University of Michigan Comprehensive Cancer Center, Ann Arbor, USA
| | - N D James
- Cancer Research Centre, University of Warwick, Warwick, UK Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, Birmingham, UK
| | - F E Lecouvet
- Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - C J Logothetis
- Department of Genitourinary Medical Oncology, MD Anderson Cancer Centre, Houston Department of Genitourinary Medical Oncology, David H. Koch Centre, The University of Texas M. D. Anderson Cancer Centre, Houston, USA
| | - K Mastris
- Europa Uomo Prostate Patients, Clayhall Ilford, UK
| | - S Nilsson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - W K Oh
- Division of Haematology and Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - D Olmos
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid CNIO-IBIMA Genitourinary Cancer Unit, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain
| | - A R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood
| | - C Parker
- Prostate Cancer Targeted Therapy Group, Academic Urology Unit and Department of Diagnostic Radiology, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK
| | - M A Rubin
- Institute for Precision Medicine, Meyer Cancer Center, Department of Pathology and Urology, Weill Cornell Medical College and NewYork Presbyterian, New York, USA
| | - J A Schalken
- Department of Urology, Radboud University, Medical Centre, Nijmegen, The Netherlands
| | - H I Scher
- Department of Medicine, Weill Cornell Medical College, New York Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York
| | - A Sella
- Department of Oncology, Assaf Harofeh Medical Centre, Tel-Aviv University, Sackler School of Medicine, Zerifin, Israel
| | - N D Shore
- Department of Urology, Carolina Urologic Research Centre, Myrtle Beach
| | - E J Small
- Helen Diller Family Comprehensive Cancer Centre, UCSF, San Francisco, USA
| | - C N Sternberg
- Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy
| | - H Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan
| | - C J Sweeney
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - I F Tannock
- Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - B Tombal
- Service D'Urologie, Institut de Recherche Clinique, Université Catholique de Louvain, Brussels, Belgium
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Goussetis E, Efstathiou E, Paisiou A, Avgerinou G, Zisaki K, Giamouris VJ, Peristeri I, Kitra V, Vessalas G, Gamaletsou MN, Sipsas NV, Graphakos S. Infectious complications following allogeneic stem cell transplantation by using anti-thymocyte globulin-based myeloablative conditioning regimens in children with hemoglobinopathies. Transpl Infect Dis 2015; 17:201-7. [PMID: 25645592 DOI: 10.1111/tid.12358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/29/2014] [Accepted: 01/11/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Anti-thymocyte globulin (ATG) has been used to prevent graft failure/rejection in the setting of allogeneic stem cell transplantation (allo-SCT) for hemoglobinopathies; however, epidemiology data for transplant-related infections in this population are scarce. METHOD We retrospectively analyzed the epidemiology of bacterial, fungal, viral, and parasitic infections in a cohort of 105 children and adolescents with β-thalassemia (n = 100) or sickle cell disease (n = 5) who underwent allo-SCT using human leukocyte antigen (HLA)-identical sibling (n = 96) or HLA-compatible unrelated donors (n = 9) in a single institution. All patients received an ATG-based conditioning regimen. RESULTS The cumulative incidence of cytomegalovirus (CMV) viremia was 45.7% (95% confidence interval [CI] 33-55%), developing at a median of 48 (range 12-142) days without evidence of overt CMV disease. Herpes zoster developed in 8 patients at a median of 12 months post transplant, while 10 patients presented with late onset hemorrhagic cystitis at a median of 35 days post transplant. The cumulative incidence of bacteremia was 17.1% (95% CI 10.6-25%), occurring at a median of 74 (range 24-110) days. No patient developed probable or definite invasive fungal infection. Four deaths were recorded; 2 of them were attributed to infections (toxoplasmosis and Pneumocystis jirovecii pneumonia, respectively). CONCLUSION The rate of infections after allo-SCT, using an ATG-containing preparative regimen, in our population of pediatric patients with hemoglobinopathies is comparable to that reported elsewhere with the use of non-ATG containing regimens.
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Affiliation(s)
- E Goussetis
- Stem Cell Transplant Unit, Aghia Sophia Children's Hospital, Thivon and Papadiamantopoulou, Athens, Greece
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Katsonouri A, Fischer M, Hadjipanayis A, Arendt M, Lavranos G, Hoffmann L, Maurer-Chronakis K, Guignard C, Fragopoulou C, Cocco E, Anastasi E, Pilavakis D, Efstathiou E, Demetriou L, Hadjiefthychiou A, Demetriou E, Aerts D, Casteleyn L, Biot P, Kolossa-Gehrin M, Den Hond E, Schoeters G, Castaño A, Esteban M, Fiddicke U, Exley K, Sepai O, Gutleb A. Harmonized European human biomonitoring in small countries: Challenges, opportunities and lessons learned in Cyprus and Luxembourg from the DEMOCOPHES study. ACTA ACUST UNITED AC 2015. [DOI: 10.1515/bimo-2015-0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract:Background: To advance human biomonitoring (HBM) for policy support in Europe, a harmonized approach was developed (COPHES project, FP7 2009- 2012) and evaluated in 17 countries (DEMOCOPHES project, Life+, 2010-2012). Cyprus (CY) and Luxembourg (LU) tested the hypothesis that the COPHES European Protocol is applicable to small countries.Materials and methods: In 2011-12, the European Protocol was adopted and tested by CY and LU for the harmonized biomonitoring of 60 children and their mothers for cadmium, phthalates and cotinine in urine and for mercury in scalp hair in two sampling areas (urban, rural). Results: Both small countries achieved the preset goals for recruitment, sample collection and analysis, which allowed for the first time the assessment of children’s and mothers’ exposures to the selected chemicals in comparison with other countries. Capacity building was accomplished and communication actions were particularly effective, with both countries taking advantage of their small size to access participants, policy makers, other stakeholders and the press. Time constrains and requirements for capacity building were limiting factors. Conclusion: The COPHES European Protocol for HBM surveys is attainable in small countries. The following elements are fundamental in the design of a harmonized European HBM program, from the perspective of small countries: (a) consultation with and active involvement of the implementing countries, (b) flexibility for national decisions, while not compromising harmonization, (c) elaboration of standardized methods, procedures and documents (d) quality assurance mechanisms, (e) means of training and support.
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Spiliotis J, Halkia E, Lianos E, Kalantzi N, Grivas A, Efstathiou E, Giassas S. Cytoreductive Surgery and HIPEC in Recurrent Epithelial Ovarian Cancer: A Prospective Randomized Phase III Study. Ann Surg Oncol 2014; 22:1570-5. [DOI: 10.1245/s10434-014-4157-9] [Citation(s) in RCA: 271] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Indexed: 12/14/2022]
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Efstathiou E, Li Ning Tapia E, Aparicio A, Tu S, Wen S, Hoang A, Pagliaro L, Harmon C, Troncoso P, Araujo J, Logothetis C. Maximal Androgen Depletion with Abiraterone Acetate (Aa) Followed By Randomization of Maximal Androgen Ablation with Molecular Targeted Therapies Dasatinib or Sunitinib Malate in Metastatic Castrate Resistant Prostate Cancer (Mcrpc). Report on Candidate Predictive Androgen Signaling Signature. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.21] [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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Efstathiou E. Where Next for Precision Medicine for Prostate Cancer? Ann Oncol 2014. [DOI: 10.1093/annonc/mdu298.5] [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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Heidenreich A, Scholz H, Ozen H, Pripatnanont C, van Oort I, Gerritsen W, Efstathiou E, Rinck J, Lee J, Boumessous A, Su Z, Hitier S, Ardavanis A. Safety of Cabazitaxel + Prednisone (Cbz + P) in Patients (Pts) with Metastatic Castration-Resistant Prostate Cancer (Mcrpc) Previously Treated with Docetaxel (Doc): Cohort Compassionate-Use Programme (Cup). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu336.30] [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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Zorzou MP, Efstathiou E, Galani E, Bozas G, Kastritis E, Papadimitriou C, Dimopoulos MA, Bamias A. Carboplatin Hypersensitivity Reactions: A Single Institution Experience. J Chemother 2013; 17:104-10. [PMID: 15828452 DOI: 10.1179/joc.2005.17.1.104] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Carboplatin-related hypersensitivity reactions, frequently encountered in the heavily pretreated subpopulation of patients with gynecologic malignancies, can be severe and even potentially lethal-precluding these patients from an effective salvage treatment. We describe our experience in the management of such reactions and the application of a pretreatment protocol with corticosteroids, antihistamines and a slow infusion rate in order to safely re-administer carboplatin to the above patients. From 1998 to 2004, twenty patients developed an allergic reaction to carboplatin. Sixteen of them (80%) suffered from ovarian cancer. Upon resolution of the acute reaction, thirteen patients were pretreated according to our protocol and were re-exposed to carboplatin. Fifteen patients experienced the reaction during second-line carboplatin-based treatment and 5 patients after 3 or more regimens. Fifteen of the reactions (75%) were severe. Thirteen patients were re-treated with carboplatin after the application of our protocol, all of them successfully, even though 10 patients (77%) experienced minor symptoms during subsequent courses. On the contrary, only one of the 6 patients who were re-treated without the application of the protocol was able to receive further platinum-based treatment. In conclusion, pretreatment with corticosteroids, antihistamines and a slower infusion rate may make re-treatment possible in patients having experienced hypersensitivity to carboplatin.
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Affiliation(s)
- M P Zorzou
- Department of Clinical Therapeutics, Medical School, University of Athens, Athens, Greece
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29
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Neocleous V, Skordis N, Portides G, Efstathiou E, Costi C, Ioannou N, Pantzaris M, Anastasiadou V, Deltas C, Phylactou LA. RET proto-oncogene mutations are restricted to codon 618 in Cypriot families with multiple endocrine neoplasia 2. J Endocrinol Invest 2011; 34:764-9. [PMID: 21422799 DOI: 10.3275/7605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND RET germline mutations predispose to the development of inherited cancer syndrome multiple endocrine neoplasia type 2 (MEN2). Several variants of the RET proto-oncogene including G691S and S904S have been suggested to act as genetic modifiers at the age of onset ofMEN2. AIM The aim of this study is to characterize clinically and molecularly 7 Cypriot patients with familial medullary thyroid carcinoma (FMTC) and 1 with MEN2A and also to determine the allelic frequencies of the RET variants G691S and S904S. SUBJECTS AND METHODS Seven probands from FMTC families and 1 from MEN2A were screened for the presence of RET mutations and the G691S and S904S variants. Additionally, 226 healthy Cypriots, who served as controls were analysed in an attempt to compare the frequencies of G691S and S904S RET variants to those observed in the 8 patients. RESULTS The clinical diagnosis of the probands was based on clinical presentation and supported with biochemical findings. The germline C618R mutation of exon 10 was identified in all 8 probands and in 15 relatives from 7 different families. No significant difference in the G691S/S904S variants allele frequencies between patients (4/16 or 25%) and controls (124/452 or 27.4%) was found. CONCLUSIONS Mutational screening of the RET gene identified a common mutation (C618R) in all 8 (7 FMTC and 1 MEN2A) unrelated Cypriot patients which may be explained by a founder effect. Additionally, no association of the G691S/S904S variants was linked with the disease.
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Affiliation(s)
- V Neocleous
- Department of Molecular Genetics, Function and Therapy, Cyprus Institute of Neurology and Genetics, P.O. Box 23462, 1683 Nicosia, Cyprus
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Spiliotis JD, Halkia EA, Efstathiou E. Peritoneal carcinomatosis 2011; it's about time for chemosurgery. J BUON 2011; 16:400-408. [PMID: 22006740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The aim of this article was to offer a review on the management of peritoneal carcinomatosis (PC) from cancers of different primary origins. Peritoneal surface malignancies have been traditionally regarded as end-stage conditions amenable to merely palliative options, treated with systemic chemotherapy alone with very poor response and a median survival of less than 6 months. The combination of aggressive cytoreductive surgery (CRS), involving peritonectomy procedures and multivisceral resections with hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) to treat microscopic residual disease is a new concept. This method was established with several phase III studies in well selected patients with PC in whom sufficient cytoreduction could be achieved. Despite the need for more high quality phase III studies, there is now a consensus among many surgical teams around the world about the use of this new combination strategy as a standard of care in pseudomyxoma peritonei, peritoneal mesothelioma and colorectal cancer patients. This review summarizes the current status and possible progress in the future.
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Efstathiou E, Titus MA, Tsavachidou D, Hoang A, Karlou M, Wen S, Troncoso P, Ashe R, Berman CJ, Mohler J, Logothetis C. MDV3100 effects on androgen receptor (AR) signaling and bone marrow testosterone concentration modulation: Apreliminary report. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4501] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Higano CS, Beer TM, Taplin M, Efstathiou E, Anand A, Hirmand M, Fleisher M, Scher HI. Antitumor activity of MDV3100 in pre- and post-docetaxel advanced prostate cancer: Long-term follow-up of a phase I/II study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
134 Background: MDV3100 is a novel androgen receptor (AR) antagonist selected for potent AR activity and devoid of partial agonist effects. A preliminary report of the phase I/II study described anti-tumor activity and adverse events (Scher HI et al. Lancet. 2010;375:1437). This abstract provides long-term follow-up on time to PSA and radiographic progression in this trial. Methods: Patients (pts) with progressive castration resistant prostate cancer (CRPC) were enrolled in sequential cohorts of 3-6 pts at MDV3100 doses of 30, 60, 150, 240, 360, 480 and 600 mg/day. Once the tolerability of a dose was established, enrollment was expanded at doses ≥60 mg/day to include approximately 12 chemotherapy naïve (naïve) pts and 12 pts previously treated with docetaxel (post-chemo) per cohort. Results: 140 pts were enrolled of which 18 (13%) pts continue on active treatment (16 naive and 2 post-chemo). The median time on treatment is 51 weeks for naïve and 17 weeks for post-chemo groups. Median time on treatment for the 18 patients still on study is 131 weeks. The median time to PSA progression, defined per-protocol as a ≥25% increase in PSA from baseline, was not met for naïve and was 33 weeks for post-chemo groups. Median time to PSA progression by Prostate Cancer Clinical Trials Working Group 2 criteria was 41 weeks for naïve and 20 weeks for post-chemo groups. Median time to radiographic progression was 56 weeks for naive and 24 weeks for post-chemo groups. Circulating tumor cell counts available for 128 of 140 pts showed 91% (70/77) with favorable pre-treatment counts (<5 cells/7.5 mL blood) remaining favorable post-treatment, while 49% (25/51) converted from unfavorable pre-treatment to favorable post-treatment. Conclusions: MDV3100 demonstrates durable anti-tumor activity in pts with CRPC both before and after chemotherapy. Based on these promising results MDV3100 is currently being evaluated in two global phase III studies in pts with metastatic CRPC, the AFFIRM study in pts previously treated with docetaxel and the PREVAIL study in chemotherapy-naïve pts who have progressed on androgen deprivation therapy. [Table: see text]
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Affiliation(s)
- C. S. Higano
- University of Washington School of Medicine, Seattle, WA; Oregon Health and Science University Knight Cancer Institute, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - T. M. Beer
- University of Washington School of Medicine, Seattle, WA; Oregon Health and Science University Knight Cancer Institute, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - M. Taplin
- University of Washington School of Medicine, Seattle, WA; Oregon Health and Science University Knight Cancer Institute, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - E. Efstathiou
- University of Washington School of Medicine, Seattle, WA; Oregon Health and Science University Knight Cancer Institute, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - A. Anand
- University of Washington School of Medicine, Seattle, WA; Oregon Health and Science University Knight Cancer Institute, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - M. Hirmand
- University of Washington School of Medicine, Seattle, WA; Oregon Health and Science University Knight Cancer Institute, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - M. Fleisher
- University of Washington School of Medicine, Seattle, WA; Oregon Health and Science University Knight Cancer Institute, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - H. I. Scher
- University of Washington School of Medicine, Seattle, WA; Oregon Health and Science University Knight Cancer Institute, Portland, OR; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Center, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
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Skordis N, Neocleous V, Kyriakou A, Efstathiou E, Sertedaki A, Philibert P, Phylactou LA, Lumbroso S, Sultan C. The IVS1-2A>G mutation in the SRD5A2 gene predominates in Cypriot patients with 5α reductase deficiency. J Endocrinol Invest 2010; 33:810-4. [PMID: 20511729 DOI: 10.1007/bf03350347] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND 5α steroid reductase deficiency (5αSRD) is an autosomal recessive enzymatic deficiency and mutations in the 5α steroid reductase type 2 gene (SRD5A2) result in male pseudohermaphrodism caused by decreased dihydrotestosterone (DHT) synthesis. AIM To identify the specific mutations of the SRD5A2 gene in Cypriot patients with 5αSRD. SUBJECTS AND METHODS Five unrelated patients with 46,XY karyotype were examined. Four of them were born with ambiguous genitalia and 1 patient, who was raised as girl, presented with primary amenorrhea. The hCG test was informative (elevated testosterone/DHT) of 5αSRD in 3 out of 4 subjects. Sequencing of the SRD5A2 gene was completed for all patients. Genomic DNA was also isolated from a total of 204 healthy unrelated Cypriot subjects. Screening for the IVS1-2A>G mutation was performed by using direct sequencing and restriction enzyme analysis. RESULTS The IVS1-2A>G was identified in homozygosity in 3 patients and in a compound heterozygote state in the other 2 patients, in combination with p.P181L and p.R171S in exon 3, respectively. The carrier frequency in the Cypriot population for the IVS1-2A>G mutation was estimated to be 0.98% or 2 in 204. CONCLUSIONS The same IVS1-2A>G mutation in the SRD5A2 gene seems to characterize all Cypriot patients with 5αSRD diagnosed so far. Furthermore this relatively rare genetic defect, which has only been reported previously in a single case in the Eastern Mediterranean region, is very likely to be the result of a founder effect.
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Affiliation(s)
- N Skordis
- Pediatric Endocrine Unit, Makarios Hospital, Nicosia 1474, Cyprus.
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Efstathiou E, Tu S, Aparicio A, Hoang A, Wen S, Troncoso P, Smith LA, Chieffo N, Molina A, Logothetis C. Use of “intracrine androgen signaling signature'' to predict benefit from abiraterone acetate (AA) in patients with castrate-resistant prostate cancer (CRPC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Anand A, Scher HI, Beer TM, Higano CS, Danila DC, Taplin M, Efstathiou E, Hirmand M, Sawyers CL, Heller G. Circulating tumor cells (CTC) and prostate specific antigen (PSA) as response indicator biomarkers in chemotherapy-naïve patients with progressive castration-resistant prostate cancer (CRPC) treated with MDV3100. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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36
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Tzelepi V, Efstathiou E, Troncoso P, Pettaway CA, Hoang A, Logothetis C, Pagliaro LC. Modulation of candidate therapy targets in regionally advanced prostate cancer by androgen ablation and docetaxel. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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37
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Ryan C, Efstathiou E, Smith M, Taplin M, Bubley G, Logothetis C, Kheoh T, Haqq C, Molina A, Small EJ. Phase II multicenter study of chemotherapy (chemo)-naive castration-resistant prostate cancer (CRPC) not exposed to ketoconazole (keto), treated with abiraterone acetate (AA) plus prednisone. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5046] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5046 Background: AA is a potent inhibitor of the enzyme CYP17, a major contributor to androgen biosynthesis. Keto is also known to inhibit this enzyme but AA is many-fold stronger in its action. 33 pts with progressive metastatic disease, normal organ function, ECOG performance status (PS) 0–1, and no prior chemo were enrolled. Pts with prior keto treatment were excluded. AA (1000 mg qd) plus prednisone (5mg bid) were administered orally in 28 day cycles. Methods: Results: At baseline median age was 71.0 (range 52–85) yrs and median PSA was 24.7 (range 7.1–1110.0) ng/mL;19/26 pts (73%) had an ECOG PS of 0 and 7/26 (27%) had PS of 1; the median number of prior hormonal therapies was 2; all pts were on LHRHa and 73% of pts had received anti-androgen, all of whom had undergone prior anti-androgen withdrawal. Pts were evaluated at each cycle for PSA response according to PSAWG criteria. 27 pts have available data for PSA response. Total maximal PSA declines of ≥30%, ≥50%, ≥90% were observed in 89% (24/27), 85% (23/27) and 41% (11/27) pts, respectively. Week 12 PSA declines displayed a similar and sustained trend: ≥30%, ≥50% and ≥90% PSA decline in 82%, 78%, and 26% of pts. Post-treatment ECOG PS score was 0 in 24 (92%) pts: 19% experienced improvement in PS (PS 1 to 0 in 5 pts) and 19/19 pts maintained a PS of 0; Median time to PSA progression has not been reached. Majority of adverse events were grades 1–2. Incidence of hypokalemia - 12%; HTN - 6%; edema - 15%. One pt experienced a grade 3 drug-related HTN. Conclusions: Abiraterone acetate plus prednisone has significant anti-cancer activity in patients with metastatic CRPC not previously treated with ketoconazole or chemotherapy, as demonstrated by declines in PSA and improvement in performance status, and is well-tolerated. [Table: see text]
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Affiliation(s)
- C. Ryan
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - E. Efstathiou
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - M. Smith
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - M. Taplin
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - G. Bubley
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - C. Logothetis
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - T. Kheoh
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - C. Haqq
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - A. Molina
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
| | - E. J. Small
- University of California, San Francisco, San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Massachusetts General Hospital, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Cougar Biotechnology, Los Angeles, CA
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Scher HI, Beer TM, Higano CS, Taplin M, Efstathiou E, Anand A, Hung D, Hirmand M, Fleisher M. Antitumor activity of MDV3100 in a phase I/II study of castration-resistant prostate cancer (CRPC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5011 Background: MDV3100 is a novel AR antagonist selected for activity in prostate cancer model systems with overexpressed AR. In contrast to bicalutamide, MDV3100 blocks nuclear translocation of AR and DNA binding, and has no known agonist activity when AR is overexpressed. Antitumor activity of MDV3100 in a Phase I/II trial was assessed by prostate-specific antigen (PSA), soft tissue and osseous disease, circulating tumor cells (CTC), and time on treatment. Methods: Patients (pts) with progressive CRPC were enrolled in sequential cohorts of 3–6 pts at 30, 60, 150, 240, 360, 480 and 600 mg/day. Once the safety of a dose was established, enrollment was expanded at doses >60 mg/day to include 12 chemotherapy-naïve (naïve) and 12 post-chemotherapy pts per cohort. Results: 140 pts were enrolled. 114 pts at 30–360 mg/day have been followed for >12 weeks. PSA declines (>50% from baseline) were observed at week 12 in 57% (37/65) of naïve and 45% (22/49) of post-chemo pts. Data suggest a dose-response trend particularly in post-chemo pts where PSA responses were 32% at 60 and 150 mg/day and 58% at 240 and 360 mg/day. At 12 weeks, radiographic control (no progression) was observed in 35/47 pts (74%) with evaluable soft tissue lesions per PCWG2 guidelines and 50/81 pts (62%) with bone lesions. CTC counts on 101 of 114 pts showed 92% (56/61) with favorable (<5) counts pretreatment maintained favorable posttreatment counts, while 53% (21/40) converted from unfavorable to favorable posttreatment. For post-chemo pts, favorable retention was 100% (17/17) and unfavorable to favorable conversion at 240 and 360 mg/day was 60% (6/10). 87 pts at 30–240 mg/day have been followed for >24 weeks; 35 (40%) received treatment >24 weeks. At 600 mg/day, 2 of 3 pts had dose limiting toxicity (rash; seizure). Dose reductions due to fatigue were noted at 480 and 360 mg/day. Conclusions: MDV3100 is a promising candidate for the treatment of prostate cancer assessed by PSA, imaging, CTC, and time on treatment. The data suggest a dose-response trend and consistency across endpoints. Pt follow-up is continuing. The efficacy comparable to that at higher doses and the better adverse event profile, led to the selection of 240 mg/day as the recommended dose for a phase III trial in CRPC. [Table: see text]
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Affiliation(s)
- H. I. Scher
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - T. M. Beer
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - C. S. Higano
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - M. Taplin
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - E. Efstathiou
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - A. Anand
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - D. Hung
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - M. Hirmand
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
| | - M. Fleisher
- Memorial Sloan-Kettering Cancer Center, New York, NY; Oregon Health and Science University, Portland, OR; University of Washington c/o SCCA, Seattle, WA; Dana-Farber Cancer Institute, Boston, MA; University of Texas M. D. Anderson Cancer Cener, Houston, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; Medivation, Inc., San Francisco, CA
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Suleiman SH, Salim OEH, Yousif DO, Eltahir MA, Elzaki K, Ibrahim SZ, Ahmed KM, Mudawi HM, Vini L, Silyvridou A, Kakana C, Janinis J, Diamantidou E, Navrozidou C, Boulogianni G, Hourmouzi D, Kopanakis K, Macheras A, Charalabopoulos A, Bistarakis D, Xylardistos P, Shizas D, Petropoulos K, Bakopoulos A, Liakakos T, Oikonomopoulos N, Martikos G, Patapis P, Misiakos E, Tsapralis D, Azas A, Charalobopoulos A, Liakakos L, Millo P, Allieta R, Nardi M, Brachet Contul R, Scozzari G, Alexandrou I, Lainakis N, Efstathiou E, Demetriadis D, Dolatzas T, Antypas S, Parini U, Persico F, Loffredo A, Lale Murix E, Fabozzi M, Roveroni M, Usai A, Da Broi J, Nardi MJ, Roustanis E, Benetatos N, Pappas-Gogos G, Tsimogiannis KE, Tsimoyiannis EC, Pramateftakis MG, Mantzoros I, Kanellos I, Demetriades H, Angelopoulos S, Despoudi K, Lazarides H, Tsachalis T, Sapidis N, Gouvas N, Tsiaoussis J, Pechlivanides G, Zervakis N, Xynos E. Abstracts Colorectal Games, Rethymnom, Crete, Greece, May 2008. Tech Coloproctol 2008. [DOI: 10.1007/s10151-008-0432-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Logothetis CJ, Wen S, Molina A, Chieffo N, Smith LA, Troncoso P, Efstathiou E. Identification of an androgen withdrawal responsive phenotype in castrate resistant prostate cancer (CRPC) patients (pts) treated with abiraterone acetate (AA). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Efstathiou E, Tsavachidou D, Wen S, Troncoso P, Mills GB, Logothetis CJ. Integrated quantative and spatial proteomic analysis of PI3kinase signaling in high grade prostate cancer (PCa) treated with Temsirolimus with or without androgen ablation. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Papadimitriou C, Dafni U, Anagnostopoulos A, Vlachos G, Voulgaris Z, Rodolakis A, Aravantinos G, Bamias A, Bozas G, Kiosses E, Gourgoulis GM, Efstathiou E, Dimopoulos MA. High-dose melphalan and autologous stem cell transplantation as consolidation treatment in patients with chemosensitive ovarian cancer: results of a single-institution randomized trial. Bone Marrow Transplant 2007; 41:547-54. [PMID: 18026149 DOI: 10.1038/sj.bmt.1705925] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The role of high-dose chemotherapy (HDCT) in epithelial ovarian cancer (EOC) remains controversial. This study was initiated to compare the efficacy and tolerability of HDCT as a consolidation approach in women with chemosensitive advanced EOC (FIGO stages IIC-IV). Patients who had achieved their first clinical complete remission after six cycles of conventional paclitaxel and carboplatin combination chemotherapy were randomly assigned to receive or not high-dose melphalan. The primary objective was to compare time to disease progression (TTP). A total of 80 patients were enrolled onto the trial. Patients who were randomized to receive HDCT were initially treated with cyclophosphamide 4 g/m(2) for PBPC mobilization. HDCT consisted of melphalan 200 mg/m(2). Of the 37 patients who were allocated to HDCT, 11 (29.7%) did not receive melphalan either due to patient refusal (n=5) or due to failure of PBPC mobilization (n=6). In an intent-to-treat analysis, there were no significant differences between the two arms in TTP (P=0.059) as well as in overall survival (OS) (P=0.38).
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Affiliation(s)
- C Papadimitriou
- Department of Clinical Therapeutics, Alexandra Hospital, University of Athens School of Medicine, Athens, Greece.
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Efstathiou E, Troncoso P, Wen S, Do K, Pettaway CA, Logothetis CJ. Coordinated modulation of sonic hedgehog (Shh) signaling and androgen receptor (AR) in the prostate tumor microenvironment by chemo-hormonal therapy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5066 Background: Shh and androgen signaling are implicated experimentally in prostate development, regeneration and neoplastic progression. We assessed expression of components of these pathways in pretreated and control high risk prostate cancers (PCa) in a hypothesis generating search for an association with resistance to therapy. Methods: Sixty-four men with high risk PCa were randomized to receive either complete androgen ablation (AA) or AA and ketoconazole, adriamycin, vinblastine and estramustine (KAVE) for 16 weeks followed by radical prostatectomy (RP). We constructed 3 tissue microarrays from RP specimens of: a) (AA) 26 men pretreated with AA, b) (CH) 27 men pretreated with AA + KAVE and c) (Control) 26 untreated men matched for clinical stage, biopsy Gleason Score and PSA. A total of 3,178 cores were obtained [median cores: 36 (range 18–90), median blocks: 5 (range 3–9) per specimen]. Immunohistochemical expression of Shh pathway components (Shh, patched, smoothened, gli2) and AR were assessed in the tumor epithelium and stroma and recorded as percentage of cells exhibiting staining. A mixed model was used for fitting the correlated data (multiple observations from a subject). Pearson’s correlations between biomarkers were calculated based on mean expression. Results: Shh signaling, as indicated by mean expression (standard deviation) of nuclear gli2, was observed in the residual tumor epithelium [AA: 79.9 (17.4), CH: 85.7 (12.2)] and adjacent stroma [ AA: 43 (18.2),CH: 53 (16.4)] following treatment, in parallel (0.78 by Pearson’s correlation), and higher than in untreated control tumor epithelium [39.9 (20.6)] and stroma [22.9 (15.2)] (P<.0001). Smoothened and Shh were expressed accordingly. AR expression was lower in the treated tumor epithelium [AA: 47.3 (20.8), CH: 46.8 (21.1)] (P<.0001), with a trend toward increased stromal AR [AA: 8.6 (10.4), CH: 10.5 (8.2)] compared to control tumor epithelium [60.1 (24.1)] and stroma [6.4 (11.7)]. Conclusions: Shh and androgen pathways are modulated in a manner that suggests they behave in a compensatory fashion, and are determinants of response to therapy. These data support the hypothesis that the tumor microenvironment is implicated in PCa therapy resistance. No significant financial relationships to disclose.
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Affiliation(s)
| | | | - S. Wen
- MD Anderson Cancer Center, Houston, TX
| | - K. Do
- MD Anderson Cancer Center, Houston, TX
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Kambouri K, Gardikis S, Giatromanolaki A, Efstathiou E, Pitiakoudis M, Ipsilantis P, Botaitis S, Perente S, Antypas S, Polychronidis A, Sivridis E, Simopoulos C. Comparison of angiogenic activity after urethral reconstruction using free grafts and pedicle flap: an experimental study. Eur J Pediatr Surg 2006; 16:323-8. [PMID: 17160776 DOI: 10.1055/s-2006-924601] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE An experimental study was undertaken in order to estimate the angiogenic activity in different free grafts and pedicle flap in urethral reconstruction in an animal model. METHODS Twenty-eight white New Zealand rabbits were randomly divided into five groups (O, A, B, C and D). A ventral urethral defect was created in all groups. In the group O, (n = 4), a simple closure of the defect was performed. Free penile skin graft (group A, n = 6), buccal mucosal graft (group B, n = 6), bladder mucosal graft (group C, n = 6), and pedicle penile skin graft (group D, n = 6) were used to bridge the urethral defect as an onlay patch. The animals were euthanized on the 21st postoperative day. The angiogenic activity was assessed with immunohistochemistry, using the anti-CD31 MoAb and the alkaline phosphatase antialkaline phosphatase procedure. The native vascularity of penile skin as well as buccal and bladder mucosa was assessed in rabbits from group O (n = 3). Statistical analysis was performed using one-way ANOVA. RESULTS The angiogenesis seen with a magnification of x 200 in groups O, A, B, C, and D was 34.1 +/- 4.1 (mean +/- SD), 61.7 +/- 6.4, 94.3 +/- 6.4, 91.5 +/- 7.2, and 30.8 +/- 5.2 vessels per optical field, respectively. There were statistically significant differences (p < 0.001) between group O and groups A, B, C and between group A and groups B, C, D, but not (p > 0.5) between groups B and C and groups O and D. The native vascularity of penile skin, buccal mucosa and bladder mucosa was 23.3 +/- 3.0, 24.6 +/- 3.7 and 17.0 +/- 2.6 vessels per optical field, respectively. CONCLUSION Buccal and bladder mucosal grafts exhibit a higher angiogenic activity than free and pedicle penile skin flap when transplanted in urethral defects. As the buccal mucosal graft showed the higher angiogenic activity and its harvesting is easier than bladder mucosa, we propose that in urethral reconstruction surgery the use of this graft might offer more reliable results.
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Affiliation(s)
- K Kambouri
- Department of Paediatric Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace-Medical School, 43 G. Papandreou Street, 68100 Alexandroupolis, Greece
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Mauri D, Pentheroudakis G, Bafaloukos D, Pectasides D, Samantas E, Efstathiou E, Kalofonos HP, Syrigos K, Klouvas G, Papakostas P, Kosmidis P, Fountzilas G, Pavlidis N. Non-small cell lung cancer in the young: a retrospective analysis of diagnosis, management and outcome data. Anticancer Res 2006; 26:3175-81. [PMID: 16886653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) in young patients is uncommon and is thought to constitute a distinct oncological entity with characteristic clinicopathological patterns. Since the reported data are scant and discordant, the presentation, management and outcome data of NSCLC patients aged under 45 years of age were analyzed and compared with those of patients over 45 years old. Prognostic factors for risk classification were also evaluated. MATERIALS AND METHODS The data were abstracted from the Hellenic Cooperative Oncology Group (HeCOG) cancer registry database. The presentation, management and outcome data of patients with histologically confirmed NSCLC, managed from 1989 until 2004 in HeCOG participating centers, were retrospectively analyzed. The clinicopathological characteristics of patients aged < and > than 45 years old were compared and evaluated for prognostic significance regarding outcome. RESULTS The data for NSCLC patients (1906), of whom 115 were aged <45, were retrieved. In comparative analysis, the young patients were more frequently asymptomatic at diagnosis, while older patients presented significantly higher rates of thoracic pain, cough and fatigue (p<0.01). The young patients were more commonly diagnosed with adenocarcinoma and less frequently with squamous cancer than patients aged over 45. Although the stage distribution was distinct, with older patients presenting higher rates of stage IV disease (21.9% vs. 12.2%), the rates of early lung cancer (stages I-IIIa) were similar. The overall survival (OS) was not significantly different (median OS 12 vs. 11.5 months, p=0.277). Among patients who underwent first-line palliative chemotherapy, young individuals had a significantly shorter time to progression: 4.3 vs. 5.8 months (p=0.0049). Univariate and multivariate regression analyses established the prognostic usefulness of the performance status, disease stage and disease-free interval for the risk of death, both in the total number of patients (1906) and in young patients (115). CONCLUSION This large retrospective series failed to present strong evidence that NSCLC among young individuals constitutes a distinct clinicopathological entity with differing biological behavior, since the same clinicopathological prognostic factors were valid in both age groups. Molecular phenotypic studies are needed to shed light on this controversial subject.
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Affiliation(s)
- D Mauri
- Hellenic Cooperative Oncologic Group (HeCOG), Greece
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Kastritis E, Efstathiou E, Gika D, Bozas G, Koutsoukou V, Papadimitriou C, Pissakas G, Dimopoulos MA, Bamias A. Brain metastases as isolated site of relapse in patients with epithelial ovarian cancer previously treated with platinum and paclitaxel-based chemotherapy. Int J Gynecol Cancer 2006; 16:994-9. [PMID: 16803475 DOI: 10.1111/j.1525-1438.2006.00596.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Brain metastases in patients with epithelial ovarian cancer (EOC) have an estimated incidence of 0.3-1.9% and are isolated in up to 50% of these patients. The risk factors and the prognostic significance of isolated central nervous system (CNS) relapse in patients with EOC who received primary treatment with platinum and paclitaxel have not been identified. We conducted a retrospective study in patients with EOC who relapsed with isolated brain metastases and report our experience. Two hundred sixty-seven patients with stages III and IV EOC, in clinical complete remission after first-line treatment with platinum and paclitaxel, were included in our analysis. After a median follow-up of 65 months, 150 patients had relapsed. Eight patients (5%) had isolated brain metastases. Patient and disease characteristics did not differ among patients who relapsed with isolated brain metastases and those with relapse outside the CNS. Median time to first disease relapse, overall survival, and survival after relapse did not differ significantly between patients with brain metastases and those with relapse outside the CNS. Two patients have died 6 and 12 months after the diagnosis of brain metastases, and 5 patients are alive 4-35 months after the diagnosis of isolated brain metastases. Three patients remain free of disease 4-18 months after treatment with radiotherapy and systemic chemotherapy for their CNS metastatic disease. Patients with isolated brain metastases have comparable survival to patients with relapse outside the CNS, and long-term remission can be achieved in some cases, provided that systemic chemotherapy is added to local treatment.
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Affiliation(s)
- E Kastritis
- Department of Clinical Therapeutics, Alexandra Hospital, Athens University School of Medicine, Athens, Greece
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Kastritis E, Efstathiou E, Gika D, Bozas G, Koutsoukou V, Papadimitriou C, Pissakas G, Dimopoulos MA, Bamias A. Brain metastases as isolated site of relapse in patients with epithelial ovarian cancer previously treated with platinum and paclitaxel-based chemotherapy. Int J Gynecol Cancer 2006. [DOI: 10.1136/ijgc-00009577-200605000-00007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Brain metastases in patients with epithelial ovarian cancer (EOC) have an estimated incidence of 0.3–1.9% and are isolated in up to 50% of these patients. The risk factors and the prognostic significance of isolated central nervous system (CNS) relapse in patients with EOC who received primary treatment with platinum and paclitaxel have not been identified. We conducted a retrospective study in patients with EOC who relapsed with isolated brain metastases and report our experience. Two hundred sixty-seven patients with stages III and IV EOC, in clinical complete remission after first-line treatment with platinum and paclitaxel, were included in our analysis. After a median follow-up of 65 months, 150 patients had relapsed. Eight patients (5%) had isolated brain metastases. Patient and disease characteristics did not differ among patients who relapsed with isolated brain metastases and those with relapse outside the CNS. Median time to first disease relapse, overall survival, and survival after relapse did not differ significantly between patients with brain metastases and those with relapse outside the CNS. Two patients have died 6 and 12 months after the diagnosis of brain metastases, and 5 patients are alive 4–35 months after the diagnosis of isolated brain metastases. Three patients remain free of disease 4–18 months after treatment with radiotherapy and systemic chemotherapy for their CNS metastatic disease. Patients with isolated brain metastases have comparable survival to patients with relapse outside the CNS, and long-term remission can be achieved in some cases, provided that systemic chemotherapy is added to local treatment.
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Kastritis E, Bamias A, Efstathiou E, Gika D, Bozas G, Zorzou P, Sarris K, Papadimitriou C, Dimopoulos MA. The outcome of advanced or recurrent non-squamous carcinoma of the uterine cervix after platinum-based combination chemotherapy. Gynecol Oncol 2005; 99:376-82. [PMID: 16051322 DOI: 10.1016/j.ygyno.2005.06.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Revised: 06/03/2005] [Accepted: 06/13/2005] [Indexed: 11/24/2022]
Abstract
BACKGROUND Data about the outcome and prognostic factors in the group of patients with non-squamous cell advanced or recurrent carcinomas of the uterine cervix are limited. We compared the outcome of patients with non-squamous with that of squamous cell carcinomas after platinum-based combination chemotherapy as first line therapy for stage IV or recurrent cervical carcinoma. PATIENTS AND METHODS A total of 200 patients with stage IV or recurrent carcinomas of the cervix received platinum-based combination chemotherapy and were included in our analysis. RESULTS There were 58 patients with non-squamous and 142 patients with squamous cell carcinomas. Response to chemotherapy was 53.5% in non-squamous vs. 43.5% in squamous carcinomas. Histology was not an independent predictor of tumor response (P = 0.797). Response rates were lower in patients with relapse only in a previously irradiated area in both squamous (26.9% vs. 53.5%, P = 0.005) and non-squamous carcinomas (47.1% vs. 65%, P = 0.270). Weight loss was the only significant predictor of survival in non-squamous histology patients (P < 0.0001). There was no significant difference in median survival between squamous (11.57 months [95% CI 9.35-13.79]) and non-squamous carcinomas (19.05 months [95% CI 13.63-24.47]) (P = 0.064). After adjustment for independent prognostic factors (ECOG performance status and weight loss), differences in survival remained not significant. CONCLUSION Our study showed a similar outcome for both squamous and non-squamous stage IV or recurrent cervical carcinomas treated with platinum-based combination chemotherapy.
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Affiliation(s)
- E Kastritis
- Department of Clinical Therapeutics, Alexandra Hospital, Athens University School of Medicine, 31 Komninon Street, Haidari, 124 62 Athens, Greece
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Kassar M, Yu Z, Bamias A, Markakis S, Kowalski D, Efstathiou E, Camp RL, Rimm DL, Psyrri D, Dimopoulos M. In situ proteomics of biomarker expression in epithelial ovarian cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Kassar
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - Z. Yu
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - A. Bamias
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - S. Markakis
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - D. Kowalski
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - E. Efstathiou
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - R. L. Camp
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - D. L. Rimm
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - D. Psyrri
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - M. Dimopoulos
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
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Kastritis E, Bozas G, Efstathiou E, Koutsoukou V, Gika D, Deliveliotis C, Antoniou N, Dimopoulos MA, Bamias A. Outcome of patients with advanced non-transitional urothelial carcinomas following platinum-based chemotherapy. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
| | - G. Bozas
- Univ of Athens Sch of Medicine, Athens, Greece
| | | | | | - D. Gika
- Univ of Athens Sch of Medicine, Athens, Greece
| | | | - N. Antoniou
- Univ of Athens Sch of Medicine, Athens, Greece
| | | | - A. Bamias
- Univ of Athens Sch of Medicine, Athens, Greece
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