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Arenare L, Porta C, Barberio D, Terzolo S, Zagonel V, Pisconti S, Del Mastro L, Pinto C, Bilancia D, Cinieri S, Rizzo M, Migliaccio G, Montesarchio V, Del Campo L, De Lorenzo F, Iannelli E, Traclò F, Gitto L, Vaccaro MC, Frontini L, Giannarelli D, Bryce J, Piccirillo MC, Jommi C, Efficace F, Riva S, Di Maio M, Gallo C, Perrone F. Confirmatory validation analysis of the PROFFIT questionnaire to assess financial toxicity in cancer patients. ESMO Open 2023; 8:102192. [PMID: 38052104 PMCID: PMC10774953 DOI: 10.1016/j.esmoop.2023.102192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND The Patient Reported Outcome for Fighting FInancial Toxicity (PROFFIT) questionnaire was developed to measure financial toxicity (FT) and identify its determinants. The aim of the present study was to confirm its validity in a prospective cohort of patients receiving anticancer treatment. PATIENTS AND METHODS From March 2021 to July 2022, 221 patients were enrolled at 10 Italian centres. Selected items of the EORTC-QLQ-C30 questionnaire represented the anchors, specifically, question 28 (Q-28) on financial difficulties, and questions 29-30 measuring global health status/quality of life (HR-QOL). The study had 80% power to detect a 0.20 correlation coefficient (r) between anchors and PROFFIT-score (items 1-7, range 0-100, 100 indicating maximum FT) with bilateral alpha 0.05 and 80% power. Confirmatory factor analysis was conducted. FT determinants (items 8-16) were described. RESULTS Median age of patients was 65 years, 116 (52.5%) were females, 96 (43.4%) had low education level. Confirmatory factor analysis confirmed goodness of fit of the PROFFIT-score. Significant partial correlation of PROFFIT-score was found with Q-28 (r = 0.51) and HR-QOL (r = -0.23). Mean (SD) PROFFIT-score at baseline was 36.5 (24.9); it was statistically significantly higher for patients living in South Italy, those with lower education level, those who were freelancer/unemployed at diagnosis and those who reported significant economic impact from the COVID-19 pandemic. Mean (SD) scores of determinants ranged from 17.6 (27.1) for item 14 (support from medical staff) to 49.0 (36.3) for item 10 (expenses for medicines or supplements). PROFFIT-score significantly increased with worsening response to determinants. CONCLUSIONS External validation of PROFFIT-score in an independent sample of patients was successful. The instrument is now being used in clinical studies.
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Affiliation(s)
- L Arenare
- Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - C Porta
- Interdisciplinary Department of Medicine, Università degli Studi 'A. Moro', Bari, Italy; Polyclinic Consortium University Hospital, Bari, Italy
| | - D Barberio
- Departmental Structure of Clinical Psycho-oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - S Terzolo
- Department of Oncology, Università di Torino, AO Ordine Mauriziano, Torino, Italy
| | - V Zagonel
- Oncology Unit 1, Istituto Oncologico Veneto, IOV, IRCCS, Padova, Italy
| | - S Pisconti
- Oncology Unit, Ospedale S. G. Moscati, Statte TA, Italy
| | - L Del Mastro
- Medical Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties (DIMI), Università di Genova, Genova, Italy
| | - C Pinto
- Medical Oncology, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - D Bilancia
- Medical Oncology, Azienda Ospedaliera San Carlo, Potenza, Italy
| | - S Cinieri
- Medical Oncologiy, Ospedale Perrino, Brindisi, Italy
| | - M Rizzo
- Polyclinic Consortium University Hospital, Bari, Italy
| | - G Migliaccio
- Departmental Structure of Clinical Psycho-oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - V Montesarchio
- Medical Oncology, Azienda Ospedaliera Specialistica dei Colli, Napoli, Italy
| | - L Del Campo
- Federazione Italiana delle Associazioni di Volontariato in Oncologia (FAVO), Rome, Italy
| | - F De Lorenzo
- Federazione Italiana delle Associazioni di Volontariato in Oncologia (FAVO), Rome, Italy; European Cancer Patient Coalition (ECPC), Brussels, Italy
| | - E Iannelli
- Federazione Italiana delle Associazioni di Volontariato in Oncologia (FAVO), Rome, Italy; Associazione Italiana Malati di Cancro (AIMAC), Roma, Italy
| | - F Traclò
- Associazione Italiana Malati di Cancro (AIMAC), Roma, Italy
| | - L Gitto
- Department of Economy, Università degli Studi di Messina, Messina, Italy
| | - M C Vaccaro
- Welfare and Health Department, Centro Studi Investimenti Sociali (CENSIS), Roma, Italy
| | - L Frontini
- Federation of Italian Cooperative Oncology Groups (FICOG), Milano, Italy
| | - D Giannarelli
- Epidemiology and Biostatistics, GSTeP, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - J Bryce
- Ascension St. John Clinical Research Institute, Tulsa, USA
| | - M C Piccirillo
- Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - C Jommi
- Department of Pharmaceutical Sciences, Università del Piemonte Orientale, Novara, Italy
| | - F Efficace
- Gruppo Italiano per le Malattie Ematologiche dell'Adulto (GIMEMA) Health Outcomes Research Unit, Roma, Italy
| | - S Riva
- St Mary's University, Twickenham, London, UK
| | - M Di Maio
- Department of Oncology, Università di Torino, AO Ordine Mauriziano, Torino, Italy
| | - C Gallo
- Professor Emeritus Medical Statistics, Università degli Studi della Campania 'Luigi Vanvitelli', Napoli, Italy
| | - F Perrone
- Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy.
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D'Aniello C, Cavaliere C, Foglia C, Facchini S, Uricchio F, Balsamo R, Franzese E, De Falco S, Izzo M, Laterza M, Liguori C, Coppola P, Diessa Y, Fasano M, Di Lauro G, Lai S, Cocetta V, Pisconti S, Montesarchio V, Facchini G. Management of systemic prostate cancer: current algorithm from castration sensitive to castration resistant setting. Eur Rev Med Pharmacol Sci 2022; 26:8481-8501. [PMID: 36459030 DOI: 10.26355/eurrev_202211_30384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
In recent years, the advanced knowledge of clinical, biological and molecular features of prostate cancer have led to the introduction of new drugs and have allowed the relocation of old drugs in different settings. In this way, the new concepts of systemic disease arise: high risk or high volume vs. low risk and low volume disease castration sensitive prostate cancer (CSPC), diversifying the use of previously approved drugs (CRPC) and opening new scenarios for sequence therapy. The aim of this review is to integrate new developments into the medical management of systemic prostate cancer.
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Affiliation(s)
- C D'Aniello
- Division of Medical Oncology, AORN dei Colli Ospedali Monaldi-Cotugno-CTO, Naples, Italy.
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3
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Lazzari G, D'Alessandro A, Cannalire F, Cramarossa M, D'Andria R, Marangi G, Melucci G, Pisconti S, Silvano G. PO-1224 The radiation oncologist’s relevance in the Breast Unit team up-front discussion: our experience. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03188-7] [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: 10/18/2022]
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4
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Daniele A, Divella R, Pilato B, Tommasi S, Pasanisi P, Patruno M, Digennaro M, Minoia C, Dellino M, Pisconti S, Casamassima P, Savino E, Paradiso AV. Can harmful lifestyle, obesity and weight changes increase the risk of breast cancer in BRCA 1 and BRCA 2 mutation carriers? A Mini review. Hered Cancer Clin Pract 2021; 19:45. [PMID: 34706754 PMCID: PMC8554866 DOI: 10.1186/s13053-021-00199-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 04/09/2021] [Accepted: 09/20/2021] [Indexed: 12/21/2022] Open
Abstract
Background and aim The BRCA 1 and BRCA 2 genes are associated with an inherited susceptibility to breast cancer with a cumulative risk of 60% in BRCA 1 mutation carriers and of 30% in BRCA 2 mutation carriers. Several lifestyle factors could play a role in determining an individual’s risk of breast cancer. Obesity, changes in body size or unhealthy lifestyle habits such as smoking, alcohol consumption and physical inactivity have been evaluated as possible determinants of breast cancer risk. The aim of this study was to explore the current understanding of the role of harmful lifestyle and obesity or weight change in the development of breast cancer in female carriers of BRCA 1/2 mutations. Methods Articles were identified from MEDLINE in October 2020 utilizing related keywords; they were then read and notes, study participants, measures, data analysis and results were used to write this review. Results Studies with very large case series have been carried out but only few of them have shown consistent results. Additional research would be beneficial to better determine the actual role and impact of such factors.
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Affiliation(s)
- A Daniele
- Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Viale Orazio Flacco 65, 70124, Bari, Italy.
| | - R Divella
- Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Viale Orazio Flacco 65, 70124, Bari, Italy
| | - B Pilato
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - S Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - P Pasanisi
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M Patruno
- Experimental Oncology, Center for Study of Heredo-Familial Tumors, IRCCS- Istituto "Tumori "Giovanni Paolo II", Bari, Italy
| | - M Digennaro
- Experimental Oncology, Center for Study of Heredo-Familial Tumors, IRCCS- Istituto "Tumori "Giovanni Paolo II", Bari, Italy
| | - C Minoia
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - M Dellino
- Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - S Pisconti
- Medical Oncology Unit, Ospedale Moscati, Taranto, Italy
| | - P Casamassima
- Clinical Pathology Laboratory Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - E Savino
- Clinical Pathology Laboratory Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - A V Paradiso
- Science Direction, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
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Tirelli U, Franzini M, Valdenassi L, Pisconti S, Taibi R, Torrisi C, Pandolfi S, Chirumbolo S. Fatigue in post-acute sequelae of SARS-CoV2 (PASC) treated with oxygen-ozone autohemotherapy - preliminary results on 100 patients. Eur Rev Med Pharmacol Sci 2021; 25:5871-5875. [PMID: 34604980 DOI: 10.26355/eurrev_202109_26809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Post-acute sequelae of SARS-CoV2 infection (PASC) are a novel terminology used to describe post-COVID persistent symptoms, mimicking somehow the previously described chronic fatigue syndrome (CFS). In this manuscript, we evaluated a therapeutical approach to address PASC-derived fatigue in a cohort of past-COVID-19 positive patients. PATIENTS AND METHODS A number of 100 patients, previously diagnosed as COVID-19 positive subjects and meeting our eligibility criteria, was diagnosed having PASC-related fatigue. They were recruited in the study and treated with oxygen-ozone autohemotherapy (O2-O3-AHT), according to the SIOOT protocol. Patients' response to O2-O3-AHT and changes in fatigue were measured with the 7-scoring Fatigue Severity Scale (FSS), according to previously published protocols. RESULTS Statistics assessed that the effects of O2-O3-AHT on fatigue reduced PASC symptoms by 67%, as a mean, in all the investigated cohort of patients (H = 148.4786 p < 0.0001) (Figure 1). Patients following O2-O3-AHT therapy, quite completely recovered for PASC-associated fatigue, a quote amounting to about two fifths (around 40%) of the whole cohort undergoing ozone treatment and despite most of patients were female subjects, the effect was not influenced by sex distribution (H = 0.7353, p = 0.39117). CONCLUSIONS Ozone therapy is able to recover normal functionality and to relief pain and discomfort in the form of PASC-associated fatigue in at least 67% of patients suffering from post-COVID sequelae, aside from sex and age distribution.
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Affiliation(s)
- U Tirelli
- Tirelli Medical Group, Pordenone, Italy.
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6
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D'Aniello C, Cavaliere C, Facchini BA, D'Errico D, Capasso M, Iovane G, Romis L, Mordente S, Liguori C, Cicala S, Formato R, Coppola P, Andreozzi F, Leo L, Montesarchio V, Di Lauro G, Pisconti S, Di Franco C, De Vita F, Vanni M, Facchini G. Penile cancer: prognostic and predictive factors in clinical decision-making. Eur Rev Med Pharmacol Sci 2020; 24:12093-12108. [PMID: 33336727 DOI: 10.26355/eurrev_202012_23998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Penile cancer (PC) is a typical tumor of non-industrialized countries. The incidence is 20-30 times higher in Africa and South America, considering the elevated prevalence of sexually transmitted diseases. Histologically, PC includes squamous cell carcinoma (SCPC), the most frequent, and nonsquamous carcinoma (NSCPC). Early diagnosis is the goal, whereas later diagnosis relates to poor functional outcomes and worse prognosis. The 5-year survival rate is 85% for patients with histologically regional negative lymph nodes, compared to 29%-40% for those with histologically regional positive lymph nodes. To date no new drugs are approved, and there are few new data about molecular mechanisms underlying tumorigenesis. The SCPC remains a rare tumor and the current therapeutic algorithm is based principally on retrospective analysis and less on prospective trials. In this review article, biomarkers of prognosis and efficacy of current treatments are summarized with a focus on those that have the potential to affect treatment decision-making in SCPC.
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Affiliation(s)
- C D'Aniello
- Division of Medical Oncology, A.O.R.N. dei COLLI "Ospedali Monaldi-Cotugno-CTO", Naples, Italy.
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7
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Facchini G, Rossetti S, Berretta M, Cavaliere C, D'Aniello C, Iovane G, Mollo G, Capasso M, Della Pepa C, Pesce L, Facchini S, Imbimbo C, Pisconti S. Prognostic and predictive factors in testicular cancer. Eur Rev Med Pharmacol Sci 2020; 23:3885-3891. [PMID: 31115016 DOI: 10.26355/eurrev_201905_17816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Testicular cancer is a relatively rare neoplasia, with an incidence of about 1,5% among male malignancies, usually in the third and fourth decade of life. Although several histological variants are known, with some histotypes affecting older patients (e.g., spermatocytic seminoma), there is a clear predominance (90-95%) of germ cell tumors among young adults patients1. Testicular Germ Cell Tumor (TGCT), undoubtedly the seminoma histological variant more than non-seminoma one, is definitely a highly curable disease, with a distinctive sensitivity to cisplatin-based therapy (and for seminomas to radiotherapy) and an outstanding cure rate of nearly 80% even for patients with advanced disease. So far, clinical and pathohistological features supported our efforts to choose the best treatment option for patients suffering from this malignancy, but we don't clearly enough know molecular and pathological features underlying different clinical behaviors, mostly in early-stage disease: by improving this knowledge, we should better "shape" therapeutic or surveillance programs for each patient, also in order to avoid unnecessary, if not harmful, treatments.
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Affiliation(s)
- G Facchini
- Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy.
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8
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Capelletto E, Osman G, Morabito A, Chiari R, Grossi F, Tiseo M, Di Costanzo F, Delmonte A, Romano G, Misino A, Scotti V, Gregorc V, Pisconti S, Bonomi M, Del Conte A, Ciuffreda L, Colantonio I, Bria E, Ricciardi S, Manzo A, Metro G, Morelli A, Critelli R, Stura I, Migliaretti G, Novello S. P2.04-84 NSCLC Survival Expectancy for Patients Treated with Docetaxel/Nintedanib in the SENECA Trial and Previous Immunotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Caponigro F, Ionna F, Scarpati GDV, Longo F, Addeo R, Manzo R, Muto P, Pisconti S, Leopaldi L, Perri F. Translational Research: A Future Strategy for Managing Squamous Cell Carcinoma of the Head and Neck? Anticancer Agents Med Chem 2019; 18:1220-1227. [PMID: 29637868 DOI: 10.2174/1871520618666180411110036] [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: 04/18/2017] [Revised: 07/12/2017] [Accepted: 10/26/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Squamous Cell Carcinoma of the Head and Neck (SCCHN) are neoplasms arising from the epithelium of the first aero-digestive tract. They are very heterogeneous both clinically and biologically. Classic and well acknowledged risk factors are alcohol and tobacco consumption and other forms of smokeless tobacco assumption, although lately the incidence of Human Papilloma Virus (HPV)-related SCCHN is rapidly increasing. HPV-related tumors are very different from their alcohol and tobacco-associated counterpart, as they show strong chemo and radio sensitivity and thus can often be treated with conservative treatment strategies. Moreover, peculiar biologic features characterize HPV-related tumors, such as wild type TP53, low expression of Epidermal Growth Factor Receptor (EGFR), wild type CCND1 and high expression of P16. In contrast, alcohol and tobacco related SCCHN show opposite features, together with higher number of chromosomal and genetic abnormalities, conferring them chemo and radio resistance. METHODS We have performed a narrative review of the PubMed database with the aim to study the mutational landscape of SCCHN. RESULTS Several lines of evidence support the existence of at least two genetically different types of SCCHN, one virus-related and the other alcohol and/or tobacco-related, characterized by both clinical and biological opposite features. Virus related SCCHN are very chemo and radiosensitive, so suitable for organ preserving strategy, which in the near future may be induction chemotherapy followed by association of chemotherapy and underpowered radiotherapy. Alcohol and tobacco related SCCHN are themselves strongly heterogeneous and can be divided in different entities on the basis of the "Driver" genetic aberration, responsible for carcinogenesis. The most frequently mutated genes in alcohol and tobacco-related SCCHN are TP53, NOTCH1, CCND1, CDKN2A, EGFR and PI3KCA. CONCLUSIONS Virus-related SCCHN can be managed with chemo-radiotherapy. Alcohol and tobacco-related tumors should be further characterized on the basis of their "Driver Mutations" in order to select effective targeted therapies.
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Affiliation(s)
- F Caponigro
- Head and Neck and Soft Tissue Sarcoma Oncology Unit, National Tumor Institute of Naples Foundation G. Pascale, Naples, Italy
| | - F Ionna
- Otolaryngology Unit, National Tumor Institute of Naples Foundation G. Pascale, Naples, Italy
| | | | - F Longo
- Otolaryngology Unit, National Tumor Institute of Naples Foundation G. Pascale, Naples, Italy
| | - R Addeo
- Medical Oncology Unit, San Giovanni di Dio' Hospital, A.S.L. Napoli 2 Nord, I-80027 Frattamaggiore, Naples, Italy
| | - R Manzo
- Radiation Oncology Unit, Ospedale Cardinale Ascalesi, ASL NA1, Naples, Italy
| | - P Muto
- Radiation Oncology Unit, National Tumor Institute of Naples, Foundation G. Pascale, Naples, Italy
| | - S Pisconti
- Head and Neck and Soft Tissue Sarcoma Oncology Unit, National Tumor Institute of Naples Foundation G. Pascale, Naples, Italy
| | - L Leopaldi
- Medical Oncology Unit, Ospedale Cardinale Ascalesi, ASL NA1, Naples, Italy
| | - F Perri
- Medical Oncology Unit POC SS Annunziata, Taranto, Italy
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10
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Normanno N, Esposito Abate R, Lambiase M, Forgione L, Cardone C, Iannaccone A, Sacco A, Rachiglio AM, Martinelli E, Rizzi D, Pisconti S, Biglietto M, Bordonaro R, Troiani T, Latiano TP, Giuliani F, Leo S, Rinaldi A, Maiello E, Ciardiello F. RAS testing of liquid biopsy correlates with the outcome of metastatic colorectal cancer patients treated with first-line FOLFIRI plus cetuximab in the CAPRI-GOIM trial. Ann Oncol 2019; 29:112-118. [PMID: 28950295 DOI: 10.1093/annonc/mdx417] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Liquid biopsy is an alternative to tissue for RAS testing in metastatic colorectal carcinoma (mCRC) patients. Little information is available on the predictive role of liquid biopsy RAS testing in patients treated with first-line anti-EGFR monoclonal antibody-based therapy. Patients and methods In the CAPRI-GOIM trial, 340 KRAS exon-2 wild-type mCRC patients received first-line cetuximab plus FOLFIRI. Tumor samples were retrospectively assessed by next generation sequencing (NGS). Baseline plasma samples were analyzed for KRAS and NRAS mutations using beads, emulsion, amplification, and magnetics digital PCR (BEAMing). Discordant cases were solved by droplet digital PCR (ddPCR) or deep-sequencing. Results A subgroup of 92 patients with available both NGS data on tumor samples and baseline plasma samples were included in this study. Both NGS analysis of tumor tissue and plasma testing with BEAMing identified RAS mutations in 33/92 patients (35.9%). However, 10 cases were RAS tissue mutant and plasma wild-type, and additional 10 cases were tissue wild-type and plasma mutant, resulting in a concordance rate of 78.3%. Analysis of plasma samples with ddPCR detected RAS mutations in 2/10 tissue mutant, plasma wild-type patients. In contrast, in all tissue wild-type and plasma mutant cases, ddPCR or deep-sequencing analysis of tumor tissue confirmed the presence of RAS mutations at allelic frequencies ranging between 0.15% and 1.15%. The median progression-free survival of RAS mutant and wild-type patients according to tissue (7.9 versus 12.6 months; P = 0.004) and liquid biopsy testing (7.8 versus 13.8 moths; P < 0.001) were comparable. Similar findings were observed for the median overall survival of RAS mutant and wild-type patients based on tissue (22.1 versus 35.8 months; P = 0.016) and plasma (19.9 versus 35.8 months; P = 0.013) analysis. Conclusion This study indicates that RAS testing of liquid biopsy results in a similar outcome when compared with tissue testing in mCRC patients receiving first-line anti-EGFR monoclonal antibodies.
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Affiliation(s)
- N Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione Giovanni Pascale" IRCCS, Napoli, Italy
| | - R Esposito Abate
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione Giovanni Pascale" IRCCS, Napoli, Italy
| | - M Lambiase
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione Giovanni Pascale" IRCCS, Napoli, Italy
| | - L Forgione
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione Giovanni Pascale" IRCCS, Napoli, Italy
| | - C Cardone
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi," Università della Campania "L. Vanvitelli," Napoli, Italy
| | - A Iannaccone
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione Giovanni Pascale" IRCCS, Napoli, Italy
| | - A Sacco
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione Giovanni Pascale" IRCCS, Napoli, Italy
| | - A M Rachiglio
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione Giovanni Pascale" IRCCS, Napoli, Italy
| | - E Martinelli
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi," Università della Campania "L. Vanvitelli," Napoli, Italy
| | - D Rizzi
- Gruppo Oncologico dell'Italia Meridionale (GOIM), Bari, Italy
| | - S Pisconti
- Medical Oncology, Hospital SS. Annunziata, Taranto, Italy
| | - M Biglietto
- Medical Oncology, Hospital "A. Cardarelli," Napoli, Italy
| | - R Bordonaro
- Medical Oncology, Hospital Garibaldi-Nesima, Catania, Italy
| | - T Troiani
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi," Università della Campania "L. Vanvitelli," Napoli, Italy
| | - T P Latiano
- Medical Oncology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - F Giuliani
- Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari, Italy
| | - S Leo
- Medical Oncology, Hospital Vito Fazzi, Lecce, Italy
| | - A Rinaldi
- Medical Oncology, Presidio Ospedaliero Polo Occidentale, Castellaneta, Bari, Italy
| | - E Maiello
- Medical Oncology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - F Ciardiello
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi," Università della Campania "L. Vanvitelli," Napoli, Italy
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11
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Perri F, Della Vittoria Scarpati G, Caponigro F, Ionna F, Longo F, Buonopane S, Muto P, Di Marzo M, Pisconti S, Solla R. Management of recurrent nasopharyngeal carcinoma: current perspectives. Onco Targets Ther 2019; 12:1583-1591. [PMID: 30881013 PMCID: PMC6396653 DOI: 10.2147/ott.s188148] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [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] [Indexed: 11/23/2022] Open
Abstract
Nasopharyngeal carcinoma is a rare disease in Western countries. Nevertheless, its incidence in China, Singapore, and other Eastern countries reaches 20 cases per 100,000 people. Being an extremely chemo- and radiosensitive disease, upfront treatment often consists in the association of intensity-modulated radiation therapy and concurrent cisplatin. Unfortunately, about 20% of the patients suffer from a radioresistant disease which recurs after upfront therapy. For these patients, mainly available therapeutic options consist in systemic therapy, in particular poly-chemotherapy. In those showing a single locoregional recurrence, chemotherapy is not considered to be the preferred approach and other different strategies may be employed. Re-irradiation and surgery are strategies that are always used more often, albeit related to high risk of morbidity. Immunotherapy and targeted therapy, such as heavy ions-based re-irradiations, are experimental but very intriguing options.
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Affiliation(s)
- F Perri
- Head and Neck/Sarcoma Medical Oncology Unit, INT IRCCS G Pascale, Naples, Italy,
| | | | - F Caponigro
- Head and Neck/Sarcoma Medical Oncology Unit, INT IRCCS G Pascale, Naples, Italy,
| | - F Ionna
- Department of Otolaryngology and Head and Neck Surgery, INT IRCCS G Pascale, Naples, Italy
| | - F Longo
- Department of Otolaryngology and Head and Neck Surgery, INT IRCCS G Pascale, Naples, Italy
| | - S Buonopane
- Department of Radiation Therapy, INT IRCCS G Pascale, Naples, Italy
| | - P Muto
- Department of Radiation Therapy, INT IRCCS G Pascale, Naples, Italy
| | - M Di Marzo
- Department of Abdominal Surgery, INT IRCCS G Pascale, Naples, Italy
| | - S Pisconti
- Medical Oncology Unit, POC SS Annunziata, Taranto, Italy
| | - R Solla
- Italian National Research Council, Institute of Biostructure and Bioimaging, Naples, Italy
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Morelli A, Migliorino M, Morabito A, Chiari R, Grossi F, Bordi P, Di Costanzo F, Delmonte A, Romano G, Misino A, Scotti V, Gregorc V, Pisconti S, Ceresoli G, Del Conte A, Colantonio I, Ciuffreda L, Capelletto E, Stura I, Novello S. Safety of nintedanib plus docetaxel in advanced non-squamous NSCLC (nsNSCLC) patients: The preliminary results of the SENECA (second-line nintedanib in non-small cell lung cancer) trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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D'Aniello C, Pisconti S, Facchini S, Imbimbo C, Cavaliere C. Estramustine phosphate induces prostate cancer cell line PC3 apoptosis by down-regulating miR-31 levels. Eur Rev Med Pharmacol Sci 2018; 22:1875-1876. [PMID: 29687836 DOI: 10.26355/eurrev_201804_14706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C D'Aniello
- Division of Medical Oncology, A.O.R.N. dei Colli - "Ospedali Monaldi-Cotugno-CTO", Naples, Italy.
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D'Aniello C, Rossetti S, Iovane G, Pisconti S, Cavaliere C. Up-regulation of LINC00346 inhibits proliferation of NSCLC cells through mediating JAK-STAT3 signaling pathway. Eur Rev Med Pharmacol Sci 2018; 22:856-857. [PMID: 29509228 DOI: 10.26355/eurrev_201802_14360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C D'Aniello
- Division of Medical Oncology, A.O.R.N. dei Colli - "Ospedali Monaldi-Cotugno-CTO", Naples, Italy.
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Carnio S, Galetta D, Scotti V, Cortinovis D, Antonuzzo A, Pisconti S, Rossi A, Martelli O, Cecere F, Lunghi A, Del Conte A, Montagna E, Topulli J, Pelizzoni D, Rapetti S, Gianetta M, Pacchiana M, Pegoraro V, Cataldo N, Bria E, Novello S. The close link between anxiety and cluster symptoms in lung cancer patients during first-line chemotherapy: further data from a dedicated WALCE (Women Against Lung Cancer in Europe) survey. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426.010] [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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Ciardiello F, Martinelli E, Cardone C, Troiani T, Normanno N, Pisconti S, Bordonaro R, Nappi A, Giuliani F, Biglietto M, Barone C, Rachiglio A, Montesarchio V, Cinieri S, Rizzi D, Febbraro A, Latiano T, Modoni G, Colucci G, Maiello E. Survival analysis of KRAS, NRAS, BRAF, PIK3CA wild type (wt) metastatic colorectal cancer (mCRC) patients (pts) treated with FOLFIRI plus cetuximab in the CAPRI- GOIM trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.006] [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: 11/12/2022] Open
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Cito P, Rinaldi A, Pisconti S, Longo V. Taxane-rechallenge in HER2-positive breast cancer patients who develop an oligo-progression during pertuzumab-trastuzumab maintenance therapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.065] [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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18
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Normanno N, Esposito Abate R, Lambiase M, Forgione L, Cardone C, Iannaccone A, Sacco A, Rachiglio A, Martinelli E, Rizzi D, Pisconti S, Cartenì G, Bordonaro R, Troiani T, Giuliani F, Leo S, Romito S, Rinaldi A, Maiello E, Ciardiello F. Analysis of liquid biopsies from metastatic colorectal carcinoma (mCRC) patients (pts) enrolled in the CAPRI GOIM clinical trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.066] [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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19
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Martinelli E, Cardone C, Troiani T, Normanno N, Pisconti S, Sforza V, Bordonaro AR, Rachiglio AM, Lambiase M, Latiano TP, Modoni G, Cordio S, Giuliani F, Biglietto M, Montesarchio V, Barone C, Tonini G, Cinieri S, Febbraro A, Rizzi D, De Vita F, Orditura M, Colucci G, Maiello E, Ciardiello F, Iaffaioli V, Nasti G, Nappi A, Botti G, Tatangelo F, Chicchinelli N, Montrone M, Sebastio A, Guarino T, Simone G, Graziano P, Chiarazzo C, Maggio G, Longhitano L, Manusia M, Cartenì G, Nappi O, Micheli P, Leo L, Rossi S, Cassano A, Tommaselli E, Giordano G, Sponziello F, Marino A, Rinaldi A, Romito S, Muda AO, Lorusso V, Leo S, Barni S, Grimaldi G, Aieta M. Clinical activity and tolerability of FOLFIRI and cetuximab in elderly patients with metastatic colorectal cancer in the CAPRI-GOIM first-line trial. ESMO Open 2017; 1:e000086. [PMID: 28848656 PMCID: PMC5548975 DOI: 10.1136/esmoopen-2016-000086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 07/13/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND In the cetuximab after progression in KRAS wild-type colorectal cancer patients (CAPRI) trial patients with metastatic colorectal cancer (mCRC) received 5-fluorouracil, folinic acid and irinotecan (FOLFIRI) and cetuximab in first line followed by 5-Fluorouracil, folinic acid, oxaliplatin (FOLFOX) with or without cetuximab until progression. Limited data are available on the efficacy and safety of anti-epidermal growth factor receptor (anti-EGFR) agents on elderly patients with mCRC. In the current study we evaluated the efficacy and safety of FOLFIRI plus cetuximab in age-defined subgroups. METHODS A post-hoc analysis was performed in CAPRI trial patients; outcomes (progression-free survival (PFS), overall response rate (ORR), safety) were analysed by age-groups and stratified according to molecular characterisation. 3 age cut-offs were used to define the elderly population (≥65; ≥70 and ≥75 years). RESULTS 340 patients with mCRC were treated in first line with FOLFIRI plus cetuximab. Among those, 154 patients were >65 years, 86 >70 years and 35 >75 years. Next-generation sequencing (NGS) was performed in 182 patients. Among them, 87 patients were >65 years, 46 >70 and 17 >75. 104 of 182 patients were wild type (WT) for KRAS, NRAS, BRAF, PIK3CA genes. In the quadruple WT group, 51 patients were ≥65 years; 29 were ≥70; 9 were ≥75. Median PFS was similar within the age-subgroups in the intention-to-treat population, NGS cohort and quadruple WT patients, respectively. Likewise, ORR was not significantly different among age-subgroups in the 3 populations. Safety profile was acceptable and similarly reported among all age-groups, with the exception of grade ≥3 diarrhoea (55% vs 25%, p=0.04) and neutropaenia (75% vs 37%, p=0.03) in patients ≥75 years and grade ≥3 fatigue (31% vs 20%, p=0.01) in patients <75 years. CONCLUSIONS Tolerability of cetuximab plus FOLFIRI was acceptable in elderly patients. Similar ORR and PFS were observed according to age-groups. No differences in adverse events were reported among the defined subgroups with the exception of higher incidence of grade ≥3 diarrhoea and neutropaenia in patients ≥75 years and grade ≥3 fatigue in patients <75 years. TRIAL REGISTRATION NUMBER 2009-014041-81.
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Affiliation(s)
- E Martinelli
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi", Universitá degli Studi della Campania "Luigi Vanvitelli" , Naples, Italy.
| | - C Cardone
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi", Universitá degli Studi della Campania "Luigi Vanvitelli" , Naples, Italy
| | - T Troiani
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi", Universitá degli Studi della Campania "Luigi Vanvitelli" , Naples, Italy
| | - N Normanno
- Cell Biology and Biotherapy Unit, National Cancer Institute "Fondazione Giovanni Pascale", Naples, Italy
| | - S Pisconti
- Department of Medical Oncology, Hospital SS. Annunziata, Taranto, Italy
| | - V Sforza
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi", Universitá degli Studi della Campania "Luigi Vanvitelli" , Naples, Italy
| | - A R Bordonaro
- Department of Medical Oncology, Hospital Garibaldi, Nesima, Catania, Italy
| | - A M Rachiglio
- Cell Biology and Biotherapy Unit, National Cancer Institute "Fondazione Giovanni Pascale", Naples, Italy; Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-National Cancer Institute "Fondazione Giovanni Pascale", Naples, Italy
| | - M Lambiase
- Cell Biology and Biotherapy Unit, National Cancer Institute "Fondazione Giovanni Pascale", Naples, Italy; Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-National Cancer Institute "Fondazione Giovanni Pascale", Naples, Italy
| | - T P Latiano
- Department of Medical Oncology, Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo (Foggia), Italy
| | - G Modoni
- Department of Medical Oncology, Hospital SS. Annunziata, Taranto, Italy
| | - S Cordio
- Department of Medical Oncology, Hospital Garibaldi, Nesima, Catania, Italy
| | - F Giuliani
- Department of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari,Italy
| | - M Biglietto
- Department of Medical Oncology, Hospital "A. Cardarelli", Naples, Italy
| | - V Montesarchio
- Department of Medical Oncology, Hospital Monaldi- Azienda Ospedaliera dei Colli, Naples,Italy
| | - C Barone
- Department of Medical Oncology, University Hospital A. Gemelli ,Rome, Italy
| | - G Tonini
- Department of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - S Cinieri
- Department of Medical Oncology, Hospital A. Perrino, Brindisi, Italy
| | - A Febbraro
- Department of Medical Oncology, Hospital Sacro Cuore di Gesù, Fatebenefratelli, Benevento, Italy
| | | | - F De Vita
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi", Universitá degli Studi della Campania "Luigi Vanvitelli" , Naples, Italy
| | - M Orditura
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi", Universitá degli Studi della Campania "Luigi Vanvitelli" , Naples, Italy
| | - G Colucci
- Department of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari,Italy
| | - E Maiello
- Department of Medical Oncology, Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo (Foggia), Italy
| | - F Ciardiello
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi", Universitá degli Studi della Campania "Luigi Vanvitelli" , Naples, Italy
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Perri F, Longo F, Giuliano M, Sabbatino F, Favia G, Ionna F, Addeo R, Della Vittoria Scarpati G, Di Lorenzo G, Pisconti S. Epigenetic control of gene expression: Potential implications for cancer treatment. Crit Rev Oncol Hematol 2017; 111:166-172. [PMID: 28259291 DOI: 10.1016/j.critrevonc.2017.01.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 01/29/2017] [Accepted: 01/31/2017] [Indexed: 02/07/2023] Open
Abstract
Epigenetic changes are defined as inherited modifications that are not present in DNA sequence. Gene expression is regulated at various levels and not only in response to DNA modifications. Examples of epigenetic control are DNA methylation, histone deacetylation and mi-RNA expression. Methylation of several tumor suppressor gene promoters is responsible for their silencing and thus potentially sustain cancerogenesis. Similarly, histone deacetylation can lead to oncogene activation. mi-RNA are small (18-20 nucleotides) non-coding RNA fragments capable of inhibiting other m-RNA, ultimately altering the balance in oncogene and tumor suppressor gene expression. It has been shown that growth of several tumor types can be stimulated by epigenetic changes in various phases of cancerogenesis, and drugs able to interfere with these mechanisms can have a positive impact on tumor progression. As matter of fact, epigenetic changes are dynamic and can be reversed by epigenetic inhibitors. Recently, methyltransferase and histone deacetylase inhibitors have attracted the attention of researchers and clinicians as they potentially provide alternative therapeutic options in some cancers. Drugs that inhibit DNA methylation or histone deacetylation have been studied for the reactivation of tumor suppressor genes and repression of cancer cell growth. Epigenetic inhibitors work alone or in combination with other therapeutic agents. To date, a number of epigenetic inhibitors have been approved for cancer treatment. The main challenge in the field of epigenetic inhibitors is their lack of specificity. In this review article we describe their mechanisms of action and potential in cancer treatment.
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Affiliation(s)
- F Perri
- Medical Oncology Unit, POC SS Annunziata, Taranto, Italy.
| | - F Longo
- Otolaryngology Unit, National Tumor Institute of Naples, G. Pascale, Italy
| | - M Giuliano
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Napoli, Italy; dLester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA
| | - F Sabbatino
- Medical Oncology Department, University of Salerno, Italy
| | - G Favia
- Otolaryngology Unit, University of Bari, Italy
| | - F Ionna
- Otolaryngology Unit, National Tumor Institute of Naples, G. Pascale, Italy
| | - R Addeo
- San Giovanni di Dio Hospital, Department of Medical Oncology, Frattamaggiore, Naples, Italy
| | | | - G Di Lorenzo
- Medical Oncology Unit, University of Naples "Federico II", Italy
| | - S Pisconti
- Medical Oncology Unit, POC SS Annunziata, Taranto, Italy
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21
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Martinelli E, Cardone C, Troiani T, Normanno N, Pisconti S, Bordonaro R, Francesco G, Biglietto M, Barone C, Rachiglio A, Montesarchio V, Tonini G, Cinieri S, Rizzi D, Febbraro A, Latiano T, Modoni G, Giuseppe C, Maiello E, Ciardiello F. Clinical activity of FOLFIRI plus cetuximab in elderly patients (pts) according to extended gene mutation status by next generation sequencing (NGS) in the CAPRI- GOIM trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.96] [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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22
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Gobbini E, Grecorc V, Galetta D, Riccardi F, Tiseo M, Scotti V, Ceribelli A, Buffoni L, Maiello E, Delmonte A, Franchina T, Migliorino M, Cortinovis D, Pisconti S, Di Maio M, Graziano P, Bria E, Rossi G, Rossi A, Novello S. Molecular profiling in advanced non-small-cell lung cancer: preliminary data of the Italian observational prospective study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw332.11] [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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Rossetti S, D'Aniello C, Vitale M, Farnesi A, Calvetti L, Laterza M, Cavaliere C, Della Pepa C, Crispo A, Di Napoli M, Cecere S, Pisconti S, De Vita F, Grillone F, Ricevuto E, De Tursi M, De Vivo R, Galli L, De Giorgi U, Cartenì G, Facchini G. Effectiveness of Axitinib second-line therapy for metastatic renal cell carcinoma: preliminary results from real-word “SAX” observational study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw334.22] [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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Maiello E, Martinelli E, Cardone C, Troiani T, Normanno N, Pisconti S, Bordonaro R, Giuliani F, Biglietto M, Barone C, Rachiglio A, Montesarchio V, Tonini G, Cinieri S, Rizzi D, Febbraro A, Latiano T, Modoni G, Colucci G, Ciardiello F. Clinical activity of FOLFIRI plus cetuximab in elderly patients (pts) according to extended gene mutation status by Next Generation Sequencing (NGS) in the CAPRI- GOIM trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cavaliere C, Caffo O, Ortega C, D'Aniello C, Cecere S, Di Napoli M, Della Pepa C, Crispo A, Maines F, Ruatta F, Iovane G, Montella M, Pisconti S, Pignata S, Facchini G. Prognostic assessment in Abiraterone Acetate (AA) post-Docetxel (DOC) mCRPC cohort. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw334.24] [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: 11/12/2022] Open
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26
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Carnio S, Galetta D, Scotti V, Cortinovis D, Antonuzzo A, Pisconti S, Rossi A, Martelli O, Cecere F, Bria E, Del Conte A, Pegoraro V, Montagna E, Topulli J, Pelizzoni D, Rapetti S, Gianetta M, Novello S. Chemotherapy-induced nausea and vomiting (CINV) in patients with stage III/IV lung cancer during the first-line treatment: assessment by physician, nurse and patient. Preliminary results from an Italian multicenter survey. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw332.21] [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: 11/13/2022] Open
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27
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Ciardiello F, Normanno N, Martinelli E, Troiani T, Pisconti S, Cardone C, Nappi A, Bordonaro AR, Rachiglio M, Lambiase M, Latiano TP, Modoni G, Cordio S, Giuliani F, Biglietto M, Montesarchio V, Barone C, Tonini G, Cinieri S, Febbraro A, Rizzi D, De Vita F, Orditura M, Colucci G, Maiello E. Cetuximab continuation after first progression in metastatic colorectal cancer (CAPRI-GOIM): a randomized phase II trial of FOLFOX plus cetuximab versus FOLFOX. Ann Oncol 2016; 27:1055-1061. [PMID: 27002107 DOI: 10.1093/annonc/mdw136] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [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: 12/24/2015] [Accepted: 03/04/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cetuximab plus chemotherapy is a first-line treatment option in metastatic KRAS and NRAS wild-type colorectal cancer (CRC) patients. No data are currently available on continuing anti-epidermal growth factor receptor (EGFR) therapy beyond progression. PATIENTS AND METHODS We did this open-label, 1:1 randomized phase II trial at 25 hospitals in Italy to evaluate the efficacy of cetuximab plus 5-fluorouracil, folinic acid and oxaliplatin (FOLFOX) as second-line treatment of KRAS exon 2 wild-type metastatic CRC patients treated in first line with 5-fluorouracil, folinic acid and irinotecan (FOLFIRI) plus cetuximab. Patients received FOLFOX plus cetuximab (arm A) or FOLFOX (arm B). Primary end point was progression-free survival (PFS). Tumour tissues were assessed by next-generation sequencing (NGS). This report is the final analysis. RESULTS Between 1 February 2010 and 28 September 2014, 153 patients were randomized (74 in arm A and 79 in arm B). Median PFS was 6.4 [95% confidence interval (CI) 4.7-8.0] versus 4.5 months (95% CI 3.3-5.7); [hazard ratio (HR), 0.81; 95% CI 0.58-1.12; P = 0.19], respectively. NGS was performed in 117/153 (76.5%) cases; 66/117 patients (34 in arm A and 32 in arm B) had KRAS, NRAS, BRAF and PIK3CA wild-type tumours. For these patients, PFS was longer in the FOLFOX plus cetuximab arm [median 6.9 (95% CI 5.5-8.2) versus 5.3 months (95% CI 3.7-6.9); HR, 0.56 (95% CI 0.33-0.94); P = 0.025]. There was a trend in better overall survival: median 23.7 [(95% CI 19.4-28.0) versus 19.8 months (95% CI 14.9-24.7); HR, 0.57 (95% CI 0.32-1.02); P = 0.056]. CONCLUSIONS Continuing cetuximab treatment in combination with chemotherapy is of potential therapeutic efficacy in molecularly selected patients and should be validated in randomized phase III trials.
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Affiliation(s)
- F Ciardiello
- Medical Oncology, Department of Clinical and Experimental Medicine 'F. Magrassi', Second University of Naples, Naples.
| | - N Normanno
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - E Martinelli
- Medical Oncology, Department of Clinical and Experimental Medicine 'F. Magrassi', Second University of Naples, Naples
| | - T Troiani
- Medical Oncology, Department of Clinical and Experimental Medicine 'F. Magrassi', Second University of Naples, Naples
| | - S Pisconti
- Medical Oncology, Hospital SS. Annunziata, Taranto
| | - C Cardone
- Medical Oncology, Department of Clinical and Experimental Medicine 'F. Magrassi', Second University of Naples, Naples
| | - A Nappi
- Medical Oncology, Department of Clinical and Experimental Medicine 'F. Magrassi', Second University of Naples, Naples
| | - A R Bordonaro
- Medical Oncology, Hospital Garibaldi, Nesima, Catania
| | - M Rachiglio
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples; Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - M Lambiase
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples; Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - T P Latiano
- Medical Oncology, Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo (Foggia)
| | - G Modoni
- Medical Oncology, Hospital SS. Annunziata, Taranto
| | - S Cordio
- Medical Oncology, Hospital Garibaldi, Nesima, Catania
| | - F Giuliani
- Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari
| | - M Biglietto
- Medical Oncology, Hospital 'A. Cardarelli', Naples
| | - V Montesarchio
- Medical Oncology, Hospital Monaldi- Azienda Ospedaliera dei Colli, Naples
| | - C Barone
- Medical Oncology, University Hospital A. Gemelli, Rome
| | - G Tonini
- Policlinico Universitario Campus Bio-Medico, Rome
| | - S Cinieri
- Medical Oncology, Hospital A. Perrino, Brindisi
| | - A Febbraro
- Medical Oncology, Hospital Sacro Cuore di Gesù, Fatebenefratelli, Benevento
| | - D Rizzi
- GOIM Trial Office, Bari, Italy
| | - F De Vita
- Medical Oncology, Department of Clinical and Experimental Medicine 'F. Magrassi', Second University of Naples, Naples
| | - M Orditura
- Medical Oncology, Department of Clinical and Experimental Medicine 'F. Magrassi', Second University of Naples, Naples
| | - G Colucci
- Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari
| | - E Maiello
- Medical Oncology, Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo (Foggia)
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Di Costanzo G, Sacco R, de Stefano G, Montesarchio V, Cabibbo G, Zolfino T, Carucci P, Pisconti S, De Vita F, Giovanis P, Attili A, Erminero C, Fontana T, Daniele B. Safety and efficacy of sorafenib in stella study, a Multicenter, Observational, Phase IV Study In Italian Centers. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Brandi G, Cereda S, Pantano F, Russano M, Lonardi S, Leone F, Reni M, Marsico V, Filippi R, Delcuratolo S, Fornaro L, Vasile E, Vivaldi C, Aprile G, Pisconti S, Luca F, Aieta M, Tonini G, Santini D. Natural history of skeletal disease in primary biliary cancers. National survey on behalf of GICO group (Gruppo Italiano Colangiocarcinoma – Onlus). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.19] [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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Ciardiello F, Normanno N, Martinelli E, Troiani T, Cardone C, Nappi A, Rachiglio A, Lambiase M, Pisconti S, Giuliani F, Barone C, Biglietto M, Montesarchio V, Tonini G, Rizzi D, Cinieri S, Bordonaro R, Febbraro A, De Vita F, Orditura M, Colucci G, Maiello E. LBA-09 Cetuximab beyond progression in RAS wild type (WT) metastatic colorectal cancer (mCRC): the CAPRI-GOIM randomized phase II study of FOLFOX versus FOLFOX plus cetuximab. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv262.09] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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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Ciccarese M, Orlando L, Fedele P, Schiavone P, Maiello E, Cilenti P, Aieta M, Bozza G, Forcignanò M, Febbraro A, Bordonaro R, Romito S, Rinaldi A, Borsellino N, Riccardi F, Pisconti S, Lorusso V, Colucci G, Cinieri S. A Multicenter Phase Ii Trial of Nab-Paclitaxel in Combination with Capecitabine in Patients (Pts) with Her-2 Negative and Triple Negative Advanced Breast Cancer (Abc): an Interim Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.20] [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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Ciardiello F, Normanno N, Maiello E, Martinelli E, Troiani T, Pisconti S, Giuliani F, Barone C, Cartenì G, Rachiglio AM, Montesarchio V, Tonini G, Rizzi D, Cinieri S, Bordonaro R, Febbraro A, De Vita F, Orditura M, Fenizia F, Lambiase M, Rinaldi A, Tatangelo F, Botti G, Colucci G. Clinical activity of FOLFIRI plus cetuximab according to extended gene mutation status by next-generation sequencing: findings from the CAPRI-GOIM trial. Ann Oncol 2014; 25:1756-1761. [PMID: 24942275 DOI: 10.1093/annonc/mdu230] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Treatment with antiepidermal growth factor receptor (anti-EGFR) monoclonal antibodies has been restricted to metastatic colorectal cancer (mCRC) patients with RAS wild-type tumors. Next-generation sequencing (NGS) allows the assessment in a single analysis of a large number of gene alterations and might provide important predictive and prognostic information. PATIENTS AND METHODS In the CAPRI-GOIM trial, 340 KRAS exon 2 wild-type mCRC patients received first-line FOLFIRI plus cetuximab. Tumor samples (182/340, 53.5%) were assessed by NGS to search for mutations in 22 genes involved in colon cancer. RESULTS Objective responses in the NGS cohort were observed in 104/182 patients [overall response rate (ORR) 57.1%; 95% confidence interval (95% CI) 52% to 66.4%] with a median progression-free survival (mPFS) of 9.8 (95% CI 8.7-11.5) months. NGS analysis was successfully completed in all 182 samples. One or more gene mutations (up to five) were detected in 124/182 (68.1%) tumors within 14/22 genes for a total of 206 mutations. KRAS exon 2 mutations were identified in 29/182 (15.9%) samples, defined as wild type by local laboratory assessment. Frequently mutated genes were: TP53 (39.6%), KRAS exons 3/4 (8.8%), NRAS exons 2/3 (7.1%), PIK3CA exons 9/20 (13.2%), BRAF (8.2%). FOLFIRI plus cetuximab treatment determined ORR of 62.0% (95% CI 55.5% to 74.6%) with mPFS of 11.1 (95% CI 9.2-12.8) months in patients with KRAS and NRAS wild-type tumors. Conversely, ORR was 46.6% (95% CI 39.9-57.5%) with mPFS of 8.9 (95% CI 7.4-9.6) months in patients with KRAS or NRAS mutations. Similarly, the subgroup of patients carrying KRAS, NRAS, BRAF, or PIK3CA mutations showed a worse outcome, although this might be due to a prognostic effect. CONCLUSIONS This study demonstrates that NGS analysis in mCRC is feasible, reveals high level of intra and intertumor heterogeneity, and identifies patients that might benefit of FOLFIRI plus cetuximab treatment.
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Affiliation(s)
- F Ciardiello
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples.
| | - N Normanno
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - E Maiello
- Medical Oncology, Hospital Casa Sollievo Della Sofferenza-San Giovanni Rotondo (Foggia), San Giovanni Rotondo
| | - E Martinelli
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples
| | - T Troiani
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples
| | - S Pisconti
- Department of Medical Oncology, Hospital SS. Annunziata, Taranto
| | - F Giuliani
- Department of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari
| | - C Barone
- Department of Medical Oncology, University Hospital A. Gemelli, Rome
| | - G Cartenì
- Department of Medical Oncology, Hospital 'A. Cardarelli', Naples
| | - A M Rachiglio
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - V Montesarchio
- Department of Medical Oncology, Hospital Monaldi- Azienda Ospedaliera dei Colli, Napoles
| | - G Tonini
- Department of Medical Oncology, Univeristy Hospital Campus Bio-Medico di Rome, Rome
| | - D Rizzi
- Department of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari
| | - S Cinieri
- Department of Medical Oncology, Hospital A. Perrino, Brindisi
| | - R Bordonaro
- Department of Medical Oncology, Hospital Garibaldi, Nesima, Catania
| | - A Febbraro
- Department of Medical Oncology, Hospital Sacro Cuore di Gesù, Fatebenefratelli, Benevento
| | - F De Vita
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples
| | - M Orditura
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples
| | - F Fenizia
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - M Lambiase
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - A Rinaldi
- Department of Medical Oncology, Hospital Polo Occidentale, Castellaneta, Bari
| | - F Tatangelo
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - G Botti
- Department of Pathology, National Cancer Institute 'Fondazione Giovanni Pascale', Naples, Italy
| | - G Colucci
- Department of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari
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Lorusso V, Giotta F, Bordonaro R, Maiello E, Del Prete S, Gebbia V, Filippelli G, Pisconti S, Cinieri S, Romito S, Riccardi F, Forcignanò R, Ciccarese M, Petrucelli L, Saracino V, Lupo LI, Gambino A, Leo S, Colucci G. Non-pegylated liposome-encapsulated doxorubicin citrate plus cyclophosphamide or vinorelbine in metastatic breast cancer not previously treated with chemotherapy:a multicenter phase III study. Int J Oncol 2014; 45:2137-42. [PMID: 25176223 DOI: 10.3892/ijo.2014.2604] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 06/20/2014] [Indexed: 11/05/2022] Open
Abstract
We conducted a phase III multicenter randomized trial to compare the efficacy of the combination of liposome encapsulated doxorubicin (Myocet(©)) plus either cyclophosphamide (MC) or vinorelbine (MV). Since July 2006, 233 patients affected with metastatic breast cancer were randomized to receive the combination of Myocet (M) 60 mg/m(2) i.v. plus cyclophosphamide (C) 600 mg/m2 on Day 1 of a 21‑day cycle (Arm A) or Myocet (M) at 50 mg/m2 plus vinorelbine (V) 25 mg/m2 i.v. on Day 1 and V 60 mg/m2 orally on Day 8 on a 21‑day cycle (Arm B). The primary endpoints of the study was time to progression (TTP); secondary endpoints were RR, toxicity and OS. Response was observed in 53/116 (45.7%) evaluable patients of Arm A vs. 51/112 (45.5%) of Arm B, respectively (P=NS). Median TTP was 41 weeks (95% CI, 32‑51) and 34 weeks (95% CI, 26‑39), for M/C and M/V, respectively (P=0.0234). The difference in median OS was not statistically significant (131 vs. 122 weeks; P=0.107). With regard to toxicity, patients treated with MV showed a slight increase of neutropenia and constipation, as compared to those treated with MC. No clinical signs of cardiotoxicity were observed. The MC combination remains as an unbeaten 'standard' in first line treatment of MBC.
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Affiliation(s)
- V Lorusso
- National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - F Giotta
- National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Bari, Italy
| | | | - E Maiello
- Casa Sollievo della Sofferenza Hospital IRCCS, San Giovanni Rotondo (FG), Italy
| | - S Del Prete
- Frattamaggiore Hospital, Frattamaggiore (NA), Italy
| | - V Gebbia
- La Maddalena Hospital, Palermo, Italy
| | | | | | - S Cinieri
- Brindisi Medical Oncology Department and Breast Unit e Medical Department, European Insitute of Oncology, Milan, Italy
| | - S Romito
- Ospedali Riuniti Hospital, Foggia, Italy
| | | | | | | | | | | | - L I Lupo
- Vito Fazzi Hospital, Lecce, Italy
| | | | - S Leo
- Vito Fazzi Hospital, Lecce, Italy
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Lorusso V, Giotta F, Bordonaro R, Maiello E, Del Prete S, Gebbia V, Filippelli G, Pisconti S, Cinieri S, Romito S, Riccardi F, Cairo G, Chiuri VE, Ciccarese M, Forcignano R, Petrucelli L, Saracino V, Colucci G. A multicenter randomized phase III trial of nonpegylated liposome-encapsulated doxorubicin citrate plus cyclophosphamide (MC) versus liposome-encapsulated doxorubicin citrate plus vinorelbine (MV) as first-line treatment in locally advanced (LABC) or metastatic breast cancer (MBC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1041] [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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Giuliani F, Febbraro A, Addeo R, Rizzi D, Maiello E, Del Prete S, Pisconti S, Colucci G. Sorafenib plus cisplatin and gemcitabine in the treatment of advanced hepatocellular carcinoma (HCC): A phase II study by the Gruppo Oncologico dell'Italia Meridionale (prot. GOIM 2705). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
225 Background: Sorafenib is the standard treatment in advanced HCC. The combination of cisplatin and gemcitabine demonstrated to be active and well tolerated in tumors with a similar poor outcome such as pancreatic and biliary-tract cancers. Considering these data, the GOIM started a phase II trial aiming to evaluate the activity and safety of the combination of sorafenib, gemcitabine and cisplatin in advanced HCC. Methods: Patients affected by advanced HCC, not suitable for surgery or locoregional procedures, with measurable disease (Recist criteria), age ≥ 18 years, clip-score ≤3, ECOG performance status ≥ 60 (K.fsky), adequate bone marrow reserve and renal and hepatic function and who signed written informed consent, were enrolled and received cisplatin 40 mg/mq iv plus gemcitabine 800 mg/mq iv bi-weekly, while sorafenib was orally administrated at the dosage of 400 mg bid continuously. A maximum of 6 cycles of chemotherapy was planned; a maintenance with sorafenib was permitted for not progressing patients. The evaluation of activity was performed every three cycles. A Simon's two stage, two steps study design was applied: at the first step, at least 3 OR had to be observed among the first 28 patients to continue the enrollment. Up to now, 23 patients have been enrolled. Their main characteristics were: sex (male/female) 19/4, median age: 70 yrs, median PS 80,main sites of disease liver 22, lymph nodes 4, lung 2, others 3. Results: Up to now 18 patients are evaluable for activity while 5 are too early. One CR, 3 PR, 6 SD and 8 PRO for an ORR of 4/18 (22%) and a tumor control of 10/18 (55%). Twenty-one patients are evaluable for safety. The main observed side effects (%G1-2/G3-4) (NCI criteria) were: hand-foot skin reaction (HFSR) 9/14, mucositis 9/4, diarrhea 23/4, nausea/vomiting 23/0, leucopenia 23/0, anemia 9/0, thrombocytopenia 19/4, asthenia 14/14, cardiovascular 0/4, others 9/4. Conclusions: Our preliminary data seems to demonstrate that the combination of cisplatin, gemcitabine, and sorafenib is active and well tolerated in advanced HCC patients. The accrual is ongoing. No significant financial relationships to disclose.
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Affiliation(s)
- F. Giuliani
- NCI, Bari, Italy; Fatebenefratelli Hospital, Benevento, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy; SS Annunziata Hospital, Taranto, Italy; Istituto Oncologico Bari, Bari, Italy
| | - A. Febbraro
- NCI, Bari, Italy; Fatebenefratelli Hospital, Benevento, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy; SS Annunziata Hospital, Taranto, Italy; Istituto Oncologico Bari, Bari, Italy
| | - R. Addeo
- NCI, Bari, Italy; Fatebenefratelli Hospital, Benevento, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy; SS Annunziata Hospital, Taranto, Italy; Istituto Oncologico Bari, Bari, Italy
| | - D. Rizzi
- NCI, Bari, Italy; Fatebenefratelli Hospital, Benevento, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy; SS Annunziata Hospital, Taranto, Italy; Istituto Oncologico Bari, Bari, Italy
| | - E. Maiello
- NCI, Bari, Italy; Fatebenefratelli Hospital, Benevento, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy; SS Annunziata Hospital, Taranto, Italy; Istituto Oncologico Bari, Bari, Italy
| | - S. Del Prete
- NCI, Bari, Italy; Fatebenefratelli Hospital, Benevento, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy; SS Annunziata Hospital, Taranto, Italy; Istituto Oncologico Bari, Bari, Italy
| | - S. Pisconti
- NCI, Bari, Italy; Fatebenefratelli Hospital, Benevento, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy; SS Annunziata Hospital, Taranto, Italy; Istituto Oncologico Bari, Bari, Italy
| | - G. Colucci
- NCI, Bari, Italy; Fatebenefratelli Hospital, Benevento, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy; SS Annunziata Hospital, Taranto, Italy; Istituto Oncologico Bari, Bari, Italy
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Abstract
In the last decade dramatic improvements have been obtained in the treatment of metastatic colorectal cancer. Thanks to the introduction in the clinical practice of new drugs such as Irinotecan and Oxaliplatin, and modern biological drugs such as Bevacizumab and Cetuximab, the response rate, progression-free and overall survival are about 50-60%, 9-11 and 20-24 months respectively. Despite this progress, many questions remain unsolved especially those related to the optimal duration of treatment and the role of maintenance therapy. To treat until progression (or unacceptable toxicity) is the classical way but in the common clinical practice is frequent to perform an induction therapy (until the maximum response is obtained) followed by a complete stop and restart on progression, or by a maintenance without the drug/s responsible of the major cumulative toxicities. The following report focus on the role of different strategies respect to the classic "treatment until progression".
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Affiliation(s)
- F Giuliani
- Medical Oncology Department, National Cancer Institute Giovanni Paolo II, via Hahnemann 10, Bari, Italy.
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Galetta D, Rossi A, Pisconti S, Millaku A, Colucci G. Maintenance or non-maintenance therapy in the treatment of advanced non-small cell lung cancer: that is the question. Cancer Treat Rev 2010; 36 Suppl 3:S30-3. [PMID: 21129607 DOI: 10.1016/s0305-7372(10)70017-7] [Citation(s) in RCA: 5] [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: 11/26/2022]
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Lotesoriere C, Perrucci B, Montrone M, Bruno M, Russo F, Pisconti S. 7 A PATIENT WITH UNRESECTABLE ADVACED PANCREATIC CANCER ACHIEVING LONG-TERM SURVIVAL WITH GEMCITABINE-BASED CHEMOTHERAPY. Cancer Treat Rev 2010. [DOI: 10.1016/s0305-7372(10)70033-5] [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: 11/24/2022]
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Silvestris N, Maiello E, De Vita F, Cinieri S, Santini D, Russo A, Tommasi S, Azzariti A, Numico G, Pisconti S, Petriella D, Lorusso V, Millaku A, Colucci G. Update on capecitabine alone and in combination regimens in colorectal cancer patients. Cancer Treat Rev 2010; 36 Suppl 3:S46-55. [DOI: 10.1016/s0305-7372(10)70020-7] [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: 10/18/2022]
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Bruno M, Lambo R, Tommasi S, Luccarelli G, Broussard C, D'Alessandro A, Nenna C, Paradiso A, Pisconti S. 73 CANCER AT OTHER SITES THAN BREAST AND OVARY IN FAMILIES WITH OR WITHOUT BRCA1/2 GENES MUTATION. Cancer Treat Rev 2010. [DOI: 10.1016/s0305-7372(10)70099-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Montrone M, Perrucci B, Lotesoriere C, Bruno M, Fanelli F, Pisconti S. 53 ERLOTINIB TREATMENT IN A PATIENT WITH BRAIN METASTASES BY NSCLC. Cancer Treat Rev 2010. [DOI: 10.1016/s0305-7372(10)70079-7] [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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Lorusso V, De Giorgi GA, Ciccarese M, Chiuri VE, Giotta F, Bordonaro R, Maiello E, Pisconti S, Cinieri S, Colucci G. Cardiac safety of nonpegylated liposomal doxorubicin in patients with advanced breast cancer treated with myocet plus vinorelbine or myocet plus cyclophosphamide in a randomized phase II trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1119] [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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Lorusso V, Leo S, Ciccarese M, Giotta F, Bordonaro R, Filippelli G, Del Prete S, Piano A, Gebbia V, Pisconti S, Colucci G. A multicenter randomized phase II study of nonpegylated liposomal doxorubicin plus vinorelbine versus nonpegylated liposomal doxorubicin plus cyclophosphamide as first line in locally advanced breast cancer (LABC) or metastatic breast cancer (MBC): Safety results. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1116 Background: We conducted a multicenter randomized phase II trial to assess activity and tolerability of the combination of nonpegylated liposomal doxorubicin plus vinorelbine versus standard nonpegylated liposomal doxorubicin plus cyclophosphamide. Methods: This multicenter randomized phase II study was planned to enrol 140 patients (pts). Elegibile pts must have LABC or MBC, PS (ECOG) ≤ 2, and measurable disease. Adjuvant or neoadjuvant chemotherapy with anthracyclines was allowed as well as prior endocrine therapy. Pts assigned to arm A received nonpegylated liposomal doxorubicin 60 mg/m2 plus cyclophosphamide 600 mg/m2 on day 1 of a 21-day cycle. Pts assigned to arm B received nonpegylated liposomal doxorubicin 50 mg/m2 plus vinorelbine 25 mg/m2 iv on day 1, and 60 mg/m2 on day 8 po, every 3 weeks. The primary outcome measure was response rate (RR), whereas safety was one of the secondary endpoints. Results: Between July 2006 and July 2008 110 women were treated; for 80 of these, safety results are available. Patient characteristics: Arm A pts (N=41): median age, 59 (range 37–69); ER status ±/unk, 26/15/0; Her-2 status ±/unk, 5/34/2; PS 0/1/2, 26/14/1; prior adjuvant treatment with anthracyclines 10 pts (24%); dominant site of disease visceral 31 pts (76%). Arm B pts (N=39): median age, 61 (range 25–70); Er status ±/unk, 29/10/0; Her-2 status ±/unk, 3/35/1; prior adjuvant treatment with anthracyclines 14 pts (36%); dominant site of disease visceral in 28 pts (72%). There was no study discontinuation due to AE either in arm A or in arm B, nor study-related deaths. Conclusions: The combination regimen of nonpegylated liposomal doxorubicin plus vinorelbine appears to be associated with a slight increase of hematological and nonhematological toxicity when compared with nonpegylated liposomal doxorubicin plus cyclophosphamide. No increase in cardiotoxicity was seen. The trial is ongoing and we plan to give preliminary efficacy results at the time of the Meeting. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- V. Lorusso
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - S. Leo
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - M. Ciccarese
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - F. Giotta
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - R. Bordonaro
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - G. Filippelli
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - S. Del Prete
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - A. Piano
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - V. Gebbia
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - S. Pisconti
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
| | - G. Colucci
- Ospedale Vito Fazzi, Lecce, Italy; Istituto Oncologico, Bari, Italy; Catania Hospital, Catania, Italy; Paola Hospital, Paola, Italy; Frattamaggiore Hospital, Frattamaggiore, Italy; Ospedale Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy; Ospedale La Maddalena, Palermo, Italy; Taranto Hospital, Taranto, Italy
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Cinieri S, Orlando L, Lorusso V, Filippelli G, Maiello E, Blasi L, Verderame F, Barni S, Pisconti S, Colucci G. New biweekly combination of trastuzumab, docetaxel, and gemcitabine for HER2-positive metastatic breast cancer: First early results from a phase II multicentric trial on behalf of Gruppo Oncologico Italia Meridionale. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1096] [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
1096 Background: The clinical activity of the combination of chemotherapy plus trastuzumab in HER-2 overexpressing metastatic breast cancer has been well documentated. We report the first results in terms of efficacy and safety of a phase II trial on biweekly combination of trastuzumab plus docetaxel and gemcitabine as first line therapy in HER-2-positive metastatic breast cancer patients. Methods: Patients at first relapse or with synchronous metastasis, were treated with trastuzumab (4 mg/kg, loading dose 6 mg/kg) plus gemcitabine (1000 mg/m2) plus docetaxel (50 mg/m2) as biweekly schedule. Primary end-point was overall response rate (ORR), secondary end-point time to progression (TTP), clinical benefit rate (CBR; PR+ CR + prolonged SD for ≥ 24 weeks), and tolerability. Based on previous data, an ORR greater than 60% was considered to indicate clinical activity in this two stage design trial. Results: A total of 26 patients with histologically confirmed, measurable MBC, tumors scored as +3 positive for HER-2 by immuno-histochemistry or FISH +, no pretreated with chemotherapy or trastuzumab for metastatic disease have been enrolled, 22 actually evaluable for response and toxicity. Median age was 49 years (range 34–66), visceral metastases were present in most patients (73%). Median number of cycles was 8 (range 3–12). The ORR was 86% (95% CI, 80–91%), with two CR (9 %) and 17 PR (77%). 3 patients had SD, 1 prolonged (14%). The CBR was 91% (95% CI, 87%-94%). No progression of disease was observed. Median TTP was 7 months (range 5- 9+ months). The worst toxicity was WHO grade 2 neutropenia and grade 2 gastric pain. Conclusions: In this phase II study, the biweekly combination of trastuzumab, gemcitabine, and docetaxel in HER-2-positive breast cancer is very active. The toxicity observed was manageable and did not lead to treatment discontinuation. Thus, the patients accrual is ongoing to the preset target of 50 patients. No significant financial relationships to disclose.
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Affiliation(s)
- S. Cinieri
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - L. Orlando
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - V. Lorusso
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - G. Filippelli
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - E. Maiello
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - L. Blasi
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - F. Verderame
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - S. Barni
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - S. Pisconti
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
| | - G. Colucci
- Sen Antonio Perrino Hospital, Brindisi, Italy; Vito Fazzi Hospital, Lecce, Italy; Civile Hospital, Paola, Italy; Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy; Fondazione San Raffaele-G Giglio, Cefalù, Italy; Ospedali Riuniti di Sciacca, Sciacca, Italy; Azienda Ospedaliera Treviglio, Treviglio, Italy; North Hospital, Taranto, Italy; Gruppo Oncologico Italia Meridionale; National Institute of Oncology, Bari, Italy
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Ferrandina G, Lorusso D, Ludovisi M, Pignata S, Sorio R, Mangili G, Breda E, Legge F, Pisconti S, Scambia G. Phase II study on pemetrexed in advanced and/or recurrent cervical cancer patients: a MITO study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5515] [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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Silvano G, Lazzari G, Resta F, Buccoliero G, Pezzella G, Pisconti S. A Herpes simplex virus-1 fatal encephalitis following chemo-radiotherapy, steroids and prophylactic cranial irradiation in a small cell lung cancer patient. Lung Cancer 2007; 57:243-6. [PMID: 17368625 DOI: 10.1016/j.lungcan.2007.01.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2006] [Revised: 01/22/2007] [Accepted: 01/31/2007] [Indexed: 11/20/2022]
Abstract
Approximately 20-25% of patients with limited small cell lung cancer (SCLC) can be cured with an aggressive approach (chest radiation concomitant with chemotherapy) followed by prophylactic cranial irradiation (PCI) to a total dose of 30-36Gy with 3-2Gy per fraction, five fractions per week. Steroid prophylactic therapy with dexamethasone is usually prescribed during PCI to minimize acute radiation induced brain oedema. This approach may induce an immunosuppressive condition leading to a reactivation of an endogenous latent Herpes simplex virus and severe or fatal acute encephalitis may occur as our report will show. A 55-year-old man affected by locally advanced SCLC was referred to our institution after four cycles of chemotherapy with a good partial remission. Chest radiation started concomitantly with two cycles of chemotherapy followed by PCI 36Gy total dose and dexamethasone 8mg i.m. daily. Fifteen days after PCI completion the patient developed acute neurological symptoms of confusion, cognitive impairment, fever with shaking requiring severe sedation therapy. Twenty-five days later MRI T1 weighted images showed haemorrhagic streaked lines on cortical convolutions of the right cerebral hemisphere and diffuse oedema suggestive of herpetic encephalitis. The DNA consensus test on cerebrospinal fluid (CSF) was positive for Herpes simplex virus 1 infection (HSV-1). A diagnosis of herpetic encephalitis HSV-1 was made. Antiviral therapy with high doses of acyclovir was prescribed but symptoms did not ameliorate leading to a comatose state. The patient died 55 days after the end of PCI. In eligible SCLC patients, PCI is an important part of an aggressive therapeutic approach that improves overall and disease free survival decreasing the risk of relapse in the brain. A primary infection or a reactivation of an endogenous latent HSV in brain parenchyma under steroid therapy concomitant to brain irradiation may compromise these benefits.
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Affiliation(s)
- G Silvano
- Radiation Therapy Unit, S.G. Moscati Hospital ASL TA/1, Taranto, Italy.
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Lorusso D, Di Stefano A, Carone V, Fagotti A, Pisconti S, Scambia G. Pegylated liposomal doxorubicin-related palmar-plantar erythrodysesthesia ('hand-foot' syndrome). Ann Oncol 2007; 18:1159-64. [PMID: 17229768 DOI: 10.1093/annonc/mdl477] [Citation(s) in RCA: 182] [Impact Index Per Article: 10.7] [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: 11/14/2022] Open
Abstract
Palmar-plantar erythrodysesthesia (PPE), also called hand-foot syndrome or hand-to-foot syndrome, is a distinctive and relatively frequent dermatologic toxic reaction associated with certain chemotherapeutic agents. Pegylated liposomal doxorubicin (PLD), a long-circulating formulation of doxorubicin in which doxorubicin hydrochloride is encapsulated within pegylated liposomes, is approved to treat patients with metastatic breast cancer, advanced ovarian cancer, and acquired immunodeficiency syndrome-related Kaposi's sarcoma. The incidence of PPE is increased in patients receiving PLD compared with conventional doxorubicin. In studies that utilized the currently approved dose of PLD (50 mg/m(2) every 4 weeks), approximately 50% of all patients receiving PLD experienced PPE, and approximately 20% experienced grade 3 PPE. The pathophysiology of PPE, as it occurs with any drug with which it is associated, is not well understood. Studies evaluating the development of PPE specifically associated with PLD have not fully elucidated the mechanism; however, data support the roles of drug excretion in sweat and local pressure as contributors. When PPE develops, clinical interventions with respect to altering PLD administration include dose reduction, less frequent dosing, and ultimately, drug withdrawal with several consequences on treatment efficacy. This article will review the available data regarding the etiology and potential management strategies of PPE associated with PLD.
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Affiliation(s)
- D Lorusso
- Department of Oncology, Catholic University of the Sacred Heart, Campobasso, Italy
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Cazzaniga M, Di Costanzo F, Mustacchi G, Pronzato P, De Matteis A, Tabiadon D, Botta M, Pisconti S, Danese S, Rulli E. 314 POSTER Young (≤45) and old (≥65) early breast cancer (EBC) patients (pts): two different populations for surgeons? Results from the NORA study. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70749-1] [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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Iaffaioli RV, Formato R, Tortoriello A, Del Prete S, Caraglia M, Pappagallo G, Pisano A, Gebbia V, Fanelli F, Ianniello G, Cigolari S, Pizza C, Marano O, Pezzella G, Pedicini T, Febbraro A, Incoronato P, Manzione L, Ferrari E, Marzano N, Quattrin S, Pisconti S, Nasti G, Giotta G, Colucci G. Phase II study of sequential hormonal therapy with anastrozole/exemestane in advanced and metastatic breast cancer. Br J Cancer 2005; 92:1621-5. [PMID: 15856035 PMCID: PMC2362023 DOI: 10.1038/sj.bjc.6602579] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [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: 10/04/2004] [Revised: 03/07/2005] [Accepted: 03/07/2005] [Indexed: 11/16/2022] Open
Abstract
Hormonal therapy is the preferred systemic treatment for recurrent or metastatic, post-menopausal hormone-receptor-positive breast cancer. Previous studies have shown that there is no cross-resistance between exemestane and reversible aromatase inhibitors. Exposure to hormonal therapy does not hamper later response to chemotherapy. Patients with locally advanced or metastatic, hormonal receptor positive or unknown, breast cancer were treated with oral anastrozole, until disease progression, followed by oral exemestane until new evidence of disease progression. The primary end point of the study was clinical benefit, defined as the sum of complete responses (CR), partial responses (PR) and > 24 weeks stable disease (SD). In all, 100 patients were enrolled in the study. Anastrozole produced eight CR and 19 PR for an overall response rate of 27% (95% CI: 18.6-36.8%). An additional 46 patients had long-term (> 24 weeks) SD for an overall clinical benefit of 73% (95% CI: 63.2-81.4). Median time to progression (TTP) was 11 months (95% CI: 10-12). A total of 50 patients were evaluated for the second-line treatment: exemestane produced one CR and three PR; 25 patients had SD which lasted > or = 6 months in 18 patients. Median TTP was 5 months. Toxicity of treatment was low. Our study confirms that treatment with sequential hormonal agents can extend the period of time during which endocrine therapy can be used, thereby deferring the decision to use chemotherapy.
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