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Tsoukalas N, Christopoulou A, Timotheadou E, Athanasiadis I, Koumarianou A, Peroukidis S, Samelis G, Psyrri A, Kapodistrias N, Nikolakopoulos A, Andreadis C, Ardavanis A, Kalofonos C, Samantas E, Papandreou C, Mavroudis D, Bokas A, Barbounis V, Kentepozidis N, Athanasiadis A, Papakotoulas P, Boukovinas I. EP10.01-018 Thromboprophylaxis for Lung Cancer Patients: Results From ACT4CAT Trial. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.895] [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: 11/26/2022]
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Tsoukalas N, Christopoulou A, Timotheadou E, Athanasiadis I, Koumarianou A, Peroukidis S, Samelis G, Psyrri A, Kapodistrias N, Nikolakopoulos A, Andreadis C, Ardavanis A, Samantas E, Papandreou C, Mavroudis D, Bokas A, Barbounis V, Kentepozidis N, Athanasiadis A, Papakotoulas P, Boukovinas I. PO-45: Cancer-associated thrombosis (CAT) in gynecological cancers: data from ACT4CAT study. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00235-3] [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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Tsoukalas N, Christopoulou A, Anastopoulou G, Papandreou C, Timotheadou E, Athanasiadis I, Koumarianou A, Peroukidis S, Samelis G, Psyrri A, Kapodistrias N, Nikolakopoulos A, Andreadis C, Ardavanis A, Samantas E, Bokas A, Barbounis V, Kentepozidis N, Mavroudis D, Athanasiadis A, Papakotoulas P, Boukovinas I. P-214 Should patients with active gastrointestinal tumors receive thromboprophylaxis to avoid the negative clinical consequences of CAT? Sub-analysis of ACT4CAT study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Karamouzis M, Sarantis P, Koustas E, Papadimitropoulou A, Papakotoulas P, Bokas A, Schizas D, Papalampros A, Felekouras E, Liakakos T, Papavassiliou A. 1550P Combination therapy of low molecular weight heparins, chemotherapy and immunotherapy induce antitumor activity in pancreatic cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Koumarianou A, Makrantonakis P, Zagouri F, Papadimitriou C, Christopoulou A, Samantas E, Christodoulou C, Psyrri A, Bafaloukos D, Aravantinos G, Papakotoulas P, Baka S, Andreadis C, Alexopoulos A, Bompolaki I, Kampoli Κ, Liori S, Karvounis K, Ardavanis A. ABREAST: a prospective, real-world study on the effect of nab-paclitaxel treatment on clinical outcomes and quality of life of patients with metastatic breast cancer. Breast Cancer Res Treat 2020; 182:85-96. [PMID: 32418045 DOI: 10.1007/s10549-020-05677-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/09/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The efficacy of nab-paclitaxel in patients with metastatic breast cancer (MBC) has been demonstrated in randomized clinical trials. However, real-world evidence on effectiveness remains limited. PATIENTS AND METHODS The primary objective of this multicenter prospective study was to assess the overall response rate (ORR) of patients with MBC treated with nab-paclitaxel. Secondary objectives included progression-free survival (PFS), overall survival (OS) and quality of life, assessed with the Functional Assessment of Cancer Therapy-Breast (FACT-B) instrument. RESULTS Eligible patients (N = 150; 36% with de novo MBC presentation) with a median age of 64.5 years were enrolled (86% were ER+, 33.3% (50/150) were ≥ 70 years of age and 53% were treated in the third or later line of treatment). A median of 6 cycles were administered but 26% of patients required dose reduction due to toxicity. The ORR was 26.7% [95% confidence interval (CI) 19.6-33.7], the median PFS was 6.2 months (95% CI 5.2-7.3), and the median OS 21.1 months (95% CI 17.2-not estimable). There was no statistical significant difference in the median PFS of patients < and ≥ 70 years of age. The patients' baseline FACT-B total score remained unchanged. The serious and non-serious adverse event incidence rates were 13% and 48%, respectively. CONCLUSIONS This prospective study provides further evidence on quality of life, efficacy, and safety of nab-paclitaxel in patients with MBC and sheds more light in special subpopulations such as the elderly and those treated beyond the second line.
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Affiliation(s)
- A Koumarianou
- Hematology Oncology Unit, Fourth Department of Internal Medicine, ATTIKON University General Hospital, National and Kapodistrian University of Athens, Medical School, Rimini 1, 124 62, Haidari, Athens, Greece.
| | - P Makrantonakis
- Second Chemotherapeutic Clinic, THEAGENIO Anti-Cancer Hospital of Thessaloniki, Thessaloniki, Greece
| | - F Zagouri
- Therapeutic Clinic, ALEXANDRA General Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - C Papadimitriou
- Oncology Unit, 2nd Dept. of Surgery, ARETAIEIO University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A Christopoulou
- Oncology Department, AGIOS ANDREAS General Hospital of Patras, Patras, Greece
| | - E Samantas
- Third Oncology Clinic, AGIOI ANARGIROI Athens General Hospital, Athens, Greece
| | - C Christodoulou
- Second Oncology Clinic, METROPOLITAN Athens Private Hospital, Piraeus, Greece
| | - A Psyrri
- Division Medical Oncology, ATTIKON University General Hospital of Athens, Haidari, Greece
| | - D Bafaloukos
- First Oncology Clinic, METROPOLITAN Athens Private Hospital, Piraeus, Greece
| | - G Aravantinos
- Second Oncology Clinic, AGIOI ANARGIROI Athens General Hospital, Athens, Greece
| | - P Papakotoulas
- First Chemotherapeutic Oncology Department, THEAGENION Anti-Cancer Hospital of Thessaloniki, Thessaloniki, Greece
| | - S Baka
- Oncology Department, European INTERBALKAN Private Hospital of Thessaloniki, Thessaloniki, Greece
| | - C Andreadis
- Third Department of Clinical Oncology and Chemotherapy, THEAGENION Anti-Cancer Hospital of Thessaloniki, Thessaloniki, Greece
| | - A Alexopoulos
- Oncology Department, HYGEIA Athens Private Hospital, Maroussi, Athens, Greece
| | - I Bompolaki
- Oncology Department, AGIOS GEORGIOS General Hospital of Chania, Chania, Crete, Greece
| | - Κ Kampoli
- Hematology Oncology Unit, Fourth Department of Internal Medicine, ATTIKON University General Hospital, National and Kapodistrian University of Athens, Medical School, Rimini 1, 124 62, Haidari, Athens, Greece
| | - S Liori
- First Department of Medical Oncology, AGIOS SAVVAS Athens General Hospital, Athens, Greece
| | - K Karvounis
- Medical Department Hematology/Oncology, Genesis Pharma S.A, Halandri, Athens, Greece
| | - A Ardavanis
- First Department of Medical Oncology, AGIOS SAVVAS Athens General Hospital, Athens, Greece
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Mavroudis D, Saloustros E, Malamos N, Kakolyris S, Boukovinas I, Papakotoulas P, Kentepozidis N, Ziras N, Georgoulias V. Corrigendum to Six versus 12 months of adjuvant trastuzumab in combination with dose-dense chemotherapy for women with HER2-positive breast cancer: a multicenter randomized study by the Hellenic Oncology Research Group (HORG): Annals of Oncology, Volume 26, Issue 7, July 2015, Pages 1333-1340. Ann Oncol 2020; 31:444-445. [PMID: 32067691 DOI: 10.1016/j.annonc.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- D Mavroudis
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Greece.
| | - E Saloustros
- Oncology Unit, General Hospital of Heraklion 'Venizelio', Greece
| | - N Malamos
- Department of Medical Oncology, Elena Venizelou Hospital, Athens, Greece
| | - S Kakolyris
- Department of Medical Oncology, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - I Boukovinas
- Department of Medical Oncology, Bioklinic of Thessaloniki, Thessaloniki, Greece
| | - P Papakotoulas
- Department of Medical Oncology, Theageneio Hospital, Thessaloniki, Greece
| | - N Kentepozidis
- Department of Medical Oncology, 251 Airforce General Hospital, Athens, Greece
| | - N Ziras
- Department of Medical Oncology, Metaxa Hospital, Athens, Greece
| | - V Georgoulias
- Department of Medical Oncology, University of Crete, School of Medicine, Heraklion, Greece
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Venetsanaki V, Boutis A, Chrisoulidou A, Papakotoulas P. Diabetes mellitus secondary to treatment with immune checkpoint inhibitors. ACTA ACUST UNITED AC 2019; 26:e111-e114. [PMID: 30853817 DOI: 10.3747/co.26.4151] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cancer immunotherapy has been one of the highlights in the advancement of cancer care. Certain immune checkpoint inhibitors bind to PD-1 on T cells and mediate an antitumour immune response. Given that immune checkpoint inhibitors are becoming part of standard care, a new class of adverse events-immune-related adverse events-has emerged. Among them is endocrine toxicity, most commonly targeting the thyroid, pituitary, or adrenal glands. New-onset diabetes mellitus has been reported in fewer than 1% of patients. We present a patient with type 1 diabetes mellitus secondary to immunotherapy, together with an overview of the associated literature. Patients who develop type 1 diabetes mellitus experience a rapid course, and diabetic ketoacidosis is commonly the presenting symptom. Insulin is currently the treatment of choice; oral antidiabetics or corticosteroids do not assist in management. Several predictive factors are under investigation, but physician awareness and prompt management are key to a positive outcome.
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Affiliation(s)
- V Venetsanaki
- First Department of Clinical Oncology, Theagenio Hospital, Thessaloniki, Greece
| | - A Boutis
- First Department of Clinical Oncology, Theagenio Hospital, Thessaloniki, Greece
| | - A Chrisoulidou
- Department of Endocrinology, Theagenio Hospital, Thessaloniki, Greece
| | - P Papakotoulas
- First Department of Clinical Oncology, Theagenio Hospital, Thessaloniki, Greece
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Tsoukalas N, Papakotoulas P, Christopoulou A, Ardavanis A, Koumakis G, Papandreou C, Papatsimpas G, Papakostas P, Andreadis C, Aravantinos G, Ziras N, Kalofonos H, Samantas E, Sougleri M, Makrantonakis P, Pentheroudakis G, Athanasiadis A, Bournakis E, Varthalitis I, Boukovinas I. Prevention and prophylaxis of thrombosis in cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.036] [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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9
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Boukovinas I, Lypas G, Liontos M, Andreadis C, Papandreou C, Papakotoulas P, Aravantinos G, Bournakis E, Karageorgopoulou S, Maragkouli E, Ziras N, Kakolyris S, Athanasiadis I, Linardou E, Koumarianou A, Kalofonos C, Pentheroudakis G, Korantzis I, Christodoulou C, Kosmidis P, Daliani D, Ardavanis A, Koumakis G, Bankousli I, Makrantonakis P, Kesisis G, Nikolaou M, Diamantidou E, Tsoukalas N, Xanthakis I, Fassas A, Barbounis V, Anagnostopoulos A, Polyzos A, Athanasiadis A, Syrios I, Peroukidis S, Mpompolaki I, Baka S, Androulakis N, Georgoulias V, Emmanouilidis C, Mavroudis D, Sgouros I, Stathopoulos C, Katopodi O, Varthalitis I, Sarikaki P, Saloustros E, Saridaki Z. Access to Genetic Testing Impacts Oncologists´ Decisions on Ovarian Cancer Personalized Treatment: Lessons Learned From a National Program in Greece. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.55800] [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
Background: State health insurance authorities in Greece do not reimburse genetic testing for cancer predisposition. The Hellenic Society of Medical Oncology has launched and carries out a national program covering genetic testing for BRCA1/2 mutations detection, with the financial support of pharmaceutical industry. Aim: This analysis evaluates how, during this program, access to genetic testing transformed the oncologists' therapeutic approach toward their ovarian cancer patients and how the results impacted treatment decisions concerning PARP inhibitors. Adoption of testing by healthy relatives and timing of testing in the disease continuum were also evaluated. Methods: Adult patients with high-grade epithelial ovarian carcinoma, irrespectively of family history or age at diagnosis were eligible for this program. Genetic counseling was recommended before testing, and both were offered at no financial cost. First degree family members of pathogenic mutation carriers were also offered free counseling and testing. Results: From March 2015 through January 2018, 708 patients were enrolled and tested. One hundred and forty seven (20.7%) mutation carriers were identified, 102 (14.4%) in BRCA1 and 45 (6.3%) in BRCA2 gene. Testing was more often pursued at initial diagnosis (61%) than at recurrence (39%), as recorded for 409 patients with available relevant information. During the 1st year of the program, average monthly tests performed were 25.1, while during the 3rd year this number increased to 34.3 tests per month. Among patients who tested positive for deleterious BRCA1/2 mutations, relapse was reported in 58 patients, 94.8% of which (n= 55) received treatment with the PARP inhibitor olaparib as per its indication. Family members of 21 patients (14.3%), out of the 147 who tested positive, received genetic counseling and testing for the mutation identified in the context of the program. Conclusion: Free access to genetic testing for BRCA1/2 for ovarian cancer patients and genetic consultation facilitates testing uptake, affects common clinical practice & has major impact on patients and their families. Still, diffusion of genetic information and broader testing of family members require further efforts by the oncological community.
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Affiliation(s)
- I. Boukovinas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Lypas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - M. Liontos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Andreadis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Papandreou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - P. Papakotoulas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Aravantinos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Bournakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - S. Karageorgopoulou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Maragkouli
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - N. Ziras
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - S. Kakolyris
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Athanasiadis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Linardou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Koumarianou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Kalofonos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Pentheroudakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Korantzis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Christodoulou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - P. Kosmidis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - D. Daliani
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Ardavanis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Koumakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Bankousli
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - P. Makrantonakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Kesisis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - M. Nikolaou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Diamantidou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - N. Tsoukalas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Xanthakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Fassas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - V. Barbounis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Anagnostopoulos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Polyzos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Athanasiadis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Syrios
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - S. Peroukidis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Mpompolaki
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - S. Baka
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - N. Androulakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - V. Georgoulias
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Emmanouilidis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - D. Mavroudis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Sgouros
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Stathopoulos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - O. Katopodi
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Varthalitis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - P. Sarikaki
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Saloustros
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - Z. Saridaki
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
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Mihailidou C, Papakotoulas P, Schizas D, Papalampros A, Vailas M, Felekouras E, Liakakos T, Papavassiliou A, Karamouzis M. Effect of ciclopirox olamine in immunotherapy effect by stimulating immunogenic cell death in pancreatic cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.055] [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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11
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Tsoukalas N, Bournakis E, Adamidis A, Andreadis C, Arvaniti K, Christopoulou A, Douna S, Moreno J, Goumas G, Kostadima L, Makaronis P, Makatsoris T, Doufexis D, Papatsimpas G, Sgouros I, Stergiou E, Thalassinou P, Boukovinas I, Papakotoulas P, Varthalitis I. Management of thrombosis in cancer patients in Greece. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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Karamouzis M, Mihailidou C, Papakotoulas P, Anestis A, Koustas E, Papavassiliou A. Targeting c-met and DNA double-strand break (DSB) repair pathways for BRCA-mutated gastric carcinomas. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mavroudis D, Matikas A, Malamos N, Papakotoulas P, Kakolyris S, Boukovinas I, Athanasiadis A, Kentepozidis N, Ziras N, Katsaounis P, Saloustros E, Georgoulias V. Dose-dense FEC followed by docetaxel versus docetaxel plus cyclophosphamide as adjuvant chemotherapy in women with HER2-negative, axillary lymph node-positive early breast cancer: a multicenter randomized study by the Hellenic Oncology Research Group (HORG). Ann Oncol 2016; 27:1873-8. [DOI: 10.1093/annonc/mdw274] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/01/2016] [Indexed: 11/14/2022] Open
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Mavroudis D, Saloustros E, Boukovinas I, Papakotoulas P, Kakolyris S, Ziras N, Christophylakis C, Kentepozidis N, Timotheadou E, Rigas G, Varthalitis II, Kalbakis K, Agelaki S, Georgoulias V. Abstract P1-12-02: Sequential versus concurrent administration of epirubicin and docetaxel as adjuvant chemotherapy in women with high-risk axillary lymph node negative early breast cancer. An interim analysis of a multicenter randomized study from the Hellenic oncology research group. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-12-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: To compare the sequential versus the concurrent administration of epirubicin and docetaxel as adjuvant therapy in high risk axillary node negative women with early breast cancer.
Patients and treatment: Women 18-75 years old with invasive breast adenocarcinoma surgically resected with no infiltrated axillary lymph nodes and absence of metastatic disease were randomized to receive 4 cycles of epirubicin 90mg/m2 followed by 4 cycles of docetaxel 75mg/m2 (sequential regimen) or 6 cycles of epirubicin 75mg/m2 followed by docetaxel 75mg/m2 (concurrent regimen). All chemotherapy cycles were administered every 21 days with prophylactic G-CSF support for days 3-10 only for the concurrent regimen. Stratification was based on menopausal status, tumor size and hormone receptor expression. By protocol amendment in 2008 women with HER2 positive tumors were excluded. The primary endpoint of the study was to compare the disease-free survival (DFS) at 5 years and 329 patients were scheduled to enroll on each arm.
Results: Between 2001-2013, 658 women were randomized and received the sequential (n=329) or the concurrent (n=329) regimen. The median age was 53 and 52 years, premenopausal status 43.8% versus 44.1%, tumor size <2cm in 44.1% versus 44.4%, histological grade 3 tumor in 52% versus 53.5% and hormone receptor negative disease in 33.1% versus 37.4% of patients in the sequential and concurrent regimens, respectively. After a median follow up of 70.5 and 70 months, there were 29 (8.8%) versus 42 (12.8%) disease relapses (p=0.102) and 11 (3.3%) versus 19 (5.8%) deaths (p=0.135), in the sequential and concurrent arms, respectively. The median DFS has not yet been reached in either arm (p=0.053) and the 5-year DFS rates were 92.6% versus 88.2% for sequential and concurrent arms, respectively. Dose reduction was required in 1.2% versus 3% (p=0.001) of the treatment cycles in the sequential and concurrent arms, respectively. Toxicity included grade 2-4 neutropenia in 54% versus 41% (p=0.001), febrile neutropenia 2.7% versus 6.1% (p=0.06), anemia 12% versus 17% (p=0.07), nausea/vomiting 18.5% versus 12.4% (p=0.03) of patients in the sequential and concurrent arms, respectively. There were no toxic deaths.
Conclusion: In this interim analysis both the efficacy and the toxicity profile seem to favor the sequential over the concurrent regimen.
Citation Format: Mavroudis D, Saloustros E, Boukovinas I, Papakotoulas P, Kakolyris S, Ziras N, Christophylakis C, Kentepozidis N, Timotheadou E, Rigas G, Varthalitis I-I, Kalbakis K, Agelaki S, Georgoulias V. Sequential versus concurrent administration of epirubicin and docetaxel as adjuvant chemotherapy in women with high-risk axillary lymph node negative early breast cancer. An interim analysis of a multicenter randomized study from the Hellenic oncology research group. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-12-02.
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Affiliation(s)
- D Mavroudis
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - E Saloustros
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - I Boukovinas
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - P Papakotoulas
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - S Kakolyris
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - N Ziras
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - C Christophylakis
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - N Kentepozidis
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - E Timotheadou
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - G Rigas
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - I-I Varthalitis
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - K Kalbakis
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - S Agelaki
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
| | - V Georgoulias
- From the Breast Cancer Investigators of the Hellenic Oncology Research Group (HORG), Athens, Greece
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Mavroudis D, Saloustros E, Malamos N, Kakolyris S, Boukovinas I, Papakotoulas P, Kentepozidis N, Ziras N, Georgoulias V. Six versus 12 months of adjuvant trastuzumab in combination with dose-dense chemotherapy for women with HER2-positive breast cancer: a multicenter randomized study by the Hellenic Oncology Research Group (HORG). Ann Oncol 2015; 26:1333-40. [PMID: 25935793 DOI: 10.1093/annonc/mdv213] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/23/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Adjuvant trastuzumab in combination with chemotherapy improves survival of women with HER2-positive early breast cancer. In this study, we compared 12 versus 6 months of adjuvant trastuzumab. PATIENTS AND METHODS Axillary node-positive or high-risk node-negative women with HER2-positive early breast cancer were randomized to receive 12 or 6 months of adjuvant trastuzumab concurrently with dose-dense, granulocyte colony-stimulating factor (G-CSF)-supported docetaxel (75 mg/m(2) every 14 days for four cycles). All patients received upfront dose-dense, G-CSF-supported FEC (5-fluorouracil 700 mg/m(2), epirubicin 75 mg/m(2), cyclophosphamide 700 mg/m(2) every 14 days for four cycles). Randomization was carried out before commence of chemotherapy. The primary end point was the 3-year disease-free survival (DFS). RESULTS A total of 481 patients were randomized to receive 12 months (n = 241) or 6 months (n = 240) of adjuvant trastuzumab. Chemotherapy was completed in 99% and 98% of patients, while trastuzumab therapy in 100% and 96% of patients in the 12- and 6-month groups, respectively. After 47 and 51 months of median follow-up, there were 17 (7.1%) and 28 (11.7%) disease relapses in the 12- and 6-month groups (P = 0.08). The 3-year DFS was 95.7% versus 93.3% in favor of the 12-month treatment group (hazard ratio = 1.57; 95% confidence interval 0.86-2.10; P = 0.137). There was no difference in terms of overall survival and cardiac toxicity between the two groups. CONCLUSIONS Our study failed to show noninferiority for the 6-month arm. The results further support the current standard of care that is administration of adjuvant trastuzumab for 12 months.
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Affiliation(s)
- D Mavroudis
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion
| | - E Saloustros
- Oncology Unit, General Hospital of Heraklion 'Venizelio'
| | - N Malamos
- Department of Medical Oncology, Elena Venizelou Hospital, Athens
| | - S Kakolyris
- Department of Medical Oncology, University General Hospital of Alexandroupolis, Alexandroupolis
| | - I Boukovinas
- Department of Medical Oncology, Bioklinic of Thessaloniki, Thessaloniki
| | - P Papakotoulas
- Department of Medical Oncology, Theageneio Hospital, Thessaloniki
| | - N Kentepozidis
- Department of Medical Oncology, 251 Airforce General Hospital, Athens
| | - N Ziras
- Department of Medical Oncology, Metaxa Hospital, Athens
| | - V Georgoulias
- Department of Medical Oncology, University of Crete, School of Medicine, Heraklion, Greece
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Tryfonidis K, Boukovinas I, Xenidis N, Christophyllakis C, Papakotoulas P, Politaki E, Malamos N, Polyzos A, Kakolyris S, Georgoulias V, Mavroudis D. A multicenter phase I-II study of docetaxel plus epirubicin plus bevacizumab as first-line treatment in women with HER2-negative metastatic breast cancer. Breast 2013; 22:1171-7. [PMID: 24091128 DOI: 10.1016/j.breast.2013.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 07/01/2013] [Accepted: 08/29/2013] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To assess the efficacy and toxicity of docetaxel (D) plus epirubicin (E) in combination with bevacizumab (B) [DEB regimen] as front-line treatment in patients with metastatic breast cancer (MBC). PATIENTS AND METHODS Women with previously untreated HER2-negative MBC received B (15 mg/kg), E (75 mg/m2) and D (75 mg/m2) with prophylactic G-CSF support every 3 weeks (q3w) for up to 9 cycles followed by B (15 mg/kg q3w) until disease progression. Primary endpoint was the overall response rate (ORR). Circulating tumor cells (CTCs) were evaluated using the CellSearch system at different time points during therapy. RESULTS Eighty-three women were enrolled with median age 62 years, performance status 0-1 in 93%, triple negative disease in 12% and liver metastases in 47%. In an intention to treat analysis, complete response was achieved in 13 (15.7%) and partial response in 42 (50.6%) (overall response rate 66.3%; 95% CI 56.09-76.44%). The median time to progression was 20.1 months and the 1-year overall survival rate 82.3%. Grade 3-4 neutropenia occurred in 37%, febrile neutropenia in 10%, anemia in 4%, thrombocytopenia in 2% and diarrhea in 2% of patients. There were two deaths possibly related to study treatment (sigmoid perforation n = 1; sudden death n = 1). Moreover, one patient developed pulmonary embolism and another one myocardial infarction while on treatment. Although DEB administration significantly reduced the proportion of patients presenting CTCs, the detection of ≥5 or ≥1 CTCs before treatment initiation was significantly associated with worse progression-free survival (p = 0.001 and p = 0.004) and overall survival (p = 0.001 and p = 0.027), respectively. CONCLUSIONS The DEB regimen is a very active but also potentially toxic combination in MBC. Detection of CTCs before treatment is associated with worse outcome. CLINICALTRIALSGOV NCT00705315.
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Affiliation(s)
- K Tryfonidis
- Hellenic Oncology Research Group, 55 Lombardou Street, 11474 Athens, Greece(1)
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Karampeazis⁎ A, Ardavanis A, Kentepozidis N, Nikolaou C, Bozionelou V, Papakotoulas P, Tryfonidis K, Saloustros E, Mavroudis D, Georgoulias V, Vamvakas L. Cyclophosphamide and liposomal-encapsulated doxorubicin (MYOCET®) in elderly women with HER-2 negative locally advanced or metastatic breast cancer: Preliminary results of a multicenter phase II trial from the Hellenic Oncology Research Group. J Geriatr Oncol 2012. [DOI: 10.1016/j.jgo.2012.10.011] [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: 10/27/2022]
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Karachaliou N, Kouroussis C, Papakotoulas P, Kalbakis K, Tryfonidis K, Vardakis N, Poppis E, Georgoulias V, Mavroudis D. A multicenter phase II trial of docetaxel plus gemcitabine as salvage treatment in anthracycline- and taxane-pretreated patients with metastatic breast cancer. Cancer Chemother Pharmacol 2012; 69:1345-52. [DOI: 10.1007/s00280-012-1824-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 01/04/2012] [Indexed: 11/28/2022]
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19
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Ziras N, Polyzos A, Xenidis N, Kalykaki A, Androulakis NE, Papakotoulas P, Kentepozidis NK, Makrantonakis P, Xynogalos S, Sougklakos I. CAPIRI plus bevacizumab (CAPIRI-B) versus FOLFIRI plus bevacizumab (FOLFIRI-B) for the treatment of patients with metastatic colorectal cancer (mCRC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mavroudis D, Boukovinas I, Christophyllakis C, Xenidis N, Papakotoulas P, Malamos NA, Kakolyris S, Polyzos A, Georgoulias V. A phase I/II study of docetaxel/epirubicin/bevacizumab (DEB) as first-line therapy for metastatic, HER2-negative breast cancer (MBC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1116] [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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21
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Pectasides DG, Xanthakis I, Makatsoris T, Samantas E, Varthalitis I, Papaxoinis G, Papakotoulas P, Bournakis E, Papandreou C, Fountzilas G. Irinotecan/capecitabine (XELIRI) plus bevacizumab versus irinotecan/fluorouracil/leucovorin (FOLFIRI) plus bevacizumab as first-line treatment in patients with metastatic colorectal cancer: A randomized phase III trial of the Hellenic Cooperative Oncology Group (HeCOG). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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22
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Mavroudis D, Papakotoulas P, Ardavanis A, Syrigos K, Kakolyris S, Ziras N, Kouroussis C, Malamos N, Polyzos A, Christophyllakis C, Kentepozidis N, Georgoulias V. Randomized phase III trial comparing docetaxel plus epirubicin versus docetaxel plus capecitabine as first-line treatment in women with advanced breast cancer. Ann Oncol 2009; 21:48-54. [PMID: 19906761 DOI: 10.1093/annonc/mdp498] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare docetaxel plus epirubicin versus docetaxel plus capecitabine combinations as front-line treatment in women with advanced breast cancer (ABC). PATIENTS AND METHODS Previously untreated patients with ABC were randomly assigned to receive docetaxel 75 mg/m(2) plus epirubicin 75 mg/m(2) (DE) on day 1 or docetaxel 75 mg/m(2) on day 1 plus capecitabine 950 mg/m(2) orally twice daily on days 1-14 (DC) in 21-day cycles. Previous anthracycline-based (neo)-adjuvant chemotherapy was allowed if completed >1 year before enrollment. The primary objective of the study was to compare time to disease progression (TTP). RESULTS One hundred and thirty-six women were treated on each arm and median TTP was 10.6 versus 11.0 months (P = 0.7), for DE and DC, respectively. According to RECIST criteria we observed 15 (11%) versus 11 (8%) complete responses and 55 (40%) versus 61 (45%) partial responses (P = 0.8), with DE and DC, respectively. Severe toxicity included grade 3-4 neutropenia (57% versus 46%; P = 0.07), febrile neutropenia (11% versus 8%; P = 0.4), hand-foot syndrome (0% versus 4%; P = 0.02), grade 2-3 anemia (20% versus 7%; P = 0.001) and asthenia (12% versus 6%; P = 0.09) with DE and DC, respectively. CONCLUSIONS The DE and DC regimens have similar efficacy but different toxicity. Either regimen can be used as front-line treatment of ABC.
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Affiliation(s)
- D Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, 71110 Heraklion, PO Box 1352, Crete, Greece.
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Paikos D, Stravoravdi P, Voyatzi S, Boukovinas I, Papakotoulas P, Kiziridou A, Sibilidis G, Stergiou I. Detection of methylation in the CpG islands of the p16INK4A, RASSF 1A and methylguanine methyltransferase gene promoters in pancreatic adenocarcinoma. Ecancermedicalscience 2009; 3:131. [PMID: 22276000 PMCID: PMC3223988 DOI: 10.3332/ecancer.2009.131] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Indexed: 11/06/2022] Open
Abstract
Pancreatic cancer consists of an accumulation of genetic and epigenetic alterations. Recently, aberrant methylation of CpG islands of cancer-related genes has emerged as an important epigenetic mechanism of their transcriptional dysregulation during tumour development [1]. Therefore, new diagnostic methods, for early detection based on a better understanding of the molecular biology of pancreatic cancer, are required. We examined the methylation status of p16INK4A, RASSF 1A and methylguanine methyltransferase (MGMT) genes considered to be inactivated by promoter methylation in several tumours. The p16INK4A is an important G1/S cell cycle regulator gene [2]. RASSF 1A gene is involved in apoptotic signalling, microtubule stabilization and cell cycle progression [3]. The MGMT gene removes mutagenic and cytotoxic alkyl-adducts from the O6-position of guanine in DNA. Hypermethylation of the gene leads to the inactivation of DNA repair and to microsatellite instability [4]. To date, little is known about the exact role of hypermethylation of these genes in pancreatic adenocarcinoma, as the molecular mechanisms underlying these neoplasms remain poorly understood.
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Affiliation(s)
- D Paikos
- Gastroenterology-Oncology Department, Theagenio Cancer Hospital, Thessaloniki, Greece
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Pallis AG, Agelaki S, Kakolyris S, Kotsakis A, Kalykaki A, Vardakis N, Papakotoulas P, Agelidou A, Geroyianni A, Agelidou M, Hatzidaki D, Mavroudis D, Georgoulias V. Chemotherapy-induced neutropenia as a prognostic factor in patients with advanced non-small cell lung cancer treated with front-line docetaxel-gemcitabine chemotherapy. Lung Cancer 2008; 62:356-63. [PMID: 18501466 DOI: 10.1016/j.lungcan.2008.03.030] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Revised: 03/26/2008] [Accepted: 03/29/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Front-line docetaxel-gemcitabine (DG) combination represents an alternative to platinum-based chemotherapy in patients with advanced NSCLC. One of its more common side effects is neutropenia. The association between the grade of DG-induced neutropenia and the clinical outcome was analyzed. PATIENTS AND METHODS Eight hundred fifty-eight patients with locally advanced/metastatic NSCLC, treated with front-line DG were retrospectively analyzed. Patients were categorized into three groups according to the presented worst neutropenia grade: absent (grade 0), mild (grades I/II) and severe (grades III/IV). RESULTS Response rate, median time to tumor progression (TTP) and median overall survival (OS) were significantly better in patients developing any grade of neutropenia compared with those without neutropenia. The median TTPs were 3.0, 5.4 and 5.6 months for the groups with absent, mild and severe neutropenia, respectively; the median OSs were 7.9, 12.5 and 11.2 months for the same groups, respectively. Multivariate analysis revealed that both mild and severe chemotherapy-induced neutropenia were independent factors associated with a better TTP and OS survival. CONCLUSION Although DG-induced neutropenia was emerged as an independent prognostic factor, it remains to be demonstrated in prospective studies that dose escalation of chemotherapy drugs in patients who do not develop neutropenia may improve the clinical efficacy.
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Affiliation(s)
- A G Pallis
- Department of Medical Oncology, University General Hospital of Heraklion, P.O. Box 1352, 71110 Heraklion, Crete, Greece
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Mavroudis D, Malamos N, Papakotoulas P, Adamou A, Christophyllakis C, Ziras N, Syrigos K, Kakolyris S, Kouroussis C, Georgoulias V. Randomized phase III trial comparing the sequential administration of docetaxel followed by epirubicin plus cyclophosphamide versus FE75C as adjuvant chemotherapy in axillary lymph node-positive breast cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.521] [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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26
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Boukovinas I, Androulakis N, Vamvakas L, Papakotoulas P, Ziras N, Polyzos A, Kalykaki A, Kotsakis A, Xenidis N, Gioulmbasanis I, Mavroudis D, Georgoulias V. Sequential gemcitabine and cisplatin followed by docetaxel as first-line treatment of advanced urothelial carcinoma: a multicenter phase II study of the Hellenic Oncology Research Group. Ann Oncol 2006; 17:1687-92. [PMID: 16968872 DOI: 10.1093/annonc/mdl286] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the toxicity and efficacy of the sequential administration of gemcitabine (GMB) in combination with cisplatin (CDDP) followed by docetaxel (Taxotere) as first-line treatment of advanced urothelial carcinoma. PATIENTS AND METHODS Patients [aged </=70 years and performance status (PS) (Eastern Cooperative Oncology Group) 0-2] with previously untreated locally advanced/recurrent or metastatic urothelial carcinoma were eligible. Study treatment consisted of GMB (1000 mg/m(2), days 1 and 8) and CDDP (70 mg/m(2), day 1) (GP regimen), every 21 days for a total of four cycles followed by docetaxel (D; 100 mg/m(2), day 1) every 21 days for four cycles. RESULTS Thirty-eight patients with a median age of 67 years were enrolled; 67% of them had PS 0 and 87% stage IV disease. Patients received a median of four GP and four D cycles per patient. Grade 3-4 neutropenia occurred in 27% and 63% patients with GP and D, respectively. Grade 3-4 thrombocytopenia occurred in 11% of patients, only with the GP regimen. Other toxic effects were mild. There was no toxic death. The objective response rate was 55.2% [95% CI: 39.45%-71.07%]. Five patients had complete response (13.15%) and 16 patients had partial response (42.1%), while nine patients had disease stabilization (23.7%) (intention-to-treat analysis). After a median follow-up period of 13 months (range 1.5-40.5 months), the median time to progression was 6.8 months (range 1-40.5 months), the median overall survival 13 months (range 1.5-40.5 months), and the 1-year survival rate 55.3%. CONCLUSION The sequential administration of GP followed by D is active and well tolerated as first-line treatment of advanced urothelial carcinoma and merits to be further evaluated.
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Affiliation(s)
- I Boukovinas
- Second Department of Medical Oncology, "Theagenion" Cancer Hospital of Thessaloniki, Thessaloniki, Greece.
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Stathopoulos GP, Syrigos K, Aravantinos G, Polyzos A, Papakotoulas P, Fountzilas G, Potamianou A, Ziras N, Boukovinas J, Varthalitis J, Androulakis N, Kotsakis A, Samonis G, Georgoulias V. A multicenter phase III trial comparing irinotecan-gemcitabine (IG) with gemcitabine (G) monotherapy as first-line treatment in patients with locally advanced or metastatic pancreatic cancer. Br J Cancer 2006; 95:587-92. [PMID: 16909140 PMCID: PMC2360678 DOI: 10.1038/sj.bjc.6603301] [Citation(s) in RCA: 163] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Our purpose was to determine the response rate and median and overall survival of gemcitabine as monotherapy versus gemcitabine plus irinotecan in advanced or metastatic pancreatic cancer. Patients with histologically or cytologically confirmed adenocarcinoma who were chemotherapy and radiotherapy naive were enrolled. Patients were centrally randomised at a one-to-one ratio to receive either gemcitabine monotherapy (900 mg m−2 on days 1, 8 and 15 every 4 weeks (arm G), or gemcitabine (days 1 and 8) plus irinotecan (300 mg m−2 on day 8) (arm IG), repeated every 3 weeks. The total number of cycles administered was 255 in the IG arm and 245 in the G arm; the median number of cycles was 3. In all, 145 patients (71 in arm IG and 74 in arm G) were enrolled; 60 and 70 patients from arms IG and G, respectively, were evaluable. A complete clinical response was achieved in three (4.3%) arm G patients; nine (15%) patients in arm IG and four (5.7%) in arm G achieved a partial response. The overall response rate was: arm IG 15% and arm G 10% (95% CI 5.96–24.04 and 95% CI 2.97–17.03, respectively; P=0.387). The median time to tumour progression was 2.8 months and 2.9 months and median survival time was 6.4 and 6.5 months for the IG and G arms, respectively. One-year survival was 24.3% for the IG arm and 21.8% for the G arm. No statistically significant difference was observed comparing gemcitabine monotherapy versus gemcitabine plus irinotecan in the treatment of advanced pancreatic cancer, with respect to overall and 1-year survival.
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Affiliation(s)
- G P Stathopoulos
- Hellenic Oncology Research Group (HORG) and Hellenic Cooperative Oncology Group (HeCOG), Semitelou 2A, 115 28 Athens, Greece.
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Stathopoulos GP, Aravantinos G, Syrigos K, Kalbakis K, Karvounis N, Papakotoulas P, Boukovinas J, Potamianou A, Polyzos A, Christophillakis CH, Georgoulias V. A randomized phase III study of irinotecan/gemcitabine combination versus gemcitabine in patients with advanced/metastatic pancreatic cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - K. Syrigos
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | - K. Kalbakis
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | - N. Karvounis
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | | | - J. Boukovinas
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | - A. Potamianou
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | - A. Polyzos
- Hellenic Oncology Research Group (HORG), Athens, Greece
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Georgoulias V, Mavroudis D, Veslemes M, Papakotoulas P, Syrigos K, Agelidou A, Pavlakou G, Rapti A, Polyzos A. Comparison of the sequential versus the alternate administration of cisplatin-etoposide and topotecan regimens as first line treatment in extensive stage small cell lung cancer (SCLC): A preliminary analysis of a multicenter randomized trial. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V. Georgoulias
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
| | - D. Mavroudis
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
| | - M. Veslemes
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
| | - P. Papakotoulas
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
| | - K. Syrigos
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
| | - A. Agelidou
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
| | - G. Pavlakou
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
| | - A. Rapti
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
| | - A. Polyzos
- For the Lung Cancer Working Group, of the Hellenic Oncology Research Group (HORG), Greece
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Stathopoulos GP, Syrigos K, Polyzos A, Fountzilas G, Rigatos SK, Ziras N, Potamiannou A, Tsiakopoulos I, Androulakis N, Aravantinos G, Athanasiadis A, Papakotoulas P, Georgoulias V. Front-line treatment of inoperable or metastatic pancreatic cancer with gemcitabine and capecitabine: an intergroup, multicenter, phase II study. Ann Oncol 2004; 15:224-9. [PMID: 14760113 DOI: 10.1093/annonc/mdh065] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To evaluate the efficacy and toxicity of gemcitabine (GEM) combined with capecitabine (CAP) in untreated patients with inoperable or metastatic pancreatic cancer. PATIENTS AND METHODS Fifty-three patients with pancreatic cancer (85% stage IV) were enrolled. Patients were treated with GEM 1000 mg/m2 on days 1 and 8 and CAP 1300 mg/m2 per day PO (per os), divided into two equal doses on days 1-14, in 21-day cycles. RESULTS In an-intention-to-treat analysis, 10 (18.9%) objective partial responses were achieved (95% confidence interval 8.33% to 29.4%). Twenty-two (42%) patients had stable disease and 15 (28%) had progressive disease. The median response time was 3 months (range 1.5-7.0) and the median time to tumor progression was 6.5 months (range 3.5-15.5). Median overall survival time was 8 months (range 1.0-15.5) and 1-year survival was 34.8%. Pain improvement during treatment was observed in 23 of 43 (53%) patients, and eight of 18 (44%) patients who had been receiving opioids discontinued their use. Weight gain was observed in 12 of 33 (36%) patients. Grade 3 anemia occurred in five (9%) patients and grade 3-4 thrombocytopenia occurred in three (6%). Grade 3-4 neutropenia occurred in 13 (25%) and five (9%) patients, respectively, and two (4%) developed febrile neutropenia. Non-hematological toxicity was mild. CONCLUSION In patients with pancreatic cancer, the combination of GEM with CAP is an active and well tolerated regimen that merits further evaluation in prospective randomized studies.
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