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Trevisan B, Pepe FF, Vallini I, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Baldelli A, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Sarti S, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Clivio L, Torri V, Cazzaniga ME. Final results of the real-life observational VICTOR-6 study on metronomic chemotherapy in elderly metastatic breast cancer (MBC) patients. Sci Rep 2023; 13:12255. [PMID: 37507480 PMCID: PMC10382472 DOI: 10.1038/s41598-023-39386-x] [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] [Received: 04/06/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
Nowadays, treatment of metastatic breast cancer (MBC) has been enriched with novel therapeutical strategies. Metronomic chemotherapy (mCHT) is a continuous and frequent administration of chemotherapy at a lower dose and so whit less toxicity. Thus, this strategy could be attractive for elderly MBC patients. Aim of this analysis is to provide insights into mCHT's activity in a real-life setting of elderly MBC patients. Data of patients ≥ 75 years old included in VICTOR-6 study were analyzed. VICTOR-6 is a multicentre, Italian, retrospective study, which collected data on mCHT in MBC patients treated between 2011 and 2016. A total of 112 patients were included. At the beginning of mCHT, median age was 81 years (75-98) and in 33% of the patients mCHT was the first line choice. Overall Response Rate (ORR) and Disease Control Rate (DCR) were 27.9% and 79.3%, respectively. Median PFS ranged between 7.6 and 9.1 months, OS between 14.1 and 18.5 months. The most relevant toxicity was the hematological one (24.1%); severe toxicity (grade 3-4) ranged from 0.9% for skin toxicity up to 8% for hematologic one. This is a large study about mCHT in elderly MBC patients, providing insights to be further investigated in this subgroup of frail patients.
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Affiliation(s)
- B Trevisan
- Azienda Ospedaliera San Gerardo, Monza, Italy
| | - F F Pepe
- Azienda Ospedaliera San Gerardo, Monza, Italy
| | - I Vallini
- Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - E Montagna
- European Institute of Oncology, Milan, Italy
| | | | - R Berardi
- Azienda Ospedaliera Universitaria Ospedali Riuniti, Torrette, Italy
| | - A Butera
- Nuovo Ospedale San Giovanni Di Dio, Florence, Italy
| | | | - L Cavanna
- Azienda Ospedaliera Piacenza, Piacenza, Italy
| | | | - S Cinieri
- Ospedale A. Perrino, Brindisi, Italy
| | | | | | - A Febbraro
- Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Ospedale San Vincenzo, Taormina, Italy
| | - A Ferzi
- Azienda Ospedaliera Ospedale Civile Di Legnano, Magenta, Italy
| | | | - A Fontana
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - O Garrone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - V Gebbia
- Ospedale La Maddalena, Palermo, Italy
| | - D Generali
- Istituti Ospitalieri Cremona, Cremona, Italy
| | | | | | | | | | - S Sarti
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | | | - C Putzu
- Azienda Ospedaliera-Universitaria, Sassari, Italy
| | - F Riccardi
- Ospedale Antonio Cardarelli, Naples, Italy
| | - D Santini
- Università Campus Bio-Medico, RomE, Italy
| | | | | | | | - P Spadaro
- Casa di Cura Villa Salus-Messina, Messina, Italy
| | | | | | | | | | | | - M R Valerio
- A.O.U. Policlinico Paolo Giaccone, Palermo, Italy
| | - P Vici
- INT Regina Elena, Rome, Italy
| | - L Clivio
- IRCCS Mario Negri Institute of Pharmacological Research, Milan, Italy
| | - V Torri
- IRCCS Mario Negri Institute of Pharmacological Research, Milan, Italy
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Cazzaniga ME, Vallini I, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Baldelli A, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Marchetti P, Sarti S, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Saracchini S, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Di Mauro P, Cogliati V, Capici S, Clivio L, Torri V. Metronomic chemotherapy (mCHT) in metastatic triple-negative breast cancer (TNBC) patients: results of the VICTOR-6 study. Breast Cancer Res Treat 2021; 190:415-424. [PMID: 34546500 PMCID: PMC8558172 DOI: 10.1007/s10549-021-06375-5] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Purpose Triple-negative breast cancer (TNBC) represents a subtype of breast cancer which lacks the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2): TNBC accounts for approximately 20% of newly diagnosed breast cancers and is associated with younger age at diagnosis, greater recurrence risk and shorter survival time. Therapeutic options are very scarce. Aim of the present analysis is to provide further insights into the clinical activity of metronomic chemotherapy (mCHT), in a real-life setting. Methods We used data included in the VICTOR-6 study for the present analysis. VICTOR-6 is an Italian multicentre retrospective cohort study, which collected data of metastatic breast cancer (MBC) patients who have received mCHT between 2011 and 2016. Amongst the 584 patients included in the study, 97 were triple negative. In 40.2% of the TNBC patients, mCHT was the first chemotherapy treatment, whereas 32.9% had received 2 or more lines of treatment for the metastatic disease. 45.4% out of 97 TNBC patients received a vinorelbine (VRL)-based regimen, which resulted in the most used type of mCHT, followed by cyclophosphamide (CTX)-based regimens (30.9%) and capecitabine (CAPE)-based combinations (22.7%). Results Overall response rate (ORR) and disease control rate (DCR) were 17.5% and 64.9%, respectively. Median progression free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.9–7.2) and 12.1 months (95% CI: 9.6–16.7). Median PFS was 6.9 months for CAPE-based regimens (95% CI: 5.0–18.4), 6.1 months (95% CI: 4.0–8.9) for CTX-based and 5.3 months (95% CI: 4.1–9.5) for VRL-based ones. Median OS was 18.2 months (95% CI: 9.1-NE) for CAPE-based regimens and 11.8 months for VRL- (95% CI: 9.3–16.7 and CTX-based ones (95%CI: 8.7–52.8). Tumour response, PFS and OS decreased proportionally in later lines. Conclusion This analysis represents the largest series of TNBC patients treated with mCHT in a real-life setting and provides further insights into the advantages of using this strategy even in this poor prognosis subpopulation.
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Affiliation(s)
- M E Cazzaniga
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy.
- Oncology Unit, ASST Monza, Monza, MB, Italy.
| | - I Vallini
- Medical Oncology, ASST Sette Laghi Ospedale Di Circolo E Fondazione Macchi, Varese, VA, Italy
| | - E Montagna
- Medical Senology Division, IEO, Milan, Italy
| | - D Amoroso
- Medical Oncology, Ospedale Versilia, ATNO, Lido Di Camaiore, LU, Italy
| | - R Berardi
- Medical Oncology, Università Politecnica Delle Marche, AOU Ospedali Riuniti, Ancona, Italy
| | - A Butera
- Medical Oncology, Ospedale San Giovanni Di Dio, Agrigento, Italy
| | - K Cagossi
- Medical Oncology, Ospedale Ramazzini, Carpi, Italy
| | - L Cavanna
- Medical Oncology, Azienda Ospedaliera Piacenza, Piacenza, Italy
| | - M Ciccarese
- Medical Oncology, Ospedale Vito Fazzi, Lecce, Italy
| | - S Cinieri
- Medical Oncology, ASL Brindisi, Brindisi, Italy
| | - E Cretella
- Medical Oncology, Ospedale Bolzano, Bolzano, Italy
| | | | - A Febbraro
- Medical Oncology, Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Medical Oncology, Osp Taormina, Taormina, Italy
| | - A Ferzi
- Medical Oncology, A.S.S.T. Ovest Milanese Legnano, Legnano, Italy
| | - A Baldelli
- Medical Oncology, Ospedale San Salvatore, Pesaro, Italy
| | - A Fontana
- Medical Oncology 2, Az. Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A R Gambaro
- Medical Oncology, ASST Fatebenefratelli Sacco, Milano, Italy
| | - O Garrone
- Breast Unit Medical Oncology, A.O. S. Croce e Carle, Cuneo, Italy
| | - V Gebbia
- Medical Oncology, Ospedale La Maddalena, Palermo, Italy
| | - D Generali
- Medical Oncology, Istituti Ospitalieri Cremona, Cremona, Italy
| | - L Gianni
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, Italy
| | - F Giovanardi
- AUSL IRCCS Reggio Emilia Provincial Oncology Unit, Reggio Emilia, Italy
| | - A Grassadonia
- Medical Oncology, P.O. SS Annunziata -ASL2 Lanciano-Vasto, Chieti, Italy
| | - V Leonardi
- Medical Oncology, Ospedale Civico, Palermo, Italy
| | - P Marchetti
- Medical Oncology, A.O. Sant'Andrea, Roma, Italy
| | - S Sarti
- IRCCS Istituto Romagnolo per lo studio dei Tumori (IRST) "Dino Amadori", 47014, Meldola, Italy
| | - A Musolino
- Department of Medicine and Surgery, Medical Oncology and Breast Unit, University of Parma and University Hospital of Parma, Parma, Italy
| | - M Nicolini
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, Italy
| | - C Putzu
- Medical Oncology, A. Ospedaliera-Universitaria, Sassari, Italy
| | - F Riccardi
- Medical Oncology, A. Ospedaliera Antonio Cardarelli, Napoli, Italy
| | - D Santini
- Medical Oncology, Università Campus Bio-Medico, Roma, Italy
| | - S Saracchini
- Medical Oncology, Az. Osp. Santa Maria degli Angeli, Pordenone, Italy
| | - M G Sarobba
- Medical Oncology, Ospedale San Francesco, Nuoro, Italy
| | - M G Schintu
- Medical Oncology, Osp Giovanni Paolo II, Olbia, Italy
| | | | - P Spadaro
- Medical Oncology, Casa di Cura Villa Salus-Messina, Messina, Italy
| | - C Taverniti
- Medical Oncology, A.O.U. Città della Salute e della Scienza, Osp. Molinette, Torino, Italy
| | - D Toniolo
- Medical Oncology, ASST Rhodense, Ospedale di Circolo Rho, Rho, Italy
| | - P Tralongo
- Medical Oncology, Osp. Umberto I, Siracusa, Italy
| | - A Turletti
- Medical Oncology, P.O. Martini, Torino, Italy
| | - R Valenza
- Medical Oncology, P.O. Vittorio Emanuele, Gela, Italy
| | - M R Valerio
- Department of Discipline Chirurgiche, Oncologiche e Stomatologiche (DICHIRONS), Medical Oncology, A.O.U. Policlinico Paolo Giaccone, Palermo, Italy
| | - P Vici
- Phase IV trials, IRCCS, INT Regina Elena, Rome, Italy
| | - P Di Mauro
- Oncology Unit, ASST Monza, Monza, MB, Italy
| | - V Cogliati
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - S Capici
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - L Clivio
- Oncology Department, IRCCS Mario Negri Institute, Milan, Italy
| | - V Torri
- Oncology Department, IRCCS Mario Negri Institute, Milan, Italy
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Torrisi R, Palumbo R, De Sanctis R, Vici P, Bianchi GV, Cortesi L, Leonardi V, Gueli R, Fabi A, Valerio MR, Gambaro AR, Tagliaferri B, Pizzuti L, Cazzaniga ME, Santoro A. Fulvestrant and trastuzumab in patients with luminal HER2-positive advanced breast cancer (ABC): an Italian real-world experience (HERMIONE 9). Breast Cancer Res Treat 2021; 190:103-109. [PMID: 34453206 DOI: 10.1007/s10549-021-06371-9] [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: 05/11/2021] [Accepted: 08/20/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The most appropriate therapy for HR + /HER2-positive (HER2 +) advanced breast cancer (ABC) is a matter of debate. Co-targeting of both receptors represents an attractive strategy to overcome the cross-talk between them. METHODS The HERMIONE 9 is an observational retrospective multicentric study which aimed to describe the clinical outcome of patients with HR + /HER2 + ABC who received the combination of Fulvestrant (F) and Trastuzumab (T) as part of their routine treatment at 10 Italian Institutions. RESULTS Eighty-seven patients were included. Median age was 63 (range, 35-87) years. The median number of previous treatments was 3 (range, 0-10) and F and T were administered as ≥ 3rd line in 67 patients. Among the 86 evaluable patients, 6 (6.9%) achieved CR, 18 (20.7%) PR, and 44 (50.6%) had SD ≥ 24 weeks with an overall CBR of 78.2%. At a median follow-up of 33.6 months, mPFS of the entire cohort was 12.9 months (range, 2.47-128.67). No difference was observed in mPFS between patients treated after progression or as maintenance therapy (mPFS 12.9 and 13.9 months in 64 and 23 patients, respectively), neither considering the number of previous treatment lines (≤ 3 or < 3). CONCLUSION The combination of F and T was active in this cohort at poor prognosis and deserves further investigations possibly in combination with pertuzumab in patients with high ER expression.
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Affiliation(s)
- Rosalba Torrisi
- Department of Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, via A. Manzoni 56 20089, Rozzano, Milano, Italy.
| | | | - Rita De Sanctis
- Department of Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, via A. Manzoni 56 20089, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Patrizia Vici
- UOC OM2 IRCCS Regina Elena National Cancer Institute, Roma, Italy
| | | | - Laura Cortesi
- Department of Oncology and Haematology, Modena Hospital University, Modena, Italy
| | - Vita Leonardi
- Department of Medical Oncology, ARNAS Civico, Palermo, Italy
| | | | - Alessandra Fabi
- Precision Medicine in Breast Cancer Unit, Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Maria Rosaria Valerio
- Medical Oncology Unit, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Anna Rita Gambaro
- Medical Oncology, ASST Fatebenefratelli Sacco PO Sacco, Milano, Italy
| | | | - Laura Pizzuti
- UOC OM2 IRCCS Regina Elena National Cancer Institute, Roma, Italy
| | - Marina Elena Cazzaniga
- Centro Ricerca Fase 1 ASST Monza and Università Degli Studi Milano Bicocca, Milano, Italy
| | - Armando Santoro
- Department of Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, via A. Manzoni 56 20089, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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Scarano A, Amodeo V, Leonardi V, Mortellaro C, Sbarbati A, Amuso D, Amore R, Pagnini D. Evaluation of the effectiveness and safety of peppermint peel (PMP) soft peeling for skin ageing. J BIOL REG HOMEOS AG 2019; 33:93-101. DENTAL SUPPLEMENT. [PMID: 32425029] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Turning to peeling in a dermatological sphere is extensively common and has been used for a long time. From the use of single acids moving on to the so-called compound peelings (associations of more than one substance in the same product) and the combined peelings which take advantage of the action of different substances in a synergistic manner (different products are applied sequentially) in order to best guarantee a greater effectiveness of the treatment for the recommended target. Superficial peelings, combined and not, have led to a drastic reduction in the percentage of incidence of adverse events typical of medium and deep peels. Nevertheless, it has been demonstrated that superficial peels bring about a rejuvenating effect through the mechanical stimulation of the Skin Stress Response System (SSRS), system designated to repairing the damaged tissue and restoring of the normal homeostasis. Clinical trials aims to evaluate the effectiveness and safety of the peppermint peel (PMP) medical device in subjects with different ageing expressions both in qualitative terms (different blemishes such as discolouration, fine wrinkles, elastosis, atony and skin inelasticity, laxity, scarce superficial hydration) and in quantitative terms (degree, extension and number of lesions). A non-controlled multi-centric clinical trial was done in 121 subjects. The use protocol calls for a session every 2 weeks for a total of 4 sessions. Subjects were evaluated before each subsequent session at the first and at 2-4-8 weeks of the fourth and last treatment. During the study there were no adverse events. Only a minimal scurfy flaking and a very slight redness were reported. From an effectiveness point of view, the percentage of therapeutic failure, judged with a score equal to or greater than 4 or 5 in Global Aesthetic Improvement Scale (GAIS) scale was 0%. Best score was obtained in subjects ranging in ages between 38 and 57 (2.02) and in women (2.02) years, while the less satisfactory one was obtained in males (2.14). The study has demonstrated that PMP and the proposed protocol are effective and safe to treat subject with skin signs of chrono and photo ageing, thanks to its capabilities of carrying out a mechanic action indicated as a coadjuvant in the treatment of the dermoepidermic revitalisation through chemical exfoliation and hydration.
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Affiliation(s)
- A Scarano
- Dean Master Program in Aesthetic Medicine Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
- Master Program in Aesthetic Medicine, University of Chieti-Pescara, Chieti, Italy
| | - V Amodeo
- Master of Aesthetic, Regenerative and Anti-Aging Medicine, University of Verona, Italy
| | - V Leonardi
- Master in Aesthetic Medicine and Wellness, University of Marconi, Roma, Italy
| | - C Mortellaro
- Full Professor Saint Camillus International University of Health Sciences Rome, Italy
| | - A Sbarbati
- Master of Aesthetic, Regenerative and Anti-Aging Medicine, University of Verona, Italy
| | - D Amuso
- Master of Aesthetic, Regenerative and Anti-Aging Medicine, University of Verona, Italy
| | - R Amore
- Master Program in Aesthetic Medicine, University of Chieti-Pescara, Chieti, Italy
- Master of Aesthetic, Regenerative and Anti-Aging Medicine, University of Verona, Italy
- Master in Aesthetic Medicine and Wellness, University of Marconi, Roma, Italy
| | - D Pagnini
- Master in Aesthetic Medicine and Wellness, University of Marconi, Roma, Italy
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Amore R, Sbarbati A, Amuso D, Leonardi V, Alsanafi S, Greco Lucchina A, Scarano A. Non-surgical treatment of lower eyelid fat pads with an injectable solution acid deoxycholic based. J BIOL REG HOMEOS AG 2019; 33:109-114. DENTAL SUPPLEMENT. [PMID: 32425031] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The use of sodium deoxycholate (DC) in aesthetic medicine for reducing unwanted localized fat deposits is a procedure in use for over 30 years. Lower eyelid fat pads are one of the main imperfections of the middle third of the face. The purpose of the study is to assess the effectiveness and the safety of a second-generation injectable solution containing sodium deoxycholate 1.25% (DB125) for the treatment of lower eyelid fat pads. A multi-centre observational prospective study was carried out between May and October 2017. Patients presented various forms and degrees of lower eyelid fat pads. They were treated montly apart until the clinical result was obtained. The technique was explained. The study treated 120 patients for a total of 306 infiltration sessions (average 2.55 per patient). Patients gave the effectiveness of the treatment an average score of 7.125 (7.28 in men and 7.03 in women). The greatest successes were in patients under the age of 40. The medical evaluation showed therapeutic success in 85.83%. Adverse events were reported. The results of the study are encouraging since they have shown a therapeutic success from both the viewpoint of specialist medical assessment and from the personal, subjective view of the patients treated. This success did not show any significant differences between sex. On the other hand, outcome has been better in the younger age groups. The high degree of effectiveness shown in the study was associated with a minimal occurrence of adverse events. Therefore DB125, used with the right technique and dosage, is effective and safe to treat lower eyelid fat pads.
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Affiliation(s)
- R Amore
- Master of aesthetic, regenerative and anti-aging medicine, University of Verona, Italy
- Master Program in Aesthetic Medicine, University of Chieti-Pescara, Chieti, Italy
- Master in Aesthetic Medicine and Wellness, University of Marconi, Roma, Italy
| | - A Sbarbati
- Master of aesthetic, regenerative and anti-aging medicine, University of Verona, Italy
| | - D Amuso
- Master of aesthetic, regenerative and anti-aging medicine, University of Verona, Italy
- Master Program in Aesthetic Medicine, University of Chieti-Pescara, Chieti, Italy
| | - V Leonardi
- Master in Aesthetic Medicine and Wellness, University of Marconi, Roma, Italy
| | - S Alsanafi
- Dermatologist, private practice Kuwait City, Kuwait
| | - A Greco Lucchina
- Research Laboratory in Regenerative Medicine and Tissue Engineering Saint Camillus International University of Health Sciences, Rome, Italy
| | - A Scarano
- Master Program in Aesthetic Medicine, University of Chieti-Pescara, Chieti, Italy
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
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Cazzaniga ME, Pinotti G, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Fiorentini G, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Marchetti P, Melegari E, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Saracchini S, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Clivio L, Torri V. Metronomic chemotherapy for advanced breast cancer patients in the real world practice: Final results of the VICTOR-6 study. Breast 2019; 48:7-16. [PMID: 31470257 DOI: 10.1016/j.breast.2019.07.006] [Citation(s) in RCA: 30] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 12/21/2022] Open
Abstract
Metronomic chemotherapy (mCHT) refers to the minimum biologically effective dose of a chemotherapy agent given as a continuous dosing regimen, with no prolonged drug-free breaks, that leads to antitumor activity. Aim of the present study is to describe the use of mCHT in a retrospective cohort of metastatic breast cancer (MBC) patients in order to collect data regarding the different types and regimens of drugs employed, their efficacy and safety. Between January 2011 and December 2016, data of 584 metastatic breast cancer patients treated with mCHT were collected. The use of VRL-based regimens increased during the time of observation (2011: 16.8% - 2016: 29.8%), as well as CTX-based ones (2011: 17.1% - 2016: 25.6%), whereas CAPE-based and MTX-based regimens remained stable. In the 1st-line setting, the highest ORR and DCR were observed for VRL-based regimens (single agent: 44% and 88%; combination: 36.7% and 82.4%, respectively). Assuming VRL-single agent as the referee treatment (median PFS: 7.2 months, 95% CI: 5.3-10.3), the longest median PFS were observed in VRL-combination regimens (9.5, 95%CI 88.8-11.3, HR = 0.72) and in CAPE-single agent (10.7, 95%CI 8.3-15.8, HR = 0.70). The VICTOR-6 study provides new data coming from the real-life setting, by adding new information regarding the use of mCHT as an option of treatment for MBC patients.
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Affiliation(s)
- M E Cazzaniga
- Research Unit Phase I Trials, ASST Monza, Monza, Italy; Oncology Unit, ASST Monza, Italy.
| | - G Pinotti
- Medical Oncology, ASST Sette Laghi "Ospedale di Circolo e Fondazione Macchi, Varese, VA, Italy
| | - E Montagna
- Medical Senology Division, IEO, Milan, Italy
| | - D Amoroso
- Medical Oncology, Ospedale Della Versilia, Lido di Camaiore, IT, Italy
| | - R Berardi
- Medical Oncology, A. Ospedaliero-universitaria Ospedali Riuniti, Ancona, IT, Italy
| | - A Butera
- Medical Oncology, Ospedale San Giovanni di Dio, Agrigento, IT, Italy
| | - K Cagossi
- Medical Oncology, Ospedale Ramazzini, Carpi, IT, Italy
| | - L Cavanna
- Medical Oncology, Azienda Ospedaliera Piacenza, Piacenza, IT, Italy
| | - M Ciccarese
- Medical Oncology, Ospedale Vito Fazzi, Lecce, IT, Italy
| | - S Cinieri
- Medical Oncology, ASL Brindisi, Brindisi, Italy
| | - E Cretella
- Medical Oncology, Ospedale Bolzano, IT, Italy
| | | | - A Febbraro
- Medical Oncology, Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Medical Oncology, Osp Taormina, Taormina, IT, Italy
| | - A Ferzi
- Medical Oncology, A.S.S.T. Ovest Milanese, Legnano, IT, Italy
| | - G Fiorentini
- Medical Oncology, Ospedale San Salvatore, Pesaro, Italy
| | - A Fontana
- Medical Oncology, Az. Ospedaliero-Universitaria, Pisana, IT, Italy
| | - A R Gambaro
- Medical Oncology, ASST Fatebenefratelli, Sacco, IT, Italy
| | - O Garrone
- Medical Oncology, A.O. S. Croce e Carle, Cuneo, Italy
| | - V Gebbia
- Medical Oncology, Ospedale La Maddalena, Palermo, IT, Italy
| | - D Generali
- Medical Oncology, Istituti Ospitalieri Cremona, Cremona, IT, Italy
| | - L Gianni
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, IT, Italy
| | - F Giovanardi
- Medical Oncology, Ospedale Civile, Guastalla, IT, Italy
| | - A Grassadonia
- Medical Oncology, P.O. SS Annunziata -ASL2 Lanciano-Vasto, Chieti, IT, Italy
| | - V Leonardi
- Medical Oncology, Ospedale Civico, Palermo, IT, Italy
| | - P Marchetti
- Medical Oncology, A.O. Sant'Andrea, Roma, IT, Italy
| | - E Melegari
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - A Musolino
- Medical Oncology, Azienda Ospedaliero-Universitaria di Parma, IT, Italy
| | - M Nicolini
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, IT, Italy
| | - C Putzu
- Medical Oncology, A. Ospedaliera-Universitaria, Sassari, IT, Italy
| | - F Riccardi
- Medical Oncology, A. Ospedaliera Antonio Cardarelli, Napoli, IT, Italy
| | - D Santini
- Medical Oncology Università Campus Bio-Medico, Roma, IT, Italy
| | - S Saracchini
- Medical Oncology, Az. Osp. Santa Maria Degli Angeli, Pordenone, IT, Italy
| | - M G Sarobba
- Medical Oncology, Ospedale San Francesco, Nuoro, IT, Italy
| | - M G Schintu
- Medical Oncology, Osp Giovanni Paolo II, Olbia, IT, Italy
| | | | - P Spadaro
- Medical Oncology, Casa di Cura Villa Salus, Messina, IT, Italy
| | - C Taverniti
- Medical Oncology, A.O.U. Città Della Salute e Della Scienza, Osp. Molinette, Torino, IT, Italy
| | - D Toniolo
- Medical Oncology, ASST Rhodense 3 Ospedale di Circolo Rho, IT, Italy
| | - P Tralongo
- Medical Oncology, Osp. Umberto I, Siracusa, IT, Italy
| | - A Turletti
- Medical Oncology, P.O. Martini, Torino, IT, Italy
| | - R Valenza
- Medical Oncology, P.O. Vittorio Emanuele, Gela, IT, Italy
| | - M R Valerio
- Medical Oncology, A.O.U. Policlinico Paolo Giaccone, Palermo, IT, Italy
| | - P Vici
- Medical Oncology, B, INT Regina Elena, Roma, IT, Italy
| | - L Clivio
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy
| | - V Torri
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy
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7
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Gori S, Puglisi F, Moroso S, Fabi A, La Verde N, Frassoldati A, Tarenzi E, Garrone O, Vici P, Laudadio L, Cretella E, Turazza M, Foglietta J, Leonardi V, Cavanna L, Barni S, Galanti D, Russo A, Marchetti F, Valerio M, Lunardi G, Alongi F, Inno A. The HERBA Study: A Retrospective Multi-Institutional Italian Study on Patients With Brain Metastases From HER2-Positive Breast Cancer. Clin Breast Cancer 2019; 19:e501-e510. [DOI: 10.1016/j.clbc.2019.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/28/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
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8
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Fabi A, Alesini D, Valle E, Moscetti L, Caputo R, Caruso M, Carbognin L, Ciccarese M, La Verde N, Arpino G, Cannita K, Paris I, Santini D, Montemurro F, Russillo M, Ferretti G, Filippelli G, Rossello R, Fabbri A, Zambelli A, Leonardi V, D'Ottavio AM, Nisticò C, Stani S, Giampaglia M, Scandurra G, Catania G, Malaguti P, Giannarelli D, Cognetti F. T-DM1 and brain metastases: Clinical outcome in HER2-positive metastatic breast cancer. Breast 2018; 41:137-143. [PMID: 30092500 DOI: 10.1016/j.breast.2018.07.004] [Citation(s) in RCA: 36] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/11/2018] [Accepted: 07/11/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND We reported the results of an Italian large retrospective analysis that evaluated the effectiveness and safety of T-DM1 in 'field-practice' breast cancer patients. We performed a sub-analysis to investigate the clinical activity of T-DM1 in patients with brain metastases (BMs). METHODS The records of 87 adult women with HER2-positive breast cancer and BMs treated with T-DM1 were reviewed. Their clinical outcomes were compared with those of 216 patients without central nervous system (CNS) involvement. RESULTS Response to T-DM1 treatment in BMs was available for 53 patients in the BM group (60.9%): two patients reported a complete response (3.8%), 11 patients obtained partial response (20.7%; overall response rate: 24.5%), 16 patients had a stable disease (30.1%). Regarding extracranial disease, a total of 77 and 191 patients were evaluable for response in BM group and non-BM group, respectively. The overall response rate was 35.1% in the BM group and 38.3% in the non-BM group; disease control rate was 53.3% and 66.6%, respectively. At a median follow-up of 16 months (range: 1-55), median cumulative progression-free survival (PFS) was 7 months (95% CI: 5.4-8.6) in the BM group and 8 months (95% CI: 5.7-10.3) in the non-BM group. In the second-line setting, PFS was 5 (95% CI: 3.1-6.9) versus 11 (95% CI: 7.1-14.9) months (p = 0.01). Overall survival was 14 months (95% CI: 12.2-15.8) in the BM group and 32 months (95% CI: 24.4-39.6) in the non-BM group (p < 0.0001). CONCLUSIONS T-DM1 is active in breast cancer patients with BMs.
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Affiliation(s)
- Alessandra Fabi
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy.
| | - Daniele Alesini
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | | | | | | | | | | | - Nicla La Verde
- Oncologia Medica, PO Fatebenefratelli e Oftalmico, Milano, Italy
| | - Grazia Arpino
- Oncologia Medica, Università Federico II, Napoli, Italy
| | - Katia Cannita
- Oncologia Medica, Ospedale S. Salvatore, Università dell'Aquila, Italy
| | - Ida Paris
- Oncologia e Ginecologica Polo Donna, Policlinico A.Gemelli, Roma, Italy
| | - Daniele Santini
- Oncologia Medica, Campus Bio-medico Universitario, Roma, Italy
| | - Filippo Montemurro
- Investigative Clinical Oncology, Cancer Institute-FPO, IRCCS, Candiolo, Torino, Italy
| | | | - Gianluigi Ferretti
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | - Rosalba Rossello
- Oncologia Medica, Ospedale S. Vincenzo, Taormina, Messina, Italy
| | | | | | | | | | - Cecilia Nisticò
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | | | - Giusy Scandurra
- Oncologia Medica, Ospedale per le Emergenze Cannizzaro, Catania, Italy
| | - Giovanna Catania
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | - Paola Malaguti
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | - Diana Giannarelli
- Unità di Biostatistica, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | - Francesco Cognetti
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
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9
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Affiliation(s)
- Sergio Palmeri
- Cattedra di Oncologia Medica, Istituto di Clinica Medica, Palermo, Italy
| | - Vita Leonardi
- Cattedra di Oncologia Medica, Istituto di Clinica Medica, Palermo, Italy
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10
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De Placido S, Gallo C, De Laurentiis M, Bisagni G, Arpino G, Sarobba MG, Riccardi F, Russo A, Del Mastro L, Cogoni AA, Cognetti F, Gori S, Foglietta J, Frassoldati A, Amoroso D, Laudadio L, Moscetti L, Montemurro F, Verusio C, Bernardo A, Lorusso V, Gravina A, Moretti G, Lauria R, Lai A, Mocerino C, Rizzo S, Nuzzo F, Carlini P, Perrone F, Agostara B, Aieta M, Alabiso O, Alicicco MG, Amadori D, Amaducci L, Amiconi G, Antuzzi G, Ardine M, Ardizzoia A, Aversa C, Badalamenti G, Barni S, Basurto C, Berardi R, Bergamasco C, Bidoli P, Bighin C, Biondi E, Bisagni G, Boni C, Borgonovo K, Botta M, Bravi S, Bruzzi P, Buono G, Butera A, Caldara A, Candeloro G, Cappelletti C, Cardalesi C, Carfora E, Cariello A, Carrozza F, Cartenì G, Caruso M, Casadei V, Casanova C, Castori L, Cavanna L, Cavazzini G, Cazzaniga M, Chilelli M, Chiodini P, Chiorrini S, Ciardiello F, Ciccarese M, Cinieri S, Clerico M, Coccaro M, Comande M, Corbo C, Cortino G, Cusenza S, Daniele G, D'arco AM, D'auria G, Dazzi C, De Angelis C, de Braud F, De Feo G, De Matteis A, De Tursi M, Di Blasio A, di Lucca G, Di Lullo L, Di Rella F, Di Renzo G, Di Stefano P, Di Stefano A, Diana A, Donati S, Fabbri A, Fabi A, Faedi M, Farina G, Farris A, Febbraro A, Fedele P, Federico P, Ferraù F, Ferretti G, Ferro A, Floriani I, Forcignanò R, Forciniti S, Forestieri V, Fornari G, Frisinghelli M, Fusco V, Gallizzi G, Galvano A, Gambardella A, Gambi A, Gebbia V, Gervasi E, Ghilardi M, Giacobino A, Giardina G, Giotta F, Giraudi S, Giuliano M, Grassadonia A, Grasso D, Grosso F, Guizzaro L, Incoronato P, Incorvaia L, Iodice G, La Verde N, Labonia V, Landi G, Latorre A, Leonardi V, Levaggi A, Limite G, Lina Bascialla L, Livi L, Maiello E, Mandelli D, Marcon I, Menon D, Montedoro M, Moraca L, Moretti A, Morritti MG, Morselli P, Mura A, Mura S, Musacchio M, Muzio A, Natale D, Natoli C, Nigro C, Nisticò C, Nuzzo A, Orditura M, Orlando L, Pacilio C, Palumbo G, Palumbo R, Pasini F, Paterno E, Pazzola A, Pelliccioni S, Pensabene M, Perroni D, Pesenti Gritti A, Petrelli F, Piccirillo MC, Pinotti G, Pogliani C, Poli D, Prader S, Recchia F, Rizzi D, Romano C, Rossello R, Rossini C, Salvucci G, Sanna V, Santini A, Saracchini S, Savastano C, Scambia G, Schettini F, Schiavone P, Schirone A, Seles E, Signoriello S, Signoriello G, Silva RR, Silvestri A, Simeon V, Spagnoletti I, Tamberi S, Teragni C, Thalmann V, Thomas R, Thomas G, Tienghi A, Tinari N, Tinessa V, Tomei F, Tonini G, Torri V, Traficante D, Tudini M, Turazza M, Vignoli R, Vitale MG, Zacchia A, Zagarese P, Zanni A, Zavallone L, Zavettieri M, Zoboli A. Adjuvant anastrozole versus exemestane versus letrozole, upfront or after 2 years of tamoxifen, in endocrine-sensitive breast cancer (FATA-GIM3): a randomised, phase 3 trial. Lancet Oncol 2018; 19:474-485. [PMID: 29482983 DOI: 10.1016/s1470-2045(18)30116-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/04/2018] [Accepted: 01/08/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Uncertainty exists about the optimal schedule of adjuvant treatment of breast cancer with aromatase inhibitors and, to our knowledge, no trial has directly compared the three aromatase inhibitors anastrozole, exemestane, and letrozole. We investigated the schedule and type of aromatase inhibitors to be used as adjuvant treatment for hormone receptor-positive early breast cancer. METHODS FATA-GIM3 is a multicentre, open-label, randomised, phase 3 trial of six different treatments in postmenopausal women with hormone receptor-positive early breast cancer. Eligible patients had histologically confirmed invasive hormone receptor-positive breast cancer that had been completely removed by surgery, any pathological tumour size, and axillary nodal status. Key exclusion criteria were hormone replacement therapy, recurrent or metastatic disease, previous treatment with tamoxifen, and another malignancy in the previous 10 years. Patients were randomly assigned in an equal ratio to one of six treatment groups: oral anastrozole (1 mg per day), exemestane (25 mg per day), or letrozole (2·5 mg per day) tablets upfront for 5 years (upfront strategy) or oral tamoxifen (20 mg per day) for 2 years followed by oral administration of one of the three aromatase inhibitors for 3 years (switch strategy). Randomisation was done by a computerised minimisation procedure stratified for oestrogen receptor, progesterone receptor, and HER2 status; previous chemotherapy; and pathological nodal status. Neither the patients nor the physicians were masked to treatment allocation. The primary endpoint was disease-free survival. The minimum cutoff to declare superiority of the upfront strategy over the switch strategy was assumed to be a 2% difference in disease-free survival at 5 years. Primary efficacy analyses were done by intention to treat; safety analyses included all patients for whom at least one safety case report form had been completed. Follow-up is ongoing. This trial is registered with the European Clinical Trials Database, number 2006-004018-42, and ClinicalTrials.gov, number NCT00541086. FINDINGS Between March 9, 2007, and July 31, 2012, 3697 patients were enrolled into the study. After a median follow-up of 60 months (IQR 46-72), 401 disease-free survival events were reported, including 211 (11%) of 1850 patients allocated to the switch strategy and 190 (10%) of 1847 patients allocated to upfront treatment. 5-year disease-free survival was 88·5% (95% CI 86·7-90·0) with the switch strategy and 89·8% (88·2-91·2) with upfront treatment (hazard ratio 0·89, 95% CI 0·73-1·08; p=0·23). 5-year disease-free survival was 90·0% (95% CI 87·9-91·7) with anastrozole (124 events), 88·0% (85·8-89·9) with exemestane (148 events), and 89·4% (87·3 to 91·1) with letrozole (129 events; p=0·24). No unexpected serious adverse reactions or treatment-related deaths occurred. Musculoskeletal side-effects were the most frequent grade 3-4 events, reported in 130 (7%) of 1761 patients who received the switch strategy and 128 (7%) of 1766 patients who received upfront treatment. Grade 1 musculoskeletal events were more frequent with the upfront schedule than with the switch schedule (924 [52%] of 1766 patients vs 745 [42%] of 1761 patients). All other grade 3-4 adverse events occurred in less than 2% of patients in either group. INTERPRETATION 5 years of treatment with aromatase inhibitors was not superior to 2 years of tamoxifen followed by 3 years of aromatase inhibitors. None of the three aromatase inhibitors was superior to the others in terms of efficacy. Therefore, patient preference, tolerability, and financial constraints should be considered when deciding the optimal treatment approach in this setting. FUNDING Italian Drug Agency.
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Affiliation(s)
- Sabino De Placido
- Dipartimento di Clinica Medica e Chirurgia, Università Federico II, Naples, Italy
| | - Ciro Gallo
- Statistica Medica, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Michelino De Laurentiis
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
| | - Giancarlo Bisagni
- Dipartimento di Oncologia, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Grazia Arpino
- Dipartimento di Clinica Medica e Chirurgia, Università Federico II, Naples, Italy
| | | | | | - Antonio Russo
- Dipartimento di Scienze Chirurgiche, Oncologiche e Stomatologiche, Sezione di Oncologia Medica, Università di Palermo, Palermo, Italy
| | - Lucia Del Mastro
- Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova-Oncologia Medica, Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Francesco Cognetti
- Divisione Oncologia Medica 1, Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Stefania Gori
- Oncologia Medica, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | | | | | - Domenico Amoroso
- Oncologia Medica, Ospedale della Versilia, Lido di Camaiore (LU), Istituto Toscano Tumori, Florence, Italy
| | | | - Luca Moscetti
- Dipartimento di Oncologia Medica, Ospedale Belcolle, Viterbo, Italy
| | - Filippo Montemurro
- Divisione di Oncologia Clinica Investigativa dell'Istituto di Candiolo-IRCCS, Candiolo, Italy
| | | | | | - Vito Lorusso
- Polo Oncologico, Ospedale Vito Fazzi, Lecce, Italy
| | - Adriano Gravina
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
| | - Gabriella Moretti
- Dipartimento di Oncologia, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Rossella Lauria
- Dipartimento di Clinica Medica e Chirurgia, Università Federico II, Naples, Italy
| | - Antonella Lai
- Oncologia Medica, Azienda Ospedaliera Universitaria, Sassari, Italy
| | | | - Sergio Rizzo
- Dipartimento di Scienze Chirurgiche, Oncologiche e Stomatologiche, Sezione di Oncologia Medica, Università di Palermo, Palermo, Italy
| | - Francesco Nuzzo
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
| | - Paolo Carlini
- Divisione Oncologia Medica 1, Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Francesco Perrone
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy.
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11
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Fabi A, Giannarelli D, Moscetti L, Santini D, Zambelli A, Laurentiis MD, Caruso M, Generali D, Valle E, Leonardi V, Cannita K, Arpino G, Filippelli G, Ferretti G, Giampaglia M, Montemurro F, Nisticò C, Gasparro S, Cognetti F. Ado-trastuzumab emtansine (T-DM1) in HER2+ advanced breast cancer patients: does pretreatment with pertuzumab matter? Future Oncol 2017; 13:2791-2797. [DOI: 10.2217/fon-2017-0336] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We evaluated the outcomes of patients treated with ado-trastuzumab emantasine (T-DM1) after first-line pertuzumab/trastuzumab, compared with those receiving a trastuzumab-only-based regimen. Patients & methods: Patients who received second-line T-DM1 after pertuzumab/trastuzumab (n = 34) were compared with those who received only trastuzumab (n = 73). Results: Overall response rate was 33.3% in patients with prior pertuzumab and 57.1% in the remaining subjects. Disease control rate was 47 and 43%, respectively, and the clinical benefit rate was 43.3 and 71.1%, respectively. Median progression-free survival was 5.0 and 11.0 months, respectively (hazard ratio: 2.02; 95% CI: 1.14–3.58; p = 0.01). Conclusion: Patients treated with T-DM1 who previously received pertuzumab present poorer clinical outcomes compared with those receiving a trastuzumab-only-based regimen in the first-line setting.
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Affiliation(s)
- Alessandra Fabi
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | - Diana Giannarelli
- Unità di Biostatistica, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | - Luca Moscetti
- Oncologia Medica, Ospedale Modena, Modena, 41125, Italy
| | - Daniele Santini
- Oncologia Medica, Campus Bio-medico Universitario, Roma, 00128, Italy
| | - Alberto Zambelli
- Oncologia Medica, Ospedale Papa Giovanni XXIII, Bergamo, 24127, Italy
| | | | - Michele Caruso
- Humanitas Centro Catanese di Oncologia, Catania, 95126, Italy
| | - Daniele Generali
- Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, 34127, Trieste, Italy
| | | | - Vita Leonardi
- Oncologia Medica, ARNAS Civico, Palermo, 90127 Italy
| | - Katia Cannita
- Oncologia Medica Ospedale L'Aquila, L'Aquila, 67100, Italy
| | - Grazia Arpino
- Oncologia Medica, Università Federico II, Napoli, 80138, Italy
| | | | - Gianluigi Ferretti
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | | | - Filippo Montemurro
- Investigative Clinical Oncology, Candiolo Cancer Institute-FPO, IRCCS, 10060 Candiolo, Torino, Italy
| | - Cecilia Nisticò
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | - Simona Gasparro
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | - Francesco Cognetti
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
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Cazzaniga M, Orlando L, Melegari E, Arcangeli V, Butera A, Pinotti G, Vallini I, Mocerino C, Giovanardi F, Cretella E, Gambaro A, Pistelli M, Donati S, Pizzuti L, Spagnuolo A, Putzu C, Leonardi V, De Angelis C, Pedroli S, Torri V. Metronomic chemotherapy (mCHT) in HER2-ve advanced breast cancer (ABC) patients (pts): old drugs, new results. The multicenter VICTOR-6 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.015] [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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13
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Gori S, Turazza M, Inno A, Lunardi G, Moroso S, La Verde N, Frassoldai A, Tarenzi E, Garrone O, Vici P, Laudadio L, Cretella E, Foglietta J, Leonardi V, Cavanna L, Barni S, Marchetti F, Valerio M, Carbognin G, Alongi F, Fabi A. The HERBA trial: a retrospective study on patients (pts) with HER2-positive (HER2+ve) breast cancer (BC) and brain metastases (BMs). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.016] [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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Fabi A, De Laurentiis M, Caruso M, Valle E, Moscetti L, Santini D, Cannita K, Carbognin L, Ciccarese M, Rossello R, Arpino G, Leonardi V, Montemurro F, La Verde N, Generali D, Zambelli A, Scandurra G, Russillo M, Paris I, D'Ottavio AM, Filippelli G, Giampaglia M, Stani S, Fabbri A, Alesini D, Cianniello D, Giannarelli D, Cognetti F. Efficacy and safety of T-DM1 in the 'common-practice' of HER2+ advanced breast cancer setting: a multicenter study. Oncotarget 2017; 8:64481-64489. [PMID: 28969087 PMCID: PMC5610019 DOI: 10.18632/oncotarget.16373] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 02/07/2017] [Accepted: 03/06/2017] [Indexed: 11/25/2022] Open
Abstract
Ado-trastuzumab emtansine (T-DM1) is an antibody-drug conjugate approved for the treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive, metastatic breast cancer (mBC). The aim of this ‘field-practice’ study was to investigate the efficacy and safety of T-DM1, focusing on treatment line, previous lapatinib treatment and patterns of metastasis. Three hundred and three patients with HER2-positive mBC who received T-DM1 were identified by reviewing the medical records of 24 Italian Institutions. One hundred fourty-nine (49%) and 264 (87%) had received prior hormonal treatment and/or anti-HER2 targeted therapy, respectively. Particularly, 149 patients had been previously treated with lapatinib. The objective response rate (ORR) was 36.2%, and 44.5% when T-DM1 was administrated as second-line therapy. Considering only patients with liver metastases, the ORR was 44.4%. The median progression-free survival (PFS) was 7.0 months in the overall population, but it reached 9.0 and 12.0 months when TDM-1 was administered as second- and third-line treatment, respectively. In conclusion, in this ‘real-word’ study evaluating the effects of T-DM1 in patients with HER2-positive mBC who progressed on prior anti-HER2 therapies, we observed a clinically-relevant benefit in those who had received T-DM1 in early metastatic treatment-line and in subjects previously treated with lapatinib.
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Affiliation(s)
- Alessandra Fabi
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | | | | | | | - Daniele Santini
- Oncologia Medica, Campus Bio-medico Universitario, Roma, Italy
| | | | | | | | - Rosalba Rossello
- UOC di Oncologia medica, Ospedale S. Vincenzo, Taormina, Messina, Italy
| | - Grazia Arpino
- Oncologia Medica, Università Federico II, Napoli, Italy
| | | | - Filippo Montemurro
- Fondazione del Piemonte per l'Oncologia, Itituto Tumori Candiolo, Torino, Italy
| | - Nicla La Verde
- Oncologia Medica, ASST Fatebenefratelli Sacco, PO Fatebenefratelli e Oftalmico, Milano, Italy
| | - Daniele Generali
- Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, Trieste, Italy
| | | | | | | | - Ida Paris
- Oncologia e Ginecologica Polo Donna, Policlinico A.Gemelli, Roma, Italy
| | | | | | | | | | | | - Daniele Alesini
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | - Diana Giannarelli
- Unità di Biostatistica, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | - Francesco Cognetti
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
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15
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Fabi A, De Laurentiis M, Caruso M, Valle E, Moscetti L, Santini D, Cannita K, Carbognin L, Ciccarese M, Rossello R, Arpino G, Leonardi V, Montemurro F, La Verde N, Generali DG, Zambelli A, Scandurra G, Russillo M, Paris I, D'Ottavio AM, Filippelli G, Giampaglia M, Stani S, Fabbri A, Alesini D, Giannarelli D, Cognetti F. Abstract P4-21-11: T-DM1 in HER2 positive advanced breast cancer patients: Real world practice from a multicenter observational study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-21-11] [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
Background: T-DM1 showed remarkable activity in metastatic HER-2 positive breast cancer (mBC) and it was recently approved for clinical use in patients (pts) who previously failed Trastuzumab- and Taxanes-based therapies. Currently, little is known on the performance of T-DM1 in a “real life” scenario. Therefore, we investigated effectiveness and safety of T-DM1 in Italian daily practice.
Methods: Pts baseline characteristics and clinical outcome of pts with HER-2 positive mBC treated with T-DM1 between 2013 and 2015 at 20 Italian Institutions were retrospectively collected and analyzed.
Results: 300 pts were included in our analysis. Median age was 51 years (27-78); visceral metastases were present in 204 (68%) pts and brain metastases in 86 (29%). It is noteworthy that 111 (37%) pts received T-DM1 as pure second line, 83 (28%) as third line and 96 (32%) as further lines. Moreover 10 (3%) pts had T-DM1 as first line because disease recurrence occurred during or adjuvant trastuzumab of within 6 months of its completion. The overall response rate (ORR) was 40%, global disease control rate (gDCR) 64%, median progression-free survival (PFS) 7.0 months (C.I.95%: 5.6-8.4) and overall survival (OS) at 2 years 63%. Pts with 1, 2 and 3 or more metastatic site had OS at 2 years of 87%, 67% and 46%, respectively (p<0.0001). When T-DM1 was given as second line the PFS was 8.0 months and beyond second-line was 6.8 months. Interestingly, for 38 (13%) pts who progressed after Pertuzumab-plus trastuzumab and taxanes as first line treatment, ORR and gDCR were similar to pertuzumab-naïve patients (38% and 62%, respectively) However PFS was 5.0 months (C.I.95%: 4.3-5.7) compared to 9.0 (95% C.I. 5.5-12.4) achieved in pts not receiving a previous pertuzumab-based treatment. Most frequent grade ≥3 toxicities were thrombocytopenia (2.6%), alopecia (2.1%), hypertransaminasemia (2.2%), neutropenia (1.3%), asthenia (1.3%) and diarrhea (0.4%).
Conclusions: To our knowledge, this is the first real life, multicenter retrospective analysis evaluating efficacy and safety of T-DM1 in pretreated HER-2 positive mBC pts. We observed remarkable results in terms of PFS and OS, especially when T-DM1 was given early in the course of metastatic disease. Shortened PFS in patients progressing after pertuzumab suggest further analyses to better define possible molecular mechanisms of cross-resistences between two molecules. As a whole there was no evidence of significant or unexpected toxicities. Although these findings should be taken with caution due to the retrospective analysis and the different lines of previous treatment considered, we confirmed the potential therapeutic role of T-DM1 across a heterogeneous population of HER-2 positive mBC patients. The final analysis will be presented to the meeting.
Citation Format: Fabi A, De Laurentiis M, Caruso M, Valle E, Moscetti L, Santini D, Cannita K, Carbognin L, Ciccarese M, Rossello R, Arpino G, Leonardi V, Montemurro F, La Verde N, Generali DG, Zambelli A, Scandurra G, Russillo M, Paris I, D'Ottavio AM, Filippelli G, Giampaglia M, Stani S, Fabbri A, Alesini D, Giannarelli D, Cognetti F. T-DM1 in HER2 positive advanced breast cancer patients: Real world practice from a multicenter observational study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-11.
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Affiliation(s)
- A Fabi
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - M De Laurentiis
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - M Caruso
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - E Valle
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - L Moscetti
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - D Santini
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - K Cannita
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - L Carbognin
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - M Ciccarese
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - R Rossello
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - G Arpino
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - V Leonardi
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - F Montemurro
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - N La Verde
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - DG Generali
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - A Zambelli
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - G Scandurra
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - M Russillo
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - I Paris
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - AM D'Ottavio
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - G Filippelli
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - M Giampaglia
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - S Stani
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - A Fabbri
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - D Alesini
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - D Giannarelli
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
| | - F Cognetti
- Istituto Nazionale Tumori Regina Elena, Roma; Istituto Nazionale Tumori Fondazione Pascale, Napoli; CCO Humanitas, Catania; Ospedale Oncologico Armando Businco, Cagliari; Azienda Ospedaliero-Universitaria, Modena; Campus Bio Medico, Roma; Presidio Ospedaliero S. Salvatore, L'Aquila; Azienda Universitaria Integrata, Verona; Ospedale Vito Fazzi, Lecce; Ospedale S. Vincenzo, Taormina; Università Federico II, Napoli; ARNAS Civico, Palermo; Fondazione del Piemonte per l'Oncologia, Candiolo; Ospedale S. Raffaele, Milano; Istituti Ospedalieri, Cremona; Azienda Ospedaliera Ospedali Riuniti, Bergamo; Ospedale Oncologico, Catania; Ospedale Oncologico, Lucca; Università Cattolica del Sacro Cuore Agostino Gemelli, Roma; Ospedale S. Giovanni Addolorata, Roma; Ospedale S. Francesco di Paola, Paola; Azienda Ospedaliera S. Carlo, Potenza; Ospedale S. Spirito, Roma; Ospedale Belcolle, Viterbo
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Fabi A, Alesini D, De Laurentiis M, Valle E, Santini D, Cannita K, Carbognin L, Ciccarese M, Arpino G, Leonardi V, Montemurro F, La Verde N, Generali D, Scandurra G, Russillo M, Paris I, D'Ottavio A, Filippelli G, Stani S, Giannarelli D, Cognetti F. Italian observational study on T-DM1 in HER2 positive advanced breast cancer patients: real world effectiveness and safety. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw337.07] [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: 11/15/2022] Open
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Duranti S, Inno A, Rossi V, Turazza M, Fiorio E, Fabi A, Bisagni G, Foglietta J, Santini D, Pavese I, Zambelli A, Vici P, Leonardi V, Barni S, Saracchini S, Bogina G, Lunardi G, Marchetti F, Montemurro F, Gori S. Clinical and pathological factors predicting long-term disease control with lapatinib and capecitabine for patients with HER2 positive metastastic breast cancer: results from a multicenter retrospective study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.32] [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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Barni S, Fontanella C, Del Mastro L, Livraghi L, Pizzuti L, Morritti M, Lutrino SE, Ciccarese M, Garrone O, Michelotti A, Latorre A, d'Onofrio L, Pellegrino A, Leonardi V, Iezzi L, La Verde NM, Airoldi M, Pistelli M, Martella F, Porcu L. A broad Italian experience with eribulin mesylate in metastatic breast cancer patients: The ESEMPiO study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e11539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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)
- Sandro Barni
- Division of Oncology, Azienda Ospedaliera Treviglio, Treviglio, Italy
| | | | | | | | - Laura Pizzuti
- Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Morritti
- IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | | | | | - Andrea Michelotti
- Oncology Unit I, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | | | | | | | | | - Laura Iezzi
- Department of Experimental and Clinical Sciences, University "G. D'Annunzio", Chieti, Italy
| | | | - Mario Airoldi
- 2nd Medical Oncology Division, A.O. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marco Pistelli
- Clinica di Oncologia Medica, Universita' Politecnica delle Marche, AOU Ospedali Riuniti, Ancona, Italy
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Gori S, Rossi V, Turazza M, Fiorio E, Fabi A, Bisagni G, Foglietta J, Santini D, Pavese I, Zambelli A, Vici P, Leonardi V, Barni S, Saracchini S, Bogina G, Duranti S, Inno A, Lunardi G, Montemurro F. Abstract P5-19-25: Multi-institutional retrospective analysis of clinical and pathological factors predicting resistance to lapatinib-based therapy in HER2 positive metastatic breast cancer (HER2+ MBC). Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p5-19-25] [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
Background
The combination of the dual HER1/HER2 inhibitor lapatinib (L) and capecitabine (C) is a therapeutic option for patients (pts) with HER2+MBC whose disease progresses after treatment with the monoclonal antibody trastuzumab. At present time, no clinical or pathological factors except HER2 status are clearly recognized as predictors of the activity of LC. We conducted a retrospective analysis of pts with HER2-positive metastatic breast cancer receiving LC after trastuzumab failure to identify factors associated with resistance to LC.
Materials and methods
We collected clinical and pathological data from 151 pts with HER2+ MBC receiving LC after failing a prior trastuzumab-based treatment (either adjuvant or for metastatic disease) treated at 13 Italian Institutions between March 2007 and December 2013. Time to progression (TTP) and overall survival (OS), calculated by the Kaplan Meier (KM) method, were from LC treatment beginning to disease progression or to death in the absence of progression (TTP), and to the date of death or to the date of last follow-up (OS), respectively. LC resistance was defined as TTP from treatment initiation lower or equal to the median TTP for the overall population. KM curves were compared by the Log-rank test. Logistic regression analysis was used to study predictors of TTP below the median value for patients receiving LC. Analyses were performed using SPSS version 17.0 (SPSS Inc., Chicago, IL).
Results
At a median follow-up of 41 months (IQR 23-62), median TTP to LC therapy was 7 months (IQR 5.5-8.5) and median OS was 18 months (IQR 10-28). Fifteen pts were excluded because of short follow-up (i.e. on LC treatment and <7 months of fu). Of the remaining 136, a total of 74 pts with a PFS≤7 months were defined LC-resistant (LC-R) and a total of 62 pts were defined LC-sensitive (LC-S). All clinical and pathological variables analyzed resulted evenly distributed between the two groups, except best tumor response (CR+PR) to LC, which was higher in patients with LC-S disease (72% vs 29%, p<0.001). Conversely, best tumor response in LC-R patients showed higher rates of PD (43% vs 2%, p<0.001). Median OS was 14 months (IC 95% 11.4-22.6) and 26 months (IC 95% 22.5-29.5) in LC-R and LC-S pts, respectively (p<0.001). Although we could not find independent predictors of LC-R, factors indicating failure of the first-line trastuzumab based therapy, as PD as best tumor response and short duration of first-line trastuzumab, were associated to LC-R.
Conclusions
A short time to progression during capecitabine and lapatinib (LC-R) is associated with reduced OS in patients failing prior trastuzumab based therapy for HER2+ MBC. Patients who had modest clinical benefit from previous trastuzumab-based therapy could experience LC-R indicating the possibility of primary resistance to anti HER2-treatment. For these patients, alternative targeting strategies are urgently needed.
Citation Format: Stefania Gori, Valentina Rossi, Monica Turazza, Elena Fiorio, Alessandra Fabi, Giancarlo Bisagni, Jennifer Foglietta, Daniele Santini, Ida Pavese, Alberto Zambelli, Patrizia Vici, Vita Leonardi, Sandro Barni, Silvana Saracchini, Giuseppe Bogina, Simona Duranti, Alessandro Inno, Gianluigi Lunardi, Filippo Montemurro. Multi-institutional retrospective analysis of clinical and pathological factors predicting resistance to lapatinib-based therapy in HER2 positive metastatic breast cancer (HER2+ MBC) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-19-25.
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Affiliation(s)
- Stefania Gori
- 1Medical Oncology – Sacro Cuore Don Calabria Hospital
| | - Valentina Rossi
- 2Medical Oncology – Institute for Cancer Research and Treatment IRCCS
| | | | | | - Alessandra Fabi
- 4Medical Oncology A – Istituto Nazionale Tumori Regina Elena
| | | | | | | | - Ida Pavese
- 8Medical Oncology – S. Pietro Fatebenefratelli Hospital
| | | | - Patrizia Vici
- 13Medical Oncology B – Istituto Nazionale Tumori Regina Elena
| | | | - Sandro Barni
- 11Medical Oncology – Azienda Ospedaliera di Treviglio
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Stumbo L, D'Andrea MR, Gasparini G, Felicioni L, Tumolo S, Pavese I, Bordonaro R, Labianca R, Bilancia D, Sanna G, Airoldi M, Buonadonna A, Leonardi V, Jacobelli S, Marchetti A. The Enriched Sequencing Method for Detection of K-Ras Mutations Enhances the Identification of Primary Resistant Colorectal Cancers to Panitumumab. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.200] [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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Caruso M, Adamo V, Tralongo P, Giuffrida D, Gebbia V, Leonardi V, Soto Parra HJ, Valenza R, Borsellino N, Sanò MV, Priolo D, Di Mari AM, Prestifilippo A, Ricciardi G, Miano E, Zacchia A, Ferraú F. Retrast: Retreatment after adjuvant trastuzumab—Our regional southern Italy experience. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e11526] [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
e11526 Background: Trastuzumab (T) is the standard of care for pts with HER2+ve BC. Relapse after adj T remains a rare event. Since the large use of T in adj setting, becomes crucial to evaluate advantages of retreatment with T for pts who relapsed after treatment in early stage. There is still lack of clinical evidence and poor data from CT to say that there is a benefit in T re-exposure after relapse following adj T. Methods: Since Jun 2006 and Dec 2011, we reviewed pts with early BC treated with T in adj therapy, relapsed and re-treated with T in first line therapy, in 10 departments of medical oncology in Sicily. We aimed to study feasibility, responses and treatment outcome. Results: 62 pts with HER2+ve fulfilled the criteria for this analysis and 47 were evaluated. Pts had a median age of 53 ys (29-79). ER/PgR-ve cases were 16 (34 %). Ki67 was > 20% in 34 pts (74%). 31 pts (64%) had >3 nodes+ve. All the pts received adj therapy with anthra+/-taxane. 55% of pts had >2 metastatic sites. 12 (25,5%) pts were revalued for HER2: 10 pts confirmed 3+ and two pts 2+ were FISH+. Median time from diagnosis to relapse was 25 mos (7 – 36). Median time from last dose of T to relapse was 10 ms (2 – 35). 33 (70,2%) pts and 14 pts (29,8%) had early (< 12 ms) and late progression (≥ 12 ms) respectively after adj T. First line of therapy was T in combination with mono/polychemotherapy in 42 pts (89,3%) and 5 pts (10,6%) respectively. 27 pts (57,4%) had objective responses (CR 5, PR 22) and 7 pts (14,8%) stable disease. 13 pts (27,6%) had progression: all of these pts had early progressive disease after adj T, 9 pts (69,2%) had Ki67>20%, 5 pts (38,4%) were ER/PgR-ve and 8 pts (61,5%) ER/PgR+ve. Median TTP was 4 mos (range 2-7). Median TTP for early and late relapses pts were respectively 3,7 and 4,8 mos, (p = 0,4). Median OS from relapse to death was 23 mos (r 12 – 37). LVSD G1 (EF < 60-50%) was observed only in 7 pts (14%). Conclusions: Our data confirm the feasibility and safety of treatment with T after adj T therapy and is active for a disease control rate in 72,4% of cases. These results demonstrate that relapses after adj T occurred early (<12 ms) in 70% of pts. However pts with primary resistance (27,6%) should be well categorized using biomolecular markers to receive up-front drugs that overcome the resistance to T.
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Affiliation(s)
- Michele Caruso
- Medical oncology department, Humanitas Centro Catanese di Oncologia, Catania, Italy
| | - Vincenzo Adamo
- Unit of Medical Oncology, A.O. Papardo; Department of Human Pathology, University of Messina, Messina, Italy
| | - Paolo Tralongo
- Medical Oncology Unit, G Di Maria Hospital, Avola, Italy
| | | | | | | | - Hector J. Soto Parra
- Medical Oncology, University Hospital Policlinico - Vittorio Emanuele, Catania, Italy
| | | | - Nicolo Borsellino
- Medical Oncology Unit - Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy
| | - Maria Vita Sanò
- Medical oncology Department, Humanitas Centro Catanese di Oncologia, Catania, Italy
| | - Domenico Priolo
- Medical Oncology Department, Ospedale S Vincenzo, Taormina, Italy
| | | | | | | | | | - Alessandra Zacchia
- Medical oncology department, Humanitas Centro Catanese di Oncologia, Catania, Italy
| | - Francesco Ferraú
- Medical Oncology Department, Ospedale S Vincenzo, Taormina, Italy
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Leonardi V, Iannito E, Meli M, Palmeri S. Ondansetron (OND) vs granisetron (GRA) in the control of chemotherapy induced acute emesis. Oncol Rep 2012; 3:919-23. [PMID: 21594482 DOI: 10.3892/or.3.5.919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We enrolled 118 chemonaive cancer patients (pts) to receive OND i.v. dl or GRA i.v. dl. Seventy of the 118 pts received moderately emetogenic (ME) chemotherapy (140 cycles), while 48 received highly emetogenic (HE) chemotherapy (93 cycles). Therapeutic success was obtained in 89% (OND) vs 94% (GRA) cycles of HE and in 96.8% (OND) vs 95.6% (GRA) cycles of ME. The main toxicities were headache (24%, OND; 23%, GRA); light-headedness (13%, OND; 18%, GRA); constipation (11%, OND; 6%, GRA). In conclusion, we think that OND and GRA are effective and the two drugs are equally active and toxic.
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Affiliation(s)
- V Leonardi
- UNIV PALERMO, INST MED CLIN 1, CHAIR MED ONCOL, I-90127 PALERMO, ITALY. UNIV PALERMO, BMT, DIV HAEMATOL, I-90127 PALERMO, ITALY. UNIV PALERMO, MED ONCOL SERV, I-90127 PALERMO, ITALY
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Di Bartolo CE, Leonardi V, Dell'Aera C, Puntorieri E, Zuppardo C, Mileto G. Increased pancreatic enzymes and inflammatory bowel diseases: What correlation? J Crohns Colitis 2011; 5:378-9. [PMID: 21683315 DOI: 10.1016/j.crohns.2011.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 04/07/2011] [Indexed: 02/08/2023]
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Seminara S, Nanni L, Generoso M, Mirri S, Leonardi V, Slabadzianiuk T, Vetrano ML, Buongiorno A, Losi S, Galluzzi F. Effect of treatment with cyproterone acetate on uterine bleeding at the beginning of GnRH analogue therapy in girls with idiopathic central precocious puberty. Horm Res Paediatr 2010; 73:386-9. [PMID: 20389110 DOI: 10.1159/000308172] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Accepted: 07/31/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The flare-up effect of GnRH analogues may cause transient uterine bleeding in girls affected with idiopathic central precocious puberty (ICPP). AIMS To assess the incidence of endometrial bleeding and verify whether pretreatment with cyproterone acetate could counteract it. METHODS Fifty-four girls affected by ICPP were divided into 2 groups. The first group (30 girls) was treated with triptorelin (3.75 mg, i.m. injection) every 28 days. The second group (24 girls) was treated with cyproterone acetate and triptorelin: cyproterone acetate (50 mg/m(2)) was administered every day for 8 weeks, and triptorelin (3.75 mg) was commenced 4 weeks after starting the cyproterone, then the intramuscular injection of triptorelin was repeated every 28 days. RESULTS Eight of 54 girls (15%) had mild withdrawal bleeding. There were no differences in incidence between groups 1 and 2. Girls with pubertal uterus at pelvic ultrasound had a higher incidence of uterine bleeding than girls with infantile uterus (25 vs. 7%), but this difference was not significant. CONCLUSION Co-administration of cyproterone acetate and GnRH analogues does not significantly decrease the incidence of uterine bleeding.
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Affiliation(s)
- S Seminara
- Paediatric Endocrinology Unit, Department of Paediatrics, University of Florence, AOU Meyer, Florence, Italy.
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Barone R, Bellafiore M, Leonardi V, Zummo G. Structural analysis of rat patellar tendon in response to resistance and endurance training. Scand J Med Sci Sports 2009; 19:782-9. [DOI: 10.1111/j.1600-0838.2008.00863.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [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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Leonardi V, Palmisano V, Pepe A, Usset A, Manuguerra G, Savio G, Laudani A, De Bella MT, Alù M, Calabria C, Carruba G, Agostara B. Docetaxel and Gemcitabine in the Treatment of Metastatic Breast Carcinoma: A Dose Finding Study. Tumori 2009; 95:427-31. [DOI: 10.1177/030089160909500403] [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
Aims and background Patients with metastatic breast cancer previously treated with anthracyclines for advanced disease are usually refractory to any further treatment with anthracyclines and have a poor prognosis. Therefore, new drugs or new combinations of drugs are needed. One approach has been to focus on the type of chemotherapy with low toxicity that preserves quality of life during treatment, such as weekly drug administration. Study design We designed a dose-finding study to determine the maximum tolerated dose of gemcitabine plus docetaxel, given on a weekly schedule in metastatic breast cancer previously treated with anthracyclines. Three escalating doses of gemcitabine (900, 1000 and 1100 mg/m2) on days 1 and 8 in combination with a fixed dose of docetaxel, 35 mg/m2 on days 1 and 8 were planned. Dose-limiting toxicity included grade >3 hematologic toxicity, grade >2 stomatitis, asthenia, diarrhea or organ-specific toxicity (except alopecia). Dose escalation was stopped if 1 out of 3 patients at any dose level experienced dose-limiting toxicity. Results Nine patients received a mean of 5.1 (range, 1–9) cycles. Gastrointestinal and leukopenia were the main dose-limiting toxicity. No patient experienced dose-limiting toxicity at dose level 1; at dose level 2, 2 out of 3 patients had dose-limiting toxicity and 3 additional patients treated at dose level 2 confirmed that the maximum tolerated dose had been reached. Conclusions The recommended gemcitabine dose in combination with docetaxel (35 mg/m2 for a phase II study) was established at 900 mg/m2.
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Affiliation(s)
- Vita Leonardi
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Valentina Palmisano
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Alessio Pepe
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Antonella Usset
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Giovanna Manuguerra
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Giuseppina Savio
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Agata Laudani
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Manuela Tamburo De Bella
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Massimo Alù
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Caterina Calabria
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Giuseppe Carruba
- Experimental Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
| | - Biagio Agostara
- Division of Medical Oncology, Oncologic Department, P.O. M. Ascoli, ARNAS, Civico, Palermo, Italy
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Leonardi V, Giubilei M, Federici E, Spaccapelo R, Šašek V, Novotny C, Petruccioli M, D'Annibale A. Mobilizing agents enhance fungal degradation of polycyclic aromatic hydrocarbons and affect diversity of indigenous bacteria in soil. Biotechnol Bioeng 2008; 101:273-85. [DOI: 10.1002/bit.21909] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Alu' M, Laudani A, Leonardi V, Palmisano V, Savio G, Pepe A, Arcuri C, Cusimano M, Calabria C, Agostara B. 3546 POSTER (XELOX)Capecitabine plus Oxaliplatin: clinical efficacy and safety in first-line treatment for metastatic gastric cancer. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71049-2] [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] Open
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Laudani A, Agostara B, Savio G, Leonardi V, Salvagno L, Palmisano V, Usset A. Capecitabine plus irinotecan (CAPIRI) as first-line treatment for patients (pts) with metastatic colorectal cancer (MCRC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.13573] [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
13573 Background: Twice-daily oral capecitabine mimics 5-FU infusion and has superior efficacy, improved safety and convenience compared with 5-FU/LV in MCRC and early-stage colon cancer. Preclinical and phase I/II clinical data suggest supra-additive efficacy of X + irinotecan and no significant pharmacokinetic interactions. We evaluated the efficacy and safety of X plus weekly irinotecan (CAPIRI) in 3-week cycles as first-line treatment for MCRC. Methods: Pts with no prior treatment for MCRC received irinotecan 80 mg/m2 i.v. infusion on d1&8 + capecitabine 1000 mg/m2 orally bid d1–14, q3w. Results: Baseline characteristics of the 39 enrolled pts (22 men/17 women) were: median age 59.9 years (range 38–76), ECOG PS 0–1, colon cancer (n=25), rectal cancer (n=14), metastatic sites (liver 74%, pelvis 20%, nodes 23%, lung 18%, peritoneum 10%, primary tumor 20%). Previous treatments were as follows: adjuvant chemotherapy (36%), radiotherapy (5%), neoadjuvant chemotherapy (3%). Pts received a total of 199 cycles (mean 5.1 per pt, range 1–13). All 39 pts were evaluable for safety and 38 for efficacy. The most common treatment-related grade 3/4 adverse events were nausea/vomiting (23% of pts), diarrhea (10%), and leucopenia (5%). The overall response rate was 45%, including 3 complete and 14 partial responses. A further 8 pts (21%) had stable disease. The duration of response in pts with a complete response was >10 months. Conclusions: These early findings indicate that this combination is effective and well tolerated as first-line treatment for MCRC. Replacing 5-FU with capecitabine in XELIRI offers benefits to the pt in terms of efficacy, safety, convenience, reduced discomfort and avoidance of central venous access compared with infusional 5-FU/LV-based regimens (IFL and FOLFIRI). No significant financial relationships to disclose.
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Affiliation(s)
- A. Laudani
- M. Ascoli ARNAS Civico, Palermo, Italy; Oncol Med Osp Civile Vittorio Veneto E Conegliano, Vittorio Veneto, Italy
| | - B. Agostara
- M. Ascoli ARNAS Civico, Palermo, Italy; Oncol Med Osp Civile Vittorio Veneto E Conegliano, Vittorio Veneto, Italy
| | - G. Savio
- M. Ascoli ARNAS Civico, Palermo, Italy; Oncol Med Osp Civile Vittorio Veneto E Conegliano, Vittorio Veneto, Italy
| | - V. Leonardi
- M. Ascoli ARNAS Civico, Palermo, Italy; Oncol Med Osp Civile Vittorio Veneto E Conegliano, Vittorio Veneto, Italy
| | - L. Salvagno
- M. Ascoli ARNAS Civico, Palermo, Italy; Oncol Med Osp Civile Vittorio Veneto E Conegliano, Vittorio Veneto, Italy
| | - V. Palmisano
- M. Ascoli ARNAS Civico, Palermo, Italy; Oncol Med Osp Civile Vittorio Veneto E Conegliano, Vittorio Veneto, Italy
| | - A. Usset
- M. Ascoli ARNAS Civico, Palermo, Italy; Oncol Med Osp Civile Vittorio Veneto E Conegliano, Vittorio Veneto, Italy
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Abstract
OBJECTIVE A phase II study was performed to evaluate efficacy and safety of the combination vinorelbine and docetaxel in patients with metastatic breast cancer previously treated with anthracycline-based regimens. Overall 41 patients were included in the study. METHODS Treatment consisted of vinorelbine 25 mg/m2 and docetaxel 75 mg/m2, both administered on day 1 every 3 weeks for a maximum of 9 cycles. Most patients (92%) were postmenopausal with a median age of 57 years, and median ECOG performance of 1. Sites of disease were viscera in 42% of patients, bones in 30%, soft-tissues in 32%. Sixty-five percent of patients had >2 metastatic sites. Previous treatments included neo-adjuvant chemotherapy in 7.3% of cases, adjuvant chemotherapy in 71%, and front-line chemotherapy for advanced disease in 50% of cases. RESULTS A total of 273 cycles of chemotherapy were delivered (mean 6 cycles/patient). All patients were assessable for toxicity: alopecia was recorded in all patients, grade 2-3 neutropenia in 34% and grade 4 in 9.7%; grade 2-3 nausea/vomiting in 29%, grade 2-3 mucositis in 24.3%. Out of 39 patients evaluable for response, 7 (18%) complete responses and 13 (33%) partial responses have been recorded with an overall response rate of 51%. Six patients (15%) experienced stable disease and 13 patients (33%) progressed. Mean duration of responses was 15.2 months. Median time to progression and median overall survival were 6.2 and 14 months, respectively. CONCLUSION In patients with metastatic breast cancer previously treated with anthracyclines the combination vinorelbine-docetaxel is very active and well tolerated representing a valid therapeutic option for the management of this patient population.
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Affiliation(s)
- Giuseppina Savio
- Department of Oncology, Division of Medical Oncology, Ospedale M. Ascoli, ARNAS Civico, Palermo, Via Parlavecchio, Palermo, Italy
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Gebbia V, Del Prete S, Borsellino N, Ferraù F, Tralongo P, Verderame F, Leonardi V, Capasso E, Maiello E, Bordonaro R, Stinco S, Agostara B, Barone C. Efficacy and Safety of Cetuximab/Irinotecan in Chemotherapy-Refractory Metastatic Colorectal Adenocarcinomas: A Clinical Practice Setting, Multicenter Experience. Clin Colorectal Cancer 2006; 5:422-8. [PMID: 16635281 DOI: 10.3816/ccc.2006.n.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [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: 11/20/2022]
Abstract
BACKGROUND This study was designed to evaluate the efficacy and safety of irinotecan/cetuximab administered as third- or fourth-line therapy in a retrospective series of patients with metastatic colorectal cancer refractory to oxaliplatin and irinotecan. PATIENTS AND METHODS Most patients (90%) had been previously treated with adjuvant 5-fluorouracil/leucovorin, and all had received oxaliplatin-based regimens before receiving irinotecan-based second-line treatment. Sixty patients with irinotecan-refractory colorectal cancer received a regimen comprising weekly irinotecan 120 mg/m2 as a 1-hour intravenous infusion and cetuximab 400 mg/m2 infused over 2 hours as the initial dose and 250 mg/m2 infused over 1 hour for the subsequent administrations. A single treatment cycle comprised 4 weekly infusions followed by 2 weeks of rest. RESULTS According to an intent-to-treat analysis, a partial response was exhibited in 12 of 60 enrolled patients (20%; 95% confidence interval, 11%-32%) with a median duration of 5.1 months (range, 3-7.4 months). The tumor growth control rate was 50% (95% confidence interval, 37%-63%). Objective responses did not correlate with performance status, number of sites of disease, and pretreatments or epidermal growth factor receptor status. The median progression-free survival was 3.1 months (range, 1.2-9 months), whereas median overall survival was 6 months (range, 2-13 months). Both survival parameters correlated with performance status at the beginning of treatment. The main grade 3/4 toxicities were nausea (33%), diarrhea (27%), leukopenia (18%), asthenia (13%), and acne-like reaction (13%). CONCLUSION Our data suggest that the weekly irinotecan/cetuximab regimen is feasible in an outpatient setting and tolerated by most patients. At present, combinations of chemotherapy with cetuximab are being evaluated in patients with earlier-stage disease in a number of ongoing studies.
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Affiliation(s)
- Vittorio Gebbia
- Department of Experimental Oncology and Clinical Applications, University of Palermo, and Medical Oncology Unit, Ospedale San Giovanni di Dio, Napoli, Italy.
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D'Annibale A, Rosetto F, Leonardi V, Federici F, Petruccioli M. Role of autochthonous filamentous fungi in bioremediation of a soil historically contaminated with aromatic hydrocarbons. Appl Environ Microbiol 2006; 72:28-36. [PMID: 16391021 PMCID: PMC1352206 DOI: 10.1128/aem.72.1.28-36.2006] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.8] [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: 11/20/2022] Open
Abstract
Nine fungal strains isolated from an aged and heavily contaminated soil were identified and screened to assess their degradative potential. Among them, Allescheriella sp. strain DABAC 1, Stachybotrys sp. strain DABAC 3, and Phlebia sp. strain DABAC 9 were selected for remediation trials on the basis of Poly R-478 decolorization associated with lignin-modifying enzyme (LME) production. These autochthonous fungi were tested for the abilities to grow under nonsterile conditions and to degrade various aromatic hydrocarbons in the same contaminated soil. After 30 days, fungal colonization was clearly visible and was confirmed by ergosterol determination. In spite of subalkaline pH conditions and the presence of heavy metals, the autochthonous fungi produced laccase and Mn and lignin peroxidases. No LME activities were detected in control microcosms. All of the isolates led to a marked removal of naphthalene, dichloroaniline isomers, o-hydroxybiphenyl, and 1,1'-binaphthalene. Stachybotrys sp. strain DABAC 3 was the most effective isolate due to its ability to partially deplete the predominant contaminants 9,10-anthracenedione and 7H-benz[DE]anthracen-7-one. A release of chloride ions was observed in soil treated with either Allescheriella sp. strain DABAC 1 or Stachybotrys sp. strain DABAC 3, suggesting the occurrence of oxidative dehalogenation. The autochthonous fungi led to a significant decrease in soil toxicity, as assessed by both the Lepidium sativum L. germination test and the Collembola mortality test.
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Affiliation(s)
- A D'Annibale
- Dipartimento di Agrobiologia e Agrochimica, University of Tuscia, Via S. C. De Lellis, 01100 Viterbo, Italy
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Palmeri S, Vaglica M, Spada S, Filippelli G, Farris A, Palmeri L, Massidda B, Misino A, Ferraù F, Comella G, Leonardi V, Condemi G, Mangiameli A, De Cataldis G, Macaluso MC, Cajozzo M, Iannitto E, Danova M. Weekly Docetaxel and Gemcitabine as First-Line Treatment for Metastatic Breast Cancer: Results of a Multicenter Phase II Study. Oncology 2005; 68:438-45. [PMID: 16020974 DOI: 10.1159/000086986] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 07/26/2004] [Accepted: 12/12/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We conducted a multicenter phase II study to evaluate the clinical efficacy, toxicity, and dose intensity of a new weekly schedule of docetaxel and gemcitabine as first-line treatment of metastatic breast cancer patients. METHODS We enrolled 58 patients, 52% of whom had received a previous anthracycline-containing chemotherapy. The treatment schedule was: docetaxel 35 mg/m2 and gemcitabine 800 mg/m2 i.v. on days 1, 8, 15 every 28 days. RESULTS All patients were assessable for toxicity and 56 for efficacy. Overall response rate was 64.3% with 16.1% of complete responses and 48.2% of partial responses. Median survival was 22.10 months (95% CI: 15.53-28.67) and median time to tumor progression was 13.6 months (95% CI: 10.71-16.49). The most common hematological toxicity was neutropenia (no febrile neutropenia), which occurred in 28 patients (48.3%) but grade 3-4 in only 8 patients (14%). Alopecia, the most common nonhematological toxicity, occurred in 20 (34.5%) patients, but only 5 patients (8.6%) experienced grade 3 alopecia. CONCLUSION The activity of docetaxel and gemcitabine in metastatic breast cancer is confirmed. The promising results of the employed schedule, in agreement with other published studies, need to be further confirmed within a phase III study.
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Affiliation(s)
- S Palmeri
- Dipartimento di Oncologia, Cattedra di Oncologia Medica, Università di Palermo, Palermo, Italia.
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Colucci G, Gebbia V, Paoletti G, Giuliani F, Caruso M, Gebbia N, Cartenì G, Agostara B, Pezzella G, Manzione L, Borsellino N, Misino A, Romito S, Durini E, Cordio S, Di Seri M, Lopez M, Maiello E, Montemurro S, Cramarossa A, Lorusso V, Di Bisceglie M, Chiarenza M, Valerio MR, Guida T, Leonardi V, Pisconti S, Rosati G, Carrozza F, Nettis G, Valdesi M, Filippelli G, Fortunato S, Mancarella S, Brunetti C. Phase III randomized trial of FOLFIRI versus FOLFOX4 in the treatment of advanced colorectal cancer: a multicenter study of the Gruppo Oncologico Dell'Italia Meridionale. J Clin Oncol 2005; 23:4866-75. [PMID: 15939922 DOI: 10.1200/jco.2005.07.113] [Citation(s) in RCA: 543] [Impact Index Per Article: 28.6] [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: 12/12/2022] Open
Abstract
PURPOSE We performed this phase III study to compare the irinotecan, leucovorin (LV), and fluorouracil (FU) regimen (FOLFIRI) versus the oxaliplatin, LV, and FU regimen (FOLFOX4) in previously untreated patients with advanced colorectal cancer. PATIENTS AND METHODS A total of 360 chemotherapy-naive patients were randomly assigned to receive, every 2 weeks, either arm A (FOLFIRI: irinotecan 180 mg/m(2) on day 1 with LV 100 mg/m(2) administered as a 2-hour infusion before FU 400 mg/m(2) administered as an intravenous bolus injection, and FU 600 mg/m(2) as a 22-hour infusion immediately after FU bolus injection on days 1 and 2 [LV5FU2]) or arm B (FOLFOX4: oxaliplatin 85 mg/m(2) on day 1 with LV5FU2 regimen). RESULTS One hundred sixty-four and 172 patients were assessable in arm A and B, respectively. Overall response rates (ORR) were 31% in arm A (95% CI, 24.6% to 38.3%) and 34% in arm B (95% CI, 27.2% to 41.5%; P = .60). In both arms A and B, median time to progression (TTP; 7 v 7 months, respectively), duration of response (9 v 10 months, respectively), and overall survival (OS; 14 v 15 months, respectively) were similar, without any statistically significant difference. Toxicity was mild in both groups: alopecia and gastrointestinal disturbances were the most common toxicities in arm A; thrombocytopenia and neurosensorial were the most common toxicities in arm B. Grade 3 to 4 toxicities were uncommon in both arms, and no statistical significant difference was observed. CONCLUSION There is no difference in ORR, TTP, and OS for patients treated with the FOLFIRI or FOLFOX4 regimen. Both therapies seemed effective as first-line treatment in these patients. The difference between these two combination therapies is mainly in the toxicity profile.
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Affiliation(s)
- Giuseppe Colucci
- Medical and Experimental Oncology Unit, Oncology Institute, Via Amendola 209, 70126 Bari, Italy.
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Winograd B, Leonardi V, Palmisano V, Pepe A, Savio G, Laudani A, Blasi L, Alù M, Rondello G, Cusimano MP, Agostara B. Pegylated liposomal doxorubicin (Peg-LD) and paclitaxel in patients with metastatic breast carcinoma: A phase II study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- B. Winograd
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - V. Leonardi
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - V. Palmisano
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - A. Pepe
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - G. Savio
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - A. Laudani
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - L. Blasi
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - M. Alù
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - G. Rondello
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - M. P. Cusimano
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
| | - B. Agostara
- Schering Plough, Kenilworth, NJ; Medcl Oncology PO “M. Ascoli” ARNAS Civico, Palermo, Italy; Medcl Oncology, Palermo, Italy; Medcl oncology PO, Palermo, Italy
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Laudani A, Gebbia V, Leonardi V, Savio G, Borsellino N, Cusimano MP, Calabria C, Stefano R, Agostara B. Activity and toxicity of oxaliplatin plus raltitrexed in 5-fluorouracil refractory metastatic colorectal adeno-carcinoma. Anticancer Res 2004; 24:1139-42. [PMID: 15154638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND This study evaluated the antitumor efficacy and safety of a novel oxaliplatin/raltitrexed combination in pretreated advanced colorectal cancer patients. PATIENTS AND METHODS Forty-five patients with 5-fluorouracil-refractory metastatic colorectal cancer received raltitrexed 3.0 mg/m2 as a 15-minute intravenous (i.v.) infusion, followed 45 min later by l-OHP 130 mg/m2 i.v. as 2-h venous infusion on 1 day every 3 weeks. All patients had histologically proven metastatic colorectal cancer, age 18-75, measurable disease and normal baseline biological values. Most patients (60%) had >2 disease sites. All patients were assessed for safety and also for response according to an intent-to-treat fashion. RESULTS The overall response rate was 29% (95% CL 16%-44%) including one CR (2%) and 12 PR (27%). Six patients (16%) showed a stabilization of disease for a tumor growth control rate of 45%. The median time to progression was 4 months (range 1-12+) and median overall survival was 9 months (range 1-29+). CONCLUSION These data confirm that this oxaliplatin/raltitrexed combination is effective against metastatic colorectal carcinoma, well tolerated with low grade toxicity and easy to administer. Further evaluation of this regimen seems warranted as an alternative to fluoropyrimidine-based combinations.
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Affiliation(s)
- Agata Laudani
- Division of Medical Oncology, Oncological Hospital M. Ascoli, Palermo, Italy
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Gebbia V, Blasi L, Borsellino N, Caruso M, Leonardi V, Agostara B, Valenza R. Paclitaxel and epidoxorubicin or doxorubicin versus cyclophosphamide and epidoxorubicin as first-line chemotherapy for metastatic breast carcinoma: a randomised phase II study. Anticancer Res 2003; 23:765-71. [PMID: 12680181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Fifty-eight patients with metastatic breast cancer were randomly treated with a combination of cyclophosphamide 500 mg/m2 on days 1 and 2 plus epidoxorubicin 90 mg/m2 on day 1 every 3 weeks (group A = 18 patients), or paclitaxel 175 mg/m2 cycle plus doxorubicin 50 mg/m2/cycle every 3 weeks (group B = 20 patients), or paclitaxel as above plus epidoxorubicin 90 mg/m2/cycle every 21 days (group C = 20 patients). The trial was designed as a randomized, multi-institutional phase II study where the cyclophosphamide/epidoxorubicin regimen represented the calibration arm. The overall response rate was 50% (95% CL 26-74%) for arm A, 65% (95% CL 41-85%) for arm B and 70% (95% CL 46-88%) for arm C. The complete response rate was 6% for arm A, 10% for arm B and 15% for arm C. Although this trial was non comparative, the median duration of response and median overall survival were almost superimposable in all arms. The taxane-based regimens were associated with significant neurotoxicity in nearly 20% of cases, while febrile neutropenia represented the most severe side-effect. Our data suggest that the anthracycline/taxane combinations are more effective than the epidoxorubicin/cyclophosphamide regimen, at least in terms of objective response rates. These regimens may represent the treatment of choice when oncologists are faced with aggressive visceral metastatic breast cancer in non elderly women.
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Affiliation(s)
- Vittorio Gebbia
- University of Palermo, Medical Oncology Unit, La Maddalena Clinic for Cancer, Palermo, Italy
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Palmeri S, Leonardi V, Tamburo De Bella M, Morabito A, Vaglica M, Accurso V, Ferraù F, Failla G, Agostara B, Massidda B, Valenza R, Fanelli M, Gasparini G. Doxorubicin-docetaxel sequential schedule: results of front-line treatment in advanced breast cancer. Oncology 2002; 63:205-12. [PMID: 12381898 DOI: 10.1159/000065466] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 11/19/2022]
Abstract
OBJECTIVE We conducted a multi-institutional phase II study to evaluate the tolerability and activity of a sequential schedule of treatment with doxorubicin and docetaxel in chemotherapy-naive women with advanced breast cancer. METHODS A total of 73 patients with PS (ECOG) 0-2, aged <70 years and adequate bone marrow, renal, liver and cardiac functions were included in the study (13 stage III B and 60 stage IV). The schedule of administration was doxorubicin 50 mg/m2 by intravenous (i.v.) 30 min injection on day 1 followed the day after by docetaxel 75 mg/m2, by i.v. 60 min infusion. Cycles were repeated every 28 days. RESULTS Overall, the median number of administered cycles was 6 (range 1-14). The most common toxicity was hematological, with 56.2% of the patients who experienced grade 3-4 neutropenia. However, febrile neutropenia occurred only in 2.8% of the cases. The median cumulative dose of doxorubicin was 350 mg/m2 (range 50-700 mg/m2). Eleven patients (15.4%) were documented to have >10% but <20% decrease in the left ventricular ejection fraction. No case of congestive heart failure was recorded. No patient experienced treatment-related death. Among the 68 evaluable patients, the overall objective response rate was 73.5% (95% confidence limits: 63-84%): 10 patients (14.7%) obtained a complete remission and 40 (58.8%) had a partial response. Only 10 patients (14.7%) experienced progressive disease. The median duration of response was 10 months (2-54+). CONCLUSION This sequential treatment with doxorubicin and docetaxel is an effective, feasible and a well-tolerated regimen. The main toxicity was neutropenia. The lack of cardiotoxicity is an important advantage of such a doxorubicin-docetaxel combination and it justifies phase III comparative studies with other anthracyclines/taxanes containing schedules in both advanced and early-stage breast cancer.
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Affiliation(s)
- S Palmeri
- Istituto di Clinica Medica, Cattedra di Oncologia Medica, Università di Palermo, Italy
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Leonardi V, Savio G, Laudani A, Blasi L, Agostara B. New approaches to breast cancer: oxaliplatin combined with 5-fluorouracil and folinic acid in pretreated advanced breast cancer patients: preliminary reports. Ann N Y Acad Sci 2002; 963:91-7. [PMID: 12095933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Oxaliplatin is a platinum compound that inhibits DNA synthesis. This drug has a broad spectrum of antineoplastic activity, and its results in breast cancer are promising. We began a phase II study in pretreated advanced breast cancer patients using oxaliplatin together with 5-fluorouracil and folinic acid, a combination based on the efficacy of both drugs in breast cancer and their different toxicity profiles. Seventeen patients with advanced breast cancer were treated with oxaliplatin, 5-fluorouracil, and folinic acid, and preliminary data were analyzed. The mean number of courses per patient was 2.82 (range 1-8). The main toxicity was gastrointestinal, with nausea and vomiting G2-3 in 53% of the patients. Hematologic toxicity was moderate with neutropenia G2-3 in 13% of the patients. Among 10 evaluable patients we obtained partial response in one and stabilized the disease in two patients. No data on survival were evaluated. The small number of enrolled and evaluable patients does not permit any conclusions to be drawn. The study is ongoing.
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Affiliation(s)
- V Leonardi
- Division of Medical Oncology, M. Ascoli Oncologic Hospital - ARNAS Civico, Palermo, Italy.
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Palmeri S, Leonardi V, Gebbia V, De Bella MT, Ferraù F, Faillú G, Spatafora M, Valenza R, Di Vita G, Vitello S, Carroccio R, Sciortino G, Vaglica M, Accurso V, Agostara B, Licata G. Gemcitabine plus vinorelbine in stage IIIB or IV non-small cell lung cancer (NSCLC): a multicentre phase II clinical trial. Lung Cancer 2001; 34:115-23. [PMID: 11557121 DOI: 10.1016/s0169-5002(01)00206-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [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: 10/27/2022]
Abstract
A phase II study in patients with stage IIIB/IV non-small cell lung cancer (NSCLC) was carried out to evaluate the clinical activity and toxicity of the chemotherapeutic combination of gemcitabine+vinorelbine (GEM/VNR). Forty-five patients (40 male, 5 female) with a median age of 67 years (range 37-73) and a median ECOG performance status of 1 (range 0-2) were enrolled into the trial. Twenty patients had stage IIIB (two positive supraclavicular nodes and 20 cytologically positive pleural effusion), and 25 had stage IV NSCLC. GEM 1000 mg/m(2) diluted in 250 cc(3) of normal saline was administered iv on days 1, 8, and 15, while VNR was given 30 mg/m(2) on days 1 and 8 every 4 weeks. The median number of courses/patient was 4 (range 3-7). According to an intent-to-treat analysis 2 (4%) patients had a complete response and 16 (36%; 95% CL 22-52%) had a partial response for an overall response rate of 40% (95% CL 26-56%). Twelve (27%) patients had stable disease and 15 (33%) were considered as treatment failures. Median overall survival of the whole series was 8+ months with 33% of patients alive at 1 year. Toxicity was generally mild. WHO grade 3-4 neutropenia was recorded in 22% of cases, grade 1-3 liver toxicity in 6% of patients and neutropenia-unrelated fever in 9%. This multicentre phase II study suggests that the GEM/VNR combination regimen is an active and well tolerated regimen in patients with stage IIIB/IV NSCLC. Larger studies comparing cisplatin-based regimens to new schedules without cisplatin are warranted.
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Affiliation(s)
- S Palmeri
- Istituto di Clinica Medica, Universita' di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy.
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Agostara B, Leonardi V, Calabria C, Laudani A, Rondello G. La Terapia Di Supporto Nei Pazienti Con Carcinoma Del Colon-Retto. Tumori 2000; 86:S56-8. [PMID: 10969620 DOI: 10.1177/03008916000863s116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- B Agostara
- Divisione di Oncologia Medica, Ospedale Oncologico M. Ascoli, Palermo
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Abstract
PURPOSE Gemcitabine (GEM) and vinorelbine (VNR) are both active against advanced breast cancer (ABC), being able to induce a median ORR of 25% and 40%, respectively. Because of their different mechanism of action and good tolerability, the combination of GEM and VNR has been tested in ABC. PATIENTS AND METHODS Twenty-nine ABC patients pretreated with anthracycline-taxane were treated with GEM 1000 mg/m2 on day 1, 8, 15, and VNR 25 mg/m2 on day 1 and 8 every twenty-eight days. Analysis of toxicity pattern, response rate, TTP and OS were carried out. RESULTS Twenty-nine patients were enrolled into the trial. The ORR was 48% (95% CI: 29-67): a CR was observed in three patients (10%; 95% CI: 2-27), while eleven patients (38%; 95 CI: 21-58) achieved PR, eight (28%) had a SD, and seven (24%) progressed. Toxicity was mainly hematological and included: grade 3 leukopenia in 48% of cases without episodes of neutropenic fever, grade 3-4 thrombocytopenia in 10%, and grade 2 anemia in 7%. Non-hematological toxicities were mild and rather infrequent. CONCLUSIONS The GEM-VNR combination seems to be active in pretreated ABC with an acceptable toxicity pattern, and may well reppresent an interesting therapeutic choice after anthracycline/taxane regimens.
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Affiliation(s)
- R Valenza
- Division Medical Oncology, Oncological Hospiral M. Ascoli, Palermo, Italy
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Palmeri S, Leonardi V, Danova M, Porta C, Ferrari S, Fincato G, Citarrella P. Prospective, randomized trial of sequential interleukin-3 and granulocyte- or granulocyte-macrophage colony-stimulating factor after standard-dose chemotherapy in cancer patients. Haematologica 1999; 84:1016-23. [PMID: 10553163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Several in vitro and animal studies have shown that IL-3 primes hematopoietic stem cells to become more sensitive to later acting growth factors. We wanted to compare the toxicity and the synergistic stimulatory effect of interleukin-3 (IL-3) followed by granulocyte colony-stimulating factor (G-CFS) or granulocyte-macrophage colony-stimulating factor (GM-CSF) on white blood cell (WBC) and platelet counts, after standard-dose chemotherapy (CT) in patients with solid tumors. DESIGN AND METHODS Fifty consecutive cancer patients with thrombocytopenia and/or leukopenia registered during a previous course of CT were randomized to receive, after the following course, IL-3 (10 microg/kg/day, s.c., day 1-5) followed by G- or GM-CSF (5 microg/kg/day, day 6-8). RESULTS The nadir of WBC in the cycles supported with the combination of IL-3 and G-CSF was significantly higher than that observed in the CT cycles not supported by growth factors (p < 0. 005). Furthermore, severe leukopenia was abrogated in all the cycles supported with IL-3+G-CSF, while in the cycles without cytokines, this event was registered in 62.5% of the cases (p < 0.0005). Finally, the recovery of WBC was achieved a mean of 4 days earlier in the cycles supported with IL-3+G-CSF. As for thrombocytoprotection, no significant differences were evidenced, but severe thrombocytopenia was abrogated in all the cycles supported by IL-3+G-CSF (p < 0.05). Furthermore, platelet recovery after CT was achieved on average 3.5 days earlier in the IL-3+G-CSF group than in the previous cycles. The nadir of WBC count in the cycles supported by the combination of IL-3 and GM-CSF was significantly higher than that observed in the CT cycles not supported by growth factors (p < 0.005). Furthermore, severe leukopenia was abrogated in 40% of the cycles supported by IL-3+GM-CSF, while in the cycles without cytokines, this event was registered in 80% of the cases (p < 0.005). Finally, the recovery of WBC was achieved a mean of 3.5 days earlier in the cycles supported by IL-3+GM-CSF. As far as thrombocytoprotection is concerned, there were no significant differences in the nadir between the cycles supported by the association IL-3+GM-CSF and the cycles not supported by cytokines. However, severe thrombocytopenia was registered in 20% of the cycles not supported by growth factors but in only 10% of the cycles supported by IL-3+GM-CSF (p < 0.05). Furthermore, platelet recovery after CT was achieved on average 3 days earlier in the IL-3+GM-CSF group. The combination of IL-3 and G-CSF would appear to be more effective than the combination of IL-3 and GM-CSF in the control of both severe thrombocytopenia and leukopenia. Indeed, severe leukopenia was abrogated in all the cycles in arm A, but only in 40% of the cycles in arm B (p < 0.0005). Furthermore, considering a platelet count below 49
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Affiliation(s)
- S Palmeri
- Istituto di Clinica Medica, Cattedra di Oncologia Medica, Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy
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Leonardi V, Danova M, Fincato G, Palmeri S. Interleukin 3 in the treatment of chemotherapy induced thrombocytopenia. Oncol Rep 1998; 5:1459-64. [PMID: 9769388 DOI: 10.3892/or.5.6.1459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We enrolled 19 cancer patients (11 females, 8 males) with thrombocytopenia after standard dose of chemotherapy to receive IL3 10 mg/kg/day s.c. until hematologic recovery. Therapeutic success was obtained in 69.6% of cycles; a major response in 39.3% and a minor response in 30.3% of cycles. We obtained the best results in case of platelet count <49,000/mm3. The main toxicity was a flu-like syndrome. In two cycles (6%) we registered allergic episodes with flushing and lipothymia. In the 47% of cycles evaluable for toxicity no side effect was registered.
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Affiliation(s)
- V Leonardi
- Institute of Medical Clinic, Medical Oncology, University of Palermo, 90127 Palermo, Italy
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Tralongo V, Daniele E, Leonardi V, Rodolico V. Prognostic value of clinicopathologic variables and DNA ploidy in stage I cutaneous malignant melanoma. Oncol Rep 1998; 5:1095-8. [PMID: 9683815 DOI: 10.3892/or.5.5.1095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We studied a consecutive series of 78 stage I cutaneous malignant melanoma in order to identify variables which might predict development of metastases. Anatomical site, sex, tumor thickness, Clark level, microscopic ulceration, growth phase, histologic type, cell type, and DNA ploidy were investigated. Lesions with tumor thickness 1.5 mm, Clark level IV-V, microscopic ulceration and DNA aneuploidy were at high risk for the development of metastases. This study showed the prognostic importance of DNA ploidy in stage I cutaneous malignant melanoma and the strong relationship between DNA ploidy and classic prognostic factors. This variable can be used in routine diagnosis for selecting a high-risk group of patients who may benefit from a more aggressive therapeutic approach.
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Affiliation(s)
- V Tralongo
- Istituto di Anatomia ed Istologia Patologica, Cattedra di Istituzioni di Anatomia Patologica, Palermo University School of Medicine, Palermo, Italy
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Abstract
We studied a consecutive series of 54 cases of lower lip squamous cell carcinoma (LLSCC) in order to identify any variables which might predict the development of lymph node metastases. The cases were divided into 38 tumors without metastases (group I) and 16 tumors with lymph node metastases (group II). The following factors were investigated: tumor size, histologic grading maximal thickness, perineural invasion, DNA ploidy and PCNA expression. In conclusion, we found that LLSCC greater than 2 cm in diameter, with histological grading G3-G4, thickness of more than 6 mm, DNA aneuploidy and high PCNA expression (PCNA LI > 0.48), were at high risk for the development of lymph node metastases.
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Affiliation(s)
- E Daniele
- Cattedra di Istituzioni di Anatomia Patologica, University of Palermo, Italy
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Palmeri S, Meli M, Danova M, Bernardo G, Leonardi V, Dastoli G, Rausa L, Russo A, Filippelli G, Palmieri G, Russo A, Della Vittoria Scarpati M, Lo Russo V, Di Lauro L, Colucci G, Bruni G, Piazzi M, Gebbia N, Spada S. 5-Fluorouracil plus interferon alpha-2a compared to 5-fluorouracil alone in the treatment of advanced colon carcinoma: a multicentric randomized study. J Cancer Res Clin Oncol 1998; 124:191-8. [PMID: 9619746 DOI: 10.1007/s004320050154] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Biochemical modulation is one of the most interesting fields in cancer chemotherapy. Interferon-alpha (IFNalpha) is a cytokine that is able to influence the pharmacodynamics of 5-fluorouracil (5FU) through a number of mechanisms. With the aim of confirming some data emerging from the literature, we initiated a multicentric randomized study comparing the combination of 5FU and IFNalpha-2a with 5FU alone in the treatment of advanced or metastatic colon cancer. A group of 205 colon cancer patients (104 in the 5FU arm and 101 in the 5FU + IFNapha-2a arm) were included in the final intention-to-treat analysis. Rectal cancers were not considered eligible. All patients had measurable disease, were aged 75 years or less, had a Karnofsky index of at least 60 and had good bone marrow, renal, liver and cardiac functions. No previous chemo-immunotherapy was allowed. The treatment was 750 mg/m2 5FU (4 h i.v. infusion) on days 1 5 and then i.v. bolus weekly, starting from day 12, with or without IFNalpha-2a given s.c. three times weekly (starting dose 3 x 10(6) IU rising to 9 x 10(6) IU, if tolerated). Patients were treated until progression or, if responsive, for a maximum of 48 weeks and then observed for a period of 2 years. The primary end-point of the study was objective clinical response (OR); secondary parameters were time to progression, overall survival, and time to death after progression. WHO criteria were used for both clinical response and toxicity measurements. Dose reduction was planned a priori in the event of significant toxicity due to 5FU, IFNalpha-2a or both. Association between primary and secondary end-points and treatment was studied by univariate and multivariate analysis. Altogether, 47 patients achieved a documented response. A 25% OR was observed in the combination arm while a 21% OR was seen in the 5FU arm; this difference is not statistically significant (P = 0.6). Patients with a small tumour burden (below 5 cm2) showed a higher probability of response in both arms. Patients in the experimental arm had a higher but not statistically significant cumulative progression-free probability. Median survival was 47.1 weeks overall, while it was 43.7 and 48.5 weeks in the control and experimental arms, respectively. The combination was clearly more toxic than 5FU alone, leukopenia being the most frequent side-effect in the experimental arm and nausea and vomiting in the control arm. In conclusion these results are quite disappointing and 5FU + IFNalpha-2a can not be considered a standard treatment for advanced colon cancer.
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Affiliation(s)
- S Palmeri
- Institute of Clinical Medicine I, University of Palermo, Italy
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Rodolico V, Daniele E, Leonardi V, Marra G, Luciani A, Settineri G, Tralongo V. Node status in lower lip squamous cell carcinoma in relation to tumor size, histological variables and DNA ploidy. Anticancer Res 1998; 18:911-4. [PMID: 9615740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We studied a consecutive series of 54 cases of lower lip squamous cell carcinoma (LLSCC) in order to identify any variables which might predict the development of lymph node metastases. The cases were divided into 38 tumors without metastases (group I) and 16 tumors with lymph node metastases (group II). The following variables were investigated: tumor size, histologic grading, tumor maximal thickness, perineural infiltration and DNA ploidy, in a group of patients undergoing surgical treatment for LLSCC, and to show which of these might be predictive of the development of lymph node metastases.
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Affiliation(s)
- V Rodolico
- Istituto di Anatomia ed Istologia Patologica, University of Palermo, Italy
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Lorusso V, Leone B, Di Vagno G, Manzione L, Palmeri S, Vallejo C, Machiavelli M, Nacci G, Bilancia D, Leonardi V, Catino A, Gargano G, Loverro G, Selvaggi L, De Lena M. Combined carboplatin plus ifosfamide and cisplatin in patients with advanced ovarian carcinoma. A phase I-II study. GOCS (Gynecological Oncology Cooperative Study). Gynecol Oncol 1998; 68:172-7. [PMID: 9514802 DOI: 10.1006/gyno.1997.4913] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Because of the relative lack of overlapping toxicity, carboplatin (PPL) and cisplatin (CDDP) can be easily combined for treatment of ovarian cancer to increase total platinum dose intensity. Ifosfamide (IFO), one of the most effective single agents in ovarian cancer, has a low hematological toxicity when administered in continuous infusion. From January 1991 to December 1993, 34 patients with advanced ovarian cancer, previously untreated with chemo- or radiotherapy, were enrolled in a phase I-II study with the aim of determining the maximum tolerated dose (MTD) of CDDP (on day 8 of a 28-day cycle) in combination with PPL (300 mg/m2 on day 1) and IFO (4,000 mg/m2/24 h by continuous infusion on day 1). The initial dose level of CDDP was 40 mg/m2, which was continuously increased by 10 mg/m2 up to the MTD defined as one dose level below that inducing dose-limiting toxicity (DLT) in at least two-thirds of treated patients; no dose escalation was allowed in the same patient. Grade 3-4 leukopenia and thrombocytopenia were observed in 54 and 49% of patients, respectively. The DLT was reached at 70 mg/m2 and therefore the dose recommended for the phase II study was 60 mg/m2. Complete (CR) plus partial response was observed in 88% of patients with a 21% pathological CR. With a minimum follow-up of 32 months (median 40 months), median progression-free survival and overall survival were 21 and 39 months, respectively. In conclusion, the combination of CDDP, PPL, and IFO provides an effective regimen for ovarian cancer with an acceptable toxicity profile.
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Leonardi V, Meli M, Palmeri S. Hydroxyurea as a modulator of multidrug resistance in resistant solid tumor. Oncol Rep 1997; 4:723-7. [DOI: 10.3892/or.4.4.723] [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: 11/06/2022] Open
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