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PubMed | AO Fatebenefratelli & Oftalmico, Fondazione Instituto Firc Of Oncologia Molecolare And Cogentech Cancer Genetics Test Laboratory, Unit of Molecular Bases of Genetic Risk and Genetic Testing, University of Milan and 2 more.
Type: Journal Article | Journal: Tumori | Year: 2016

Patients with hereditary breast cancer (BC) may benefit from genetic counseling and testing for detection of causative mutations, definition of therapeutic and preventive strategies, and identification of at-risk relatives. Italy has few oncogenetic centers and genetic evaluation of all patients with BC is not feasible. Moreover, lack of uniformity in the selection of patients generates inappropriate referral to the geneticist. We designed a model that may represent a reproducible way to select patients at risk for hereditary BC, with the aims of rationalizing access to genetic centers and improving clinical management and surveillance.The genetic unit of a Cancer Center and the Departments of Oncology from 2 public Hospitals in Milan were involved in the project. After training sessions at the genetic unit, operators from the 2 hospitals evaluated all patients with BC attending a first oncologic visit, through a specific interview. Patients considered at risk of hereditary BC attended counseling at the genetic unit.Of 419 patients, 61 (14.5%) were eligible for genetic counseling after the interview. Of these, 46 (10.9%) strictly met testing criteria. Overall, 52 (12.4%) patients underwent genetic counseling and 47 were tested for BRCA1/BRCA2 mutation. After genetic test results, the available options for treatment/surveillance were discussed by a multidisciplinary team, according to the level of genetic risk.It is possible to improve the process of referring patients with suspected hereditary BC for genetic risk assessment. The application of clinical screening reduced the genetics units workload and enabled optimization of time and resources.

PubMed | Breast Unit, Medical Oncology, Candiolo Cancer Institute IRCCS, A.O.U. Citta della Salute e della Science and 3 more.
Type: | Journal: SpringerPlus | Year: 2016

This retrospective multicenter analysis was aimed to evaluate clinical activity and tolerability of eribulin in pretreated metastatic breast cancer patients in clinical practice. Patients treated with eribulin from January 2012 to July 2013 were enrolled in the observational study from 10 italian hospitals. Tumor and toxicity evaluation were performed according to Agenzia Italiana Farmaco. One-hundred and thirteen patients were included in the study. Median age 62years old. 71.7% of the patients had visceral involvement and the majority had a burden of disease involving two or more organs with a median number of 2 (1-6). The median number of previous chemotherapy regimens for advanced disease was 3 (1-10). Median number of eribulin cycles was 4 (1-27). Overall response rate was 24% (95% CI 16.0-31.8). Clinical benefit rate, was 35.4% (95% CI 26.6-44.2). At a median follow-up of 29.6months (8.3-41.9) the median progression free survival was 3.3months (0.6-26.7; 95% CI 2.4-4.2), and the median overall survival 11.6months (0.6-33.3; 95% CI 8.7-14.5). No correlation was recorded between subtypes in terms of ORR and CBR. Toxicity was manageable. Main common grade 3-4 toxicities were neutropenia (19.4%), febrile neutropenia (0.9%), asthenia (3.5%), abnormal liver function test (1.8%), stomatitis (0.9%). Our results confirm that treatment with eribulin is feasible and safe in real-world patients.

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