De Bari B.,University of Brescia |
Fiorentino A.,IRCCS |
Greto D.,Radiotherapy Unit |
Ciammella P.,Azienda Ospedaliera ASMN |
And 11 more authors.
Tumori | Year: 2013
Aims and background. The diagnostic and therapeutic approach to prostate cancer has evolved rapidly in last decades. Young professionals need an update about these recent developments in order to improve the care of patients treated in their daily clinical practice. Methods. On May 18, 2013, AIRO Giovani (the young section of the Italian Association of Radiation Oncology) organized a multidisciplinary meeting involving, as speakers, several young physicians from many parts of Italy actively involved in the diagnostic and therapeutic approach to prostate cancer. The meeting was specifically addressed to young physicians (radio-oncologists, urologists, medical oncologists) and presented the state-of-the-art of the diagnostic/therapeutic approach based on the latest evidence on the issue. Highlights of the congress are summarized and presented in this report. Results. The large participation in the meeting (more than 120 participants were present) confirmed the interest of young radiation oncologists in improving their skills in prostate cancer management. The contributions of the speakers confirmed the need for regular updates, considering the promising results of recently published studies and the many new ongoing trials, on the diagnostic and therapeutic approaches to prostate cancer. Conclusions. Multidisciplinary meetings are helpful to improve the skills of young professionals. Copyright - Il Pensiero Scientifico Editore.
Guarneri V.,University of Padua |
Dieci M.V.,University of Padua |
Bisagni G.,Azienda Ospedaliera ASMN |
Boni C.,Azienda Ospedaliera ASMN |
And 5 more authors.
Annals of Surgical Oncology | Year: 2015
Purpose: The phase II Ca.Pa.Be trial evaluated preoperative carboplatin–paclitaxel in combination with bevacizumab in triple-negative breast cancer patients with previously untreated stage II–III disease. The primary aim was the assessment of the rate of pathologic complete response (pCR). Secondary aims included safety, breast-conserving surgery rate, and early response assessment with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods: Patients with hormone receptor-negative, HER-2-negative stage II–III breast cancer were eligible. Treatment included paclitaxel 80 mg/mq + carboplatin area under the curve (AUC) 2 on days 1, 8, and 15, combined with bevacizumab 10 mg/kg on days 1 and 15 each 28 days, for 5 courses. At baseline, patients underwent breast DCE-MRI, followed by a single dose of bevacizumab 5 mg/kg (day −6). DCE-MRI was repeated before the initiation of chemotherapy. Results: Forty-four patients were enrolled. Forty-three patients underwent surgery, and 22 (50 %) received breast-conserving surgery (conversion rate from mastectomy indication at baseline, 34.4 %). A pCR in breast and axillary lymph nodes occurred in 22 patients (50 %). Bevacizumab-associated adverse events (AEs) were mild: G1–2 hypertension and bleeding occurred in 6 (13.6 %) and 12 (27 %) patients, respectively. No G4 nonhematologic AEs were recorded. More frequent G3 AEs were liver function test abnormalities (6.8 %), and diarrhea and fatigue (4.5 % each). The only G3–4 hematologic toxicity was neutropenia (G3, 25 %; G4, 9 %). Early assessed DCE-MRI response parameters failed to predict pCR. Conclusions: The neoadjuvant anthracycline-free combination of weekly paclitaxel and carboplatin plus bevacizumab is active and safe in triple-negative breast cancer, and the rate of pCR is comparable to that observed with more intensive carboplatin- and bevacizumab-containing regimens. Further investigation is warranted. © 2015, Society of Surgical Oncology.
Magnani E.,Azienda Ospedaliera ASMN |
Farnetti E.,Laboratory of Molecular Biology |
Nicoli D.,Laboratory of Molecular Biology |
Casali B.,Laboratory of Molecular Biology |
And 5 more authors.
Internal and Emergency Medicine | Year: 2013
Dihydropyrimidine dehydrogenase (DPD) is a key enzyme in the metabolic catabolism of 5-fluorouracil (5-FU) and its derivatives (capecitabine and tegafur). Complete or partial deficiency of DPD activity has been demonstrated to induce severe toxicities in cancer patients treated with fluoropyrimidine therapy. We analyzed 180 individuals that were candidates for a treatment with 5-FU class drugs for the most common DPD mutation, IVS14+1G>A, and detected four heterozygous patients. We recorded the toxicities for all 180 individuals after the first two chemotherapy cycles and found that three of the four patients, although they were treated with a dose reduction in 50 % on the basis of the genetic analysis, all showed severe toxicities that resulted in hospitalization of patient and premature discontinuation of treatment. One patient with mutated DPD was not treated with chemotherapy upon the clinician's decision because of his DPD mutated genotype and the presence of microsatellite instability. Our data suggest that greater dose reductions or alternative therapies are needed for patients with DPD IVS14+1G>A mutations. © 2013 SIMI.
The Breast Avastin Trial: Phase II study of bevacizumab maintenance therapy after induction chemotherapy with docetaxel and capecitabine for the first-line treatment of patients with locally recurrent or metastatic breast cancer
Bisagni G.,Azienda Ospedaliera ASMN |
Musolino A.,Medical Oncology Unit |
Panebianco M.,Azienda Ospedaliera ASMN |
De Matteis A.,Medical Oncology Unit |
And 8 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2013
Background: Therapeutic approach for patients with metastatic breast cancer (MBC) is still controversial. This study was conducted to assess the efficacy and safety of bevacizumab in combination with docetaxel plus capecitabine as first-line treatment for MBC. The feasibility of bevacizumab maintenance therapy in this setting was also evaluated. Patients and methods: In this single-arm, multicenter phase II study, patients received bevacizumab 15 mg/kg and docetaxel 60 mg/m2 on day 1, plus capecitabine 900 mg/m2 twice daily on days 1-14 every 21 days. Treatment was administered for up to 6 cycles, then bevacizumab continued until progressive disease. The primary end point was progression-free survival (PFS); secondary end points were tumor response rate, overall survival, and toxicity. Results: Seventy-nine eligible patients were treated with bevacizumab in combination with docetaxel plus capecitabine. The overall response rate was 61 %, with a complete response rate of 8 % and a median duration of response of 10 months. At a median follow-up of 28 months, the median PFS was 11 months. Fifty-two (65 %) patients received bevacizumab maintenance therapy for a median duration of 7 months (range 1 to 33+). Neutropenia was the most common grade 3-4 toxicity (28.1 % of patients), and two fatal adverse events occurred (septic shock and gastrointestinal perforation). Conclusions: Bevacizumab in combination with docetaxel and capecitabine demonstrates significant activity and quite acceptable toxicity profile as first-line treatment of MBC. Subsequent maintenance therapy with bevacizumab is feasible for a long period of stable disease. Results deserve confirmation. © 2013 Springer-Verlag Berlin Heidelberg.
Zedde M.,Azienda Ospedaliera ASMN |
Malferrari G.,Azienda Ospedaliera ASMN |
De Berti G.,Neuroradiology Unit |
Maggi M.,Neuroradiology Unit |
Lodigianic L.,Esaote S.p.a.
Perspectives in Medicine | Year: 2012
Introduction: Neuroradiological techniques are known for their high spatial resolution in imaging of intracranial structures, in comparison with neurosonological techniques (TCCS), known for their high temporal resolution. An ideal study of intracranial circulation should combine the high temporal resolution of ultrasound with the high spatial resolution of Magnetic Resonance (MR) Imaging. This imaging fusion system is actually used for the ultrasound liver examination and it is known as Virtual Navigator. Therefore we implemented this system for the examination of the intracranial venous hemodynamics. Patients and methods: Fifteen consecutive subjects (7 men and 8 women, mean age 51.5±8.64 years) were chosen among patients who underwent standard TCCS examinations at our lab and had age >18 years, a suitable temporal acoustic window and a recently performed intracranial MR venography. The axial scanning approach was used from the temporal window and the standard TCCS examination was compared with the Virtual Navigator examination, for the insonation rate of the basal vein of Rosenthal (BVR), Galen vein (GV), Straight sinus (SRS) and Transverse sinus (TS). Results and discussion: The insonation rates of the venous structures are only slightly improved for BVR (from 90% to 96.67%) but are substantially increased for SRS and TS (for this last one from 63.33% to 86.67%) with a statistically significant difference (p < 0.05). Conclusions: The Virtual Navigator protocol can help to insonate the intracranial venous system. ©2012 Elsevier GmbH. All rights reserved.