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Ymittos Athens, Greece

Souglakos J.,University of Crete | Karavasilis V.,Papageorgiou General Hospital | Tsotra E.,Papageorgiou General Hospital | Samantas E.,General Oncology Hospital Agioi Anargyroi | And 11 more authors.
Forum of Clinical Oncology | Year: 2013

Background: Advanced pancreatic adenocarcinoma (APA) remains a difficult to manage disease with a high mortality rate. Limited data is available from the Greek Cancer Registry on patients with pancreatic cancer. Patients & Methods: The PATHOS multicenter survey aimed at capturing real-world data on pancreatic cancer disease status in Greece. A standardized questionnaire administered to ten interviewed physicians specialized in pancreatic cancer, captured data from patient medical records as well as the physicians' opinion about limitations of the most common treatment modalities for APA and the likelihood of using nab-paclitaxel in the metastatic APA population. Results: During 2011, 187 patients with APA, 63.6% of whom had been diagnosed with metastatic (Stage IV) disease, were treated by the participating physicians. Surgery had been performed in 39.7% of patients with locally advanced and in 8.4% of those with metastatic APA. Overall, 62/68 patients with locally advanced disease received chemotherapy (31 adjuvant/neoadjuvant). Of 119 patients with metastatic disease, 101 received chemotherapy (7 adjuvant; 94 palliative). As part of standard practice, 89% of patients with metastatic APA had received firstline therapy, mainly with gemcitabine, gemcitabine +erlotinib or FOLFIRINOX. However, various limitations were reported for gemcitabine +erlotinib and FOLIFIRINOX, underscoring the need for new treatments. Of the physicians, 80% reported that they were highly likely to use the combination of nab-paclitaxel/gemcitabine for metastatic APA in the future. Conclusions: The survey demonstrated that APA in Greece is mostly diagnosed in the metastatic state and underscored the importance of adding new treatment modalities to the current therapeutic armamentarium.

Karachaliou N.,Hellenic Oncology Research Group | Polyzos A.,Hellenic Oncology Research Group | Kentepozidis N.,Hellenic Oncology Research Group | Kakolyris S.,Hellenic Oncology Research Group | And 6 more authors.
Oncology | Year: 2010

Purpose: To evaluate the efficacy and tolerability of oxaliplatin (L-OHP) in combination with irinotecan (CPT-11) as first-line treatment of advanced biliary tract cancer. Patients and Methods: Patients with histologically confirmed nonresectable biliary adenocarcinoma were treated with oxaliplatin (85 mg/m2) and irinotecan (200 mg/m2) every 3 weeks.Results: Twenty-eight patients were enrolled between May 2005 and March 2009. The overall objective response rate was 17.9% with an additional 21.4% of patients with stable disease (disease control rate 39.3%). The median overall survival time was 9.2 months (95% CI 5.8-12.5) and the median progression-free survival time 2.7 months (95% CI 2.2-3.2). Grades 3 and 4 neutropenia occurred in 1 (3.6%) and 4 (14.3%) patients, respectively, and febrile neutropenia in 3 (10.7%). Grade 3-4 diarrhea was observed in 2 (7.1%) patients and grade 3 asthenia in 1 (6%). There were no treatment-related deaths. Conclusion: The combination of oxaliplatin and irinotecan has a modest antitumor activity with manageable toxicity as first-line treatment in metastatic cancer of the biliary tract and therefore it cannot be recommended as front-line treatment for unresectable biliary tract cancer. Copyright © 2010 S. Karger AG, Basel.

Tryfonidis K.,Hellenic Oncology Research Group | Boukovinas I.,Hellenic Oncology Research Group | Xenidis N.,Hellenic Oncology Research Group | Christophyllakis C.,Hellenic Oncology Research Group | And 7 more authors.
Breast | Year: 2013

Purpose: To assess the efficacy and toxicity of docetaxel (D) plus epirubicin (E) in combination with bevacizumab (B) [DEB regimen] as front-line treatment in patients with metastatic breast cancer (MBC). Patients and methods: Women with previously untreated HER2-negative MBC received B (15mg/kg), E (75mg/m2) and D (75mg/m2) with prophylactic G-CSF support every 3 weeks (q3w) for up to 9 cycles followed by B (15mg/kg q3w) until disease progression. Primary endpoint was the overall response rate (ORR). Circulating tumor cells (CTCs) were evaluated using the CellSearch system at different time points during therapy. Results: Eighty-three women were enrolled with median age 62 years, performance status 0-1 in 93%, triple negative disease in 12% and liver metastases in 47%. In an intention to treat analysis, complete response was achieved in 13 (15.7%) and partial response in 42 (50.6%) (overall response rate 66.3%; 95% CI 56.09-76.44%). The median time to progression was 20.1 months and the 1-year overall survival rate 82.3%. Grade 3-4 neutropenia occurred in 37%, febrile neutropenia in 10%, anemia in 4%, thrombocytopenia in 2% and diarrhea in 2% of patients. There were two deaths possibly related to study treatment (sigmoid perforation n=1; sudden death n=1). Moreover, one patient developed pulmonary embolism and another one myocardial infarction while on treatment. Although DEB administration significantly reduced the proportion of patients presenting CTCs, the detection of ≥5 or ≥1 CTCs before treatment initiation was significantly associated with worse progression-free survival (. p=0.001 and p=0.004) and overall survival (. p=0.001 and p=0.027), respectively. Conclusions: The DEB regimen is a very active but also potentially toxic combination in MBC. Detection of CTCs before treatment is associated with worse outcome. Clinicaltrials.gov: NCT00705315. © 2013 Elsevier Ltd.

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