Comparison of effectiveness of biosimilar filgrastim (Nivestim™), reference Amgen filgrastim and pegfilgrastim in febrile neutropenia primary prevention in breast cancer patients treated with neo(adjuvant) TAC: a non-interventional cohort study
Brito M.,Instituto Portugues Of Oncologia Francisco Gentil |
Esteves S.,Instituto Portugues Of Oncologia Francisco Gentil |
Andre R.,Instituto Portugues Of Oncologia Francisco Gentil |
Andre R.,Novartis |
And 2 more authors.
Supportive Care in Cancer | Year: 2016
Purpose: Biosimilars are supported by limited clinical data at the time of approval. Recently, Nivestim™, a biosimilar of reference of filgrastim, was approved for prevention of chemotherapy-related febrile neutropenia (FN). To add clinical experience to this new biosimilar, we performed a study to compare the effectiveness of Nivestim™ with reference filgrastim and pegfilgrastim in FN prevention in patients receiving high-risk FN chemotherapy. Methods: This is a comparative cohort study, with retrospective data collection. Three cohorts were identified according to the type of primary prophylaxis employed over different time periods: reference filgrastim (2004–2006), pegfilgrastim (2007–2008) and biosimilar filgrastim (2011–2012). The study included female patients with early breast cancer that received FN primary prophylaxis during (neo)adjuvant docetaxel/doxorubicin/cyclophosphamide (TAC). Results: Reference filgrastim cohort included 147 patients and pegfilgrastim and biosimilar filgrastim cohorts 139 and 134 patients, respectively. FN rates per patient/cycle were 16 % (95 % confidence interval (CI) 10.2–22.5 %)/3 % (95 % CI 2.1–4.7 %) in the reference filgrastim group, 9 % (95 % CI 4.5–14.6 %)/2 % (95 % CI 1.3–3.6 %) in the pegfilgrastim group and 16 % (95 % CI 10.0–22.9 %)/4 % (95 % CI 2.5–5.3 %) in the biosimilar filgrastim cohort. The median absolute neutrophil count (ANC) at FN presentation was lower in the biosimilar group in comparison with reference filgrastim. FN episodes with ANC < 100 cells/μL were more frequent in the biosimilar group (50 %) when compared with reference filgrastim (4 %) and pegfilgrastim (6 %). No differences concerning FN complications were seen, with the exception of more chemotherapy delays in the biosimilar group when compared with pegfilgrastim. Conclusion: No differences in biosimilar effectiveness were detected. The clinical relevance of the profound neutropenia found in the biosimilar cohort needs further attention. © 2015, Springer-Verlag Berlin Heidelberg.
Almeida A.M.,Instituto Portugues Of Oncologia Francisco Gentil |
Ramos F.,Hospital Universitario Of Leon
Leukemia Research Reports | Year: 2016
AML is an aggressive hematological malignancy with highest incidence in the older adults. The adverse features of AML in the elderly, and the frailties and comorbidities frequently present in them, make their management a particularly difficult therapeutic challenge. In this context, it is important to assess carefully patient- as well as disease-associated prognostic features with validated tools. The fittest patients should be considered for curative therapy, such as bone marrow transplantation, whereas low intensity options may be more appropriate for frail patients. Here we review how to assess patients with elderly AML and the treatments options available for them. © 2016 The Authors.
Borges A.,Instituto Portugues Of Oncologia Francisco Gentil |
Casselman J.,A Z St Jan Bruges And A Z St Augustinus Antwerpen Hospitals
European Journal of Radiology | Year: 2010
Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve. © 2010 Elsevier Ireland Ltd. All rights reserved.
Caiado F.,Instituto Portugues Of Oncologia Francisco Gentil |
Caiado F.,Instituto Gulbenkian Ciencia |
Dias S.,Instituto Portugues Of Oncologia Francisco Gentil |
Dias S.,Instituto Gulbenkian Ciencia
Fibrogenesis and Tissue Repair | Year: 2012
In the last decade there have been multiple studies concerning the contribution of endothelial progenitor cells (EPCs) to new vessel formation in different physiological and pathological settings. The process by which EPCs contribute to new vessel formation in adults is termed postnatal vasculogenesis and occurs via four inter-related steps. They must respond to chemoattractant signals and mobilize from the bone marrow to the peripheral blood; home in on sites of new vessel formation; invade and migrate at the same sites; and differentiate into mature endothelial cells (ECs) and/or regulate pre-existing ECs via paracrine or juxtacrine signals. During these four steps, EPCs interact with different physiological compartments, namely bone marrow, peripheral blood, blood vessels and homing tissues. The success of each step depends on the ability of EPCs to interact, adapt and respond to multiple molecular cues. The present review summarizes the interactions between integrins expressed by EPCs and their ligands: extracellular matrix components and cell surface proteins present at sites of postnatal vasculogenesis. The data summarized here indicate that integrins represent a major molecular determinant of EPC function, with different integrin subunits regulating different steps of EPC biology. Specifically, integrin α4β1 is a key regulator of EPC retention and/or mobilization from the bone marrow, while integrins α5β1, α6β1, αvβ3 and αvβ5 are major determinants of EPC homing, invasion, differentiation and paracrine factor production. β2 integrins are the major regulators of EPC transendothelial migration. The relevance of integrins in EPC biology is also demonstrated by many studies that use extracellular matrix-based scaffolds as a clinical tool to improve the vasculogenic functions of EPCs. We propose that targeted and tissue-specific manipulation of EPC integrin-mediated interactions may be crucial to further improve the usage of this cell population as a relevant clinical agent. © 2012 Caiado and Dias; licensee BioMed Central Ltd.
Gomes S.F.S.,Instituto Portugues Of Oncologia Francisco Gentil |
dos Santos M.M.M.C.C.,Polytechnic Institute of Coimbra |
Carolino E.T.M.A.,Polytechnic Institute of Coimbra
Revista Latino-Americana de Enfermagem | Year: 2013
Objective: To identify sources of stress and coping strategies in nurses who work in three Head and Neck Surgery Oncology Services, in three central hospitals in Portugal. Method: A cross-sectional descriptive-exploratory study, whose sample was made up of the 96 nurses from the three services. The following were used in the data collection: A socio-demographic questionnaire; the 12-item General Health Questionnaire; and the Occupational Stress Inventory; Brief COPE. Results: Reasonable levels of general health were ascertained. The most-mentioned stressors were: Burden with work; low pay; the physical space where they work; emotionally-disturbing situations and lack of recognition of the profession. The most-used coping strategies were: Planning; active coping; acceptance and self-distraction. Conclusion: The stressors identified are mainly related to organizational aspects and work conditions, and the coping strategies chosen are aimed at resolving problems and improving the nurses' well-being. A significant percentage of the nurses presents high levels of pressure and depressed emotions. The results presented corroborate previous studies which warn of the importance of developing strategies for preventing these stress levels. © 2013 Revista Latino-Americana de Enfermagem.
Fidalgo C.,Instituto Portugues Of Oncologia Of Lisbon Francisco Gentil |
Fidalgo C.,Instituto Portugues Of Oncologia Francisco Gentil |
Calado J.,Hospital Of Curry Cabral |
Cravo M.,Instituto Portugues Of Oncologia Of Lisbon Francisco Gentil
BioDrugs | Year: 2010
Systemic AA amyloidosis is a serious complication of many chronic inflammatory disorders. Its association with Crohn's disease implies that the inflammatory burden is high enough for amyloid fibrils to form deposits in tissues. A case is presented in which this complication occurred while the patient was clinically well, with biological and endoscopic markers showing an inactive or mildly active disease under anti-tumor necrosis factor alpha therapy. © 2010 Adis Data Information BV. All rights reserved.
Cravo M.,Instituto Portugues Of Oncologia Francisco Gentil |
Silva R.,Hospital Central do Funchal |
Serrano M.,Instituto Portugues Of Oncologia Francisco Gentil
BioDrugs | Year: 2010
Infliximab and adalimumab are anti-tumor necrosis factor (TNF) alpha agents used for treating Crohn's disease. Autoimmune hepatitis (AIH) is a rare complication of treatment with these drugs. We report on a case of AIH in a patient with Crohn's disease treated with infliximab who fully recovered after drug withdrawal. More interestingly, because there were no other treatment options, the patient was then treated with adalimumab without recurrence of the liver disease and with control of the intestinal disease. © 2010 Adis Data Information BV. All rights reserved.
Borges A.,Instituto Portugues Of Oncologia Francisco Gentil
European Journal of Radiology | Year: 2010
Denervation changes maybe the first sign of a cranial nerve injury. Recognition of denervation patterns can be used to determine the site and extent of a lesion and to tailor imaging studies according to the most likely location of an insult along the course of the affected cranial nerve(s). In addition, the extent of denervation can be used to predict functional recovery after treatment. On imaging, signs of denervation can be misleading as they often mimic recurrent neoplasm or inflammatory conditions. Imaging can both depict denervation related changes and establish its cause. This article briefly reviews the anatomy of the extracranial course of motor cranial nerves with particular emphasis on the muscles supplied by each nerve, the imaging features of the various stages of denervation, the different patterns of denervation that maybe helpful in the topographic diagnosis of nerve lesions and the most common causes of cranial nerve injuries leading to denervation. © 2010 Elsevier Ireland Ltd. All rights reserved.
Marum S.,Instituto Portugues Of Oncologia Francisco Gentil |
Price S.,Instituto Portugues Of Oncologia Francisco Gentil
Current Cardiology Reviews | Year: 2011
Echocardiography (echo) is a powerful technique that permits direct visualization and assessment of all the cardiac structures and assessment of the patients' haemodynamic status at the bedside. Echo allows detection of valvular disease, evaluation of ventricular function and the pericardium, detection of intracardiac/intrapulmonary shunts, and can be used to calculate flows and relative pressures between the cardiac chambers. This rapid point-of-care haemodynamic evaluation provides information to guide therapeutic interventions, including volume resuscitation, instigation of vasoactive therapy and/or referral for specialist cardiac/surgical intervention. Although there is abundant evidence in the cardiology literature regarding the use of echo, data in the critical care arena is less well defined, but emerging. The use of echo by intensive care doctors is likely to become routine, and therefore training for intensivists in this technique needs to be developed and supported. The Portuguese Working Group on Echocardiography has developed a skill-based program, FADE (Focused Assessment Diagnostic Echocardiography) in order to train clinicians in the use of bedside ultrasound as a diagnostic and monitoring tool for the critically ill. © 2011 Bentham Science Publishers.
Mello R.A.,Instituto Portugues Of Oncologia Francisco Gentil
Einstein (São Paulo, Brazil) | Year: 2014
This article addresses some current issues about genetic polymorphisms studied in the non-small-cell lung cancer translational field. Furthermore, it discusses about new potential biomarkers regarding lung cancer risk and prognosis.