Labianca R.,Oncologia Medica |
Sobrero A.,Oncologia Medica |
Isa L.,Oncologia Medica |
Cortesi E.,Oncologia Medica |
And 11 more authors.
Annals of Oncology | Year: 2011
Background: In advanced colorectal cancer, chemotherapy is usually administered without pauses and until progression but patients can experience cumulative toxicity and cannot tolerate a heavy therapeutic charge. Aim: The aim of the present trial was to evaluate whether an intermittent chemotherapy with levo-leucovorin + 5-fluorouracil (5-FU) + irinotecan (CPT-11) was at least as effective as the same regimen given continuously, both administered until progression, in patients affected with advanced colorectal cancer and not previously exposed to chemotherapy for metastatic disease. Patients, materials and methods: A total of 337 patients from 27 institutions were randomised between levo-leucovorin, 100/mg/m2 i.v. + 5-FU; 400 mg/m2 i.v. bolus + 5-FU; 600 mg/m2 22-h continuous infusion, days 1 and 2 + CPT-11; 180 mg/m2 day 1, administered every 2 weeks 2 months on and 2 months off (arm A) and the same regimen administered continuously (arm B), until progression in both arms. The main end point was overall survival (OS), the secondary progression-free survival (PFS) and toxicity. Results: At a median follow-up of 41 months, OS was 18 months in arm A and 17 months in arm B [hazard ratio (HR), 0.88]. Also PFS was comparable in the two groups (6 months in both, with HR, 1.03), and even grades 3-4 toxicity (mainly myelosuppression, fever and diarrhoea) was similar. Second-line oxaliplatin-based treatment was administered in a similar percentage (66%) in the two arms. The median chemotherapy-free period (drug holiday) in arm A was 3.5 months. Conclusion: Reducing the charge of therapy in this population did not diminish the efficacy of treatment. Further studies with this strategy, including biologicals, are warranted. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Ascierto P.A.,Unita Melanoma |
Chiarion-Sileni V.,Unita Melanoma |
Muggiano A.,Struttura Semplice Dipartimentale Melanoma e Patologie Rare |
Mandala M.,Oncologia |
And 5 more authors.
Journal of Chemotherapy | Year: 2014
The degree to which interferon (IFN) alpha-2b offers real clinical benefits in the adjuvant therapy of melanoma at high risk of recurrence is a subject of debate. This, together with questions over optimal treatment scheme and concerns over toxicity, has limited its clinical use. On the basis of a review of the literature, an Italian Expert Panel has made practical recommendations for a consistent approach in the use of IFN. Although it is clear that more research into predictive factors to identify patients most likely to benefit from adjuvant IFN therapy is required, IFN remains the only currently available adjuvant option for melanoma. Based on meta-analyses of clinical trials, there is clear evidence that treatment with IFN is beneficial with regard to overall and recurrence-free survival (RFS). As such, IFN should be offered to patients who are at high risk of recurrence. Specific recommendations with regard to disease stage are provided. © 2014 Edizioni Scientifiche per l'Informazione su Farmaci e Terapia.
Luna-Fineman S.,Stanford University |
Barnoya M.,Oncologia y Oftalmologia |
Bonilla M.,Hospital Benjamin Bloom |
Fu L.,Hospital Escuela Materno Infantil |
And 2 more authors.
Pediatric Blood and Cancer | Year: 2012
Background: Retinoblastoma is highly curable in high income countries. Low income countries have poor results due to advanced disease and lack of resources. Central American Association of Pediatric Hematology Oncology (AHOPCA) aimed to standardize the approach and to improve outcomes of patients with retinoblastoma. Procedure: One hundred seventy-one patients, age <18 years newly diagnosed with retinoblastoma were treated according to laterality and stage. Therapeutic modalities were: surgery (enucleation), local control (laser therapy, cryotherapy), chemotherapy, and radiation therapy. Chemotherapy consisted of vincristine, etoposide, and carboplatin (6 cycles). Outcomes were measured by overall survival. Events were abandonment of therapy and death. Results: One hundred seventy-one patients (129 unilateral, 42 bilateral) were treated. Median age was 2 years 4 months; 112 (66%) were diagnosed before 3 years of age. 119 (92%) eyes in patients with unilateral disease were Reese-Ellsworth IV or V versus 52 (62%) eyes in patients with bilateral disease. Extraocular disease was more prevalent in unilateral disease (65% vs. 50%). Older age at diagnosis correlated with higher stage. Estimated overall survival at 60 months was 0.48±0.04. Outcome of patients with bilateral disease was significantly better than unilateral (62%±0.09 vs. 42%±0.05, P=0.0006). Thirty-eight patients (22%) refused or abandoned therapy. Conclusions: Protocol-directed therapy for retinoblastoma in Central America is possible. Patients present with advanced disease and outcome is significantly worse than in middle and high-income countries. Refusal and abandonment of therapy are societal events that affect outcome. Initiatives aimed at improving early diagnosis, while dedicated treatment centers are developed, are critical. © 2011 Wiley Periodicals, Inc.
Dovigo A.G.,Cirugia General A |
Diaz M.B.,Cirugia General A |
Gutierrez M.G.,Cirugia General A |
Selles C.F.,Cirugia General B |
And 4 more authors.
Transplantation Proceedings | Year: 2011
The Gruber-Frantz tumor or solid pseudopapillary tumor of the pancreas accounts for 1% to 2% of pancreatic tumors. It occurs more frequently among women between 20 and 40 years of age and in the Asian population. These tumors are of low malignant potential and show slow growth. The symptoms are subtle, the most striking being pain and an abdominal mass. The most common site is the pancreatic tail. The location and local invasion determine the surgical technique. With R0 resection, survival is 95% at 5 years. In 15% of cases metastatic disease appears, mostly in the liver. The treatment of liver metastases is surgical resection. In the case of multiple liver metastases, the treatment is controversial. QT has been used, as well as radiofrequency ablation, arterial embolization, and intraarterial chemotherapy. Herein we have described the case of a 44-year-old woman with massive liver metastases who did not respond to QT lines and underwent successful liver transplantation with survival free of recurrence at 1 year later. This is the first liver transplantation for a metastatic pancreatic pseudopapillary tumor in Spain and the second described in the literature. © 2011 by Elsevier Inc. All rights reserved.
De Marinis F.,UOC Pneumologia Oncologica |
De Marinis F.,Italian National Cancer Institute |
Ardizzoni A.,U.O. Oncologia Medica |
Fontanini G.,University of Pisa |
And 9 more authors.
Clinical Lung Cancer | Year: 2014
Results The longitudinal phase was conducted between January and August 2012. Of 464 patients who began second-line therapy outside of clinical trials within the baseline evaluation, 56 (12.1%) were still receiving second-line therapy at the end of the observation period and 17 (3.7%) withdrew during or after second-line therapy. Of the remaining 391 patients, 158 (40.4%) received third-line treatment outside of clinical trials: 93 received a third-line chemotherapy and 65 a targeted agent. The main reason for interrupting third-line treatment was disease progression or death. During the same observation period, 25 of 113 patients who completed a third-line therapy received a fourth line of treatment. From diagnosis of NSCLC to the end of observation, biomarkers were tested in 323 patients (59.7%): epidermal growth factor receptor mutations in 315 (58.2%), Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) mutations in 83 (15.3%) and Anaplastic lymphoma kinase (ALK) translocation in 84 (15.5%).Conclusion In Italian clinical practice, the proportion of patients with advanced NSCLC receiving more than 2 treatment lines of therapy is not negligible.Patients and Methods In the longitudinal phase, described here, the primary aim was to determine the proportion of patients receiving third-line therapy among those who received second-line active treatment according to clinical practice. The proportion of patients receiving further treatment lines was also estimated.Introduction/Background Patients with advanced NSCLC who experience disease progression after second-line therapy might receive further active treatment. LIFE was an Italian cohort multicenter observational study composed of a cross-sectional and a longitudinal phase. © 2014 Elsevier Inc.