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Macerelli M.,Gustave Roussy | Macerelli M.,University of Udine | Caramella C.,Gustave Roussy | Faivre L.,Gustave Roussy | And 10 more authors.
Lung Cancer | Year: 2014

Background: Clinical implications of KRAS mutational status in advanced non-small cell lung cancer (NSCLC) remain unclear. To clarify this point, we retrospectively explored whether KRAS mutations could impact tumor response, and disease control rate (DCR) to first-line platinum-based chemotherapy (CT) as well as progression-free survival (PFS) or overall survival (OS). Methods: Between June 2009 and June 2012, 340 patients with advanced (stage IIIB/IV) NSCLC were reviewed in a single institution (Institut Gustave Roussy). Two hundred and one patients had a biomolecular profile and received a platinum-based first-line CT. Patients with an unknown mutational status or with actionable alterations were excluded. We retained two groups: patients with KRAS mutated tumor (MUT) and patients with wild-type KRAS/. EGFR (WT). Multivariate analyses with Cox model were used. Survival curves were calculated with Kaplan-Meier method. Results: One hundred and eight patients were included in the analysis: 39 in the MUT group and 69 in the WT group. Baseline radiological assessment demonstrated more brain (P= 0.01) and liver (P= 0.04) metastases in MUT patients. DCR was 76% for MUT vs. 91% for WT group (P= 0.03), regardless of the type of platinum-based CT (use of pemetrexed or not). Although no statistically significant differences were found, shorter PFS (4.9 vs. 6.0 months; P= 0.79) and OS (10.3 vs. 13.2 months; P= 0.40) were observed for patients with KRAS mutated tumors in univariate analysis. Conclusions: KRAS mutant tumors had a lower DCR after the first-line platinum-based CT, but this difference did not translate in PFS or OS. The presence of KRAS mutations may confer a more aggressive disease, with greater baseline incidence of hepatic and cerebral metastases. © 2013 Elsevier Ireland Ltd. Source


Wong K.K.,University of Michigan | Laird A.M.,University of Michigan | Moubayed A.,University of Michigan | Chondrogiannis S.,Santa Maria Della Misericordia Hospital | And 4 more authors.
Nuclear Medicine Communications | Year: 2012

Medullary thyroid cancer (MTC) arises from parafollicular C cells and is an elusive tumor to image. It occurs as a sporadic neoplasm in 70-80% of cases and is hereditary in 20-30% because of germline mutations of the rearranged during transfection proto-oncogene. Successful disease management relies on accurate staging. Tumor secretory biomarkers are highly sensitive to a disease; however, despite a wide variety of radiopharmaceuticals for molecular imaging that take advantage of hybrid SPECT/CT and PET/CT fusion imaging, imaging of MTC is still problematic. After initial surgical resection, the limited sensitivity of localization of small locoregional disease and the inability to detect early liver metastases hamper the success of later surgical approaches. 18F-fluorodeoxyglucose PET has been used to detect MTC recurrences with modest success and may be best suited for only a small subset of more biologically aggressive MTCs. Recent developments in PET imaging with novel radiopharmaceuticals targeting specific cellular processes of MTC offer increased sensitivity for identifying recurrence, assessing prognosis, and guiding selection of optimal therapies. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source


Pasello G.,Oncologic Venetian Institute | Marulli G.,University of Padua | Polo V.,Oncologic Venetian Institute | Breda C.,University of Padua | And 4 more authors.
Anticancer Research | Year: 2012

Aim: The objective of this study was the retrospective evaluation of tolerability and activity of pemetrexed with carboplatin (AC) or cisplatin (AP) as neoadjuvant chemotherapy in a consecutive series of patients with malignant pleural mesothelioma (MPM). Patients and Methods: Patients with operable MPM received three cycles of AC or AP followed by surgery and radiotherapy. Results: Since 2005, 51 patients have been treated with AC (27) and AP (24). We observed higher incidence of grade 3 anaemia, cumulative grade 2-3 asthenia and worsening of performance status in the AP group. Response to AC and AP were; complete: 4% vs. 0%, partial: 18% vs. 17%, stable disease: 74% vs. 79%, progressive disease: 4%; the resection rate was 81% vs. 79%. Conclusion: AC and AP are active and feasible neoadjuvant regimens. Progression-free survival, response, disease control and resection rate were similar in the two treatment groups. The lower tolerability to AP treatment could impair the clinical condition of patients undergoing surgery. Source

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