Oncology Unit

Reggio nell'Emilia, Italy

Oncology Unit

Reggio nell'Emilia, Italy
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Brighenti M.,Oncology Unit
Annals of Translational Medicine | Year: 2015

MicroRNAs (miRNAs) are a class of small non-protein coding RNAs that modulate important cellular functions via their post-transcriptional regulation of messenger RNAs (mRNAs). Recent evidences from multiple tumor types and model systems implicate miRNA dysregulation as a common mechanism of tumorigenesis, cancer progression and resistance to therapy. Several miRNAs are dysregulated in cancers and a single miRNA can have multiple targets involved in different oncogenic pathways. MET, the tyrosine kinase receptor for hepatocyte growth factor (HGF), has a central role in lung cancer development and in acquired resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors; it has been predicted and shown to be the target gene of multiple miRNAs, which play a crucial role in controlling its activity in a stimulatory or inhibitory sense. In this review we will focus on the most important and recent studies about the role of miRNAs in the control of MET expression, reporting also the progress made using miRNAs for therapy of lung cancer. © Annals of Translational Medicine. All rights reserved.

Petrelli F.,Oncology Unit | Borgonovo K.,Oncology Unit | Barni S.,Oncology Unit
Expert Opinion on Pharmacotherapy | Year: 2010

Importance of the field: Taxanes are agents for the treatment of breast cancer. Paclitaxel is hydrophobic, and available formulations require polyoxyethylated castor oil, Cremphor EL® (CrEL) and an ethanol vehicle to allow parental administration. Nanoparticle albumin-bound paclitaxel (nab-P) is a CrEL-free formulation of paclitaxel. The human albumin-stabilized paclitaxel particles have a size of approximately 130 nm, which allows intravenous infusion without capillary blockage. Areas covered in this review: Efficacy and safety of nab-P in breast cancer has been compared with paclitaxel and docetaxel in large Phase III and II trials. Additionally, the efficacy and safety of nab-P have been investigated in other single-arm clinical trials, in early and advanced disease. What the reader will gain: Preclinical and clinical development of the drug across all clinical trials published so far, the approved clinical indications, the benefits of this taxane formulation and a look into the future with emphasis on the application in specific subtypes of breast cancer. Take home message: nab-P has been approved for the treatment of metastatic breast cancer in patients who have failed first-line treatment for metastatic disease and for whom standard, anthracycline-containing therapy is not indicated and represents one of most authoritative and sophisticated applications of nanotechnology in cancer treatment so far. © 2010 Informa UK Ltd.

Germano D.,Oncology Unit | Daniele B.,Oncology Unit
World Journal of Gastroenterology | Year: 2014

The management of hepatocellular carcinoma (HCC) has substantially changed in the past few decades, the introduction of novel therapies (such as sorafenib) have improved patient survival. Nevertheless, HCC remains the third most common cause of cancer-related deaths worldwide. Decision-making largely relies on evidence-based criteria, as showed in the US and European clinical practice guidelines, which endorse five therapeutic recommendations:resection; transplantation; radiofre-quency ablation; chemoembolization; and sorafenib. Many molecularly targeted agents that inhibit angiogen-esis, epidermal growth factor receptor, and mammalian target of rapamycin are at different stages of clinical development in advanced HCC. Future research should continue to unravel the mechanism of hepatocarcino-genesis and to identify key relevant molecular targets for therapeutic intervention. Identification and validation of potential surrogate and predictive biomarkers hold promise to individualize patient's treatment to maximize clinical benefit and minimize the toxicity and cost of targeted agents. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

Brain metastases (BM) are a common occurrence in patients with non-small cell lung cancer (NSCLC). Standard therapy options include whole brain radiotherapy and, in selected patients, surgery or stereotactic radiosurgery. The role of systemic treatment is controversial. There is a strong clinical rationale for the use of targeted therapies, because patients often have a poor performance status, and are not candidates for cytotoxic chemotherapy or radiotherapy, yet treatment is required to improve the extra-cranial disease. The efficacy of epidermal growth factor receptor (EGFR) inhibitors in the treatment of patients with BM from NSCLC has been reported mainly in case reports or small retrospective case series, with only a few prospective trials. Current evidence suggests that the use of EGFR tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib should be considered in patients with asymptomatic CNS involvement, when clinical characteristics suggest a high likelihood of response; these characteristics are adenocarcinoma histology, never-smoker status, female gender and East Asian ethnicity. Upfront therapy with EGFR TKIs should be strongly considered in asymptomatic patients harboring activating EGFR mutations. In symptomatic BM, radiotherapy (RT) remains the standard treatment. Based on currently available data, treatment with concurrent RT and EGFR TKIs should be investigated in experimental trials only. © 2012 Bentham Science Publishers.

The only approved agents for second-line therapy in unselected non-small-cell lung cancer are docetaxel and pemetrexed (chemotherapies) and erlotinib (targeted therapies). Several new molecular drugs have now entered clinical trials and are being compared with approved agents (e.g., vandetanib). Alternative pathways are also being explored to overcome resistance to established agents (c-MET and ALK inhibitors), and predictive factors are now crucial for the selection of drug and of patients (e.g., EGFR mutations). Better patient selection permits second-line treatment to be tailored according to disease identity, which confers a particular benefit in certain subgroups of patients. In this review, the authors examine existing trials comparing targeted therapies with the standard of care as second-line therapy for advanced non-small-cell lung cancer.

Petrelli F.,Oncology Unit | Barni S.,Oncology Unit
Head and Neck | Year: 2012

Background. Anti-epidermal growth factor receptor (EGFR) therapies are effective in head and neck carcinoma. A meta-analysis was performed to assess their efficacy and safety in advanced head and neck carcinoma. Methods. Six trials randomizing 2257 patients with recurrent/metastatic head and neck carcinoma for chemotherapy or best supportive care with or without anti-EGFR therapies were identified. The efficacy data included progression-free survival (PFS), overall survival (OS), response rate, and toxicity. Results. The response rate was higher in the experimental arm (p <.0001; relative risk = 1.62). A significant PFS benefit (p <.0001; hazard ratio [HR] = 0.70) favored the anti-EGFR treatment. Survival was significantly increased if trials of monoclonal antibodies were included (p =.004; HR = 0.83). A higher incidence of diarrhea, skin rash, anorexia, and hypomagnesemia was observed. Conclusions. This meta-analysis suggests that in recurrent/metastatic head and neck cancer the addition of anti-EGFR monoclonal antibodies to standard therapy confers a statistically significant improvement in OS, PFS, and overall response rate. © 2011 Wiley Periodicals, Inc.

Petrelli F.,Oncology Unit | Borgonovo K.,Oncology Unit | Barni S.,Oncology Unit
Targeted Oncology | Year: 2013

Skin rash is an early and frequent phenomenon during treatment with anti-epidermal growth factor receptor monoclonal antibodies. The objective of this review is to assess the predictive value of skin rash in patients with advanced colorectal cancer treated with cetuximab and panitumumab. We searched PubMed and ASCO Meetings for publications reporting the correlation of skin rash with survival and/or response rate. Hazard ratios (HRs) with 95 % confidence intervals for progression and/or survival, and/or risk ratios (RRs) for response rate in patients with rash were obtained from publications and pooled in a meta-analysis. Fourteen publications (for a total of 3,833 patients) were included in this meta-analysis. The occurrence of skin toxicity represents a predictive factor for survival (HR 0.51; p < 0.00001) and progression (HR 0.58; p < 0.00001). Similarly, patients who developed moderate or severe rash had an increased chance of response (35 vs 13 %; RR 2.23, p < 0.00001). The occurrence of skin rash during treatment with cetuximab and panitumumab represents a significant predictor of the efficacy of these drugs. The hypothesis that, in patients who lack substantial skin toxicity, this treatment is not beneficial and requires early discontinuation deserves further study. © 2013 Springer-Verlag France.

Petrell F.,Oncology Unit | Barni S.,Oncology Unit
Annals of Oncology | Year: 2013

Background: Polychemotherapy and biological drugs have increased therapeutic options and outcomes of advanced colorectal cancer (CRC). We examined the relation between progression-free survival (PFS), post-progression survival (PPS) and overall survival (OS) in trials of modern (oxaliplatin- and irinotecan-based) chemotherapy alone or with targeted therapies for advanced CRC. We also evaluated surrogacy of PFS and OS. Patients and methods: A PubMed search identified 34 randomized trials. We split the OS, PFS and PPS and evaluated the correlation between OS and either PFS or PPS. Results: The median PPS and PFS were 10.75 and 8.4 months, respectively. For all trials, PPS was strongly associated with OS [regression coefficient (R2) = 0.8; Spearman's rank correlation coefficient (r) = 0.88], whereas PFS was moderately associated with OS (R2 = 0.43; r = 0.64). In trials with targeted therapies, the correlation of PPS with OS was 0.88. However, across all trials, correlation between differences in median PFS (δPFS) and median OS (δOS) is 0.59 (P = 0.0007), confirming PFS/OS surrogacy. Conclusion: Our findings indicate that in recent first-line, phase III, trials, OS becomes more associated with PPS than PFS. However, improvements in PFS are strongly associated with improvements in OS. Inthis setting so, PFS may be an appropriate surrogate for OS. © The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Alon S.,Oncology Unit
Journal of Pediatric Hematology/Oncology | Year: 2011

The objective of discussion is to stimulate healthcare professionals to deepen knowledge and understanding of the difficulties, challenges, and developmental tasks of elderly patients coping with cancer. Current research suggests that the psychological impact of cancer is less negative among the elderly, compared with younger patients (such as easier adjustment process). However, the specific psychosocial themes and needs of the elderly patients are not well enough adapted. Evidence-based data may offer clinicians and researchers a better understanding of the coping mechanisms defining elderly people, which may play a role in protecting them from severe emotional distress. Clinical implications would be improved screening, evaluation and intervention skills, which are suitable and adequate to the needs of the elderly population. Copyright © 2011 by Lippincott Williams & Wilkins.

News Article | November 10, 2016
Site: www.prweb.com

Brian & Lizzie Dipp Metzger and her family have given back to the El Paso community by sponsoring the Children’s Oncology Unit Playroom at the El Paso Children’s Hospital. The Dipp Metzger S.A.M. Foundation Oncology Unit Playroom is one of the busiest playrooms in the Children's Hospitals because oncology kids are there the longest. It is the home of the Therapeutic Art Program. It's the home of puzzles and games and story hours. The Dipp Metzger family will debut their present to the community on November 2, 2016 at a reception at the Children’s Hospital Oncology playroom from 5:30 – 6:30 pm. “It has always been our dream to be able to create a foundation to help children,” says Dipp Metzger. “As a teenager, I volunteered at both the Child Crisis Center and Providence Hospital. That experience showed me the impact that we can all make with our time and our money. Helping children has always been important to my family, and we are thrilled to be able to impact many children through the Oncology Playroom.” Mrs. Dipp Metzger is president of Crown Wealth Strategies, a comprehensive wealth strategies firm in El Paso, TX serving clients nationwide. As a Financial Professional, Lizzie provides clients with an integrated retirement and insurance strategy focused on maximizing value over the course of their lifetime. Lizzie’s focus is physicians, professionals, and business owners in the affluent market. Lizzie provides holistic strategies for retirement, college funding, business planning, and wealth accumulation. The Family Dipp Metzger have lived in El Paso for 14 years and Lizzie is an El Paso native. They are actively involved in the community serving many organizations including the United Way, Boy Scots and the Paso del Norte Children’s Development Center.

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