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Procopio G.,Fondazione IRCCS Instituto Nazionale dei Tumori | Derosa L.,Instituto Toscano Tumori | Gernone A.,Oncologia Medica Universitaria | Morelli F.,U.O.C. Oncologia | And 19 more authors.
Future Oncology | Year: 2014

Aim: The Italian Retrospective Analysis of Sorafenib as First or Second Target Therapy study assessed the efficacy and safety of sorafenib in metastatic renal cell carcinoma patients treated in the community. Patients & methods: Patients receiving first- or second-line single-agent sorafenib between January 2008 and December 2010 were eligible. Retrospective data collection started in 2012 and covers at least 1-year follow-up. The primary end point was overall survival (OS). Results: Median OS was 17.2 months (95% CI: 15.5-19.6): 19.9 months (95% CI: 15.9-25.3) in patients treated with first-line sorafenib and 16.3 months (95% CI: 13.1-18.2) with second-line sorafenib. Overall median (95% CI) progression-free survival was 5.9 months (95% CI: 4.9-6.7): 6.6 (95% CI: 4.9-9.3) and 5.3 months (95% CI: 4.3-6.0) in first- and second-line patients, respectively. Conclusion: The efficacy and safety of sorafenib in routine community practice was generally good, especially in relation to OS in patients treated in the second line, where results were similar to those seen in recent prospective clinical trials. © 2014 Future Medicine Ltd.


Pagliaro G.,U.O.C. Psicologia Ospedaliera | Pagliaro G.,University of Bologna | Pandolfi P.,U.O.C. Epidemiologia | Collina N.,U.O.S. Epidemiologia Descrittiva | And 14 more authors.
Explore: The Journal of Science and Healing | Year: 2016

Context Tong Len meditation is an important therapeutic tool in the Tibetan medicine, and it can be used for self-healing and/or to heal others. Currently, in the West, there is no scientific study concerning the efficacy of a Tong Len distant healing effect on psychological disorders in cancer patients. Objectives To evaluate a distant healing effect of Tong Len meditation on stress, anxiety, depression, fatigue, and self-perceived quality of life in cancer patients. These psychological objectives were chosen as a consequence of the limited scientific literature of present day. Design We performed a double-blind randomized controlled trial on 103 cancer patients with tumors. Overall, 12 meditators used Tong Len in aid of 52 patients randomly selected as experimental group, while the remaining 51 patients constituted the control group. Patients and meditators did not know each other. All patients completed profile of mood states (POMS) and European Quality of Life - 5 dimensions (EQ-5D) questionnaires before treatment (T0), after two (T1) and three months of treatment (T2), and one month after treatment cessation (T3). Results With regard to the parameters related to depression, a statistically significant improvement (P =.003) was observed in the treatment group compared to controls. On the other hand, the vigor/activity parameter saw significant improvements in the control group (P =.009). Both groups exhibited significant improvements in the other factors assessed in the POMS and EQ-5D questionnaires. Conclusions This study did not provide sufficient evidence supporting an efficacy of Tong Len meditation in distant psychological healing as compared to a control condition. The research highlighted some psychological improvements through Tong Len distant meditation in a group of patients unknown to meditators. Therefore, the enhancement detected in most parameters in both treatment and control groups raises interest on in-depth analysis and evaluation of distant meditation on cancer patients to mitigate psychological problems caused by the disease. © 2016 Elsevier Inc.


Wildiers H.,University Hospitals Leuven | Brain E.,Institute Curie Hopital Rene Huguenin Saint Cloud | Penninckx B.,EORTC Headquarters | Ring A.,Royal Sussex County Hospital | And 5 more authors.
European Journal of Cancer, Supplement | Year: 2012

The EORTC Cancer in the ElderlyTask Force (ETF) aims to develop, conduct, coordinate and stimulate research on elderly patients with cancer. Towards this goal, the ETF has established close interactions with disease-oriented EORTC groups by having representatives from most of these groups attend the ETF meetings. In addition, the ETF reviews every new protocol for elderly-specific questions within the protocol review process of the EORTC aiming to reduce ageism within study protocols. Since 2006, the ETF decided to focus on three aspects: open a discussion on specific methodology for clinical trials in the older population; create a common language for describing heterogeneity between older individuals, the EORTC minimal dataset for geriatric assessment in older cancer patients; and develop specific clinical trials in the older population. This article reports the achievements of the ETF in these three domains and discusses its future strategies. © 2012 European Organisation for Research and Treatment of Cancer.


Riccardi F.,UOC Oncologia | Nappi O.,UOC Anatomia Patologica | Balzano A.,UOC Gastroenterologia | De Palma M.,UOC Endocrinochirurgia | And 17 more authors.
International Journal of Immunopathology and Pharmacology | Year: 2011

Neuroendocrine tumors (NETs) are rare, with an incidence of about 5 per 100,000 inhabitants. As no study on NETs has ever been specifically conducted on the population of Campania, we performed a retrospective analysis of all newly diagnosed NETs at the "Antonio Cardarelli" hospital between 2006-2009. A search of the registry of the Pathology Department of the "Antonio Cardarelli" hospital was carried out to retrieve available data on all newly diagnosed NET cases. Two hundred and ninety-nine NET tumors were diagnosed at our Institution from January, 2006 to December, 2009. Globally, 121 patients (40% of the population) had a lung NET, while 92 patients (30% of the population) presented a GEP-NET. The most common primary tumor site varied by sex, with female patients being more likely to have a primary NET in the lung, breast or colon, and male patients being more likely to have a primary tumor in the lung. Also, twenty-three cases of breast NETs were identified, and clinical information regarding therapy and response was available for 22 patients. Our study represents a pioneering effort to provide the medical community in Campania with basic information on a large number of patients with different types of NETs. The "Antonio Cardarelli" hospital could greatly benefit from cooperation with other hospitals in order to become a highly specialized center for NETs in the region and Southern Italy. Copyright © by BIOLIFE, s.a.s.


Bordoni B.,UOC Cardiologia | Urbinati S.,UOC Cardiologia | Tosoni A.,UOC Oncologia | Labanti G.,UOC Cardiologia | Brandes A.,UOC Oncologia
Monaldi Archives for Chest Disease - Cardiac Series | Year: 2014

Cardiologic evaluation of patients undergoing chemoterapy. B. Bordoni, S. Urbinati, A. Tosoni, G. Labanti, A. Brandes. Life expectancy in patients affected by cancer has recently increased because of early diagnosis and actual therapies. In recent years, Oncology and Cardiology developed a tight relationship because of common risk factors (i.e. obesity, smoking, alcool intake, etc-), and for preventing the prothrombotic status due to cancer and the potential cardiotoxicity of chemotherapy. Cardiotoxicity incidence is reported from 1% up to 70% in retrospective analyses of drug protocols, mainly representing by left ventricular dysfunction (both reversible or irreversible), but also by arrhythmias, hypertension, atrioventricular block, coronary spasm, and arterial or venous thromboembolism. The early detection of the chemoterapy induced cardiotoxicity is now mandatory and can be obtained through a proper patients selection for different treatments and a strict monitoring during the follow-up period. The role of biomarkers of early cardiac damage, mainly, troponin I and brain natriuretic peptide-BNP, has been recently challenged, and algorithms are currently available. In the present paper, we propose how to perform a cardiological evaluation of patients undergoing chemoterapy tailored by the known adverse effects of the drugs.


Di Lorenzo G.,University of Naples Federico II | Buonerba C.,University of Naples Federico II | Faiella A.,University of Naples Federico II | Rescigno P.,University of Naples Federico II | And 14 more authors.
BJU International | Year: 2011

OBJECTIVE To determine the activity and tolerability of docetaxel re-treatment after first-line therapy with docetaxel in castration-resistant prostate cancer (CRPC). PATIENTS AND METHODS Between November 2005 and January 2009, 45 patients initially responding to docetaxel and then experiencing disease progression after a period of biochemical remission of at least 5 months were enrolled in a prospective multicenter study and re-treated with docetaxel. The primary endpoint was the biochemical response (biochemical partial response defined as >50% prostate-specific antigen [PSA] decline); secondary endpoints were objective response, toxicity, progression-free survival (PFS) and overall survival (OS). RESULTS Partial PSA responses were observed in 11 patients (24.5%), 4 (25%) of whom also had an objective response. The treatment was well tolerated, with grade 1-2 neutropenia, thrombocytopenia, vomiting and peripheral neuropathy noted in 18 (40%), 11 (24.5%), 8 (17.8%), and 6 (13.3%) patients, respectively. The most common grade 3 toxicity was neutropenia, which was observed in 8 patients (17.8%). Median PFS was 5 months and median OS was 13 months. CONCLUSIONS Docetaxel re-treatment preserves anti-tumour activity and is well tolerated in a selected population of pretreated patients with CRPC. Further randomized trials are needed to confirm our preliminary results. © 2010 BJU INTERNATIONAL.


Riccardi F.,UOC Oncologia | Di Lorenzo G.,UOC Oncologia | Buonerba C.,UOC Oncologia | Monaco G.,UOC Chirurgia Toracica | And 6 more authors.
World Journal of Surgical Oncology | Year: 2010

Background: Defining the optimal treatment for patients with inoperable non small cell lung cancer (NSCLC), presenting with metastatic mediastinal lymph nodes, is challenging. Nevertheless, preoperative chemotherapy or radiotherapy might offer a chance for these patients for radical surgical resection and, possibly, complete recovery.Case Presentation: A 62-year old man with IIIA-N2 inoperable NSCLC was treated with first-line single agent docetaxel. A platinum-based treatment, though considered more active, was ruled out because of renal impairment. The patient tolerated the treatment very well and, although his initial response was not impressive, after 14 cycles he obtained a complete clinical response, which was confirmed pathologically after he underwent surgical lobectomy.Conclusion: In non-operable NSCLC patients not eligible for a platinum-based treatment, single-agent docetaxel can provide complete pathologic responses. Failure to obtain a response after the first few cycles should not automatically discourage to continue treatment. © 2010 Riccardi et al; licensee BioMed Central Ltd.


Di Lorenzo G.,UOC Oncologia | Buonerba C.,UOC Oncologia | Biglietto M.,UOC Oncologia | Scognamiglio F.,UOC Oncologia | And 3 more authors.
Cancer Treatment Reviews | Year: 2010

Purpose: Over the last few years, targeted agents have assumed a predominant role in treatment of metastatic renal cell carcinoma (mRCC). Our aim is to discuss recent developments on this rapidly evolving topic. Evidence synthesis: Sunitinib represents front-line standard treatment for the good- and intermediate prognosis groups of patients with clear cell renal carcinoma. Bevacizumab/interferon and pazopanib have also been FDA-approved as first-line agents, while sorafenib has moved toward second-line and later therapy. Temsirolimus, an mTOR inhibitor, is recommended as front line therapy for patients in the poor-risk group and is the best front-line choice for patients with non-clear cell histology. Another mTOR inhibitor, everolimus, has shown clinical benefit post-tyrosine kinasis inhibitors failure in a phase III study and is considered the standard of care in this setting. Novel prognostic and efficacy markers might help to define most appropriate therapeutic strategy. Best sequence of use of these effective agents in mRCC patients remains up to the discretion of treating physician. Conclusions: In light of the considerable advances in understanding the biology of mRCC, several new drugs have been recently developed, with an increasing number of treatment options. Several markers are under evaluation for diagnostic, prognostic and efficacy purposes. A treatment algorithm, based on the best scientific evidence produce so far, is presented and it will evolve as data from ongoing trials will be available. © 2010 Elsevier Ltd.

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