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1. Final results of the real-life observational VICTOR-6 study on metronomic chemotherapy in elderly metastatic breast cancer (MBC) patients

Author

Trevisan, B., Pepe, F. F., Vallini, I., Montagna, E., Amoroso, D., Berardi, R., Butera, A., Cagossi, K., Cavanna, L., Ciccarese, M., Cinieri, S., Cretella, E., De Conciliis, E., Febbraro, A., Ferraù, F., Ferzi, A., Baldelli, A., Fontana, A., Gambaro, A. R., Garrone, O., Gebbia, V., Generali, D., Gianni, L., Giovanardi, F., Grassadonia, A., Leonardi, V., Sarti, S., Musolino, A., Nicolini, M., Putzu, C., Riccardi, F., Santini, D., Sarobba, M. G., Schintu, M. G., Scognamiglio, G., Spadaro, P., Taverniti, C., Toniolo, D., Tralongo, P., Turletti, A., Valenza, R., Valerio, M. R., Vici, P., Clivio, L., Torri, V., and Cazzaniga, M. E.

Published
2023
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2. Metronomic chemotherapy for advanced breast cancer patients in the real world practice: Final results of the VICTOR-6 study

Author

Cicchiello, F., Riva, F., Vallini, I., Mazza, M., Bonfadini, C., Bordin, E., Canicattì, M., Cappuccio, F., Collovà, E., De Angelis, C., Desorte, R., Donati, S., Drudi, G., Galanti, D., Mocerino, C., Orlando, L., Pellegrino, B., Pizzuti, L., Ridolfi, C., Rocca, A., Sarti, D., Spagnoletti, I., Tinari, N., Vandone, A., Vizzini, L., Cazzaniga, M.E., Pinotti, G., Montagna, E., Amoroso, D., Berardi, R., Butera, A., Cagossi, K., Cavanna, L., Ciccarese, M., Cinieri, S., Cretella, E., De Conciliis, E., Febbraro, A., Ferraù, F., Ferzi, A., Fiorentini, G., Fontana, A., Gambaro, A.R., Garrone, O., Gebbia, V., Generali, D., Gianni, L., Giovanardi, F., Grassadonia, A., Leonardi, V., Marchetti, P., Melegari, E., Musolino, A., Nicolini, M., Putzu, C., Riccardi, F., Santini, D., Saracchini, S., Sarobba, M.G., Schintu, M.G., Scognamiglio, G., Spadaro, P., Taverniti, C., Toniolo, D., Tralongo, P., Turletti, A., Valenza, R., Valerio, M.R., Vici, P., Clivio, L., and Torri, V.

Published
2019
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3. Final results of the real-life observational VICTOR-6 study on metronomic chemotherapy in elderly metastatic breast cancer (MBC) patients

Author

Trevisan, B, Pepe, F, Vallini, I, Montagna, E, Amoroso, D, Berardi, R, Butera, A, Cagossi, K, Cavanna, L, Ciccarese, M, Cinieri, S, Cretella, E, De Conciliis, E, Febbraro, A, Ferrau, F, Ferzi, A, Baldelli, A, Fontana, A, Gambaro, A, Garrone, O, Gebbia, V, Generali, D, Gianni, L, Giovanardi, F, Grassadonia, A, Leonardi, V, Sarti, S, Musolino, A, Nicolini, M, Putzu, C, Riccardi, F, Santini, D, Sarobba, M, Schintu, M, Scognamiglio, G, Spadaro, P, Taverniti, C, Toniolo, D, Tralongo, P, Turletti, A, Valenza, R, Valerio, M, Vici, P, Clivio, L, Torri, V, Cazzaniga, M, Trevisan B., Pepe F. F., Vallini I., Montagna E., Amoroso D., Berardi R., Butera A., Cagossi K., Cavanna L., Ciccarese M., Cinieri S., Cretella E., De Conciliis E., Febbraro A., Ferrau F., Ferzi A., Baldelli A., Fontana A., Gambaro A. R., Garrone O., Gebbia V., Generali D., Gianni L., Giovanardi F., Grassadonia A., Leonardi V., Sarti S., Musolino A., Nicolini M., Putzu C., Riccardi F., Santini D., Sarobba M. G., Schintu M. G., Scognamiglio G., Spadaro P., Taverniti C., Toniolo D., Tralongo P., Turletti A., Valenza R., Valerio M. R., Vici P., Clivio L., Torri V., Cazzaniga M. E., Trevisan, B, Pepe, F, Vallini, I, Montagna, E, Amoroso, D, Berardi, R, Butera, A, Cagossi, K, Cavanna, L, Ciccarese, M, Cinieri, S, Cretella, E, De Conciliis, E, Febbraro, A, Ferrau, F, Ferzi, A, Baldelli, A, Fontana, A, Gambaro, A, Garrone, O, Gebbia, V, Generali, D, Gianni, L, Giovanardi, F, Grassadonia, A, Leonardi, V, Sarti, S, Musolino, A, Nicolini, M, Putzu, C, Riccardi, F, Santini, D, Sarobba, M, Schintu, M, Scognamiglio, G, Spadaro, P, Taverniti, C, Toniolo, D, Tralongo, P, Turletti, A, Valenza, R, Valerio, M, Vici, P, Clivio, L, Torri, V, Cazzaniga, M, Trevisan B., Pepe F. F., Vallini I., Montagna E., Amoroso D., Berardi R., Butera A., Cagossi K., Cavanna L., Ciccarese M., Cinieri S., Cretella E., De Conciliis E., Febbraro A., Ferrau F., Ferzi A., Baldelli A., Fontana A., Gambaro A. R., Garrone O., Gebbia V., Generali D., Gianni L., Giovanardi F., Grassadonia A., Leonardi V., Sarti S., Musolino A., Nicolini M., Putzu C., Riccardi F., Santini D., Sarobba M. G., Schintu M. G., Scognamiglio G., Spadaro P., Taverniti C., Toniolo D., Tralongo P., Turletti A., Valenza R., Valerio M. R., Vici P., Clivio L., Torri V., and Cazzaniga M. E.

Abstract

Nowadays, treatment of metastatic breast cancer (MBC) has been enriched with novel therapeutical strategies. Metronomic chemotherapy (mCHT) is a continuous and frequent administration of chemotherapy at a lower dose and so whit less toxicity. Thus, this strategy could be attractive for elderly MBC patients. Aim of this analysis is to provide insights into mCHT’s activity in a real-life setting of elderly MBC patients. Data of patients ≥ 75 years old included in VICTOR-6 study were analyzed. VICTOR-6 is a multicentre, Italian, retrospective study, which collected data on mCHT in MBC patients treated between 2011 and 2016. A total of 112 patients were included. At the beginning of mCHT, median age was 81 years (75–98) and in 33% of the patients mCHT was the first line choice. Overall Response Rate (ORR) and Disease Control Rate (DCR) were 27.9% and 79.3%, respectively. Median PFS ranged between 7.6 and 9.1 months, OS between 14.1 and 18.5 months. The most relevant toxicity was the hematological one (24.1%); severe toxicity (grade 3–4) ranged from 0.9% for skin toxicity up to 8% for hematologic one. This is a large study about mCHT in elderly MBC patients, providing insights to be further investigated in this subgroup of frail patients.

Published
2023

4. Metronomic chemotherapy (mCHT) in metastatic triple-negative breast cancer (TNBC) patients: results of the VICTOR-6 study

Author

Cazzaniga, M, Vallini, I, Montagna, E, Amoroso, D, Berardi, R, Butera, A, Cagossi, K, Cavanna, L, Ciccarese, M, Cinieri, S, Cretella, E, De Conciliis, E, Febbraro, A, Ferrau, F, Ferzi, A, Baldelli, A, Fontana, A, Gambaro, A, Garrone, O, Gebbia, V, Generali, D, Gianni, L, Giovanardi, F, Grassadonia, A, Leonardi, V, Marchetti, P, Sarti, S, Musolino, A, Nicolini, M, Putzu, C, Riccardi, F, Santini, D, Saracchini, S, Sarobba, M, Schintu, M, Scognamiglio, G, Spadaro, P, Taverniti, C, Toniolo, D, Tralongo, P, Turletti, A, Valenza, R, Valerio, M, Vici, P, Di Mauro, P, Cogliati, V, Capici, S, Clivio, L, Torri, V, Cazzaniga M. E., Vallini I., Montagna E., Amoroso D., Berardi R., Butera A., Cagossi K., Cavanna L., Ciccarese M., Cinieri S., Cretella E., De Conciliis E., Febbraro A., Ferrau F., Ferzi A., Baldelli A., Fontana A., Gambaro A. R., Garrone O., Gebbia V., Generali D., Gianni L., Giovanardi F., Grassadonia A., Leonardi V., Marchetti P., Sarti S., Musolino A., Nicolini M., Putzu C., Riccardi F., Santini D., Saracchini S., Sarobba M. G., Schintu M. G., Scognamiglio G., Spadaro P., Taverniti C., Toniolo D., Tralongo P., Turletti A., Valenza R., Valerio M. R., Vici P., Di Mauro P., Cogliati V., Capici S., Clivio L., Torri V., Cazzaniga, M, Vallini, I, Montagna, E, Amoroso, D, Berardi, R, Butera, A, Cagossi, K, Cavanna, L, Ciccarese, M, Cinieri, S, Cretella, E, De Conciliis, E, Febbraro, A, Ferrau, F, Ferzi, A, Baldelli, A, Fontana, A, Gambaro, A, Garrone, O, Gebbia, V, Generali, D, Gianni, L, Giovanardi, F, Grassadonia, A, Leonardi, V, Marchetti, P, Sarti, S, Musolino, A, Nicolini, M, Putzu, C, Riccardi, F, Santini, D, Saracchini, S, Sarobba, M, Schintu, M, Scognamiglio, G, Spadaro, P, Taverniti, C, Toniolo, D, Tralongo, P, Turletti, A, Valenza, R, Valerio, M, Vici, P, Di Mauro, P, Cogliati, V, Capici, S, Clivio, L, Torri, V, Cazzaniga M. E., Vallini I., Montagna E., Amoroso D., Berardi R., Butera A., Cagossi K., Cavanna L., Ciccarese M., Cinieri S., Cretella E., De Conciliis E., Febbraro A., Ferrau F., Ferzi A., Baldelli A., Fontana A., Gambaro A. R., Garrone O., Gebbia V., Generali D., Gianni L., Giovanardi F., Grassadonia A., Leonardi V., Marchetti P., Sarti S., Musolino A., Nicolini M., Putzu C., Riccardi F., Santini D., Saracchini S., Sarobba M. G., Schintu M. G., Scognamiglio G., Spadaro P., Taverniti C., Toniolo D., Tralongo P., Turletti A., Valenza R., Valerio M. R., Vici P., Di Mauro P., Cogliati V., Capici S., Clivio L., and Torri V.

Abstract

Purpose: Triple-negative breast cancer (TNBC) represents a subtype of breast cancer which lacks the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2): TNBC accounts for approximately 20% of newly diagnosed breast cancers and is associated with younger age at diagnosis, greater recurrence risk and shorter survival time. Therapeutic options are very scarce. Aim of the present analysis is to provide further insights into the clinical activity of metronomic chemotherapy (mCHT), in a real-life setting. Methods: We used data included in the VICTOR-6 study for the present analysis. VICTOR-6 is an Italian multicentre retrospective cohort study, which collected data of metastatic breast cancer (MBC) patients who have received mCHT between 2011 and 2016. Amongst the 584 patients included in the study, 97 were triple negative. In 40.2% of the TNBC patients, mCHT was the first chemotherapy treatment, whereas 32.9% had received 2 or more lines of treatment for the metastatic disease. 45.4% out of 97 TNBC patients received a vinorelbine (VRL)-based regimen, which resulted in the most used type of mCHT, followed by cyclophosphamide (CTX)-based regimens (30.9%) and capecitabine (CAPE)-based combinations (22.7%). Results: Overall response rate (ORR) and disease control rate (DCR) were 17.5% and 64.9%, respectively. Median progression free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.9–7.2) and 12.1 months (95% CI: 9.6–16.7). Median PFS was 6.9 months for CAPE-based regimens (95% CI: 5.0–18.4), 6.1 months (95% CI: 4.0–8.9) for CTX-based and 5.3 months (95% CI: 4.1–9.5) for VRL-based ones. Median OS was 18.2 months (95% CI: 9.1-NE) for CAPE-based regimens and 11.8 months for VRL- (95% CI: 9.3–16.7 and CTX-based ones (95%CI: 8.7–52.8). Tumour response, PFS and OS decreased proportionally in later lines. Conclusion: This analysis represents the largest series of TNBC patients treated with mCHT in

Published
2021

7. Management of toxicities associated with targeted therapies for HR-positive metastatic breast cancer: a multidisciplinary approach is the key to success

Author

Cazzaniga M. E., Danesi R., Girmenia C., Invernizzi P., Elvevi A., Uguccioni M., Amaducci L., Atzori F., Blasi L., Butti C., Collova E., De Conciliis E., Fabi A., Febbraro A., Garrone O., Gianni L., Giotta F., La Verde N., Michelotti A., Palumbo R., Paris I., Pistelli M., Pizzuti L., Rubino D., Valerio M. R., Zustovich F., Cazzaniga M.E., Danesi R., Girmenia C., Invernizzi P., Elvevi A., Uguccioni M., Amaducci L., Atzori F., Blasi L., Butti C., Collova E., De Conciliis E., Fabi A., Febbraro A., Garrone O., Gianni L., Giotta F., La Verde N., Michelotti A., Palumbo R., Paris I., Pistelli M., Pizzuti L., Rubino D., Valerio M.R., Zustovich F., Cazzaniga, M, Danesi, R, Girmenia, C, Invernizzi, P, Elvevi, A, Uguccioni, M, Amaducci, L, Atzori, F, Blasi, L, Butti, C, Collova, E, De Conciliis, E, Fabi, A, Febbraro, A, Garrone, O, Gianni, L, Giotta, F, La Verde, N, Michelotti, A, Palumbo, R, Paris, I, Pistelli, M, Pizzuti, L, Rubino, D, Valerio, M, and Zustovich, F

Subjects
0301 basic medicine, Cancer Research, Review, Disease, chemistry.chemical_compound, 0302 clinical medicine, Ribociclib, Molecular Targeted Therapy, Abemaciclib, Clinical Trials as Topic, Disease Management, Metastatic breast cancer, Everolimu, Oncology, Receptors, Estrogen, 030220 oncology & carcinogenesis, Female, Advanced breast cancer, Receptors, Progesterone, Breast Neoplasm, medicine.drug, Human, medicine.medical_specialty, Neutropenia, Drug-Related Side Effects and Adverse Reactions, Antineoplastic Agents, Hormonal, Protein Kinase Inhibitor, Breast Neoplasms, Palbociclib, 03 medical and health sciences, Breast cancer, medicine, Biomarkers, Tumor, Humans, Everolimus, Intensive care medicine, Adverse effect, Protein Kinase Inhibitors, business.industry, medicine.disease, Clinical trial, 030104 developmental biology, chemistry, MED/06 - ONCOLOGIA MEDICA, business, Drug-Related Side Effects and Adverse Reaction
Abstract

Purpose: Agents targeting HR-positive, HER2-negative locally advanced or metastatic breast cancer have improved patient outcomes compared with conventional single-agent endocrine therapy. Currently, approved targeted agents include everolimus and three CDK4/6 inhibitors, palbociclib, ribociclib, and abemaciclib. Unlike the well-characterized and easily manageable safety profile of endocrine therapies, adverse events associated with targeted therapies are complex and potentially severe. Their prompt recognition and treatment, crucial for prolonged endocrine sensitivity and survival, may be challenging and requires a multidisciplinary effort and a good knowledge of drug interactions. Methods: We reviewed the current evidence on the drug safety of targeted agents for metastatic breast cancer currently used in clinical practice in Italy, supported by the clinical experience of Italian oncologists with expertise in the field. Results: All oncologists had used CDK4/6 inhibitors in clinical practice and/or within a clinical trial. The clinical management of toxicities, including dose adjustments, treatment interruptions, and concerns regarding special populations is discussed, and the management of relevant adverse events, related to individual agents and class-specific, toxicities is reviewed. Hematologic toxicities have the greatest impact on clinical management of the disease and on patients. Although toxicities associated with the new treatments result in more visits to the physician and more time and attention with patients, they are manageable, with no need for the oncologist to consult with specialist physicians. Conclusions: Based on the available evidence and current guidelines, we propose a series of practical recommendations for multidisciplinary clinical management of the various toxicities associated with the addition of targeted agents to endocrine therapy.

Published
2019

8. Management of toxicities associated with targeted therapies for HR-positive metastatic breast cancer: a multidisciplinary approach is the key to success

Author

Cazzaniga, M, Danesi, R, Girmenia, C, Invernizzi, P, Elvevi, A, Uguccioni, M, Amaducci, L, Atzori, F, Blasi, L, Butti, C, Collova, E, De Conciliis, E, Fabi, A, Febbraro, A, Garrone, O, Gianni, L, Giotta, F, La Verde, N, Michelotti, A, Palumbo, R, Paris, I, Pistelli, M, Pizzuti, L, Rubino, D, Valerio, M, Zustovich, F, Cazzaniga M. E., Danesi R., Girmenia C., Invernizzi P., Elvevi A., Uguccioni M., Amaducci L., Atzori F., Blasi L., Butti C., Collova E., De Conciliis E., Fabi A., Febbraro A., Garrone O., Gianni L., Giotta F., La Verde N., Michelotti A., Palumbo R., Paris I., Pistelli M., Pizzuti L., Rubino D., Valerio M. R., Zustovich F., Cazzaniga, M, Danesi, R, Girmenia, C, Invernizzi, P, Elvevi, A, Uguccioni, M, Amaducci, L, Atzori, F, Blasi, L, Butti, C, Collova, E, De Conciliis, E, Fabi, A, Febbraro, A, Garrone, O, Gianni, L, Giotta, F, La Verde, N, Michelotti, A, Palumbo, R, Paris, I, Pistelli, M, Pizzuti, L, Rubino, D, Valerio, M, Zustovich, F, Cazzaniga M. E., Danesi R., Girmenia C., Invernizzi P., Elvevi A., Uguccioni M., Amaducci L., Atzori F., Blasi L., Butti C., Collova E., De Conciliis E., Fabi A., Febbraro A., Garrone O., Gianni L., Giotta F., La Verde N., Michelotti A., Palumbo R., Paris I., Pistelli M., Pizzuti L., Rubino D., Valerio M. R., and Zustovich F.

Abstract

Purpose: Agents targeting HR-positive, HER2-negative locally advanced or metastatic breast cancer have improved patient outcomes compared with conventional single-agent endocrine therapy. Currently, approved targeted agents include everolimus and three CDK4/6 inhibitors, palbociclib, ribociclib, and abemaciclib. Unlike the well-characterized and easily manageable safety profile of endocrine therapies, adverse events associated with targeted therapies are complex and potentially severe. Their prompt recognition and treatment, crucial for prolonged endocrine sensitivity and survival, may be challenging and requires a multidisciplinary effort and a good knowledge of drug interactions. Methods: We reviewed the current evidence on the drug safety of targeted agents for metastatic breast cancer currently used in clinical practice in Italy, supported by the clinical experience of Italian oncologists with expertise in the field. Results: All oncologists had used CDK4/6 inhibitors in clinical practice and/or within a clinical trial. The clinical management of toxicities, including dose adjustments, treatment interruptions, and concerns regarding special populations is discussed, and the management of relevant adverse events, related to individual agents and class-specific, toxicities is reviewed. Hematologic toxicities have the greatest impact on clinical management of the disease and on patients. Although toxicities associated with the new treatments result in more visits to the physician and more time and attention with patients, they are manageable, with no need for the oncologist to consult with specialist physicians. Conclusions: Based on the available evidence and current guidelines, we propose a series of practical recommendations for multidisciplinary clinical management of the various toxicities associated with the addition of targeted agents to endocrine therapy.

Published
2019

9. Metronomic chemotherapy for advanced breast cancer patients in the real world practice: Final results of the VICTOR-6 study

Author

Cazzaniga, M, Pinotti, G, Montagna, E, Amoroso, D, Berardi, R, Butera, A, Cagossi, K, Cavanna, L, Ciccarese, M, Cinieri, S, Cretella, E, De Conciliis, E, Febbraro, A, Ferrau, F, Ferzi, A, Fiorentini, G, Fontana, A, Gambaro, A, Garrone, O, Gebbia, V, Generali, D, Gianni, L, Giovanardi, F, Grassadonia, A, Leonardi, V, Marchetti, P, Melegari, E, Musolino, A, Nicolini, M, Putzu, C, Riccardi, F, Santini, D, Saracchini, S, Sarobba, M, Schintu, M, Scognamiglio, G, Spadaro, P, Taverniti, C, Toniolo, D, Tralongo, P, Turletti, A, Valenza, R, Valerio, M, Vici, P, Clivio, L, Torri, V, Cicchiello, F, Riva, F, Vallini, I, Mazza, M, Bonfadini, C, Bordin, E, Canicatti, M, Cappuccio, F, Collova, E, De Angelis, C, Desorte, R, Donati, S, Drudi, G, Galanti, D, Mocerino, C, Orlando, L, Pellegrino, B, Pizzuti, L, Ridolfi, C, Rocca, A, Sarti, D, Spagnoletti, I, Tinari, N, Vandone, A, Vizzini, L, Cazzaniga M. E., Pinotti G., Montagna E., Amoroso D., Berardi R., Butera A., Cagossi K., Cavanna L., Ciccarese M., Cinieri S., Cretella E., De Conciliis E., Febbraro A., Ferrau F., Ferzi A., Fiorentini G., Fontana A., Gambaro A. R., Garrone O., Gebbia V., Generali D., Gianni L., Giovanardi F., Grassadonia A., Leonardi V., Marchetti P., Melegari E., Musolino A., Nicolini M., Putzu C., Riccardi F., Santini D., Saracchini S., Sarobba M. G., Schintu M. G., Scognamiglio G., Spadaro P., Taverniti C., Toniolo D., Tralongo P., Turletti A., Valenza R., Valerio M. R., Vici P., Clivio L., Torri V., Cicchiello F., Riva F., Vallini I., Mazza M., Bonfadini C., Bordin E., Canicatti M., Cappuccio F., Collova E., De Angelis C., Desorte R., Donati S., Drudi G., Galanti D., Mocerino C., Orlando L., Pellegrino B., Pizzuti L., Ridolfi C., Rocca A., Sarti D., Spagnoletti I., Tinari N., Vandone A., Vizzini L., Cazzaniga, M, Pinotti, G, Montagna, E, Amoroso, D, Berardi, R, Butera, A, Cagossi, K, Cavanna, L, Ciccarese, M, Cinieri, S, Cretella, E, De Conciliis, E, Febbraro, A, Ferrau, F, Ferzi, A, Fiorentini, G, Fontana, A, Gambaro, A, Garrone, O, Gebbia, V, Generali, D, Gianni, L, Giovanardi, F, Grassadonia, A, Leonardi, V, Marchetti, P, Melegari, E, Musolino, A, Nicolini, M, Putzu, C, Riccardi, F, Santini, D, Saracchini, S, Sarobba, M, Schintu, M, Scognamiglio, G, Spadaro, P, Taverniti, C, Toniolo, D, Tralongo, P, Turletti, A, Valenza, R, Valerio, M, Vici, P, Clivio, L, Torri, V, Cicchiello, F, Riva, F, Vallini, I, Mazza, M, Bonfadini, C, Bordin, E, Canicatti, M, Cappuccio, F, Collova, E, De Angelis, C, Desorte, R, Donati, S, Drudi, G, Galanti, D, Mocerino, C, Orlando, L, Pellegrino, B, Pizzuti, L, Ridolfi, C, Rocca, A, Sarti, D, Spagnoletti, I, Tinari, N, Vandone, A, Vizzini, L, Cazzaniga M. E., Pinotti G., Montagna E., Amoroso D., Berardi R., Butera A., Cagossi K., Cavanna L., Ciccarese M., Cinieri S., Cretella E., De Conciliis E., Febbraro A., Ferrau F., Ferzi A., Fiorentini G., Fontana A., Gambaro A. R., Garrone O., Gebbia V., Generali D., Gianni L., Giovanardi F., Grassadonia A., Leonardi V., Marchetti P., Melegari E., Musolino A., Nicolini M., Putzu C., Riccardi F., Santini D., Saracchini S., Sarobba M. G., Schintu M. G., Scognamiglio G., Spadaro P., Taverniti C., Toniolo D., Tralongo P., Turletti A., Valenza R., Valerio M. R., Vici P., Clivio L., Torri V., Cicchiello F., Riva F., Vallini I., Mazza M., Bonfadini C., Bordin E., Canicatti M., Cappuccio F., Collova E., De Angelis C., Desorte R., Donati S., Drudi G., Galanti D., Mocerino C., Orlando L., Pellegrino B., Pizzuti L., Ridolfi C., Rocca A., Sarti D., Spagnoletti I., Tinari N., Vandone A., and Vizzini L.

Abstract

Metronomic chemotherapy (mCHT) refers to the minimum biologically effective dose of a chemotherapy agent given as a continuous dosing regimen, with no prolonged drug-free breaks, that leads to antitumor activity. Aim of the present study is to describe the use of mCHT in a retrospective cohort of metastatic breast cancer (MBC) patients in order to collect data regarding the different types and regimens of drugs employed, their efficacy and safety. Between January 2011 and December 2016, data of 584 metastatic breast cancer patients treated with mCHT were collected. The use of VRL-based regimens increased during the time of observation (2011: 16.8% - 2016: 29.8%), as well as CTX-based ones (2011: 17.1% - 2016: 25.6%), whereas CAPE-based and MTX-based regimens remained stable. In the 1st-line setting, the highest ORR and DCR were observed for VRL-based regimens (single agent: 44% and 88%; combination: 36.7% and 82.4%, respectively). Assuming VRL-single agent as the referee treatment (median PFS: 7.2 months, 95% CI: 5.3–10.3), the longest median PFS were observed in VRL-combination regimens (9.5, 95%CI 88.8–11.3, HR = 0.72) and in CAPE-single agent (10.7, 95%CI 8.3–15.8, HR = 0.70). The VICTOR-6 study provides new data coming from the real-life setting, by adding new information regarding the use of mCHT as an option of treatment for MBC patients.

Published
2019

10. Metronomic chemotherapy (mCHT) in metastatic triple-negative breast cancer (TNBC) patients: results of the VICTOR-6 study.

Author

Cazzaniga, M. E., Vallini, I., Montagna, E., Amoroso, D., Berardi, R., Butera, A., Cagossi, K., Cavanna, L., Ciccarese, M., Cinieri, S., Cretella, E., De Conciliis, E., Febbraro, A., Ferraù, F., Ferzi, A., Baldelli, A., Fontana, A., Gambaro, A. R., Garrone, O., and Gebbia, V.

Abstract

Purpose: Triple-negative breast cancer (TNBC) represents a subtype of breast cancer which lacks the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2): TNBC accounts for approximately 20% of newly diagnosed breast cancers and is associated with younger age at diagnosis, greater recurrence risk and shorter survival time. Therapeutic options are very scarce. Aim of the present analysis is to provide further insights into the clinical activity of metronomic chemotherapy (mCHT), in a real-life setting. Methods: We used data included in the VICTOR-6 study for the present analysis. VICTOR-6 is an Italian multicentre retrospective cohort study, which collected data of metastatic breast cancer (MBC) patients who have received mCHT between 2011 and 2016. Amongst the 584 patients included in the study, 97 were triple negative. In 40.2% of the TNBC patients, mCHT was the first chemotherapy treatment, whereas 32.9% had received 2 or more lines of treatment for the metastatic disease. 45.4% out of 97 TNBC patients received a vinorelbine (VRL)-based regimen, which resulted in the most used type of mCHT, followed by cyclophosphamide (CTX)-based regimens (30.9%) and capecitabine (CAPE)-based combinations (22.7%). Results: Overall response rate (ORR) and disease control rate (DCR) were 17.5% and 64.9%, respectively. Median progression free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.9–7.2) and 12.1 months (95% CI: 9.6–16.7). Median PFS was 6.9 months for CAPE-based regimens (95% CI: 5.0–18.4), 6.1 months (95% CI: 4.0–8.9) for CTX-based and 5.3 months (95% CI: 4.1–9.5) for VRL-based ones. Median OS was 18.2 months (95% CI: 9.1-NE) for CAPE-based regimens and 11.8 months for VRL- (95% CI: 9.3–16.7 and CTX-based ones (95%CI: 8.7–52.8). Tumour response, PFS and OS decreased proportionally in later lines. Conclusion: This analysis represents the largest series of TNBC patients treated with mCHT in a real-life setting and provides further insights into the advantages of using this strategy even in this poor prognosis subpopulation. [ABSTRACT FROM AUTHOR]

Published
2021
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11. Metronomic chemotherapy for advanced breast cancer patients in the real world practice: Final results of the VICTOR-6 study

Author

Cazzaniga, M.E., primary, Pinotti, G., additional, Montagna, E., additional, Amoroso, D., additional, Berardi, R., additional, Butera, A., additional, Cagossi, K., additional, Cavanna, L., additional, Ciccarese, M., additional, Cinieri, S., additional, Cretella, E., additional, De Conciliis, E., additional, Febbraro, A., additional, Ferraù, F., additional, Ferzi, A., additional, Fiorentini, G., additional, Fontana, A., additional, Gambaro, A.R., additional, Garrone, O., additional, Gebbia, V., additional, Generali, D., additional, Gianni, L., additional, Giovanardi, F., additional, Grassadonia, A., additional, Leonardi, V., additional, Marchetti, P., additional, Melegari, E., additional, Musolino, A., additional, Nicolini, M., additional, Putzu, C., additional, Riccardi, F., additional, Santini, D., additional, Saracchini, S., additional, Sarobba, M.G., additional, Schintu, M.G., additional, Scognamiglio, G., additional, Spadaro, P., additional, Taverniti, C., additional, Toniolo, D., additional, Tralongo, P., additional, Turletti, A., additional, Valenza, R., additional, Valerio, M.R., additional, Vici, P., additional, Clivio, L., additional, Torri, V., additional, Cicchiello, F., additional, Riva, F., additional, Vallini, I., additional, Mazza, M., additional, Bonfadini, C., additional, Bordin, E., additional, Canicattì, M., additional, Cappuccio, F., additional, Collovà, E., additional, De Angelis, C., additional, Desorte, R., additional, Donati, S., additional, Drudi, G., additional, Galanti, D., additional, Mocerino, C., additional, Orlando, L., additional, Pellegrino, B., additional, Pizzuti, L., additional, Ridolfi, C., additional, Rocca, A., additional, Sarti, D., additional, Spagnoletti, I., additional, Tinari, N., additional, Vandone, A., additional, and Vizzini, L., additional

Published
2019
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12. Abstract P5-21-29: Moving from the CLEOPATRA study to real life: Preliminary results from the G.O.N.O. SUPER trial

Author

Garrone, O, primary, D'Onofrio, L, additional, Blondeaux, E, additional, Bertolini, I, additional, Giarratano, T, additional, Beano, A, additional, Saggia, C, additional, Cazzaniga, M, additional, LaVerde, N, additional, Collovà, E, additional, Milani, A, additional, De Conciliis, E, additional, Coltelli, L, additional, Airoldi, M, additional, Del Mastro, L, additional, Cursano, MC, additional, Michelotti, A, additional, Vandone, AM, additional, Guarneri, V, additional, Donadio, M, additional, Riva, F, additional, Nuzzo, A, additional, and Merlano, MC, additional

Published
2018
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13. From the CLEOPATRA study to real life: preliminary results from the G.O.N.O. SUPER trial

Author

Garrone, O., primary, Cursano, M.C., additional, De Angelis, C., additional, Giarratano, T., additional, Saggia, C., additional, Beano, A., additional, Cazzaniga, M., additional, La Verde, N., additional, Milani, A., additional, Collovà, E., additional, Coltelli, L., additional, de Conciliis, E., additional, Vandone, A.M., additional, Airoldi, M., additional, D'Onofrio, L., additional, Bertolini, I., additional, Guarneri, V., additional, Donadio, M., additional, Riva, F., additional, and Merlano, M.C., additional

Published
2017
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14. Nab-paclitaxel in clinical practice: data from the MANTEL study

Author

Vanella, P., primary, Garrone, O., additional, Saggia, C., additional, Bergnolo, P., additional, Beano, A., additional, Airoldi, M., additional, Turletti, A., additional, Castiglione, F., additional, Manzin, E., additional, Denaro, N., additional, de Conciliis, E., additional, Vandone, A.M., additional, Donadio, M., additional, Miraglio, E., additional, and Merlano, M.C., additional

Published
2017
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15. Metronomic chemotherapy (mCHT) in HER2-ve advanced breast cancer (ABC) patients (pts): Old drugs, new opportunities Preliminary results of the VICTOR-6 study

Author

Cazzaniga, M., primary, Cagossi, K., additional, Valerio, M.R., additional, Russo, S., additional, Casadei, V., additional, Scognamiglio, G., additional, Cavanna, L., additional, Toniolo, D., additional, De Conciliis, E., additional, Melegari, E., additional, Stocchi, L., additional, Gebbia, V., additional, Vandone, A.M., additional, Cursano, M.C., additional, Pinotti, G., additional, Rossello, R., additional, Ortu, S., additional, Pellegrino, B., additional, Saracchini, S., additional, and Torri, V., additional

Published
2017
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16. L’incidenza del diabete tipo 1 al di sotto del primo anno di vita. Sardegna versus resto d’Italia

Author

Cherubini V, Frongia P, M. Songini, A. Ogada, F. Carle, M. Cotellessa, E. De Conciliis e. Gruppo di Studio di Diabetologia Pediatrica F. Chiarelli, U. Iannilli, R. Dhamo, A. Pinelli, GV Coppa, L. Bellu, A. R. Fifi, L. Cavallo, E. Frezza, E. Piccinno, A. Vergerio, E. Cacciari, S. Salardi, E. Angius, P. Frongia, C. Pintor, A. La Loggia, M. Cicchetti, G. Reitano, M. Mancuso, ML Arpi, M. Pocecco, G. Cerasoli, A. Verrotti, E. Altobelli, R. Vanini, L. Spallino, A. Vaccà, P. Banin, S. Toni, R. Lorini, P. Picco, A. Monaci, F. De Luca, F. Lombardo, G. Chiumello, F. Meschi, S. Bernasconi, S. Mariani, A. Franzese, O. Stoppoloni, F. Prisco, Bona, C. Monciotti, F. Cardella, M. Vanelli, G. Chiari, G. D’Annunzio, G. De Giorgi, L. Calisti, G. Zanette, E. Bartolotta, A. Crinò, L. Lucentini, I. P. Patera, G. Marietti, G. Multari, N. Sulli, A. M. Marinaro, A. Falorni, F. Cerutti, I. Rabbone, Bruno, V. Cauvin, A. Visentin, G. Tonini, E. Buratti, P. Salvatoni, L. Pinelli, IAFUSCO, Dario, Cherubini, V, Iafusco, Dario, Frongia, P, M., Songini, A., Ogada, F., Carle, M., Cotellessa, E. De Conciliis e. Gruppo di Studio di Diabetologia Pediatrica F., Chiarelli, U., Iannilli, R., Dhamo, A., Pinelli, Gv, Coppa, L., Bellu, A. R., Fifi, L., Cavallo, E., Frezza, E., Piccinno, A., Vergerio, E., Cacciari, S., Salardi, E., Angiu, P., Frongia, C., Pintor, A., La Loggia, M., Cicchetti, G., Reitano, M., Mancuso, Ml, Arpi, M., Pocecco, G., Cerasoli, A., Verrotti, E., Altobelli, R., Vanini, L., Spallino, A., Vaccà, P., Banin, S., Toni, R., Lorini, P., Picco, A., Monaci, F., De Luca, F., Lombardo, G., Chiumello, F., Meschi, S., Bernasconi, S., Mariani, A., Franzese, O., Stoppoloni, F., Prisco, Bona, C., Monciotti, F., Cardella, M., Vanelli, G., Chiari, G., D’Annunzio, G., De Giorgi, L., Calisti, G., Zanette, E., Bartolotta, A., Crinò, L., Lucentini, I. P., Patera, G., Marietti, G., Multari, N., Sulli, A. M., Marinaro, A., Falorni, F., Cerutti, I., Rabbone, Bruno, V., Cauvin, A., Visentin, G., Tonini, E., Buratti, P., Salvatoni, and L., Pinelli

Published
1999

17. 301P - Metronomic chemotherapy (mCHT) in HER2-ve advanced breast cancer (ABC) patients (pts): Old drugs, new opportunities Preliminary results of the VICTOR-6 study

Author

Cazzaniga, M., Cagossi, K., Valerio, M.R., Russo, S., Casadei, V., Scognamiglio, G., Cavanna, L., Toniolo, D., De Conciliis, E., Melegari, E., Stocchi, L., Gebbia, V., Vandone, A.M., Cursano, M.C., Pinotti, G., Rossello, R., Ortu, S., Pellegrino, B., Saracchini, S., and Torri, V.

Published
2017
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18. Inoggettività, insoggettività, virtualità

Author

De Conciliis, E, Meccariello, A, Diodato, Roberto, Diodato, Roberto (ORCID:0000-0002-4100-3676), De Conciliis, E, Meccariello, A, Diodato, Roberto, and Diodato, Roberto (ORCID:0000-0002-4100-3676)

Abstract

revisione dei concetti di oggettività e soggettività in epoca virtuale

Published
2013

19. Baudrillard e il Simbolico

Author

de Conciliis, E, Carmagnola, R, Carmagnola, RPF, de Conciliis, E, Carmagnola, R, and Carmagnola, RPF

Abstract

Il fondamentale contributo degli studi di jean Baudrillard alla definizione delal nozione di "scambio simbolico" e le differenze rispetto alla versione lacaniana del concetto di Simbolico

Published
2009

20. Metronomic chemotherapy (mCHT) in metastatic triple-negative breast cancer (TNBC) patients: results of the VICTOR-6 study

Author

Katia Cagossi, A. Ferzi, Domenico Amoroso, A. Baldelli, Luca Clivio, Mariangela Ciccarese, Viola Cogliati, Ornella Garrone, P. Spadaro, Daniele Santini, Vita Leonardi, Elisabetta Cretella, Luca Gianni, A. Gambaro, Alfredo Butera, A. Turletti, M.G. Sarobba, Giovanni Scognamiglio, Vittorio Gebbia, Cristiana Taverniti, F. Ferraù, D. Toniolo, Saverio Cinieri, C. Putzu, S. Capici, Antonino Musolino, Daniele Generali, Paolo Tralongo, Marina Elena Cazzaniga, Valter Torri, Antonino Grassadonia, Andrea Fontana, Emilia Montagna, E. de Conciliis, P. Di Mauro, Maria Rosaria Valerio, Rossana Berardi, Silvana Saracchini, Ferdinando Riccardi, Antonio Febbraro, I. Vallini, Patrizia Vici, Luigi Cavanna, M. G. Schintu, Roberto Valenza, F. Giovanardi, M. Nicolini, Samanta Sarti, Paolo Marchetti, Cazzaniga, M, Vallini, I, Montagna, E, Amoroso, D, Berardi, R, Butera, A, Cagossi, K, Cavanna, L, Ciccarese, M, Cinieri, S, Cretella, E, De Conciliis, E, Febbraro, A, Ferrau, F, Ferzi, A, Baldelli, A, Fontana, A, Gambaro, A, Garrone, O, Gebbia, V, Generali, D, Gianni, L, Giovanardi, F, Grassadonia, A, Leonardi, V, Marchetti, P, Sarti, S, Musolino, A, Nicolini, M, Putzu, C, Riccardi, F, Santini, D, Saracchini, S, Sarobba, M, Schintu, M, Scognamiglio, G, Spadaro, P, Taverniti, C, Toniolo, D, Tralongo, P, Turletti, A, Valenza, R, Valerio, M, Vici, P, Di Mauro, P, Cogliati, V, Capici, S, Clivio, L, Torri, V, Cazzaniga, M. E., Vallini, I., Montagna, E., Amoroso, D., Berardi, R., Butera, A., Cagossi, K., Cavanna, L., Ciccarese, M., Cinieri, S., Cretella, E., De Conciliis, E., Febbraro, A., Ferrau, F., Ferzi, A., Baldelli, A., Fontana, A., Gambaro, A. R., Garrone, O., Gebbia, V., Generali, D., Gianni, L., Giovanardi, F., Grassadonia, A., Leonardi, V., Marchetti, P., Sarti, S., Musolino, A., Nicolini, M., Putzu, C., Riccardi, F., Santini, D., Saracchini, S., Sarobba, M. G., Schintu, M. G., Scognamiglio, G., Spadaro, P., Taverniti, C., Toniolo, D., Tralongo, P., Turletti, A., Valenza, R., Valerio, M. R., Vici, P., Clivio, L., Torri, V., Cazzaniga, M E, Ferraù, F, Gambaro, A R, Sarobba, M G, Schintu, M G, and Valerio, M R

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Receptor, ErbB-2, Breast Neoplasms, Triple Negative Breast Neoplasms, Vinorelbine, Capecitabine, Cyclophosphamide, Methotrexate, Metronomic chemotherapy, Triple-negative breast cancer, Antineoplastic Combined Chemotherapy Protocols, Female, Humans, Retrospective Studies, ErbB-2, Breast cancer, Retrospective Studie, Internal medicine, medicine, Progression-free survival, Antineoplastic Combined Chemotherapy Protocol, business.industry, medicine.disease, Clinical Trial, Metronomic Chemotherapy, Metastatic breast cancer, Regimen, business, Breast Neoplasm, Human, Receptor, medicine.drug
Abstract

Purpose Triple-negative breast cancer (TNBC) represents a subtype of breast cancer which lacks the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2): TNBC accounts for approximately 20% of newly diagnosed breast cancers and is associated with younger age at diagnosis, greater recurrence risk and shorter survival time. Therapeutic options are very scarce. Aim of the present analysis is to provide further insights into the clinical activity of metronomic chemotherapy (mCHT), in a real-life setting. Methods We used data included in the VICTOR-6 study for the present analysis. VICTOR-6 is an Italian multicentre retrospective cohort study, which collected data of metastatic breast cancer (MBC) patients who have received mCHT between 2011 and 2016. Amongst the 584 patients included in the study, 97 were triple negative. In 40.2% of the TNBC patients, mCHT was the first chemotherapy treatment, whereas 32.9% had received 2 or more lines of treatment for the metastatic disease. 45.4% out of 97 TNBC patients received a vinorelbine (VRL)-based regimen, which resulted in the most used type of mCHT, followed by cyclophosphamide (CTX)-based regimens (30.9%) and capecitabine (CAPE)-based combinations (22.7%). Results Overall response rate (ORR) and disease control rate (DCR) were 17.5% and 64.9%, respectively. Median progression free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.9–7.2) and 12.1 months (95% CI: 9.6–16.7). Median PFS was 6.9 months for CAPE-based regimens (95% CI: 5.0–18.4), 6.1 months (95% CI: 4.0–8.9) for CTX-based and 5.3 months (95% CI: 4.1–9.5) for VRL-based ones. Median OS was 18.2 months (95% CI: 9.1-NE) for CAPE-based regimens and 11.8 months for VRL- (95% CI: 9.3–16.7 and CTX-based ones (95%CI: 8.7–52.8). Tumour response, PFS and OS decreased proportionally in later lines. Conclusion This analysis represents the largest series of TNBC patients treated with mCHT in a real-life setting and provides further insights into the advantages of using this strategy even in this poor prognosis subpopulation.

Published
2021

22. In nome del popolo (e delle sue divisioni). Cartografie dei sottosuoli e delle utopie giudiziarie

Author

BRINDISI, Gianvito, ADORNO, TH. W., GUATTARI, F., BONITO OLIVA, R., BOTTONE, M., BRINDISI, G., CAIGNARD, R., DE CONCILIIS, E., NEGARESTANI, R., PALMA, M., VIGNOLA, P., RUSSO, G., CUOMO, V., G. Brindisi, V. Cuomo, E. de Conciliis, and Brindisi, Gianvito

Subjects
Félix Guattari, Legge, Giustizia, Cartografie giudiziarie
Abstract

This article aims to discuss the sense and the value of the social cartographies of justice starting from what could be defined the schizoanalysis of judicial power of Félix Guattari. Beginning from the preface of Guattari in the Chronique des flagrants délits of Christian Hennion, contextualizing it, analyzing it in its specific framework and discussing it through a confrontation with other theoretical implants that have the same critical tonality, the article examines different typologies of judicial undergrounds and an utopic perspective as an answer to them. In this way, it makes the guattarian schizoanalysis an important component of a more general cartographical method that aims to analyze the strengths that act in judgments and to disclose their overall social and aesthetical depth, related to the individual and collective sensibility. Therefore, the principal thesis is that the critic of the politics of judgment – namely of the state and the changes of social sensibility (political, juridical and moral) – is extremely important in the problematization of the forms of experience.

Published
2016

23. Editoriale Sottosuoli

Author

BRINDISI, Gianvito, Cuomo, Vincenzo, de Conciliis, Eleonora, ADORNO, TH. W., GUATTARI, F., BONITO OLIVA, R., BOTTONE, M., BRINDISI, G., CAIGNARD, R., DE CONCILIIS, E., NEGARESTANI, R., PALMA, M., VIGNOLA, P., RUSSO, G., CUOMO, V., G. Brindisi, V. Cuomo, E. de Conciliis, Brindisi, Gianvito, Cuomo, Vincenzo, and de Conciliis, Eleonora

Subjects
Sottosuolo, Risentimento, Soggettività contemporanea
Published
2016

24. Application de la loi

Author

BRINDISI, Gianvito, ADORNO, TH. W., GUATTARI, F., BONITO OLIVA, R., BOTTONE, M., BRINDISI, G., CAIGNARD, R., DE CONCILIIS, E., NEGARESTANI, R., PALMA, M., VIGNOLA, P., RUSSO, G., CUOMO, V., G. Brindisi, V. Cuomo, E. de Conciliis, and Brindisi, Gianvito

Subjects
Legge, Inconscio, Libido giudiziaria
Published
2016

25. Baudrillard e il Simbolico

Author

Carmagnola, RPF, de Conciliis, E, and Carmagnola, R

Subjects
Baudrillard, Lacan, Zizek, scambio simbolico, M-FIL/04 - ESTETICA
Abstract

Il fondamentale contributo degli studi di jean Baudrillard alla definizione delal nozione di "scambio simbolico" e le differenze rispetto alla versione lacaniana del concetto di Simbolico

Published
2009

26. Eribulin in pretreated metastatic breast cancer patients: results of the TROTTER trial-a multicenter retrospective study of eribulin in real life.

Author

Garrone O, Montemurro F, Saggia C, La Verde N, Vandone AM, Airoldi M, De Conciliis E, Donadio M, Lucio F, Polimeni MA, Oletti MV, Giacobino A, and Merlano MC

Abstract

This retrospective multicenter analysis was aimed to evaluate clinical activity and tolerability of eribulin in pretreated metastatic breast cancer patients in clinical practice. Patients treated with eribulin from January 2012 to July 2013 were enrolled in the observational study from 10 italian hospitals. Tumor and toxicity evaluation were performed according to Agenzia Italiana Farmaco. One-hundred and thirteen patients were included in the study. Median age 62 years old. 71.7 % of the patients had visceral involvement and the majority had a burden of disease involving two or more organs with a median number of 2 (1-6). The median number of previous chemotherapy regimens for advanced disease was 3 (1-10). Median number of eribulin cycles was 4 (1-27). Overall response rate was 24 % (95 % CI 16.0-31.8). Clinical benefit rate, was 35.4 % (95 % CI 26.6-44.2). At a median follow-up of 29.6 months (8.3-41.9) the median progression free survival was 3.3 months (0.6-26.7; 95 % CI 2.4-4.2), and the median overall survival 11.6 months (0.6-33.3; 95 % CI 8.7-14.5). No correlation was recorded between subtypes in terms of ORR and CBR. Toxicity was manageable. Main common grade 3-4 toxicities were neutropenia (19.4 %), febrile neutropenia (0.9 %), asthenia (3.5 %), abnormal liver function test (1.8 %), stomatitis (0.9 %). Our results confirm that treatment with eribulin is feasible and safe in real-world patients.

Published
2016
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27. Urinary tract infection caused by Kluyvera ascorbata in a child: case report and review of the kluyvera infections in children.

Author

Ruffini E, Pace F, Carlucci M, De Conciliis E, Staffolani P, and Carlucci A

Subjects
Adolescent, Age Factors, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Sex Factors, Time Factors, Treatment Outcome, Urinary Tract Infections drug therapy, Urine microbiology, Enterobacteriaceae Infections drug therapy, Enterobacteriaceae Infections epidemiology, Enterobacteriaceae Infections urine, Kluyvera isolation & purification, Urinary Tract Infections microbiology
Abstract

Kluyvera species are described infrequently in association with clinically significant infections, and infections caused by these gram negative rods are rare in children. The spectrum of disease due to Kluyvera infection in children includes urinary tract infections, enteritis, soft tissue infections, sepsis, central venous catheter infections and peritonitis. The authors report a case of Kluyvera ascorbata urinary tract infection in a 3-month-old female baby, and they review the literature on Kluyvera infections in children.

Published
2008

28. Cardioprotective effect of dexrazoxane in patients with breast cancer treated with anthracyclines in adjuvant setting: a 10-year single institution experience.

Author

Testore F, Milanese S, Ceste M, de Conciliis E, Parello G, Lanfranco C, Manfredi R, Ferrero G, Simoni C, Miglietta L, Ferro S, Giaretto L, and Bosso G

Subjects
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cardiovascular Agents adverse effects, Dose-Response Relationship, Drug, Doxorubicin administration & dosage, Electrocardiography, Epirubicin administration & dosage, Female, Follow-Up Studies, Heart Failure chemically induced, Humans, Incidence, Life Expectancy, Middle Aged, Neoplasm Metastasis, Razoxane administration & dosage, Retrospective Studies, Antineoplastic Combined Chemotherapy Protocols adverse effects, Breast Neoplasms drug therapy, Cardiovascular Agents therapeutic use, Heart Failure prevention & control
Abstract

Background and Objective: Anthracyclines are highly effective and widely used cytotoxic agents, but their application is often limited by cumulative dose-dependent cardiotoxicity. Dexrazoxane has been shown in several clinical trials to prevent the development of this serious toxicity. The aim of our study was to analyze the incidence of cardiac dysfunction over a 10-year period in patients with breast cancer who were treated with anthracycline-based regimens with addition of dexrazoxane, mainly in an adjuvant setting., Methods: We conducted a retrospective analysis on a population of women with breast cancer treated at our institution between January 1993 and October 2003. We reviewed patients' medical records and data on patient characteristics, treatment history, and adverse events that were collected, starting from the time of first visit before starting therapy, with the use of software created and designed for clinical records management in our institution (1999 OK-DH). Patients underwent an ECG assessment prior to starting chemotherapy, and were clinically monitored for cardiac failure. Those who developed signs and symptoms suggestive of cardiac dysfunction underwent further ECG. If clinical findings indicated, echocardiography and further cardiologic investigations were performed. The main outcome measure was the development of signs and symptoms indicative of congestive heart failure (CHF)., Results: A total of 318 female patients were treated with an anthracycline (doxorubicin or epirubicin)-based combination chemotherapy regimen during this time, in most cases in the adjuvant setting (n = 285). Most patients (n = 302) had early-stage disease and only 16 women presented with metastatic disease with good life expectancy (at least 1 year). All patients received dexrazoxane 1000 mg/m(2) intravenously prior to anthracycline administration during each chemotherapy cycle. The median follow-up duration was 35 months. During this time, five patients (1.57%) developed signs and symptoms of CHF. No patient at our institution died of heart failure during the period analyzed. Dexrazoxane was well tolerated, with no reports of adverse events associated with this drug., Conclusions: The reported incidence of cardiotoxicity in this study represents a marked reduction compared with historical data for patients receiving anthracycline-based chemotherapy without dexrazoxane. Dexrazoxane appears to have a cardioprotective effect in women with early-stage or advanced breast cancer treated with anthracycline-based combination chemotherapy, mainly as an adjuvant treatment. Prospective, randomized, controlled clinical trials in adjuvant setting should be performed to confirm these results.

Published
2008
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