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1. Sex and survival outcomes in patients with renal cell carcinoma receiving first-line immune-based combinations

Author

Incorvaia, Lorena, Monteiro, Fernando Sabino Marques, Massari, Francesco, Park, Se Hoon, Roviello, Giandomenico, Fiala, Ondřej, Myint, Zin W., Kucharz, Jakub, Molina-Cerrillo, Javier, Santini, Daniele, Buttner, Thomas, Poprach, Alexandr, Kopecky, Jindrich, Zeppellini, Annalisa, Pichler, Martin, Buchler, Tomas, Pichler, Renate, Facchini, Gaetano, Fay, Andre Poisl, Soares, Andrey, Manneh, Ray, Iezzi, Laura, Kuronya, Zsofia, Russo, Antonio, Bourlon, Maria T., Bhuva, Dipen, Ansari, Jawaher, Kanesvaran, Ravindran, Grande, Enrique, Buti, Sebastiano, and Santoni, Matteo

Published
2024
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2. Global real-world experiences with pembrolizumab in advanced urothelial carcinoma after platinum-based chemotherapy: the ARON-2 study

Author

Massari, Francesco, Santoni, Matteo, Takeshita, Hideki, Okada, Yohei, Tapia, Jose Carlos, Basso, Umberto, Maruzzo, Marco, Scagliarini, Sarah, Büttner, Thomas, Fornarini, Giuseppe, Myint, Zin W., Galli, Luca, Souza, Vinicius Carrera, Pichler, Renate, De Giorgi, Ugo, Gandur, Nathalia, Lam, Elaine T., Gilbert, Danielle, Popovic, Lazar, Grande, Enrique, Mammone, Giulia, Berardi, Rossana, Crabb, Simon J., Kemp, Robert, Molina-Cerrillo, Javier, Freitas, Marcelo, Luz, Murilo, Iacovelli, Roberto, Calabrò, Fabio, Tural, Deniz, Atzori, Francesco, Küronya, Zsófia, Chiari, Rita, Campos, Saul, Caffo, Orazio, Fay, André P., Kucharz, Jakub, Zucali, Paolo Andrea, Rinck, José Augusto, Zeppellini, Annalisa, Bastos, Diogo Assed, Aurilio, Gaetano, Mota, Augusto, Trindade, Karine, Ortega, Cinzia, Sade, Juan Pablo, Rizzo, Mimma, Fiala, Ondřej, Vau, Nuno, Giannatempo, Patrizia, Barillas, Allan, Monteiro, Fernando Sabino M., Dauster, Breno, Mennitto, Alessia, Nogueira, Lucas, de Carvalho Fernandes, Roni, Seront, Emmanuel, Aceituno, Luís Garcia, Grillone, Francesco, Cutuli, Hernan Javier, Fernandez, Mauricio, Bassanelli, Maria, Kopp, Ray Manneh, Roviello, Giandomenico, Abahssain, Halima, Procopio, Giuseppe, Milella, Michele, Kopecky, Jindrich, Martignetti, Angelo, Messina, Carlo, Caitano, Manuel, Inman, Eva, Kanesvaran, Ravindran, Herchhorn, Daniel, Santini, Daniele, Bamias, Aristotelis, Bisonni, Renato, Mosca, Alessandra, Morelli, Franco, Maluf, Fernando, Soares, Andrey, Nunes, Fernando, Pinto, Alvaro, Zgura, Anca, Incorvaia, Lorena, Ansari, Jawaher, Zabalza, Ignacio Ortego, Landmesser, Johannes, Rizzo, Alessandro, Mollica, Veronica, Marchetti, Andrea, Rosellini, Matteo, Sorgentoni, Giulia, Battelli, Nicola, Buti, Sebastiano, Porta, Camillo, and Bellmunt, Joaquim

Published
2024
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3. Use of concomitant proton pump inhibitors, statins or metformin in patients treated with pembrolizumab for metastatic urothelial carcinoma: data from the ARON-2 retrospective study

Author

Fiala, Ondřej, Buti, Sebastiano, Takeshita, Hideki, Okada, Yohei, Massari, Francesco, Palacios, Georgia Anguera, Dionese, Michele, Scagliarini, Sarah, Büttner, Thomas, Fornarini, Giuseppe, Myint, Zin W., Galli, Luca, Souza, Vinicius Carrera, Pichler, Renate, De Giorgi, Ugo, Quiroga, María Natalia Gandur, Gilbert, Danielle, Popovic, Lazar, Grande, Enrique, Mammone, Giulia, Berardi, Rossana, Crabb, Simon J., Molina-Cerrillo, Javier, Freitas, Marcelo, Luz, Murilo, Iacovelli, Roberto, Calabrò, Fabio, Tural, Deniz, Atzori, Francesco, Küronya, Zsófia, Chiari, Rita, Campos, Saul, Caffo, Orazio, Fay, André P., Kucharz, Jakub, Zucali, Paolo Andrea, Rinck, José Augusto, Zeppellini, Annalisa, Bastos, Diogo Assed, Aurilio, Gaetano, Mota, Augusto, Trindade, Karine, Ortega, Cinzia, Sade, Juan Pablo, Rizzo, Mimma, Vau, Nuno, Giannatempo, Patrizia, Barillas, Allan, Monteiro, Fernando Sabino Marques, Dauster, Breno, Cattrini, Carlo, Nogueira, Lucas, de Carvalho Fernandes, Roni, Seront, Emmanuel, Aceituno, Luís Garcia, Grillone, Francesco, Cutuli, Hernan Javier, Fernandez, Mauricio, Bassanelli, Maria, Roviello, Giandomenico, Abahssain, Halima, Procopio, Giuseppe, Milella, Michele, Kopecky, Jindrich, Martignetti, Angelo, Messina, Carlo, Caitano, Manuel, Inman, Eva, Kanesvaran, Ravindran, Herchenhorn, Daniel, Santini, Daniele, Manneh, Ray, Bisonni, Renato, Zakopoulou, Roubini, Mosca, Alessandra, Morelli, Franco, Maluf, Fernando, Soares, Andrey, Nunes, Fernando, Pinto, Alvaro, Zgura, Anca, Incorvaia, Lorena, Ansari, Jawaher, Zabalza, Ignacio Ortego, Landmesser, Johannes, Rizzo, Alessandro, Mollica, Veronica, Sorgentoni, Giulia, Battelli, Nicola, Porta, Camillo, Bellmunt, Joaquim, and Santoni, Matteo

Published
2023
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4. Real-world effectiveness of pembrolizumab as first-line therapy for cisplatin-ineligible patients with advanced urothelial carcinoma: the ARON-2 study

Author

Santoni, Matteo, Myint, Zin W., Büttner, Thomas, Takeshita, Hideki, Okada, Yohei, Lam, Elaine T., Gilbert, Danielle, Küronya, Zsófia, Tural, Deniz, Pichler, Renate, Grande, Enrique, Crabb, Simon J., Kemp, Robert, Massari, Francesco, Scagliarini, Sarah, Iacovelli, Roberto, Vau, Nuno, Basso, Umberto, Maruzzo, Marco, Molina-Cerrillo, Javier, Galli, Luca, Bamias, Aristotelis, De Giorgi, Ugo, Zucali, Paolo Andrea, Rizzo, Mimma, Seront, Emmanuel, Popovic, Lazar, Caffo, Orazio, Buti, Sebastiano, Kanesvaran, Ravindran, Kopecky, Jindrich, Kucharz, Jakub, Zeppellini, Annalisa, Fiala, Ondřej, Landmesser, Johannes, Ansari, Jawaher, Giannatempo, Patrizia, Rizzo, Alessandro, Zabalza, Ignacio Ortego, Monteiro, Fernando Sabino M., Battelli, Nicola, Calabrò, Fabio, and Porta, Camillo

Published
2023
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5. Clinical features and response to immune combinations in patients with renal cell carcinoma and sarcomatoid de‐differentiation (ARON‐1 study).

Author

Ciccarese, Chiara, Büttner, Thomas, Cerbone, Linda, Zampiva, Ilaria, Monteiro, Fernando Sabino M., Basso, Umberto, Pichler, Martin, Vitale, Maria Giuseppa, Fiala, Ondrej, Roviello, Giandomenico, Kopp, Ray Manneh, Carrozza, Francesco, Pichler, Renate, Grillone, Francesco, Calabuig, Esther Pérez, Zeppellini, Annalisa, Küronya, Zsófia, Galli, Luca, Facchini, Gaetano, and Sunela, Kaisa

Subjects
OVERALL survival, SURVIVAL rate, KINASE inhibitors, IMMUNE response, PROGNOSIS
Abstract

Metastatic renal cell carcinoma (mRCC) carrying sarcomatoid features (sRCC) has aggressive biology and poor prognosis. First‐line immunotherapy (IO)‐based combinations have improved the outcome of clear cell RCC patients, including that of sRCC. Real‐world data confirming the adequate first‐line management of sRCC is largely lacking. We investigated the clinical features and the outcome of sRCC patients treated with IO‐based combinations within the ARON‐1 study population (NCT05287464). The primary objective was to define the incidence and baseline clinical characteristics of sRCC compared with non‐sRCC patients. The secondary objective was to describe the outcome of sRCC patients based on type of first‐line treatment (IO + IO vs. IO + tyrosin kinase inhibitor [TKI]). We identified 1362 mRCC patients with IMDC intermediate or poor risk, 226 sRCC and 1136 non‐sRCC. These two subgroups did not differ in terms of baseline characteristics. The median overall survival (OS) was 26.8 months (95%CI 21.6–44.2) in sRCC and 35.3 months (95%CI 30.2–40.4) in non‐sRCC patients (p =.013). The median progression‐free survival (PFS) was longer in non‐sRCC patients compared to sRCC (14.5 vs. 12.3 months, p =.064). In patients treated with first‐line IO + TKI the median OS was 34.4 months compared to 26.4 months of those who received IO + IO (p =.729). The median PFS was 12.4 months with IO + TKI and 12.3 months with IO + IO (p =.606). In conclusion, we confirm that sRCC are aggressive tumors with poor prognosis. IO‐based combinations improve survival outcomes of sRCC patients, regardless from the type of strategy (IO + IO versus IO + TKI) adopted. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Comparison of tumor microenvironment in primary and paired metastatic ER+/HER2- breast cancers: results of a pilot study

Author

Annalisa Zeppellini, Stefania Galimberti, Biagio Eugenio Leone, Claudia Pacifico, Francesca Riva, Federica Cicchiello, Serena Capici, Claudia Maggioni, Luca Sala, and Marina Elena Cazzaniga

Subjects
Breast Cancer, Luminal, Microenvironment, Tumor infiltrating lymphocytes (TILs), T CD8 +, T CD4+ FOXP3+, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Tumor microenvironment (TME) is a dynamic setting and changes in TILs and their subpopulations are potential candidates to influence the metastatic process. Aim of this pilot study is to describe the changes occurring between primary breast cancers and their paired metastases in terms of TILs composition. To assess if these changes influence the process of metastasis development, we used a control group of patients. Methods We retrospectively identified 18 Luminal patients, for whom primary and metastatic tissue were available (cases) and 18 paired-matched patients (controls), not relapsed after at least 9 years of follow-up, and we quantified TILs and their composition (i.e. T CD8+ and CD4+/FOXP3+). The presence of TILs was defined as ≥10%. Results Our results showed that the microenvironment composition of relapsed patients was poor of TILs (median = 5%, I-III quartiles = 0.6–5%), CD8+ (2.5%, 0–5%) and CD4+/FOXP3 + (0%, 0–0.6%) in the primary tumor. Comparable results were observed in their related metastases (TILs 3.8%, 0.6–5%; CD8+ 0%, 0–1.3%; CD4+/FOXP3+ 0%,0–1.9%). On the contrary, the microenvironment in the control group was richer of TILs (5%, 5–17.5%) in comparison to cases, both in primary tumor (p = 0.035) and related metastases (p = 0.018). Although CD8+ in controls were similar to cases at primary tumor (p = 0.6498), but not at metastasis (p = 0.0223), they expressed only one part on the TILs subpopulations (p = 0.0060), while TILs in the cases at primary tumor were almost completely CD8+ (p = 0.5034). Conclusions These findings suggest that the lack of activation of immune system in the primary tumor might influence the multifactor process of cancer progression.

Published
2021
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8. Influence dosimetric study of different couches in radiotherapy treatments

Author

Renata Aline Del Nero, Caroline Zeppellini Santos Emiliozzi, Alexandre Ruggieri Serante, Paulo de Tarso Dalledone Siqueira, and Paula Christina Guimarães Antunes

Subjects
radiotherapy, attenuation, BrainLAB, Exact, iBEAM, Science
Abstract

Radiotherapy is a recommended procedure, in average, for 52% of cancer cases as one of the treatment forms, therefore, it is important for the clinical practice to investigate the affecting factors in dose distribution received by the patients, and for example, devices and treatment couch. With the introduction of treatments with modulated intensity techniques like IMRT and VMAT, the number of incidence fields used for patient treatment increased, which makes the couch’s dosimetric effect more significant in these modalities. The attenuation data acquisition referring to the treatment couches, as well as the TPS data evaluation, show as important parameters for the clinical practice because they show what happens with the dose delivery during the treatment, ensuring a better quality and safety to the treatments. This research presents experimental results evaluating the couch’s impact in the treatments by a study of perturbation in the distribution of surface dose, dose attenuation according to the gantry’s angle for the couches BrainLABTM, ExactTM and iBEAMTM. Then we propose better density values for the couches BrainLABTM and ExactTM for their inclusion in EclipseTM TPS. Lastly, we compare the dose difference considering the presence or not of couch in the planning. In conclusion, the beam’s attenuation increase by the couches and the doses alterations on the skin must be taken in consideration in the treatment planning process. It is of great relevance that each treatment center perform internal tests to determinate the best density values for available TPS.

Published
2022

10. 11-year workload and barrier analysis for a high-energy linear accelerator

Author

Isabela Rodrigues Rigo, Ana Paula Vollet Cunha, Caroline Zeppellini dos Santos Emiliozzi, and Gisela Menegussi

Subjects
shielding, workload, IMRT, VMAT, Science
Abstract

The formalism used for barriers calculations is based on a conservative estimation of workload, use factor, and occupancy factor. IMRT techniques (Intensity Modulated Radiation Therapy) and VMAT (Volumetric Modulated Arc Therapy) are known for being superior to conventional techniques, but costly from the shielding standpoint, as they increase the number of monitor units used to deliver the same dose to the patient, increasing the leakage radiation produced and, consequently, the thickness of the secondary barriers. At InRad (Radiology Institute of HC-FMUSP) a 2100CD LINAC already installed was upgraded to perform IMRT/VMAT techniques, and the existing barrier was reassessed. The present study proposes a methodology for acquiring real workload data from the institution's management software (MOSAIQ®) to replace the initially estimated data and recalculate the thickness of the barriers, assessing the impact of the introduction of these techniques and understanding the profile of the treatments carried out at the institution over the years of 2010 to 2020. Through this methodology, a decrease in the workload of 15 MV was observed as the technique of modulated intensity with 6 MV was introduced, reducing the thicknesses calculated for primary barriers. However, no significant changes were observed in the thicknesses calculated for the secondary barriers, because despite the increase in the leakage workload of 6 MV, the total workload of 15 MV decreased. There was also a trend towards an increase in the number of patients treated with modulated intensity year after year, which went from 5% in 2016 to 67% in 2020.

Published
2021
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11. Supplementary Data from Immune Checkpoint Inhibitors and the Exposome: Host-Extrinsic Factors Determine Response, Survival, and Toxicity

Author

Pizzutilo, Elio Gregory, primary, Romanò, Rebecca, primary, Roazzi, Laura, primary, Agostara, Alberto G., primary, Oresti, Sara, primary, Zeppellini, Annalisa, primary, Giannetta, Laura, primary, Cerea, Giulio, primary, Signorelli, Diego, primary, Siena, Salvatore, primary, and Sartore-Bianchi, Andrea, primary

Published
2023
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13. Immune Checkpoint Inhibitors and the Exposome: Host-Extrinsic Factors Determine Response, Survival, and Toxicity

Author

Pizzutilo, Elio Gregory., primary, Romanò, Rebecca, additional, Roazzi, Laura, additional, Agostara, Alberto Giuseppe., additional, Oresti, Sara, additional, Zeppellini, Annalisa, additional, Giannetta, Laura, additional, Cerea, Giulio, additional, Signorelli, Diego, additional, Siena, Salvatore, additional, and Sartore-Bianchi, Andrea, additional

Published
2023
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14. Real-world effectiveness of pembrolizumab as first-line therapy for cisplatin-ineligible patients with advanced urothelial carcinoma: the ARON-2 study

Author

Matteo Santoni, Zin W. Myint, Thomas Büttner, Hideki Takeshita, Yohei Okada, Elaine T. Lam, Danielle Gilbert, Zsófia Küronya, Deniz Tural, Renate Pichler, Enrique Grande, Simon J. Crabb, Robert Kemp, Francesco Massari, Sarah Scagliarini, Roberto Iacovelli, Nuno Vau, Umberto Basso, Marco Maruzzo, Javier Molina-Cerrillo, Luca Galli, Aristotelis Bamias, Ugo De Giorgi, Paolo Andrea Zucali, Mimma Rizzo, Emmanuel Seront, Lazar Popovic, Orazio Caffo, Sebastiano Buti, Ravindran Kanesvaran, Jindrich Kopecky, Jakub Kucharz, Annalisa Zeppellini, Ondřej Fiala, Johannes Landmesser, Jawaher Ansari, Patrizia Giannatempo, Alessandro Rizzo, Ignacio Ortego Zabalza, Fernando Sabino M. Monteiro, Nicola Battelli, Fabio Calabrò, and Camillo Porta

Subjects
Cancer Research, Oncology, Immunology, Immunology and Allergy
Published
2023
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15. Immune Checkpoint Inhibitors and the Exposome: Host-Extrinsic Factors Determine Response, Survival, and Toxicity

Author

Elio Gregory. Pizzutilo, Rebecca Romanò, Laura Roazzi, Alberto Giuseppe. Agostara, Sara Oresti, Annalisa Zeppellini, Laura Giannetta, Giulio Cerea, Diego Signorelli, Salvatore Siena, and Andrea Sartore-Bianchi

Subjects
Cancer Research, Oncology
Abstract

Cancer immunotherapy, largely represented by immune checkpoint inhibitors (ICIs), has led to substantial changes in preclinical cancer research and clinical oncology practice over the past decade. However, the efficacy and toxicity profiles of ICIs remain highly variable among patients, with only a fraction achieving a significant benefit. New combination therapeutic strategies are being investigated, and the search for novel predictive biomarkers is ongoing, mainly focusing on tumor- and host-intrinsic components. Less attention has been directed to all the external, potentially modifiable factors that compose the exposome, including diet and lifestyle, infections, vaccinations, and concomitant medications, which could affect the immune system response and its activity against cancer cells. We hereby provide a review of the available clinical evidence elucidating the impact of host-extrinsic factors on ICI response and toxicity.

Published
2023
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16. Comparison of tumor microenvironment in primary and paired metastatic ER+/HER2- breast cancers: results of a pilot study

Author

Zeppellini, A, Galimberti, S, Leone, B, Pacifico, C, Riva, F, Cicchiello, F, Capici, S, Maggioni, C, Sala, L, Cazzaniga, M, Zeppellini, Annalisa, Galimberti, Stefania, Leone, Biagio Eugenio, Pacifico, Claudia, Riva, Francesca, Cicchiello, Federica, Capici, Serena, Maggioni, Claudia, Sala, Luca, Cazzaniga, Marina Elena, Zeppellini, A, Galimberti, S, Leone, B, Pacifico, C, Riva, F, Cicchiello, F, Capici, S, Maggioni, C, Sala, L, Cazzaniga, M, Zeppellini, Annalisa, Galimberti, Stefania, Leone, Biagio Eugenio, Pacifico, Claudia, Riva, Francesca, Cicchiello, Federica, Capici, Serena, Maggioni, Claudia, Sala, Luca, and Cazzaniga, Marina Elena

Abstract

BACKGROUND: Tumor microenvironment (TME) is a dynamic setting and changes in TILs and their subpopulations are potential candidates to influence the metastatic process. Aim of this pilot study is to describe the changes occurring between primary breast cancers and their paired metastases in terms of TILs composition. To assess if these changes influence the process of metastasis development, we used a control group of patients.METHODS: We retrospectively identified 18 Luminal patients, for whom primary and metastatic tissue were available (cases) and 18 paired-matched patients (controls), not relapsed after at least 9years of follow-up, and we quantified TILs and their composition (i.e. T CD8+ and CD4+/FOXP3+). The presence of TILs was defined as ≥10%.RESULTS: Our results showed that the microenvironment composition of relapsed patients was poor of TILs (median=5%, I-III quartiles=0.6-5%), CD8+ (2.5%, 0-5%) and CD4+/FOXP3+(0%, 0-0.6%) in the primary tumor. Comparable results were observed in their related metastases (TILs 3.8%, 0.6-5%; CD8+0%, 0-1.3%; CD4+/FOXP3+0%,0-1.9%). On the contrary, the microenvironment in the control group was richer of TILs (5%, 5-17.5%) in comparison to cases, both in primary tumor (p=0.035) and related metastases (p=0.018). Although CD8+ in controls were similar to cases at primary tumor (p=0.6498), but not at metastasis (p=0.0223), they expressed only one part on the TILs subpopulations (p=0.0060), while TILs in the cases at primary tumor were almost completely CD8+ (p=0.5034).CONCLUSIONS: These findings suggest that the lack of activation of immune system in the primary tumor might influence the multifactor process of cancer progression.

Published
2021

19. The evolving panorama of HER2-targeted treatments in metastatic urothelial cancer: A systematic review and future perspectives

Author

Giorgio Patelli, Annalisa Zeppellini, Francesco Spina, Elena Righetti, Stefano Stabile, Alessio Amatu, Federica Tosi, Silvia Ghezzi, Salvatore Siena, and Andrea Sartore-Bianchi

Subjects
Carcinoma, Transitional Cell, Settore MED/06 - Oncologia Medica, Receptor, ErbB-2, Carcinoma, Antineoplastic Agents, General Medicine, Trastuzumab, Metastatic bladder cancer, ERBB2, HER2, Metastatic urothelial cancer, Targeted treatment, Humans, Mutation, Urinary Bladder Neoplasms, ErbB-2, Oncology, Radiology, Nuclear Medicine and imaging, Transitional Cell, Receptor
Abstract

HER2 alterations are potential candidates for targeted treatments in metastatic urothelial/bladder cancer (mUC). ERBB2 gene amplification and mutations are found in around 6% and 4% of mUC, respectively.This is a systematic review of clinical trials evaluating HER2-targeting (amplification and mutations) in mUC. We assigned each study to one of the following strategies: HER2-targeting with single agents, anti-HER2 agents in combination with cytotoxic chemotherapy, dual HER2 blockade, HER2-targeted antibody-drug conjugates (ADCs), and other novel therapeutic approaches.36 clinical trials (17 with results and 19 ongoing) were included. As for ERBB2 amplification, anti-HER2 single agents (5 studies) and combinations with chemotherapy (4 studies) failed to provide any benefit, whereas dual HER2 blockade through monoclonal antibodies proved active in one trial in pretreated patients. Two studies assessed single-agent targeting for ERBB2 mutations with negative results. Most promising data come from 2 studies with ADCs in ERBB2 amplified tumors (disitamab-vedotin and trastuzumab-duocarmazine), while 2 other studies with TDM-1 and ADCT-502 was discontinued due to toxicity. In this category, trastuzumab-deruxtecan and other ADCs are still under investigation for either ERBB2-amplified or mutated mUC. Novel approaches include ADCs with immunotherapy (1 study with results), CAR-T cells, and HER2-sensitising vaccines.ERBB2 amplification could become a novel target in mUC, although the magnitude of clinical benefit remains to be clarified. To this regard, novel ADCs are the most promising strategy. ERBB2 mutations are still at very early stage of clinical study.

Published
2021

20. Comparison of tumor microenvironment in primary and paired metastatic ER+/HER2- breast cancers: results of a pilot study

Author

Federica Cicchiello, Marina Elena Cazzaniga, Luca Sala, Annalisa Zeppellini, Biagio Eugenio Leone, Stefania Galimberti, Serena Capici, Francesca Riva, Claudia Maggioni, Claudia Pacifico, Zeppellini, A, Galimberti, S, Leone, B, Pacifico, C, Riva, F, Cicchiello, F, Capici, S, Maggioni, C, Sala, L, and Cazzaniga, M

Subjects
0301 basic medicine, Oncology, Cancer Research, Receptor, ErbB-2, T CD8 +, Biopsy, Pilot Projects, Metastasis, 0302 clinical medicine, Surgical oncology, Tumor Microenvironment, Breast, Mastectomy, Aged, 80 and over, FOXP3, hemic and immune systems, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prognosis, Primary tumor, Receptors, Estrogen, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Disease Progression, Female, Research Article, medicine.medical_specialty, Microenvironment, chemical and pharmacologic phenomena, Breast Neoplasms, lcsh:RC254-282, Luminal, 03 medical and health sciences, Breast cancer, Lymphocytes, Tumor-Infiltrating, Internal medicine, Breast Cancer, Genetics, medicine, Humans, Aged, Retrospective Studies, Tumor microenvironment, business.industry, Cancer, T CD4+ FOXP3+, medicine.disease, 030104 developmental biology, Case-Control Studies, Tumor infiltrating lymphocytes (TILs), Neoplasm Recurrence, Local, business, CD8, Follow-Up Studies
Abstract

Background Tumor microenvironment (TME) is a dynamic setting and changes in TILs and their subpopulations are potential candidates to influence the metastatic process. Aim of this pilot study is to describe the changes occurring between primary breast cancers and their paired metastases in terms of TILs composition. To assess if these changes influence the process of metastasis development, we used a control group of patients. Methods We retrospectively identified 18 Luminal patients, for whom primary and metastatic tissue were available (cases) and 18 paired-matched patients (controls), not relapsed after at least 9 years of follow-up, and we quantified TILs and their composition (i.e. T CD8+ and CD4+/FOXP3+). The presence of TILs was defined as ≥10%. Results Our results showed that the microenvironment composition of relapsed patients was poor of TILs (median = 5%, I-III quartiles = 0.6–5%), CD8+ (2.5%, 0–5%) and CD4+/FOXP3 + (0%, 0–0.6%) in the primary tumor. Comparable results were observed in their related metastases (TILs 3.8%, 0.6–5%; CD8+ 0%, 0–1.3%; CD4+/FOXP3+ 0%,0–1.9%). On the contrary, the microenvironment in the control group was richer of TILs (5%, 5–17.5%) in comparison to cases, both in primary tumor (p = 0.035) and related metastases (p = 0.018). Although CD8+ in controls were similar to cases at primary tumor (p = 0.6498), but not at metastasis (p = 0.0223), they expressed only one part on the TILs subpopulations (p = 0.0060), while TILs in the cases at primary tumor were almost completely CD8+ (p = 0.5034). Conclusions These findings suggest that the lack of activation of immune system in the primary tumor might influence the multifactor process of cancer progression.

Published
2020

21. 11-year workload and barrier analysis for a high-energy linear accelerator

Author

Ana Paula Vollet Cunha, Caroline Zeppellini dos Santos Emiliozzi, Gisela Menegussi, and Isabela Rodrigues Rigo

Subjects
Nuclear engineering, Environmental science, Workload, General Agricultural and Biological Sciences, Energy (signal processing), Linear particle accelerator
Abstract

The formalism used for barriers calculations is based on a conservative estimation of workload, use factor, and occupancy factor. IMRT techniques (Intensity Modulated Radiation Therapy) and VMAT (Volumetric Modulated Arc Therapy) are known for being superior to conventional techniques, but costly from the shielding standpoint, as they increase the number of monitor units used to deliver the same dose to the patient, increasing the leakage radiation produced and, consequently, the thickness of the secondary barriers. At InRad (Radiology Institute of HC-FMUSP) a 2100CD LINAC already installed was upgraded to perform IMRT/VMAT techniques, and the existing barrier was reassessed. The present study proposes a methodology for acquiring real workload data from the institution's management software (MOSAIQ®) to replace the initially estimated data and recalculate the thickness of the barriers, assessing the impact of the introduction of these techniques and understanding the profile of the treatments carried out at the institution over the years of 2010 to 2020. Through this methodology, a decrease in the workload of 15 MV was observed as the technique of modulated intensity with 6 MV was introduced, reducing the thicknesses calculated for primary barriers. However, no significant changes were observed in the thicknesses calculated for the secondary barriers, because despite the increase in the leakage workload of 6 MV, the total workload of 15 MV decreased. There was also a trend towards an increase in the number of patients treated with modulated intensity year after year, which went from 5% in 2016 to 67% in 2020.

Published
2021
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22. Efficacy and Safety of the All-Oral Schedule of Metronomic Vinorelbine and Capecitabine in Locally Advanced or Metastatic Breast Cancer Patients: The Phase I-II VICTOR-1 Study

Author

M. E. Cazzaniga, V. Torri, F. Villa, N. Giuntini, F. Riva, A. Zeppellini, D. Cortinovis, and P. Bidoli

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background. Vinorelbine (VRB) and capecitabine (CAPE) are demonstrated to be active in pretreated metastatic breast cancer patients. Different studies have demonstrated that the metronomic treatment is active with an acceptable toxicity profile. We designed a Phases I-II study to define the MTD of oral metronomic, VRB, and CAPE. Patients and Methods. Phase I: fixed dose of CAPE was 500 mg thrice a day, continuously. Level I of VRB was 20 mg/tot thrice a week for 3 weeks (1 cycle). Subsequent levels were 30 mg/tot and 40 mg/tot (Level III), respectively, if no Grades 3-4 toxicity were observed in the previous level. Phase II: further 32 patients received the MTD of VRB plus CAPE for a total of 187 cycles to confirm toxicity profile. Results. 12 patients were enrolled in Phase I and 22 in Phase II. Phase I: the MTD of VRB was 40 mg. Phase II: 187 cycles were delivered, observing 5.9% of Grades 3-4 toxicity. 31 patients are evaluable for efficacy, obtaining a clinical benefit rate of 58.1%. Conclusion. MTD of VRB with fixed dose of CAPE was 40 mg thrice a week and was the recommended dose for the ongoing Phase II multicenter study.

Published
2014
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26. De l’omnipotence à la détresse: Sur le rapport entre la mémoire phylogénétique et le vieillissement

Author

José Carlos Zeppellini Junior and Manoel Tosta Berlinck

Subjects
lcsh:RC435-571, 系统发育, phylogenesis, 记忆, Mémoire, Developmental psychology, Memory, lcsh:Psychiatry, détresse, phylogénie, Phylogenese, Memoria, Memória, filogénesis, Hilflosigkei, envejecimiento, filogenese, Memory and aging, 无助感, Phylogenetic tree, Omnipotence, aging, vieillissement, Erinnerung, abandonment, desamparo, Psychiatry and Mental health, Clinical Psychology, envelhescência, 衰老过程, Abandonment (emotional), Psychology, Alterungsprozess
Abstract

Este artigo dedica-se, com base em fragmentos de um caso clínico, a discutir a contribuição dos traços mnêmicos filo e ontogenéticos para a formação de compromissos que acontecem diante do terror suscitado pela velhice. Concomitantemente, apresenta a viabilidade do amparo clínico como alternativa à ameaça de desamparo que emerge da consciência de finitude e salienta a complexidade e a importância do trabalho psíquico de envelhescência como condição fundamental à escuta na transferência. Based on fragments of a clinical case, this paper discusses the contribution of phylo and ontogenetic mnemonic traits to the formation of commitments that occur facing the terror of old age. At the same time, it presents the feasibility of clinical support as an alternative to the threat of abandonment that emerges from consciousness of finitude, and highlights the complexity and the importance of psychological work referring to aging as a fundamental condition to listening in transference. Cet article, basé en partie sur une étude clinique, discute la contribution des traits mnémoniques phylogénétique et ontogénétiques à l’adhésion à des compromis qui s’opèrent face à la crainte suscitée par le vieillissement. Parallèlement, cet article présente la faisabilité du support clinique comme alternative à la menace de la détresse qui se dégage de la prise de conscience de la finitude. Il souligne d’ailleurs la complexité et l’importance du travail psychique sur le vieillissement en tant que condition fondamentale à l’écoute pendant le transfert. Este artículo se dedica, basado en los fragmentos de un caso clínico, a discutir la contribución de las huellas mnémicas filo y ontogenéticas, en la formación de compromisos que se dan ante el terror suscitado por la vejez. Concomitantemente, presenta la factibilidad del apoyo clínico, como alternativa a la amenaza de desamparo que emerge del conocimiento de la finitud, y refleja la complejidad y la importancia del trabajo psíquico durante el envejecimiento como una condición fundamental para la escucha en la transferencia. Der vorliegende Artikel widmet sich mit Hilfe der Betrachtung eines klinischen Falls der Frage des Beitrags phylogenetischer und ontogenetischer mnemischer Züge zur Bildung von Kompromissen, welche angesichts der Angst vor dem Altern entstehen. Gleichzeitig weist er auf die Durchführbarkeit der klinischen Unterstützung als alternative Lösung gegen die Bedrohung der Hilflosigkeit hin, welche durch das Bewusstsein über die Endlichkeit ausgelöst wird und betont die Komplexität und Wichtigkeit der psychischen Verarbeitung des Alterungsprozess als grundlegende Bedingung des Zuhörens während der Übertragung. 本论文通过一临床病例片段的分析，讨论因衰老而唤起的恐惧感，从而引发了新的本体认知。我们知道这是一种系统发生学现象。与此同时，作者提出针对病人在终结意识下产生无助感的时刻，给病人提供临床支持。作者强调在衰老症的心理疏导过程中，精神分析学家的在聆听工作的复杂性和重要性。

Published
2017
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31. A complex ventricular septal defect following transcatheter aortic valve implantation evaluated by 3D transthoracic echocardiography

Author

Giovanni Barbati, Angelo Ramondo, Roberto Zeppellini, and Giovanna Erente

Subjects
Heart Septal Defects, Ventricular, medicine.medical_specialty, medicine.medical_treatment, Echocardiography, Three-Dimensional, 030204 cardiovascular system & hematology, Prosthesis, Diagnosis, Differential, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, Pseudoaneurysm, 0302 clinical medicine, Aortic valve replacement, Internal medicine, medicine, Ventricular outflow tract, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Cardiac catheterization, Aged, business.industry, medicine.disease, Aortic valve stenosis, cardiovascular system, Cardiology, Female, Differential diagnosis, Cardiology and Cardiovascular Medicine, business, Complication
Abstract

Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of elderly patients with symptomatic severe aortic valve stenosis. Among the possible TAVI complications, a rare one is the annular/left ventricular outflow tract rupture. We report a rare case of a late complex ventricular septal defect (VSD) following TAVI with a balloon-expandable prosthesis, conservatively managed. Our case demonstrates the role of 3D transthoracic echocardiography (3DTTE) in the accurate diagnosis of this TAVI complication and suggests that, in some cases, it can be used as an alternative to other diagnostic tools, such as transesophageal echocardiography, cardiac catheterization, and computed tomography.

Published
2017

32. [Right atrial appendage thrombosis during atrial fibrillation: an element to look for]

Author

Giovanni, Barbati, Renato, De Domenico, Stefania, Rossi, Elena, Vecchiato, and Roberto, Zeppellini

Subjects
Male, Atrial Fibrillation, Humans, Atrial Appendage, Thrombosis, Middle Aged
Abstract

Oral anticoagulant therapy (OAT) is a mainstay of atrial fibrillation (AF) pharmacological treatment. Left atrial appendage closure is a possible treatment, when feasible, in patients with intracerebral hemorrhage during OAT. We report a case of right atrial appendage thrombosis in a patient with chronic AF admitted for syncope due to diuretic-induced orthostatic hypotension. Two years previously, he had undergone left atrial appendage closure with the Amplatzer Cardiac Plug device because of intracerebral hemorrhage during OAT. After neurological consult, OAT was resumed with apixaban 5 mg twice daily, and transesophageal echocardiography performed two months later showed complete resolution of the right atrial appendage thrombosis. This particular case underlines the importance of searching for a possible right atrial appendage thrombosis in patients affected by AF, and suggests that left atrial appendage closure in AF patients not suitable for OAT does not fully eliminate the risk of thromboembolism.

Published
2017

33. Effects of acute k-strophantidin administration on left ventricular relaxation and filling phase in coronary artery disease

Author

Bolognesi, Roberto, Cucchini, Francesco, Javernaro, Antonio, Zeppellini, Roberto, Manca, Carlo, and Visioli, Odoardo

Subjects
Coronary heart disease -- Care and treatment, Diastole (Cardiac cycle) -- Drug therapy, Heart attack -- Drug therapy, Health
Abstract

In 10 patients with coronary artery disease, preserved left ventricular (LV) performance and absence of previous myocardial infarction, the effects of an acute intravenous administration of k-strophantidin (0.005 mg/kg over 10 minutes) on selected parameters of both LV systolic and diastolic function, including relaxation, were evaluated. An increase in positive first derivative of LV pressure (dP.dt) and in the ratio between dP/dt and the pressure developed (dP/dt/P) (1,530 [+ or -] 287) 1,600 [+ or -] 329 mm Hg/s [p However, LV relaxation was impaired by k-strophantidin injection; in fact, mean values of T constant were significantly increased from 50 [+ or -] 12 to 55 [+ or -] 13 ms (p Therefore, in patients with coronary artery disease and LV preserved performance, an acute intravenous administration of k-strophantidin appears to stimulate contractility and to worsen relaxation, and minimal LV and end-diastolic pressures.

Published
1992

36. Poster session Friday 13 December - PM: 13/12/2013, 14:00-18:00 * Location: Poster area

Author

A. Rojek, M. Bekbossynova, J. Onaindia, R. Ferrer Lopez, B. Javani, A. Sharif-Rasslan, N. Al, R. Davies, U. Ikeda, R. Ferreira, A. Cincin, M. Plewka, F. Weidemann, B. Fadel, O. Akgul, Z. Frikha, M. Haghjoo, J. Jensen, G. Agoston, M. Sunbul, R. Strasser, M. Pepi, Y. Fuku, M. Minamisawa, J. Holm, O. Dzikowska Diduch, Y. Pya, J. Macancela Quinones, P. Gaudron, G. Ertl, S. Thivolet, C. Koukoulis, H. Yun, S. Iancovici, D. Capodanno, M. Barthelet, A. Medeiros-Domingo, T. Le Tourneau, A. P. Lee, G. Derumeaux, I. Rodriguez, B. Naegeli, S. Rahmatullah, A. Bayes, H. Schaff, A. M. Caggegi, C. Zito, M. D'alto, R. Favilli, J. Baan, M. Aydin, J. Bonaque Gonzalez, A. Akhundova, I. Cruz, R. Karpov, H. Okura, D. Dequanter, M. T. Grillo, A. Ingvarsson, S. Prasad, A. Dahiya, U. Rosenschein, G. Sinagra, J. Kochanowski, M. Niemann, Y. Saijo, B. Bouma, K. Sveric, Y. Topilsky, M. Ministeri, J. Piek, C. Marinescu, M. Bilik, I. Ikuta, M. Al-Admawi, C. Araujo, D. Trifunovic, S. Onciul, G. Pavlidis, F. Ruiz Lopez, M. Oyumlu, C. Kenny, F. Kayan, C. Ginghina, R. Piatkowski, I. Lekuona Goya, A. Almeida, G. Portugal, H. Motoki, M. Cinteza, B. Seifert, S. Lee, M. Banovic, T. Sakakura, A. Pappalardo, B. Stuart, Y. Chuyasova, T. Yamanaka, N. Roche, C. Wunderlich, X. Arana, L. Ernande, V. Ribeiro, Y. Tanabe, L. Vazdar, Y. Tayyareci, E. Malev, M. Eren, J. Gil, S. Lunghetti, D. Krieger, S. Mangiafico, M. Izumo, D. Cacela, A. Kovacs, A E Van Den Bosch, E. Reffo, P. G. Jorgensen, O. Dubourg, J. Abreu, S. Wang, E. Cervesato, K. Theodoropoulos, N. Ozaydogdu, L. Jung, Y. Kijima, E. Ostenfeld, C. Corsi, M. Florescu, M. Chenilleau, K. Yokota, A. Faeh-Gunz, R. Winter, J. Dreyfus, D. Kang, S. K. Saha, S. Surdulli, L. Abikeyeva, M. Marchel, P. Meregalli, M. Yamat, X. Arana Achaga, C. Shahla, V. Palicka, M. Tanaka, A. Galrinho, K. Endo, M. Saravi, J. Bogaert, H. Oeygarden, S. Okabe, J. Reiken, G. Ionescu, C. Selton-Suty, A. Nunes-Diogo, E. S. Davidsen, E. Kinova, A. Bandeira, Y. Seo, S. Hojberg, G. Siblini, M. Pellegrino, M. Ostojic, J. J. Onaindia Gandarias, M. Pereira, F. Antonini-Canterin, F. Akturk, T. Nakajima, M. Al Fayyadh, S. Herrmann, G. Stellin, M. E. Menting, B. Sasko, J. Song, T. Kurokawa, F. Dipasqua, T. Maruo, M. Geleijnse, H. Triantafyllidi, M. Komeda, R. Praus, V. Nesvetov, M. Fineschi, A. Auricchio, M. Dorobantu, A. Degirmencioglu, E. Laraudogoitia Zaldumbide, S. Velasco Del Castillo, Z. Marcetic, U. Waje-Andreassen, F. Fang, K. Farsalinos, L. Vasina, D. Muraru, M. Faludi, P. Rio, S. Peppes, T. Karaahmet, G. Suermeci, P. Maccarthy, S. Kotsovilis, Y. Akashi, G. Di Salvo, Z. Issa, J. Gibbs, A. Poletti, E. Bonnefoy-Cudraz, A. Madej-Pilarczyk, E. Gerdts, K. Solymossy, P. Kogoj, T. Tomita, M. Lisi, K. Suzuki, S. Sifakis, E.A. Surkova, T. Fritz-Hansen, V. Tritakis, E. Romeo, T. Akesson-Lindow, B. Lasota, A. Florian, M. Maciel, K. Gieszczyk-Strozik, M. Imazio, S. Ozyilmaz, K. Kadota, V. Peric, E. Zencirci, B. Tzvetkov, U. Aguirre Larracoechea, D. Caldeira, Y. Motoyoshi, M. Russo, R. Suri, H. Pintaric, O. Celik, D. Himbert, L. Branco, B. Sun, S. Dzhetybayeva, A. Esen Zencirci, M. Ciurzynski, R. Nunyez, B. Iung, K. Takenaka, A. S. Omran, K. Ozden, J. Argacha, S. Pradel, A. M. Pistritto, M. Pfyffer, C. Dedobbeleer, J. Vojacek, P. Costa, E. Albuquerque, A. Tamadoni, B. Sarubbi, M. Carlsson, R. Mogelvang, G. Oria, K. Kimura, E. Kim, F. Kousathana, A. Mateescu, A. Varga, J. Clerc, M. Noni, S. Kyrzopoulos, S. Andossova, S. Almeida, E. Shkolnik, J. Koyama, M. Daimon, S. Saeed, B. Popescu, M. Tigen, R. Wennemann, C. Venner, M. Guazzi, R. Magalhaes, H. Hayashi, M. Salagianni, A. Kiotsekoglou, A. Baggiano, C. Chao, T. Nakao, H. Becher, R. Zeppellini, J. Marrugat, G. Erente, P. Lancellotti, R. Rimbas, D. M'barek, M. Cameli, Y. Katahira, S. Carerj, C. Grasso, P. Moulin, D. Lavergne, B. Merkely, D. Mahoney, C. Tamburino, W. Kosmala, G. Romagna, T. Potpara, T. Ha, R. Biffanti, C. Dundar, E. Gunyeli, L. Weinert, R. Dworakowski, A. Ferreira, T. Biering-Sorensen, H. Engblom, M. Erturk, G. Varlan, M. Ikeda, L. Thorell, S Von Bardeleben, S. Palomar, K. Boerlage-Van Dijk, T. Ishizu, S. Stoerk, I. Germanakis, H. Yamamoto, Q. Shang, A. Borizanova, C. Fiorentini, R. Candinas, U. Inci, F. Macedo, O. Huttin, R. Pudil, I. D. Gabric, C. Silveira, I. Sari, V. Lambadiari, L. Laczmanski, E. Timofeev, A. Izgi, D. Bravo Bustos, K. Wierzbowska-Drabik, P. Masci, H. Pusuroglu, F. Navarro Garcia, P. Adhikari, K. Mizia-Stec, S. Celik, A. Medressova, S. Pala, R. Retkoceri, O. Tautu, S. Tzikas, S. Ohtsuki, T. Akbulut, S. Goliszek, K. Mitsudo, P. Palczewski, A. Spyrou, K. Filipiak, I. Tzoulaki, A. Erdem, M. Krupa, K. Yoshida, M. Polovina, J. Vanoverschelde, H. Pereira, K. Obase, O. V. Tereshina, J. Liebeton, L. Petrescu, W. Gin-Sing, T. A. Warsame, B. Lichodziejewska, M. Takeuchi, J. Cuypers, Y. Jung, E. Martins, S. Mondillo, D. Liu, D. Planinc, I. Subirana, S. Shahrzad, U. Richter, M. Prull, C.H. Attenhofer Jost, E. Alfonzetti, A. Kosztin, V. Carvalho, M. van Bracht, K. Shahgaldi, M. Altman, A. Cacicedo, R. Dulgheru, M. Arslan, L. Dell'angela, M. De Biasio, J. Roos-Hesselink, A. Sawant, B. Ghadrdoust, H. Tabuchi, I. Rangel, M. Aguado Martin, L. Pedro-Botet, K. Koch, G. Zugazabeitia Irazabal, I. Hausmanowa-Petrusewicz, A. Werther-Evaldsson, A. Korshunova, Q. Zhang, A. Anton Ladislao, C. Bergerot, F. Karlsen, T. Akagi, M. Jasinski, I. Komuro, A. Apor, L. Fourcade, P. Argiento, E. Zemtsovsky, A. Correra, J. Chudek, S. Choi, G. Barletta, A. Varela, A. Manouras, H. Oe, A. D'andrea, S. Ramezani, M. Akil, A. Azevedo, S. Imme, A. Ionac, E. Saracoglu, K. Nakagawa, O. Vinter, S. Reeva, G. Van Camp, T. Forster, T. Butz, I. Ikonomidis, A. Costa, M. Ruiz Lopez, D. Vinereanu, G. Opolski, K. Akay, A. Vrublevsky, J. Silva Marques, L. Sousa, F. D'ascenzi, N. Oprescu, F. Veronesi, A. Mysiak, R. Dan, M. Nobre Menezes, D. Kim, V. Vida, Y. Kim, V. Di Bello, D. Sharif, A. I. Nagy, A. Sikora-Puz, H. Moladoust, C. Florescu, M. Kostrubiec, L. Pierard, E. Ural, A. Goncalves, K. Grudzka, A. Charalampopoulos, A. Luycx-Bore, M. Wilkins, S. Mushtaq, D. Messika-Zeitoun, N. Olsen, C. Mornos, M. Tesic, R. Symons, S. Bekbossynov, H. Erer, M. Kokorina, I. Joao, C. Cotrim, D. Voilliot, M. Yamawaki, N. Roszczyk, J. Inamo, C. Sousa, A. Porto, I. Lekakis, A. G. Caelian, D. Rigopoulos, T. Komori, G. Pontone, S. Scandura, F. Melao, N. Toh, A. Neikova, V. Aboyans, S. La Carrubba, D. Zamfir, S. Dymarkowski, J. Magne, G. Szeplaki, S. Velasco, J. Mcghie, M. Losito, L. Shkolnik, M. Petrovic, I. Papadakis, D. Brito, I. Schilling, O. Bech-Hanssen, M. Enriquez-Sarano, C. Lafaras, O. Enescu, B. Bijnens, R. Lang, C. Lestuzzi, C. Kirma, N. Vallejo, F. Elmkies, M. Vasatova, N. Uslu, M. Yuksel, M. Anastasiou-Nana, G. Gatti, O. Milanesi, V. Donghi, A. Kozuka, C. Henri, K. Tsimopoulou, G. Karakus, A. Cerutti, J. Macancela Quinonez, E. Laraudogoitia, P. Unger, A. Roijer, K. Kurnicka, M. Carasi, D. Djikic, M. Dragovic, H. Aksu, S. Srivatsa, A. Khan, N. Maschietto, D. Cozma, V. Andreakos, C. Meurling, O. Wendler, C. Doulaptsis, E. Aliot, T. Damy, Z. Ojaghihaghighi, L. Mateu, S. Knop, M. Vis, M. Mizia, A. Khalil, E. Abate, M. Gomez Recio, J. Ko, M. Seo, D. Tsiapras, E. Tekbas, C. Celeng, K. Aonuma, M. Przewlocka-Kosmala, S. Laaraibi, T. Sahin, D. Mohty, P. Jorgensen, A. Fiarresga, C. Scharf, E. Conte, V. Pergola, C. Jons, M. Padalino, R. Krecki, M. Malicse, F. Parthenakis, N. Bolivar Herrera, G. Foldes, O. Vriz, J. Kasprzak, S. Janssens, H. Bejiqi, H. Nakajima, R. Naeije, E. Papadavid, A. Subinas, R. Calabro, M. Trbusic, W. Tomkowski, M. Ooshima, A N Vachev, A. Fotaki, E. Brochet, F. Scholz, A. Boshchenko, P. Massoure, S. Munoz Troyano, J. Zumalde, M. Tsakalou, E. Bertella, M. Carminati, A. Kalkan, Y. Miyashita, I. Comanescu, A. M. Esen, K. Nakamura, A. Sanchez Espino, G. Berkenboom, H. Trappe, B. Castaldi, M. Cielecka-Prynda, Y. Otsuji, R. Bejiqi, E. Caiani, A. Moreo, P. Vaida, J. Castillo, S. Stankovic, C. Davos, H. Murata, T. Komiya, K. Berta, A. Aussoleil, A. Yildiz, B. Piamonti, K. Sato, J. Silva-Cardoso, I. Popescu, R. Pap, A. Serafin, K. Addetia, F. Olsen, J. Cautela, C. Yu, R. El Mahmoud, C. Cardoso, N. Echahidi, V. Pyankov, T. Yamada, R. Hoffmann, H. Johno, L. Lopes, R. Li, R. Onut, J. Lekakis, G. Nicolosi, N. Watanabe, Y. Basaran, A. Matos, A. Chmiel, N. Host, M. Sabria, N. Gronkova, P. Hulek, H. Cakmak, E. Wiegerinck, A. Goudev, A. Romero Pereiro, A. Pellegrini, L. Badano, P. Cameli, N. Abdullah, M. Deja, A. Ekmekci, A. Vahanian, A. Retkoceri, V. Mor-Avi, H. Ito, N. Bindraban, T. Rigo, R. Vanderpool, N. Mansencal, M. K. Tigen, J. Bech, H. Thibault, A. Pshepiy, A. Decker-Bellaton, L. Saghy, Z. Al Bulbul, G. Generati, I. Nedeljkovic, Y. Kuatbayev, G. A. Derumeaux, M. Varoudi, Y. Juilliere, K. Uno, P. Virot, B.M. van Dalen, M. Witsenburg, E. Yamashita, K. Okada, E. Gomez, P. Pinto-Teixeira, T. Yambe, N. Preumont, K. Hu, R. Jalalian, A. Formenti, M. Monaghan, P. Pruszczyk, L. Massa, D. Andreini, A. Fromm, E. Stoupel, D. Ural, R. Pilliere, L. Llobera, W. Kim, M. Sobczak, F. Bandera, S. Oliveira, P. Mills, H. Zemir, E. Oner, S. Sparla, C. Cosgrove, S. Kou, A. Annoni, B. Vujisic-Tesic, M. Hojati, L. Carr, P. Meimoun, A. Jaccard, E. Varotto, N. Bulj, T. Kawata, M. Bulut, G. Dimitriadis, B. Ramondo, V. Voudris, H. Christensen, H. Eguchi, J. Grapsa, P. R. Silva Fazendas Adame, C. Cimadevilla, L. Christensen, M. Cikes, A. Izawa, G. Merchan Ortega, A. Makrigiannakis, M. Forkmann, G. Radegran, P. Dias, A. Faiz, C. Stefopoulos, Y. Vasyuk, A. Akyol, L. Howard, A. Correia, J. Younger, and C. Greis

Subjects
medicine.medical_specialty, business.industry, medicine, Radiology, Nuclear Medicine and imaging, Medical physics, General Medicine, Session (computer science), Cardiology and Cardiovascular Medicine, business
Published
2013
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37. Efficacy and Safety of the All-Oral Schedule of Metronomic Vinorelbine and Capecitabine in Locally Advanced or Metastatic Breast Cancer Patients: The Phase I-II VICTOR-1 Study

Author

Cazzaniga, M, Torri, V, Villa, F, Giuntini, N, Riva, F, Zeppellini, A, Cortinovis, D, Bidoli, P, Cazzaniga ME, Torri V, Villa F, Giuntini N, Riva F, Zeppellini A, Cortinovis D, Bidoli P, Cazzaniga, M, Torri, V, Villa, F, Giuntini, N, Riva, F, Zeppellini, A, Cortinovis, D, Bidoli, P, Cazzaniga ME, Torri V, Villa F, Giuntini N, Riva F, Zeppellini A, Cortinovis D, and Bidoli P

Abstract

Background. Vinorelbine (VRB) and capecitabine (CAPE) are demonstrated to be active in pretreated metastatic breast cancer patients. Different studies have demonstrated that the metronomic treatment is active with an acceptable toxicity profile. We designed a Phases I-II study to define the MTD of oral metronomic, VRB, and CAPE. Patients and Methods. Phase I: fixed dose of CAPE was 500 mg thrice a day, continuously. Level I of VRB was 20 mg/tot thrice a week for 3 weeks (1 cycle). Subsequent levels were 30 mg/tot and 40 mg/tot (Level III), respectively, if no Grades 3-4 toxicity were observed in the previous level. Phase II: further 32 patients received the MTD of VRB plus CAPE for a total of 187 cycles to confirm toxicity profile. Results. 12 patients were enrolled in Phase I and 22 in Phase II. Phase I: the MTD of VRB was 40 mg. Phase II: 187 cycles were delivered, observing 5.9% of Grades 3-4 toxicity. 31 patients are evaluable for efficacy, obtaining a clinical benefit rate of 58.1%. Conclusion. MTD of VRB with fixed dose of CAPE was 40 mg thrice a week and was the recommended dose for the ongoing Phase II multicenter study

Published
2014

38. Caracterização de dosímetros semicondutores para dosimetria in Vivo na técnica de TBI

Author

Caroline Castilhano Sampaio, Laura Furnari, and Caroline Zeppellini dos Santos Emiliozzi

Subjects
General Medicine
Abstract

A técnica de irradiação de corpo inteiro (TBI) é considerada uma técnica de alta a complexidade em radioterapia já que exige campos alargados. Os esquemas de cálculo para fazer a determinação exata da distribuição da dose no TBI são complexos e variações na posição do paciente alteram dramaticamente as distribuições de dose. Sendo assim é desejável ter uma técnica de medição in vivo disponível. Os diodos semicondutores são robustos, relativamente baratos e fornecem leituras on-line para inferência imediata de dose o que é uma grande vantagem em comparação com o processo de reaquecimento prolongado requerido para um dosímetro termoluminescente (TLD). O objetivo deste trabalho é a caracterização e validação do diodo semicondutor (T600010L PTW) para utilização em medidas in vivo, e em tempo real, da dose liberada em um tratamento de irradiação de corpo inteiro. Os dosímetros devem ser caracterizados e calibrados para sua utilização na técnica em questão. Sendo assim foi feito o estudo da reprodutibilidade, da linearidade e da dependência da resposta dos diodos com a taxa de dose, com a distância fonte-detector (SSD) e com o ângulo de incidência do feixe de radiação. A calibração dos diversos diodos foi realizada por intercomparação com uma câmara de ionização Farmer e sua verificação foi feita com a simulação de um tratamento em um phantom antropomórfico RANDO®. Uma vez que o dosímetro mostrou-se adequado e com variações menores que 1%, estabeleceram-se limites de ação para dosimetria in vivo de acordo com a região a ser tratada e levando em conta fatores de incertezas que não são intrínsecos ao detector. O valor máximo encontrado para o limite de ação foi de 9,6% na região do joelho.

Published
2018
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39. Poster session II * Thursday 9 December 2010, 14:00-18:00

Author

P. A. Pabari, A. Kyriacou, M. Moraldo, B. Unsworth, R. Baruah, N. Sutaria, A. Hughes, J. Mayet, D. P. Francis, T. Uejima, K. Loboz, F. Antonini-Canterin, C. Polombo, S. Carerj, D. Vinereanu, A. Evangelista, G. Leftheriotis, A. G. Fraser, A. Kiotsekoglou, M. Govindan, S. C. Govind, S. K. Saha, A. J. Camm, P. M. Azcarate, S. Castano, M. Rodriguez-Manero, M. Arraiza, B. Levy, J. Barba, G. Rabago, G. Bastarrika, A. Nemes, R. Takacs, T. Varkonyi, H. Gavaller, I. Baczko, T. Forster, T. Wittmann, J. G. Papp, C. Lengyel, A. Varro, L. R. Tumasyan, K. G. Adamyan, O. Savu, T. Mieghem, P. Dekoninck, L. Gucciardo, R. Jurcut, S. Giusca, B. A. Popescu, C. Ginghina, J. Deprest, J. U. Voigt, M. Versiero, M. Galderisi, R. Esposito, A. Rapacciuolo, G. Esposito, R. Raia, T. Morgillo, F. Piscione, G. De Simone, M. A. Oraby, F. A. Maklady, E. M. Mohamed, A. Z. Eraki, D. Zaliaduonyte-Peksiene, E. Tamuleviciute, J. Janenaite, J. Marcinkeviciene, V. Mizariene, S. Bucyte, J. Vaskelyte, D. Trifunovic, I. Nedeljkovic, D. Popovic, M. Ostojic, B. Vujisic-Tesic, M. Petrovic, S. Stankovic, D. Sobic-Saranovic, M. Banovic, A. Dikic-Djordjevic, K. Savino, A. Lilli, E. Grikstaite, V. Giglio, E. Bordoni, G. Maragoni, C. Cavallini, G. Ambrosio, B. Jakovljevic, B. Beleslin, M. Nedeljkovic, O. Petrovic, S. Moral, J. Rodriguez-Palomares, M. Descalzo, G. Marti, V. Pineda, P. Mahia, L. Gutierrez, T. Gonzalez-Alujas, D. Garcia-Dorado, F. Schnell, E. Donal, C. Thebault, A. Bernard, H. Corbineau, H. Le Breton, J. Kochanowski, P. Scislo, R. Piatkowski, M. Roik, M. Marchel, D. Kosior, G. Opolski, A. M. Lesniak-Sobelga, E. Wicher-Muniak, M. Kostkiewicz, M. Olszowska, E. Suchon, P. Klimeczek, P. Banys, M. Pasowicz, W. Tracz, P. Podolec, A. Laynez, D. E. Hoefsten, B. B. Loegstrup, B. Norager, J. E. Moller, A. Flyvbjerg, K. Egstrup, W. Streb, M. Szulik, J. Nowak, E. Markowicz-Pawlus, A. Duszanska, A. Sedkowska, Z. Kalarus, T. Kukulski, L. Spinelli, C. Morisco, E. Assante Di Panzillo, F. Buono, S. Crispo, B. Trimarco, A. A. Hawary, G. M. Nasr, M. M. Fawzy, L. Faber, W. Scholtz, J. Boergermann, M. Wiemer, G. Kleikamp, N. Bogunovic, Z. Dimitriadis, J. Gummert, D. Hering, D. Horstkotte, F. Luca', S. Gelsomino, R. Lorusso, S. Caciolli, R. Carella, G. Bille', G. De Cicco, V. Pazzagli, G. F. Gensini, A. Borowiec, R. Dabrowski, J. Janas, A. Kraska, B. Firek, I. Kowalik, H. Szwed, K. A. Marcus, C. L. De Korte, T. Feuth, J. M. Thijssen, L. Kapusta, J. Dahl, L. Videbaek, M. K. Poulsen, P. A. Pellikka, K. Veien, L. I. Andersen, T. Haghfelt, M. Haberka, K. Mizia - Stec, T. Adamczyk, M. Mizia, A. Chmiel, P. Pysz, M. Sosnowski, Z. Gasior, M. Trusz - Gluza, M. Tendera, T. Niklewski, K. Wilczek, P. Chodor, T. Podolecki, A. Frycz-Kurek, M. Zembala, S. Yurdakul, O. Yildirimturk, Y. Tayyareci, K. Memic, I. C. C. Demiroglu, S. Aytekin, C. J. Garcia Alonso, E. Ferrer Sistach, L. Delgado, J. Lopez Ayerbe, N. Vallejo Camazon, F. Gual Capllonch, M. Espriu Simon, X. Ruyra, A. Caballero Parrilla, A. Bayes Genis, L. Lecuyer, A. Berrebi, E. Florens, M. Noghin, C. Huerre, P. Achouh, R. Zegdi, J. N. Fabiani, B. De Chiara, A. Moreo, F. Musca, F. De Marco, E. Lobiati, O. Belli, F. Mauri, S. Klugmann, A. Caballero, N. Vallejo, A. Gonzalez Guardia, R. Nunez Aragon, C. Bosch, E. Ferrer, M. L. Pedro Botet, F. Gual, M. Cusma-Piccione, C. Zito, G. Oreto, R. Giuffre, M. C. Todaro, C. M. Barbaro, S. Lanteri, C. Longordo, J. Salvia, A. Bensaid, R. Gallet, E. Fougeres, P. Lim, J. Nahum, J. F. Deux, P. Gueret, E. Teiger, J. L. Dubois-Rande, J. L. Monin, F. Behramoglu, Z. Colakoglu, V. Aytekin, C. Demiroglu, L. Gargani, E. Poggianti, R. Bucalo, M. Rizzo, F. Agrusta, P. Landi, R. Sicari, E. Picano, A. Sutandar, B. B. Siswanto, I. Irmalita, G. Harimurti, S. Y. Hayashi, M. M. Nascimento, B. Lindholm, B. Lind, A. Seeberger, M. A. Pachaly, M. C. Riella, A. Bjallmark, L. A. Brodin, L. Poanta, M. Porojan, D. L. Dumitrascu, I. Ikonomidis, S. Tzortzis, J. Lekakis, D. T. Kremastinos, I. Paraskevaidis, I. Andreadou, M. Nikolaou, P. Katsibri, M. Anastasiou-Nana, A. M. Maceira Gonzalez, C. Ripoll, J. Cosin-Sales, B. Igual, J. Salazar, V. Belloch, J. Cosin-Aguilar, D. J. Pennell, M. Masaki, J. N. Pulido, T. Yuasa, S. Gillespie, B. Afessa, D. R. Brown, S. V. Mankad, J. K. Oh, A. L. Gurghean, A. M. Mihailescu, I. Tudor, C. Homentcovschi, M. Muraru, I. V. Bruckner, C. E. Correia, B. Rodrigues, D. Moreira, L. F. Santos, P. Gama, O. Dionisio, C. Cabral, O. Santos, T. Bombardini, S. Gherardi, G. Arpesella, S. Valente, I. Calamai, E. Pasanisi, S. Sansoni, P. Szymanski, P. Dobrowolski, M. Lipczynska, A. Klisiewicz, P. Hoffman, D. Stepowski, B. Kurtz, G. Grezis-Soulie, A. Savoure, F. Anselme, F. Bauer, J. Castillo, N. Herszkowicz, C. Ferreira, A. Goscinska, K. Mizia-Stec, W. Poborski, O. Azevedo, I. Quelhas, J. Guardado, M. Fernandes, C. S. Miranda, P. Gaspar, A. Lourenco, R. Medeiros, J. Almeida, S. L Bennani, V. Algalarrondo, S. Dinanian, J. Guiader, C. Juin, D. Adams, M. S. Slama, J. J. Onaindia, O. Quintana, S. Velasco, E. Astigarraga, A. Cacicedo, J. Gonzalez, I. Rodriguez, M. Sadaba, M. Eneriz, E. Laraudogoitia Zaldumbide, I. Nunez-Gil, M. Luaces, J. Zamorano, J. C. Garcia Rubira, D. Vivas, B. Ibanez, P. Marcos Alberca, C. Fernandez Golfin, J. Alonso, C. Macaya, J. Silva Marques, A. G. Almeida, V. Carvalho, C. Jorge, D. Silva, M. Gato Varela, S. Martins, D. Brito, M. G. Lopes, E. Tripodi, B. Miserrafiti, V. Montemurro, R. Scali, P. Tripodi, A. Winkler, A. Madej, I. Hausmanowa-Petrusewicz, M. Fijalkowski, A. Koprowski, M. Jaguszewski, R. Galaska, M. Taszner, A. Rynkiewicz, R. Citro, F. Rigo, G. Provenza, Q. Ciampi, M. M. Patella, A. D'andrea, O. Vriz, C. Astarita, E. Bossone, F. Heggemann, T. H. Walter, T. H. Kaelsch, T. Sueselbeck, T. H. Papavassiliu, M. Borggrefe, D. Haghi, T. Monk-Hansen, C. Have Dall, S. Bisgaard Christensen, M. Snoer, F. Gustafsson, H. Rasmusen, E. Prescott, G. Finocchiaro, B. Pinamonti, M. Merlo, G. Barbati, A. Di Lenarda, R. Bussani, G. Sinagra, T. Butz, C. N. Lang, A. Meissner, G. Plehn, H. Yeni, C. Langer, H. J. Trappe, X. Gu, X. Y. Gu, Y. H. He, Z. A. Li, J. C. Han, J. Chen, P. Gaudron, M. Niemann, S. Herrmann, K. Hu, B. Bijnens, H. Hillenbrand, M. Beer, G. Ertl, F. Weidemann, A. Mazzone, M. Mariani, I. Foffa, A. Vianello, S. Del Ry, S. Bevilacqua, M. G. Andreassi, M. Glauber, S. Berti, M. Grabowski, M. Postula, A. Dragulescu, G. Van Arsdell, O. Al-Radi, C. Caldarone, L. Mertens, K. J. Lee, R. P. Casula, H. Yadav, A. Cherian, A. D. Hughes, A. Vitarelli, S. D'orazio, B. L. Nguyen, G. Iorio, D. Battaglia, F. Caranci, V. Padella, L. Capotosto, L. Alessandroni, F. Barilla, C. Cardin, S. Hascoet, M. Saudron, G. Caudron, B. Arnaudis, P. Acar, M. M. Sun, X. H. Shu, C. Z. Pan, X. Y. Fang, D. H. Kong, F. Fang, Q. Zhang, Y. S. Chan, J. M. Xie, W. K. Yip, Y. Y. Lam, J. E. Sanderson, C. M. Yu, M. Rosca, K. O' Connor, G. Romano, J. Magne, A. Calin, D. Muraru, L. Pierard, P. Lancellotti, A. Roushdy, I. Elfiky, G. El Shahid, A. Elfiky, M. El Sayed, K. Wierzbowska-Drabik, L. Chrzanowski, A. Kapusta, E. Plonska-Goscinak, M. Krzeminska-Pakula, M. Kurpesa, T. Rechcinski, E. Trzos, J. D. Kasprzak, M. K. Ersboll, N. Valeur, U. M. Mogensen, M. Andersen, C. Hassager, P. Sogaard, L. V. Kober, M. Kloeckner, D. Hayat, C. Dussault, N. Lellouche, N. Elbaz, A. Demopoulos, G. Hatzigeorgiou, E. Leontiades, A. Motsi, G. Karatasakis, G. Athanassopoulos, P. Zycinski, J. Kasprzak, M. C. Vazquez Alvarez, C. Medrano Lopez, M. Camino Lopez, S. Granja, J. L. Zunzunegui Martinez, E. Maroto Alvaro, W.-C. Tsai, J.-Y. Chen, Y.-W. Liu, C.-C. Lin, L.-M. Tsai, D. C. Gomes, S. Robalo Martins, M. R. Gois, S. Ribeiro, A. Nunes Diogo, P. Sengupta, G. Di Bella, G. Caracciolo, S. Lentini, E. Kinova, N. Zlatareva, A. Goudev, N. Papagiannis, M. Mpouki, A. Papagianni, M. Vorria, G. Mpenetos, D. Lytra, E. Papadopoulou, P. Sgourakis, J. Malakos, J. Kyriazis, V. Kodali, R. Toole, A. S. Gopal, J. Celutkiene, A. Rudys, V. Grabauskiene, S. Glaveckaite, E. Sadauskiene, Z. Lileikiene, N. Bickauskaite, E. Ciburiene, V. Skorniakov, A. Laucevicius, C. H. Attenhofer Jost, M. Pfyffer, R. Lindquist, J. L. F. Santos, O. R. C. Coelho, C. M. Mady, M. H. P. Picard, V. M. C. Salemi, L. Funk, M. W. Prull, J.-Y. Shih, Y.-Y. Huang, K. O'connor, M. Moonen, L. A. Pierard, D. C. Cozma, C. Mornos, A. Ionac, L. Petrescu, D. Dragulescu, R. Dan, I. Popescu, S. I. Dragulescu, T. G. Von Lueder, A. Hodt, G. F. Gjerdalen, T. E. Andersen, E. E. Solberg, K. Steine, T. Van Mieghem, M. Rostek, W. Pikto-Pietkiewicz, M. Dluzniewski, A. Antoniewicz, S. Poletajew, A. Borowka, T. Pasierski, S. K. Malyutina, M. Ryabikov, J. Ragino, A. Ryabikov, S. Sitia, L. Tomasoni, F. Atzeni, L. Gianturco, P. Sarzi-Puttini, V. De Gennaro Colonna, M. Turiel, F. R. Gutierrez, G. Lefhtheriotis, R. T. Hurst, M. R. Nelson, F. Mookadam, V. Thota, U. Emani, M. Al Harthi, J. Stepanek, S. Cha, S. J. Lester, E. M. M. Ho, L. Hemeryck, M. Hall, K. Scott, K. Bennett, A. Mahmud, C. Daly, G. King, R. T. Murphy, A. S. Brown, A. J. Teske, J. D'Hooge, P. Claus, F. Rademakers, L. Santos, N. Cortez-Dias, S. Goncalves, M. Almeida Ribeiro, A. Bordalo E Sa, C. Magnino, P. Marcos-Alberca, A. Milan, C. Almeria, V. Caniadas, J. L. Rodrigo, L. Perez De Isla, J. L. Zamorano, U. Gustafsson, M. Larsson, P. Lindqvist, L. Brodin, A. Waldenstrom, B. Roosens, S. Hernot, S. Droogmans, G. Van Camp, T. Lahoutte, B. Cosyns, C. M. Rao, D. Aguglia, G. Casciola, C. Imbesi, A. Marvelli, M. Sgro, D. Benedetto, R. Tripepi, C. Zoccali, F. A. Benedetto, L. P. Badano, M. Cardillo, L. Del Mestre, P. Gianfagna, A. Proclemer, H. D. Tschernich, B. Mora, E. Base, U. Weber, J. Dumfarth, C. Mukherjee, H. S. Skaltsiotis, A. K. Kaladaridis, D. B. Bramos, G. K. Kottis, A. A. Antoniou, I. A. Agrios, D. T. Takos, N. V. Vasiladiotis, K. P. Pamboucas, S. T. T. Toumanidis, A. Shim, P. Lipec, B. Michalski, B. Wozniakowski, L. Stefanczyk, A. Rotkiewicz, M. Cameli, M. Lisi, M. Padeletti, E. Bigio, S. Bernazzali, C. Tsoulpas, M. Maccherini, M. Henein, S. Mondillo, I. Garcia Lunar, S. Mingo Santos, V. Monivas Palomero, C. Mitroi, P. Beltran Correas, L. Ruiz Bautista, A. Muniz Lozano, M. Gonzalez Gonzalez, B. Stegemann, K. Willson, R. Zeppellini, A. Iavernaro, M. Zadro, M. Carasi, R. De Domenico, T. Rigo, E. Artuso, G. Erente, A. Ramondo, T. T. Le, F. Q. Huang, Y. Gu, and R. S. Tan

Subjects
Cardiac function curve, medicine.medical_specialty, medicine.anatomical_structure, business.industry, Ventricle, Internal medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine, Rotation, business
Published
2010
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40. Validação de Filtro Dinâmico em um acelerador linear Clinac 2100 CD

Author

Larissa Frediani, Laura Furnari, Caroline Zeppellini dos Santos Emiliozzi, Camila P. Sales, and Gabriela Reis Santos de Jesus

Subjects
General Medicine
Abstract

O filtro dinâmico otimizado (Enhanced Dynamic Wedge, EDW) utiliza o movimento do colimador para fazer o efeito de filtro, diminuindo o tempo de tratamento em relação ao filtro físico. Para validação do sistema foram feitas algumas comparações entre dados medidos e calculados pelo sistema de planejamento tais como: fluência de perfil de feixe; planos de tratamentos, utilizando a análise gama; Fator Filtro; e PDP. Os resultados da análise gama da comparação de fluência, tanto de perfil de feixe quanto para planos de tratamentos, foram entre 96% à 100% respectivamente, e, de Fator Filtro e PDP, a diferença máxima é de 1,9%. Assim os resultados se mostraram satisfatórios

Published
2018
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41. Efficacy and Safety of the All-Oral Schedule of Metronomic Vinorelbine and Capecitabine in Locally Advanced or Metastatic Breast Cancer Patients: The Phase I-II VICTOR-1 Study

Author

A. Zeppellini, Francesca Riva, Paolo Bidoli, Diego Cortinovis, N. Giuntini, F. Villa, Marina Elena Cazzaniga, Valter Torri, Cazzaniga, M, Torri, V, Villa, F, Giuntini, N, Riva, F, Zeppellini, A, Cortinovis, D, and Bidoli, P

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Article Subject, business.industry, Locally advanced, Vinorelbine, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Metastatic breast cancer, Fixed dose, lcsh:RC254-282, Surgery, Capecitabine, Breast cancer, Phase i ii, Internal medicine, Toxicity, medicine, Clinical Study, Pharmacology (medical), business, medicine.drug
Abstract

Background. Vinorelbine (VRB) and capecitabine (CAPE) are demonstrated to be active in pretreated metastatic breast cancer patients. Different studies have demonstrated that the metronomic treatment is active with an acceptable toxicity profile. We designed a Phases I-II study to define the MTD of oral metronomic, VRB, and CAPE.Patients and Methods. Phase I: fixed dose of CAPE was 500 mg thrice a day, continuously. Level I of VRB was 20 mg/tot thrice a week for 3 weeks (1 cycle). Subsequent levels were 30 mg/tot and 40 mg/tot (Level III), respectively, if no Grades 3-4 toxicity were observed in the previous level. Phase II: further 32 patients received the MTD of VRB plus CAPE for a total of 187 cycles to confirm toxicity profile.Results. 12 patients were enrolled in Phase I and 22 in Phase II. Phase I: the MTD of VRB was 40 mg. Phase II: 187 cycles were delivered, observing 5.9% of Grades 3-4 toxicity. 31 patients are evaluable for efficacy, obtaining a clinical benefit rate of 58.1%.Conclusion. MTD of VRB with fixed dose of CAPE was 40 mg thrice a week and was the recommended dose for the ongoing Phase II multicenter study.

Published
2014

46. Regorafenib in metastatic colorectal cancer

Author

Andrea Sartore-Bianchi, Alessio Amatu, Riccardo Ricotta, Annalisa Zeppellini, Katia Bencardino, and Salvatore Siena

Subjects
Oncology, medicine.medical_specialty, Colorectal cancer, Pyridines, Angiogenesis Inhibitors, Antineoplastic Agents, medicine.disease_cause, chemistry.chemical_compound, Internal medicine, Regorafenib, Tumor Microenvironment, Medicine, Neoplasm, Humans, Pharmacology (medical), Neoplasm Metastasis, Protein Kinase Inhibitors, Tumor microenvironment, business.industry, Kinase, Phenylurea Compounds, medicine.disease, chemistry, Fibroblast growth factor receptor, Drug Resistance, Neoplasm, Cancer cell, business, Carcinogenesis, Colorectal Neoplasms
Abstract

Regorafenib is an oral multikinase inhibitor that blocks the activity of protein kinases involved in the regulation of tumor angiogenesis (VEGFR1, 2, 3; angiopoietin-1 receptor), oncogenesis (stem cell growth factor receptor; RET; BRAF including BRAFV600E), and tumor microenvironment (PDGFR-β and FGFR). Based on data from the Phase III CORRECT study, regorafenib stands as a further option for patient affected by metastatic colorectal cancer who have exhausted previous available therapies. Its multi-targeted effect might explain activity in advanced lines of treatment, when cancer cells have been heavily challenged with previous lines of therapy and potentially developed multiple mechanisms of resistance, but also makes difficult to identify predictive biomarkers. In this article we examine preclinical as well as clinical data of regorafenib in the therapy of metastatic colorectal cancer, challenges for potential markers of efficacy and its role in the treatment algorithm.

Published
2014

47. Aortic Intramural Hematoma: An Increasingly Recognized Aortic Disease

Author

Roberto Bolognesi, F. Cucchini, Carlo Manca, Dimitri Tsialtas, P. Vasini, Visioli O, R. De Domenico, and Roberto Zeppellini

Subjects
Male, medicine.medical_specialty, Aortography, genetic structures, Aortic Diseases, Autopsy, Pericardial effusion, Diagnosis, Differential, Electrocardiography, Fatal Outcome, Hematoma, medicine.artery, Ascending aorta, medicine, Humans, Pharmacology (medical), Aged, Retrospective Studies, Aged, 80 and over, Aortic dissection, Aorta, Aortic Aneurysm, Thoracic, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Surgery, Aortic Dissection, Coronary care unit, Radiology, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal, Follow-Up Studies
Abstract

Aortic intramural hematoma (IMH) is a rarely diagnosed pathological condition that is not well characterized to date. We diagnosed IMH in 4 of 31 patients with suspected aortic dissection admitted to our coronary care unit from 1992 to 1995. In all 4 cases, IMH was located in the ascending aorta. At the time of hospitalization, all patients showed tachycardia, hypotension and pericardial effusion. Diagnosis of IMH was made by transesophageal echocardiography and computed tomography. We performed aortography in 2 patients, but it was non-diagnostic in both of them. One patient died before surgery. Autopsy confirmed the diagnosis of IMH and showed severe pericardial effusion. In another patient, the diagnosis was confirmed during successful surgery, while the remaining 2 patients recovered after medical therapy. The 3 surviving patients are still under follow-up control 12, 16 and 20 months after the initial acute event. We briefly discuss the epidemiological, clinical, diagnostic, therapeutic and prognostic aspects of IMH.

Published
1998
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48. Da onipotência ao desamparo: sobre a relação entre memória filogenética e envelhescência

Author

José Carlos Zeppellini Junior and Manoel Tosta Berlinck

Subjects
Memória, filogenese, envelhescência, desamparo, Psychiatry, RC435-571
Abstract

Este artigo dedica-se, com base em fragmentos de um caso clínico, a discutir a contribuição dos traços mnêmicos filo e ontogenéticos para a formação de compromissos que acontecem diante do terror suscitado pela velhice. Concomitantemente, apresenta a viabilidade do amparo clínico como alternativa à ameaça de desamparo que emerge da consciência de finitude e salienta a complexidade e a importância do trabalho psíquico de envelhescência como condição fundamental à escuta na transferência.

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49. Misleading Echo-Doppler Findings in Prolapsing Right Atrial Myxoma

Author

Roberto Zeppellini, Giuseppe Gheno, and Francesco Cucchini

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Cardiac cycle, business.industry, Regurgitation (circulation), Flow pattern, medicine.anatomical_structure, Internal medicine, cardiovascular system, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, In patient, cardiovascular diseases, Radiology, Right Atrial Myxoma, Abnormality, Cardiology and Cardiovascular Medicine, Vein, business, Echo doppler
Abstract

In patients with prolapsing right atrial myxoma, paradoxical ventricular septal motion and right chamber dilatation have been observed. The abnormal septal motion has been ascribed to concomitant severe tricuspid regurgitation. Frame-by-frame analysis of echo-Doppler tracings in one case allows an alternative explanation: the septal motion abnormality and the hepatic vein flow pattern are mainly due to hemodynamic effects of tumor movements during the cardiac cycle.

Published
1995
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50. Effects of acute k-strophantidin administration on left ventricular relaxation and filling phase in coronary artery disease

Author

Carlo Manca, Roberto Bolognesi, Antonio Javernaro, Roberto Zeppellini, Francesco Cucchini, and Visioli O

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Diastole, Hemodynamics, Coronary Disease, Ventricular Function, Left, Coronary artery disease, Contractility, Internal medicine, Strophanthins, Ventricular relaxation, Humans, Medicine, Myocardial infarction, Aged, Chemotherapy, Relaxation (psychology), business.industry, Middle Aged, medicine.disease, Injections, Intravenous, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

In 10 patients with coronary artery disease, preserved left ventricular (LV) performance and absence of previous myocardial infarction, the effects of an acute intravenous administration of k-strophantidin (0.005 mg/kg over 10 minutes) on selected parameters of both LV systolic and diastolic function, including relaxation, were evaluated. An increase in positive first derivative of LV pressure (dP/dt) and in the ratio between dP/dt and the pressure developed (dP/dt/P) (1,530 +/- 287) 1,600 +/- 329 mm Hg/s [p less than 0.05], and 30 +/- 6 to 34 +/- 8 s-1 [p less than 0.05], respectively) demonstrated the inotropic effect of k-strophantidin, whereas volumetric parameters of systolic function (end-systolic and stroke volume indexes, and ejection fraction) did not show any significant change. However, LV relaxation was impaired by k-strophantidin injection; in fact, mean values of T constant were significantly increased from 50 +/- 12 to 55 +/- 13 ms (p less than 0.01). Lowest LV and end-diastolic pressures increased from 8 +/- 4 to 11 +/- 4 mm Hg (p less than 0.05) and from 17 +/- 6 to 20 +/- 8 mm Hg (p less than 0.05), respectively. The end-diastolic volume and maximal rate of volumetric increase during the early and late filling phases were not modified by k-strophantidin. Mean aortic pressure increased from 110 +/- 10 to 120 +/- 12 mm Hg (p less than 0.001). Therefore, in patients with coronary artery disease and LV preserved performance, an acute intravenous administration of k-strophantidin appears to stimulate contractility and to worsen relaxation, and minimal LV and end-diastolic pressures.

Published
1992
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