Athanasios Athanasiadis - Academia.edu (original) (raw)

Papers by Athanasios Athanasiadis

Cancers, 2020

Background: Cancer patients are at high risk for cancer-associated thrombosis (CAT). CAT is the s... more Background: Cancer patients are at high risk for cancer-associated thrombosis (CAT). CAT is the second leading cause of death in these patients but it can be preventable with thromboprophylaxis. Patients and Methods: An observational, prospective, multicenter study aiming to record CAT management in clinical practice was conducted by the Hellenic Society of Medical Oncology (HeSMO). Results: A total of 426 active cancer patients (mean age 65.3 years, mean BMI: 26.1 kg/m2) who received thromboprophylaxis, were included from 18 oncology units. Tumor types were lung 25.1%, pancreas 13.9%, breast 8.7%, stomach 8.5%, ovarian 7.8%, and others 36%, while 69% had metastases. A total of 71% had a Khorana score ≤2 and 61% received High Thrombotic Risk Chemotherapy Agents (HTRCAs, e.g., platinum). For thromboprophylaxis patients received mainly Low Molecular Weight Heparins (LMWHs), on higher than prophylactic doses in 50% of cases. Overall, 16 (3.8%) thrombotic events and 6 (1.4%) bleeding ev...

Annals of Gastroenterology, 2016

There is discrepancy and failure to adhere to current international guidelines for the management... more There is discrepancy and failure to adhere to current international guidelines for the management of metastatic colorectal cancer (CRC) in hospitals in Greece and Cyprus. The aim of the present document is to provide a consensus on the multidisciplinary management of metastastic CRC, considering both special characteristics of our Healthcare System and international guidelines. Following discussion and online communication among the members of an executive team chosen by the Hellenic Society of Medical Oncology (HeSMO), a consensus for metastastic CRC disease was developed. Statements were subjected to the Delphi methodology on two voting rounds by invited multidisciplinary international experts on CRC. Statements reaching level of agreement by ≥80% were considered as having achieved large consensus, whereas statements reaching 60-80% moderate consensus. One hundred and nine statements were developed. Ninety experts voted for those statements. The median rate of abstain per statement was 18.5% (range: 0-54%). In the end of the process, all statements achieved a large consensus. The importance of centralization, care by a multidisciplinary team, adherence to guidelines, and personalization is emphasized. R0 resection is the only intervention that may offer substantial improvement in the oncological outcomes.

Annals of Gastroenterology, 2016

In rectal cancer management, accurate staging by magnetic resonance imaging, neo-adjuvant treatme... more In rectal cancer management, accurate staging by magnetic resonance imaging, neo-adjuvant treatment with the use of radiotherapy, and total mesorectal excision have resulted in remarkable improvement in the oncological outcomes. However, there is substantial discrepancy in the therapeutic approach and failure to adhere to international guidelines among different Greek-Cypriot hospitals. The present guidelines aim to aid the multidisciplinary management of rectal cancer, considering both the local special characteristics of our healthcare system and the international relevant agreements (ESMO, EURECCA). Following background discussion and online communication sessions for feedback among the members of an executive team, a consensus rectal cancer management was obtained. Statements were subjected to the Delphi methodology voting system on two rounds to achieve further consensus by invited multidisciplinary international experts on colorectal cancer. Statements were considered of high, moderate or low consensus if they were voted by ≥80%, 60-80%, or <60%, respectively; those obtaining a low consensus level after both voting rounds were rejected. One hundred and two statements were developed and voted by 100 experts. The mean rate of abstention per statement was 12.5% (range: 2-45%). In the end of the process, all statements achieved a high consensus. Guidelines and algorithms of diagnosis and treatment were proposed. The importance of centralization, care by a multidisciplinary team, adherence to guidelines, and personalization is emphasized.

Anticancer research, 2005

BACKGROUND Our purpose was to evaluate the survival of patients with pleural and intraperitoneal ... more BACKGROUND Our purpose was to evaluate the survival of patients with pleural and intraperitoneal malignant mesothelioma and, particularly, to estimate the efficacy of chemotherapy as well as radiotherapy and surgery. A review of the literature with respect to these parameters is included. PATIENTS AND METHODS Thirty-five patients with malignant mesothelioma (28 with pleural and 7 with intraperitoneal) were enrolled. Twenty-eight patients underwent chemotherapy, 7/35 radiation and 9/35 surgery (2 with pleural and 7 with abdominal disease). Combination chemotherapy included cisplatin-gemcitabine, cisplatin (or carboplatin) with premetrexed and doxorubicin-cyclophosphamide. RESULTS In 2/28 patients with pleural mesothelioma the tumor was excised and in 7 with intraperitoneal disease, surgical therapy was palliative and there was survival prolongation. Radiotherapy was only palliative. Chemotherapy produced a very low response: 2/28 (7.14%) patients achieved a partial response. The medi...

Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology

Colorectal cancer remains a major cause of cancer mortality in the Western world both in men and ... more Colorectal cancer remains a major cause of cancer mortality in the Western world both in men and women. In this manuscript a concise overview and recommendations on adjuvant chemotherapy in colon cancer are presented. An executive team from the Hellenic Society of Medical Oncology was assigned to develop a consensus statement and guidelines on the adjuvant treatment of colon cancer. Fourteen statements on adjuvant treatment were subjected to the Delphi methodology. Voting experts were 68. All statements achieved a rate of consensus above than 80% (>87%) and none revised and entered to a second round of voting. Three and 8 of them achieved a 100 and an over than 90% consensus, respectively. These statements describe evaluations of therapies in clinical practice. They could be considered as general guidelines based on best available evidence for assistance in treatment decision-making. Furthermore, they serve to identify questions and targets for further research and the settings i...

Oncology, 2008

To evaluate the efficacy and tolerance of capecitabine (CAP) given every other week and biweekly ... more To evaluate the efficacy and tolerance of capecitabine (CAP) given every other week and biweekly oxaliplatin (OX; modified CAPOX regimen) in patients with advanced colorectal cancer previously treated with irinote- can-based frontline chemotherapy.

European Journal of Cancer, 1995

European Journal of Cancer, 2001

European Journal of Cancer, 1994

... 1 AHEPA Hospital, Aristotle University, Thessaloniki, Macedonia, Greece. 2 “Agii Anargiri” Ca... more ... 1 AHEPA Hospital, Aristotle University, Thessaloniki, Macedonia, Greece. 2 “Agii Anargiri” Cancer Hospital, Athens, Greece. 3 METAXA Cancer Hospital, Piraeous, Greece. 4 HeCOG Data Office, Athens, Greece. 5 University of Ioannina, Ioannina, Greece. ...

Critical Reviews in Oncology/Hematology, 2010

Activities in exploitation and developing tight gas reservoirs grown tremendously in recent years... more Activities in exploitation and developing tight gas reservoirs grown tremendously in recent years. The horizontal well with multi-stage hydraulic fracture stimulation has proven to be an effective strategy of developing these unconventional resources. However, to evaluate the fracturing treatment and predict the long-term production behavior of wells in gas recovery it is important to estimate the effective half-length and spacing of created hydraulic fractures and the extent of the stimulated reservoir volume (SRV). In this paper, a simplified linear model is presented to represent the relationship between fractures and matrix rock. Four flow regimes are identified with this model which exhibits the production dynamics of multi-stage fractured horizontal wells (MFHW). Rate-normalized gas pseudopressure is derived from production data and used to interpret flow regimes with corresponding calculation equations. We illustrate the analysis procedure with two field cases from a tight gas reservoir in Northeast China. The results prove that the proposed method works well in analyzing production data from tight gas wells in their early life. The potential in further developing this technique for practical application is obvious and looks very promising.

Breast Cancer Research and Treatment, 2009

British Journal of Cancer, 2006

To compare the efficacy and toxicity of oxaliplatin (L-OHP) in combination with irinotecan (CPT-1... more To compare the efficacy and toxicity of oxaliplatin (L-OHP) in combination with irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin (LV) (FOLFOXIRI) vs irinotecan and 5-FU/LV (FOLFIRI) as first-line treatment of patients with metastatic colorectal cancer (MCC). A total of 283 chemotherapy-naïve patients with MCC were enrolled (FOLFIRI arm: n ¼ 146; FOLFOXIRI arm: n ¼ 137). In the FOLFOXIRI arm, CPT-11 (150 mg m À2) was given on d 1 , L-OHP (65 mg m À2) on d 2 , LV (200 mg m À2) on days 2 and 3 and 5-FU (400 mg m À2 as i.v. bolus and 600 mg m À2 as 22 h i.v. continuous infusion) on days 2 and 3. In the FOLFIRI arm, CPT-11 (180 mg m À2) was given on d 1 whereas LV and 5-FU were administered in the same way as in the FOLFOXIRI regimen. Both regimens were administered every 2 weeks. There was no difference in terms of overall survival (median OS: 19.5 and 21.5 months, for FOLFIRI and FOLFOXIRI, respectively; P ¼ 0.337), median time to disease progression (FOLFIRI: 6.9 and FOLFOXIRI: 8.4 months; P ¼ 0.17), response rates (33.6 and 43% for FOLFIRI and FOLFOXIRI, respectively; P ¼ 0.168). Patients treated with FOLFOXIRI had a significantly higher incidence of alopecia (P ¼ 0.0001), diarrhoea (P ¼ 0.0001) and neurosensory toxicity (P ¼ 0.001) compared with patients treated with FOLFIRI. The present study failed to demonstrate any superiority of the FOLFOXIRI combination compared with the FOLFIRI regimen, although the observed median OS is one of the best ever reported in the literature.

Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology

There is discrepancy and failure to adhere to current international guidelines for the management... more There is discrepancy and failure to adhere to current international guidelines for the management of metastatic colorectal cancer (CRC) in hospitals in Greece and Cyprus. The aim of the present document is to provide a consensus on the multidisciplinary management of metastastic CRC, considering both special characteristics of our Healthcare System and international guidelines. Following discussion and online communication among the members of an executive team chosen by the Hellenic Society of Medical Oncology (HeSMO), a consensus for metastastic CRC disease was developed. Statements were subjected to the Delphi methodology on two voting rounds by invited multidisciplinary international experts on CRC. Statements reaching level of agreement by ≥80% were considered as having achieved large consensus, whereas statements reaching 60-80% moderate consensus. One hundred and nine statements were developed. Ninety experts voted for those statements. The median rate of abstain per statemen...

European Journal of Cancer Supplements, 2007

British journal of cancer, Jan 27, 2006

To compare the efficacy and toxicity of oxaliplatin (L-OHP) in combination with irinotecan (CPT-1... more To compare the efficacy and toxicity of oxaliplatin (L-OHP) in combination with irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin (LV) (FOLFOXIRI) vs irinotecan and 5-FU/LV (FOLFIRI) as first-line treatment of patients with metastatic colorectal cancer (MCC). A total of 283 chemotherapy-naïve patients with MCC were enrolled (FOLFIRI arm: n=146; FOLFOXIRI arm: n=137). In the FOLFOXIRI arm, CPT-11 (150 mg m(-2)) was given on d1, L-OHP (65 mg m(-2)) on d2, LV (200 mg m(-2)) on days 2 and 3 and 5-FU (400 mg m(-2) as i.v. bolus and 600 mg m(-2) as 22 h i.v. continuous infusion) on days 2 and 3. In the FOLFIRI arm, CPT-11 (180 mg m(-2)) was given on d1 whereas LV and 5-FU were administered in the same way as in the FOLFOXIRI regimen. Both regimens were administered every 2 weeks. There was no difference in terms of overall survival (median OS: 19.5 and 21.5 months, for FOLFIRI and FOLFOXIRI, respectively; P=0.337), median time to disease progression (FOLFIRI: 6.9 and FOLFOXIRI: 8....

British journal of cancer, Jan 3, 2005

The aim of this study was to compare the irinotecan/cisplatin regimen with cisplatin as second-li... more The aim of this study was to compare the irinotecan/cisplatin regimen with cisplatin as second-line chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC) pretreated with a taxane/gemcitabine regimen. Patients (n = 147) with stage IV NSCLC pretreated with a taxane/gemcitabine regimen were randomly assigned to receive either irinotecan (110 mg m(-2), day 1 and 100 mg m(-2), day 8) and cisplatin (80 mg m(-2), day 8) (IC; n = 74) or CDDP (80 mg m(-2), day 1) (C; n = 73) every 3 weeks. Patients treated with IC and C had a median survival of 7.8 and 8.8 months, respectively (P = 0.933). The 1-year survival rate was 34.3% for IC-treated patients and 31.7% for C-treated patients. Cox's regression analysis revealed that response to treatment (hazard ratio (HR) = 2.787; 95% confidence interval (CI): 1.1578-4.922) and performance status (HR = 1.865; 95% CI: 1.199-2.872) was independent prognostic factors for survival. Overall response rate was 22.5% (95% CI: 12.8-32.2%)...

Anticancer research

The objective of the present study was to investigate the effectiveness of weekly paclitaxel admi... more The objective of the present study was to investigate the effectiveness of weekly paclitaxel administration in combination with oral estramustine in patients with prostate cancer refractory to hormonal manipulation. Between 1999 and 2000, 41 patients were included in the study. All patients had disease progression while on treatment with LH-RH and antiandrogens. After being off hormonal therapy for at least 4 weeks, oral estramustine 520 mg twice daily and 60 minutes paclitaxel 60 mg/m2 once weekly, were administered. In total 152 courses were given (median 3.71). Toxicity was well-tolerated. The most common adverse effect was low-grade (I-II) neurotoxicity. Objective partial responses were observed in 9 (22%) patients; when PSA decrease was included the total number of responders was 25 (61%) patients. Median survival was 17 months (range 4-42+ months). Long-term median and overall survival was achieved in patients with prostate cancer refractory to hormonal treatment, with oral es...

Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, 1997

Based on the high activity of single-agent paclitaxel and the superior one-year survival rates of... more Based on the high activity of single-agent paclitaxel and the superior one-year survival rates of patients with non-small-cell lung cancer (NSCLC) treated with carboplatin, a phase II trial was initiated using both agents in patients with inoperable stages III and IV disease to investigate the efficacy and toxicity of the combination. Since July 1995, 60 patients fulfilling all eligibility criteria entered this study. All patients received paclitaxel 175 mg/m2 as a three-hour infusion, and carboplatin dosed to an area under the concentration-time curve of seven, every three weeks. No granulocyte colony-stimulating factor was given. Of the 56 male and four female patients, the median age was 57 years (range 29 to 75 years) and the median Eastern Co-Operative Oncology Group performance status was one. Most of the patients had stage IV (34) adenocarcinoma (31) with low differentiation (28). The median number of chemotherapy cycles was three, with a range of one to eight. Of 55 evaluabl...

Seminars in oncology, 1996

Based on the activity of single-agent paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton,... more Based on the activity of single-agent paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) and the significant 1-year survival rates of patients with non-small cell lung cancer treated with carboplatin, the Hellenic Cooperative Oncology Group initiated a phase II trial using both agents in patients with inoperable stage III or IV disease to investigate the efficacy and toxicity of the combination. Since July 1995, 31 patients fulfilling all eligibility criteria entered this study. All patients received paclitaxel 175 mg/m2 as a 3-hour infusion and carboplatin dosed to an area under the concentration-time curve of 7, every 3 weeks. No granulocyte colony-stimulating factor was given. Among the 29 male and two female patients, the median age was 55 years (age range, 29 to 73 years) and the median Eastern Cooperative Oncology Group performance status was 1. Most of the patients had stage IV adenocarcinoma (19) with low differentiation (15). The median number of chemotherapy c...

European Journal of Cancer Supplements, 2009

Results: 91 patients (48 males, 43 females) were evaluable. Median age was 66 yrs. 70% had PS of ... more Results: 91 patients (48 males, 43 females) were evaluable. Median age was 66 yrs. 70% had PS of 0 or 1, 27% PS 2, and 3% PS 3. The total number of courses recorded was 170 (107 carboplatin and vinorelbine, 42 cisplatin and vinorelbine, and 21 vinorelbine alone). D8 vinorelbine was not dministred as planned in 23 courses (14%). In 20 (12%) courses, d8 vinorelbine was omitted, delayed in 2, and given with dose reduction in 1. Low FBC was the reason for d8 vinorelbine omission in only 1 course; a patient with PS 2 treated with vinorelbine monotherapy. Conclusions: D8 vinorelbine administration can generally be safely led by clinical assessment alone in patients receiving combination treatment. We will still assess FBC on d8 in patients receiving single agent vinorelbine. This will save NHS resources and improve patient comfort.

Cancers, 2020

Background: Cancer patients are at high risk for cancer-associated thrombosis (CAT). CAT is the s... more Background: Cancer patients are at high risk for cancer-associated thrombosis (CAT). CAT is the second leading cause of death in these patients but it can be preventable with thromboprophylaxis. Patients and Methods: An observational, prospective, multicenter study aiming to record CAT management in clinical practice was conducted by the Hellenic Society of Medical Oncology (HeSMO). Results: A total of 426 active cancer patients (mean age 65.3 years, mean BMI: 26.1 kg/m2) who received thromboprophylaxis, were included from 18 oncology units. Tumor types were lung 25.1%, pancreas 13.9%, breast 8.7%, stomach 8.5%, ovarian 7.8%, and others 36%, while 69% had metastases. A total of 71% had a Khorana score ≤2 and 61% received High Thrombotic Risk Chemotherapy Agents (HTRCAs, e.g., platinum). For thromboprophylaxis patients received mainly Low Molecular Weight Heparins (LMWHs), on higher than prophylactic doses in 50% of cases. Overall, 16 (3.8%) thrombotic events and 6 (1.4%) bleeding ev...

Annals of Gastroenterology, 2016

There is discrepancy and failure to adhere to current international guidelines for the management... more There is discrepancy and failure to adhere to current international guidelines for the management of metastatic colorectal cancer (CRC) in hospitals in Greece and Cyprus. The aim of the present document is to provide a consensus on the multidisciplinary management of metastastic CRC, considering both special characteristics of our Healthcare System and international guidelines. Following discussion and online communication among the members of an executive team chosen by the Hellenic Society of Medical Oncology (HeSMO), a consensus for metastastic CRC disease was developed. Statements were subjected to the Delphi methodology on two voting rounds by invited multidisciplinary international experts on CRC. Statements reaching level of agreement by ≥80% were considered as having achieved large consensus, whereas statements reaching 60-80% moderate consensus. One hundred and nine statements were developed. Ninety experts voted for those statements. The median rate of abstain per statement was 18.5% (range: 0-54%). In the end of the process, all statements achieved a large consensus. The importance of centralization, care by a multidisciplinary team, adherence to guidelines, and personalization is emphasized. R0 resection is the only intervention that may offer substantial improvement in the oncological outcomes.

Annals of Gastroenterology, 2016

In rectal cancer management, accurate staging by magnetic resonance imaging, neo-adjuvant treatme... more In rectal cancer management, accurate staging by magnetic resonance imaging, neo-adjuvant treatment with the use of radiotherapy, and total mesorectal excision have resulted in remarkable improvement in the oncological outcomes. However, there is substantial discrepancy in the therapeutic approach and failure to adhere to international guidelines among different Greek-Cypriot hospitals. The present guidelines aim to aid the multidisciplinary management of rectal cancer, considering both the local special characteristics of our healthcare system and the international relevant agreements (ESMO, EURECCA). Following background discussion and online communication sessions for feedback among the members of an executive team, a consensus rectal cancer management was obtained. Statements were subjected to the Delphi methodology voting system on two rounds to achieve further consensus by invited multidisciplinary international experts on colorectal cancer. Statements were considered of high, moderate or low consensus if they were voted by ≥80%, 60-80%, or <60%, respectively; those obtaining a low consensus level after both voting rounds were rejected. One hundred and two statements were developed and voted by 100 experts. The mean rate of abstention per statement was 12.5% (range: 2-45%). In the end of the process, all statements achieved a high consensus. Guidelines and algorithms of diagnosis and treatment were proposed. The importance of centralization, care by a multidisciplinary team, adherence to guidelines, and personalization is emphasized.

Anticancer research, 2005

BACKGROUND Our purpose was to evaluate the survival of patients with pleural and intraperitoneal ... more BACKGROUND Our purpose was to evaluate the survival of patients with pleural and intraperitoneal malignant mesothelioma and, particularly, to estimate the efficacy of chemotherapy as well as radiotherapy and surgery. A review of the literature with respect to these parameters is included. PATIENTS AND METHODS Thirty-five patients with malignant mesothelioma (28 with pleural and 7 with intraperitoneal) were enrolled. Twenty-eight patients underwent chemotherapy, 7/35 radiation and 9/35 surgery (2 with pleural and 7 with abdominal disease). Combination chemotherapy included cisplatin-gemcitabine, cisplatin (or carboplatin) with premetrexed and doxorubicin-cyclophosphamide. RESULTS In 2/28 patients with pleural mesothelioma the tumor was excised and in 7 with intraperitoneal disease, surgical therapy was palliative and there was survival prolongation. Radiotherapy was only palliative. Chemotherapy produced a very low response: 2/28 (7.14%) patients achieved a partial response. The medi...

Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology

Colorectal cancer remains a major cause of cancer mortality in the Western world both in men and ... more Colorectal cancer remains a major cause of cancer mortality in the Western world both in men and women. In this manuscript a concise overview and recommendations on adjuvant chemotherapy in colon cancer are presented. An executive team from the Hellenic Society of Medical Oncology was assigned to develop a consensus statement and guidelines on the adjuvant treatment of colon cancer. Fourteen statements on adjuvant treatment were subjected to the Delphi methodology. Voting experts were 68. All statements achieved a rate of consensus above than 80% (>87%) and none revised and entered to a second round of voting. Three and 8 of them achieved a 100 and an over than 90% consensus, respectively. These statements describe evaluations of therapies in clinical practice. They could be considered as general guidelines based on best available evidence for assistance in treatment decision-making. Furthermore, they serve to identify questions and targets for further research and the settings i...

Oncology, 2008

To evaluate the efficacy and tolerance of capecitabine (CAP) given every other week and biweekly ... more To evaluate the efficacy and tolerance of capecitabine (CAP) given every other week and biweekly oxaliplatin (OX; modified CAPOX regimen) in patients with advanced colorectal cancer previously treated with irinote- can-based frontline chemotherapy.

European Journal of Cancer, 1995

European Journal of Cancer, 2001

European Journal of Cancer, 1994

... 1 AHEPA Hospital, Aristotle University, Thessaloniki, Macedonia, Greece. 2 “Agii Anargiri” Ca... more ... 1 AHEPA Hospital, Aristotle University, Thessaloniki, Macedonia, Greece. 2 “Agii Anargiri” Cancer Hospital, Athens, Greece. 3 METAXA Cancer Hospital, Piraeous, Greece. 4 HeCOG Data Office, Athens, Greece. 5 University of Ioannina, Ioannina, Greece. ...

Critical Reviews in Oncology/Hematology, 2010

Activities in exploitation and developing tight gas reservoirs grown tremendously in recent years... more Activities in exploitation and developing tight gas reservoirs grown tremendously in recent years. The horizontal well with multi-stage hydraulic fracture stimulation has proven to be an effective strategy of developing these unconventional resources. However, to evaluate the fracturing treatment and predict the long-term production behavior of wells in gas recovery it is important to estimate the effective half-length and spacing of created hydraulic fractures and the extent of the stimulated reservoir volume (SRV). In this paper, a simplified linear model is presented to represent the relationship between fractures and matrix rock. Four flow regimes are identified with this model which exhibits the production dynamics of multi-stage fractured horizontal wells (MFHW). Rate-normalized gas pseudopressure is derived from production data and used to interpret flow regimes with corresponding calculation equations. We illustrate the analysis procedure with two field cases from a tight gas reservoir in Northeast China. The results prove that the proposed method works well in analyzing production data from tight gas wells in their early life. The potential in further developing this technique for practical application is obvious and looks very promising.

Breast Cancer Research and Treatment, 2009

British Journal of Cancer, 2006

To compare the efficacy and toxicity of oxaliplatin (L-OHP) in combination with irinotecan (CPT-1... more To compare the efficacy and toxicity of oxaliplatin (L-OHP) in combination with irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin (LV) (FOLFOXIRI) vs irinotecan and 5-FU/LV (FOLFIRI) as first-line treatment of patients with metastatic colorectal cancer (MCC). A total of 283 chemotherapy-naïve patients with MCC were enrolled (FOLFIRI arm: n ¼ 146; FOLFOXIRI arm: n ¼ 137). In the FOLFOXIRI arm, CPT-11 (150 mg m À2) was given on d 1 , L-OHP (65 mg m À2) on d 2 , LV (200 mg m À2) on days 2 and 3 and 5-FU (400 mg m À2 as i.v. bolus and 600 mg m À2 as 22 h i.v. continuous infusion) on days 2 and 3. In the FOLFIRI arm, CPT-11 (180 mg m À2) was given on d 1 whereas LV and 5-FU were administered in the same way as in the FOLFOXIRI regimen. Both regimens were administered every 2 weeks. There was no difference in terms of overall survival (median OS: 19.5 and 21.5 months, for FOLFIRI and FOLFOXIRI, respectively; P ¼ 0.337), median time to disease progression (FOLFIRI: 6.9 and FOLFOXIRI: 8.4 months; P ¼ 0.17), response rates (33.6 and 43% for FOLFIRI and FOLFOXIRI, respectively; P ¼ 0.168). Patients treated with FOLFOXIRI had a significantly higher incidence of alopecia (P ¼ 0.0001), diarrhoea (P ¼ 0.0001) and neurosensory toxicity (P ¼ 0.001) compared with patients treated with FOLFIRI. The present study failed to demonstrate any superiority of the FOLFOXIRI combination compared with the FOLFIRI regimen, although the observed median OS is one of the best ever reported in the literature.

Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology

There is discrepancy and failure to adhere to current international guidelines for the management... more There is discrepancy and failure to adhere to current international guidelines for the management of metastatic colorectal cancer (CRC) in hospitals in Greece and Cyprus. The aim of the present document is to provide a consensus on the multidisciplinary management of metastastic CRC, considering both special characteristics of our Healthcare System and international guidelines. Following discussion and online communication among the members of an executive team chosen by the Hellenic Society of Medical Oncology (HeSMO), a consensus for metastastic CRC disease was developed. Statements were subjected to the Delphi methodology on two voting rounds by invited multidisciplinary international experts on CRC. Statements reaching level of agreement by ≥80% were considered as having achieved large consensus, whereas statements reaching 60-80% moderate consensus. One hundred and nine statements were developed. Ninety experts voted for those statements. The median rate of abstain per statemen...

European Journal of Cancer Supplements, 2007

British journal of cancer, Jan 27, 2006

To compare the efficacy and toxicity of oxaliplatin (L-OHP) in combination with irinotecan (CPT-1... more To compare the efficacy and toxicity of oxaliplatin (L-OHP) in combination with irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin (LV) (FOLFOXIRI) vs irinotecan and 5-FU/LV (FOLFIRI) as first-line treatment of patients with metastatic colorectal cancer (MCC). A total of 283 chemotherapy-naïve patients with MCC were enrolled (FOLFIRI arm: n=146; FOLFOXIRI arm: n=137). In the FOLFOXIRI arm, CPT-11 (150 mg m(-2)) was given on d1, L-OHP (65 mg m(-2)) on d2, LV (200 mg m(-2)) on days 2 and 3 and 5-FU (400 mg m(-2) as i.v. bolus and 600 mg m(-2) as 22 h i.v. continuous infusion) on days 2 and 3. In the FOLFIRI arm, CPT-11 (180 mg m(-2)) was given on d1 whereas LV and 5-FU were administered in the same way as in the FOLFOXIRI regimen. Both regimens were administered every 2 weeks. There was no difference in terms of overall survival (median OS: 19.5 and 21.5 months, for FOLFIRI and FOLFOXIRI, respectively; P=0.337), median time to disease progression (FOLFIRI: 6.9 and FOLFOXIRI: 8....

British journal of cancer, Jan 3, 2005

The aim of this study was to compare the irinotecan/cisplatin regimen with cisplatin as second-li... more The aim of this study was to compare the irinotecan/cisplatin regimen with cisplatin as second-line chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC) pretreated with a taxane/gemcitabine regimen. Patients (n = 147) with stage IV NSCLC pretreated with a taxane/gemcitabine regimen were randomly assigned to receive either irinotecan (110 mg m(-2), day 1 and 100 mg m(-2), day 8) and cisplatin (80 mg m(-2), day 8) (IC; n = 74) or CDDP (80 mg m(-2), day 1) (C; n = 73) every 3 weeks. Patients treated with IC and C had a median survival of 7.8 and 8.8 months, respectively (P = 0.933). The 1-year survival rate was 34.3% for IC-treated patients and 31.7% for C-treated patients. Cox's regression analysis revealed that response to treatment (hazard ratio (HR) = 2.787; 95% confidence interval (CI): 1.1578-4.922) and performance status (HR = 1.865; 95% CI: 1.199-2.872) was independent prognostic factors for survival. Overall response rate was 22.5% (95% CI: 12.8-32.2%)...

Anticancer research

The objective of the present study was to investigate the effectiveness of weekly paclitaxel admi... more The objective of the present study was to investigate the effectiveness of weekly paclitaxel administration in combination with oral estramustine in patients with prostate cancer refractory to hormonal manipulation. Between 1999 and 2000, 41 patients were included in the study. All patients had disease progression while on treatment with LH-RH and antiandrogens. After being off hormonal therapy for at least 4 weeks, oral estramustine 520 mg twice daily and 60 minutes paclitaxel 60 mg/m2 once weekly, were administered. In total 152 courses were given (median 3.71). Toxicity was well-tolerated. The most common adverse effect was low-grade (I-II) neurotoxicity. Objective partial responses were observed in 9 (22%) patients; when PSA decrease was included the total number of responders was 25 (61%) patients. Median survival was 17 months (range 4-42+ months). Long-term median and overall survival was achieved in patients with prostate cancer refractory to hormonal treatment, with oral es...

Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, 1997

Based on the high activity of single-agent paclitaxel and the superior one-year survival rates of... more Based on the high activity of single-agent paclitaxel and the superior one-year survival rates of patients with non-small-cell lung cancer (NSCLC) treated with carboplatin, a phase II trial was initiated using both agents in patients with inoperable stages III and IV disease to investigate the efficacy and toxicity of the combination. Since July 1995, 60 patients fulfilling all eligibility criteria entered this study. All patients received paclitaxel 175 mg/m2 as a three-hour infusion, and carboplatin dosed to an area under the concentration-time curve of seven, every three weeks. No granulocyte colony-stimulating factor was given. Of the 56 male and four female patients, the median age was 57 years (range 29 to 75 years) and the median Eastern Co-Operative Oncology Group performance status was one. Most of the patients had stage IV (34) adenocarcinoma (31) with low differentiation (28). The median number of chemotherapy cycles was three, with a range of one to eight. Of 55 evaluabl...

Seminars in oncology, 1996

Based on the activity of single-agent paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton,... more Based on the activity of single-agent paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) and the significant 1-year survival rates of patients with non-small cell lung cancer treated with carboplatin, the Hellenic Cooperative Oncology Group initiated a phase II trial using both agents in patients with inoperable stage III or IV disease to investigate the efficacy and toxicity of the combination. Since July 1995, 31 patients fulfilling all eligibility criteria entered this study. All patients received paclitaxel 175 mg/m2 as a 3-hour infusion and carboplatin dosed to an area under the concentration-time curve of 7, every 3 weeks. No granulocyte colony-stimulating factor was given. Among the 29 male and two female patients, the median age was 55 years (age range, 29 to 73 years) and the median Eastern Cooperative Oncology Group performance status was 1. Most of the patients had stage IV adenocarcinoma (19) with low differentiation (15). The median number of chemotherapy c...

European Journal of Cancer Supplements, 2009

Results: 91 patients (48 males, 43 females) were evaluable. Median age was 66 yrs. 70% had PS of ... more Results: 91 patients (48 males, 43 females) were evaluable. Median age was 66 yrs. 70% had PS of 0 or 1, 27% PS 2, and 3% PS 3. The total number of courses recorded was 170 (107 carboplatin and vinorelbine, 42 cisplatin and vinorelbine, and 21 vinorelbine alone). D8 vinorelbine was not dministred as planned in 23 courses (14%). In 20 (12%) courses, d8 vinorelbine was omitted, delayed in 2, and given with dose reduction in 1. Low FBC was the reason for d8 vinorelbine omission in only 1 course; a patient with PS 2 treated with vinorelbine monotherapy. Conclusions: D8 vinorelbine administration can generally be safely led by clinical assessment alone in patients receiving combination treatment. We will still assess FBC on d8 in patients receiving single agent vinorelbine. This will save NHS resources and improve patient comfort.