Gabriel Prolla - Academia.edu (original) (raw)

Papers by Gabriel Prolla

Brazilian Journal of Health Review

Introduction: Although new treatments and diagnostic methods for Neuroendocrine Neoplasms (NEN) h... more Introduction: Although new treatments and diagnostic methods for Neuroendocrine Neoplasms (NEN) have been introduced, the level of access to them needs somehow to be further investigated. Objectives: to understand the aspects that influence the access to the diagnosis, follow-up and treatment of patients with NEN in Brazil. Methods: This is a cross-sectional electronic survey conducted by the Brazilian Group of Gastrointestinal Tumors (GTG) and containing sixteen questions sent to Brazilian Oncologists via messaging app, aiming to identify access profiles to diagnostic and follow-up tests among patients with NEN, in addition to proven effective treatments in the Public and Private Brazilian Health Care System. Descriptive analysis was used to report the outcomes.Results: The survey was carried out with 201 Oncologists. Since (31.8%) of the Oncologists responded that they have been trained for more than 15 years and have been working with clinical practice within the scope of the Bra...

Cancer Treatment and Research Communications

JAMA Network Open, 2021

IMPORTANCE Immune checkpoint inhibitors (ICIs) have yielded conflicting results in hepatocellular... more IMPORTANCE Immune checkpoint inhibitors (ICIs) have yielded conflicting results in hepatocellular carcinoma (HCC). The overall effect of ICIs compared with standard therapies in unresectable HCC requires more research. OBJECTIVE To estimate the efficacy and safety associated with ICIs compared with standard therapies in patients with unresectable HCC.

Annals of Oncology, 2018

s and RAS/BRAF status have changed the treatment colorectal cancer (mCRC). This study was perform... more s and RAS/BRAF status have changed the treatment colorectal cancer (mCRC). This study was performed to underof Brazilian oncologists for patients with advanced/unresectcancer (mCRC), especially in the emergent context of tumor F V600E status. electronic survey composed of 6 questions, which oncologists and medical oncology groups by email,. The survey instrument assessed current practices in terms for fit patients with mCRC, including left-sided wild-, right-sided wt-RAS/wt-BRAFV600E and any-side that all drugs were available. The instrument also elicited in Medical Oncology, gender and how much of each oncolto gastrointestinal tumors (GI). Those with at least 75% patients with GI malignancies were considered specialists. for answers for 12 days. completed during a 12-day period by 222 medical oncologists Because the survey was not sent to all individual emails, we rate but for those who responded, the completion rate were male (57.2%) and were in Oncology practice for less 9.4% of the participants were specialists in GI tumors. For 600E mCRC, most oncologists (81.9%) chose first line-EGFR therapy, with 53.2% of them preferring FOLFIRI as , for right-sided, wt-RAS/wt-BRAFV600E mCRC, the offer CT þ bevacizumab (53.7% with FOLFOX, 31.6% with FOLFOXIRI). For mutated-RAS mCRC, most oncologists X þ bevacizumab (33.6% for FOLFIRI þ bevacizumab þ bevacizumab). first study conducted among Brazilian oncologists to investiaccording to sidedness and RAS/BRAF V600E status. Our sidedness influences the choice of both CT backbone and unresectable wt-RAS mCRC. tive analysis of clinical factors associated with a greater Trifluridine and Tipiracil in metastasic colorectal cancer

Expert Opinion on Biological Therapy

JCO Global Oncology, 2021

PURPOSE The utility of administering fluorouracil (5-FU) in bolus in regimens of infusional 5-FU ... more PURPOSE The utility of administering fluorouracil (5-FU) in bolus in regimens of infusional 5-FU has been questioned. We aimed to quantify the use of 5-FU bolus in infusional regimens for gastrointestinal malignancies among Brazilian oncologists. METHODS This was a cross-sectional electronic survey composed of eight multiple-choice questions sent to Brazilian oncologists during 14 days in February 2021. The survey instrument collected demographic data of participants and assessed practices in terms of 5-FU bolus use. We evaluated the association of demographic variables and 5-FU prescribing patterns with Fisher’s exact test (odds ratio [OR]). RESULTS The survey was completed by 332 medical oncologists. Overall, 37% were experienced oncologists and 32% were gastrointestinal specialists. In the first-line metastatic and in the adjuvant settings, 40% and 67% of oncologists always prescribe 5-FU bolus in infusional regimens, respectively. Experienced oncologists more frequently omit 5-F...

Journal of Clinical Oncology

e16631 Background: ICIs have ushered a new era in cancer therapy, but their efficacy in HCC is un... more e16631 Background: ICIs have ushered a new era in cancer therapy, but their efficacy in HCC is uncertain. Single-arm phase II studies with sorafenib-refractory patients have suggested clinical activity of nivolumab and pembrolizumab, which have become FDA-approved therapies. Nevertheless, the overall effect of ICIs compared with the standard of care (SOC) in unresectable HCC patients is still unknown. Methods: We systematically searched PubMed, Cochrane Library, Web of Science, LILACS, and ASCO and ESMO Meeting Proceedings in the last 10 years for RCTs that have compared the efficacy of ICIs versus the SOC in the systemic therapy of unresectable HCC. Outcomes of interest included overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and grade 3-4 treatment-related adverse events (TRAEs). A summary hazard ratio (HR) of OS and PFS was calculated using 95% confidence intervals (CI) by fixed-effects model. The likelihood of ICIs being associated with ORR a...

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Journal of Clinical Oncology

Brazilian Journal of Oncology

Objectives: Tumor sidedness and RAS/BRAF status have changed the treatment landscape of metastati... more Objectives: Tumor sidedness and RAS/BRAF status have changed the treatment landscape of metastatic colorectal cancer (mCRC). This study was performed to understand the first line choices of Brazilian oncologists for patients with mCRC, especially in the emergent context of tumor sidedness and RAS/BRAFV600E status. Methods: This was a cross-sectional electronic survey composed of six questions sent to Brazilian medical oncologists through social media. The survey instrument collected demographic data of participants and assessed current practices in terms of first-line treatment choices for fit patients with mCRC. Participants with at least 50% of their clinical practice dedicated to patients with GI malignancies were deemed GI specialists. Results: The survey was completed by 239 medical oncologists from across the country. Most oncologists were male (59%) and were in oncology practice for less than 10 years (62.2%). Only 20.9% of the participants were specialists in GI tumors. For left-sided, wild-type (wt) RAS/wt-BRAFV600E mCRC, most oncologists (82%) chose first line chemotherapy (CT) + anti-EGFR therapy, with 53.6% of them preferring FOLFIRI as the CT backbone. Meanwhile, for right-sided, wt-RAS/wt-BRAFV600E mCRC, the majority (70.7%) would offer CT + bevacizumab (53.9% with FOLFOX). For mutated-RAS mCRC, most oncologists decided for FOLFOX + bevacizumab (51.9%). Subgroup analyses revealed statistically significant differences for therapeutic choices in first line for left-sided wt-RAS/wt-BRAFV600E mCRC: female oncologists prefer FOLFOX as CT backbone (p=0.004) and in right-sided wt-RAS/wt-BRAFV600E mCRC, GI cancer specialists more often use FOLFOXIRI and bevacizumab (18 vs 7.9%; p=0.001). Conclusion: Our survey indicates that tumor sidedness influences the choice of both CT backbone and monoclonal antibody in unresectable wt-RAS mCRC. In addition, oncologists' gender and percentage of time dedicated to treat GI cancers also impacted on therapeutic choices for mCRC in Brazil.

Brazilian Journal of Oncology

In 2018, there were some important trials presented over multiple international meetings. The obj... more In 2018, there were some important trials presented over multiple international meetings. The objective of this article is to summarize the most important and practice changing studies in gastrointestinal oncology this year. Some studies in gastroesophageal, pancreatic, colorectal and anal canal have been selected, including adjuvant therapy in pancreatic cancer, immunotherapy in metastatic gastroesophageal cancer, as well as strategies in regorafenib dose escalation and the role of hyperthermic intraperitoneal chemotherapy in metastatic colorectal.

Rev Hcpa Fac Med Univ Fed Rio Gd Do Sul, Aug 1, 1988

Rev Med St Casa, Jun 1, 2000

Arquivos de Gastroenterologia, 2016

The Brazilian Gastrointestinal Tumor Group developed guidelines for the surgical and clinical man... more The Brazilian Gastrointestinal Tumor Group developed guidelines for the surgical and clinical management of patients with billiary cancers. The multidisciplinary panel was composed of experts in the field of radiology, medical oncology, surgical oncology, radiotherapy, endoscopy and pathology. The panel utilized the most recent literature to develop a series of evidence-based recommendations on different treatment and diagnostic strategies for cholangiocarcinomas and gallbladder cancers.

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2015

Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution o... more Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution of patients with these tumors. In this module, was contextualized the clinical situations and parameterized epidemiological data and results of the various treatment modalities established. Was realized deep discussion on detecting and staging metastatic colorectal cancer, as well as employment of imaging methods in the evaluation of response to instituted systemic therapy. The next step was based on the definition of which patients would have their metastases considered resectable and how to expand the amount of patients elegible for modalities with curative intent. Were presented clinical, pathological and molecular prognostic factors, validated to be taken into account in clinical practice.

Rev Hcpa Fac Med Univ Fed Rio Gd Do Sul, Apr 1, 1989

Rev Med St Casa, Jun 1, 2000

Brazilian Journal of Health Review

Introduction: Although new treatments and diagnostic methods for Neuroendocrine Neoplasms (NEN) h... more Introduction: Although new treatments and diagnostic methods for Neuroendocrine Neoplasms (NEN) have been introduced, the level of access to them needs somehow to be further investigated. Objectives: to understand the aspects that influence the access to the diagnosis, follow-up and treatment of patients with NEN in Brazil. Methods: This is a cross-sectional electronic survey conducted by the Brazilian Group of Gastrointestinal Tumors (GTG) and containing sixteen questions sent to Brazilian Oncologists via messaging app, aiming to identify access profiles to diagnostic and follow-up tests among patients with NEN, in addition to proven effective treatments in the Public and Private Brazilian Health Care System. Descriptive analysis was used to report the outcomes.Results: The survey was carried out with 201 Oncologists. Since (31.8%) of the Oncologists responded that they have been trained for more than 15 years and have been working with clinical practice within the scope of the Bra...

Cancer Treatment and Research Communications

JAMA Network Open, 2021

IMPORTANCE Immune checkpoint inhibitors (ICIs) have yielded conflicting results in hepatocellular... more IMPORTANCE Immune checkpoint inhibitors (ICIs) have yielded conflicting results in hepatocellular carcinoma (HCC). The overall effect of ICIs compared with standard therapies in unresectable HCC requires more research. OBJECTIVE To estimate the efficacy and safety associated with ICIs compared with standard therapies in patients with unresectable HCC.

Annals of Oncology, 2018

s and RAS/BRAF status have changed the treatment colorectal cancer (mCRC). This study was perform... more s and RAS/BRAF status have changed the treatment colorectal cancer (mCRC). This study was performed to underof Brazilian oncologists for patients with advanced/unresectcancer (mCRC), especially in the emergent context of tumor F V600E status. electronic survey composed of 6 questions, which oncologists and medical oncology groups by email,. The survey instrument assessed current practices in terms for fit patients with mCRC, including left-sided wild-, right-sided wt-RAS/wt-BRAFV600E and any-side that all drugs were available. The instrument also elicited in Medical Oncology, gender and how much of each oncolto gastrointestinal tumors (GI). Those with at least 75% patients with GI malignancies were considered specialists. for answers for 12 days. completed during a 12-day period by 222 medical oncologists Because the survey was not sent to all individual emails, we rate but for those who responded, the completion rate were male (57.2%) and were in Oncology practice for less 9.4% of the participants were specialists in GI tumors. For 600E mCRC, most oncologists (81.9%) chose first line-EGFR therapy, with 53.2% of them preferring FOLFIRI as , for right-sided, wt-RAS/wt-BRAFV600E mCRC, the offer CT þ bevacizumab (53.7% with FOLFOX, 31.6% with FOLFOXIRI). For mutated-RAS mCRC, most oncologists X þ bevacizumab (33.6% for FOLFIRI þ bevacizumab þ bevacizumab). first study conducted among Brazilian oncologists to investiaccording to sidedness and RAS/BRAF V600E status. Our sidedness influences the choice of both CT backbone and unresectable wt-RAS mCRC. tive analysis of clinical factors associated with a greater Trifluridine and Tipiracil in metastasic colorectal cancer

Expert Opinion on Biological Therapy

JCO Global Oncology, 2021

PURPOSE The utility of administering fluorouracil (5-FU) in bolus in regimens of infusional 5-FU ... more PURPOSE The utility of administering fluorouracil (5-FU) in bolus in regimens of infusional 5-FU has been questioned. We aimed to quantify the use of 5-FU bolus in infusional regimens for gastrointestinal malignancies among Brazilian oncologists. METHODS This was a cross-sectional electronic survey composed of eight multiple-choice questions sent to Brazilian oncologists during 14 days in February 2021. The survey instrument collected demographic data of participants and assessed practices in terms of 5-FU bolus use. We evaluated the association of demographic variables and 5-FU prescribing patterns with Fisher’s exact test (odds ratio [OR]). RESULTS The survey was completed by 332 medical oncologists. Overall, 37% were experienced oncologists and 32% were gastrointestinal specialists. In the first-line metastatic and in the adjuvant settings, 40% and 67% of oncologists always prescribe 5-FU bolus in infusional regimens, respectively. Experienced oncologists more frequently omit 5-F...

Journal of Clinical Oncology

e16631 Background: ICIs have ushered a new era in cancer therapy, but their efficacy in HCC is un... more e16631 Background: ICIs have ushered a new era in cancer therapy, but their efficacy in HCC is uncertain. Single-arm phase II studies with sorafenib-refractory patients have suggested clinical activity of nivolumab and pembrolizumab, which have become FDA-approved therapies. Nevertheless, the overall effect of ICIs compared with the standard of care (SOC) in unresectable HCC patients is still unknown. Methods: We systematically searched PubMed, Cochrane Library, Web of Science, LILACS, and ASCO and ESMO Meeting Proceedings in the last 10 years for RCTs that have compared the efficacy of ICIs versus the SOC in the systemic therapy of unresectable HCC. Outcomes of interest included overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and grade 3-4 treatment-related adverse events (TRAEs). A summary hazard ratio (HR) of OS and PFS was calculated using 95% confidence intervals (CI) by fixed-effects model. The likelihood of ICIs being associated with ORR a...

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Journal of Clinical Oncology

Brazilian Journal of Oncology

Objectives: Tumor sidedness and RAS/BRAF status have changed the treatment landscape of metastati... more Objectives: Tumor sidedness and RAS/BRAF status have changed the treatment landscape of metastatic colorectal cancer (mCRC). This study was performed to understand the first line choices of Brazilian oncologists for patients with mCRC, especially in the emergent context of tumor sidedness and RAS/BRAFV600E status. Methods: This was a cross-sectional electronic survey composed of six questions sent to Brazilian medical oncologists through social media. The survey instrument collected demographic data of participants and assessed current practices in terms of first-line treatment choices for fit patients with mCRC. Participants with at least 50% of their clinical practice dedicated to patients with GI malignancies were deemed GI specialists. Results: The survey was completed by 239 medical oncologists from across the country. Most oncologists were male (59%) and were in oncology practice for less than 10 years (62.2%). Only 20.9% of the participants were specialists in GI tumors. For left-sided, wild-type (wt) RAS/wt-BRAFV600E mCRC, most oncologists (82%) chose first line chemotherapy (CT) + anti-EGFR therapy, with 53.6% of them preferring FOLFIRI as the CT backbone. Meanwhile, for right-sided, wt-RAS/wt-BRAFV600E mCRC, the majority (70.7%) would offer CT + bevacizumab (53.9% with FOLFOX). For mutated-RAS mCRC, most oncologists decided for FOLFOX + bevacizumab (51.9%). Subgroup analyses revealed statistically significant differences for therapeutic choices in first line for left-sided wt-RAS/wt-BRAFV600E mCRC: female oncologists prefer FOLFOX as CT backbone (p=0.004) and in right-sided wt-RAS/wt-BRAFV600E mCRC, GI cancer specialists more often use FOLFOXIRI and bevacizumab (18 vs 7.9%; p=0.001). Conclusion: Our survey indicates that tumor sidedness influences the choice of both CT backbone and monoclonal antibody in unresectable wt-RAS mCRC. In addition, oncologists' gender and percentage of time dedicated to treat GI cancers also impacted on therapeutic choices for mCRC in Brazil.

Brazilian Journal of Oncology

In 2018, there were some important trials presented over multiple international meetings. The obj... more In 2018, there were some important trials presented over multiple international meetings. The objective of this article is to summarize the most important and practice changing studies in gastrointestinal oncology this year. Some studies in gastroesophageal, pancreatic, colorectal and anal canal have been selected, including adjuvant therapy in pancreatic cancer, immunotherapy in metastatic gastroesophageal cancer, as well as strategies in regorafenib dose escalation and the role of hyperthermic intraperitoneal chemotherapy in metastatic colorectal.

Rev Hcpa Fac Med Univ Fed Rio Gd Do Sul, Aug 1, 1988

Rev Med St Casa, Jun 1, 2000

Arquivos de Gastroenterologia, 2016

The Brazilian Gastrointestinal Tumor Group developed guidelines for the surgical and clinical man... more The Brazilian Gastrointestinal Tumor Group developed guidelines for the surgical and clinical management of patients with billiary cancers. The multidisciplinary panel was composed of experts in the field of radiology, medical oncology, surgical oncology, radiotherapy, endoscopy and pathology. The panel utilized the most recent literature to develop a series of evidence-based recommendations on different treatment and diagnostic strategies for cholangiocarcinomas and gallbladder cancers.

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2015

Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution o... more Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution of patients with these tumors. In this module, was contextualized the clinical situations and parameterized epidemiological data and results of the various treatment modalities established. Was realized deep discussion on detecting and staging metastatic colorectal cancer, as well as employment of imaging methods in the evaluation of response to instituted systemic therapy. The next step was based on the definition of which patients would have their metastases considered resectable and how to expand the amount of patients elegible for modalities with curative intent. Were presented clinical, pathological and molecular prognostic factors, validated to be taken into account in clinical practice.

Rev Hcpa Fac Med Univ Fed Rio Gd Do Sul, Apr 1, 1989

Rev Med St Casa, Jun 1, 2000