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the World Wide Web at: The online version of this article, along with updated information and ser... more the World Wide Web at: The online version of this article, along with updated information and services, is located on by guest on M arch 3, 2014

Trastuzumab with either docetaxel or vinorelbine as first-line treatment for patients with HER2po... more Trastuzumab with either docetaxel or vinorelbine as first-line treatment for patients with HER2positive advanced breast cancer: a retrospective comparison

Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxic... more Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxicity, their use in combination with trastuzumab has been discouraged in patients with human epidermal growth factor receptor (HER)-2 ؉ metastatic breast cancer. We sought to describe how this treatment paradigm influenced the use of anthracyclines in this patient setting. We analyzed a multi-institutional database containing the treatment history of 450 patients who received at least one trastuzumab-based regimen for HER-2 ؉ metastatic breast cancer. Patients were considered eligible for anthracyclines for metastatic disease if they were never exposed (NE) or had been previously exposed (PE) to an anthracycline in the neoadjuvant or adjuvant setting and had relapsed after 12 months from the last dose. We then assessed the use of anthracycline-based therapy after failure with the first trastuzumab-based regimen in eligible patients. Three-hundred twenty-one patients were considered eligibl...

Journal of Clinical Oncology

576Background: EXE-EVE significantly improved progression free survival (PFS) in patients (pts) w... more 576Background: EXE-EVE significantly improved progression free survival (PFS) in patients (pts) with HR+ MBC progressing on a nonsteroidal aromatase inhibitor regardless of age, at the expenses of acceptable toxicities. The majority of elderly MBC pts have HR+ disease and EXE-EVE is a valuable treatment option. Toxicities are likely to be more frequent in non-trial populations, and tolerability in elderly pts is of particular interest. Methods: We retrospectively analysed efficacy and safety of EXE-EVE in 63 elderly ( ≥ 70 years of age) MBC pts treated at 5 UK Institutions between May 2012 and April 2015. Efficacy end points: PFS, response rate (complete CR + partial response PR), clinical benefit rate (CBR = CR + PR + stabilization ≥ 24 weeks), overall survival (OS). Safety end points: dose reductions and interruptions, toxicities. Results: Median age is 74 (range 70-85) years. 24% of pts had ECOG PS 2; 21% had bone only disease. 21% of pts received EXE-EVE as 1st line treatment for MBC, 40% as 3rd line ...

Breast (Edinburgh, Scotland), Jan 29, 2017

Leptomeningeal disease (LMD) is an uncommon complication of advanced breast cancer. The prognosis... more Leptomeningeal disease (LMD) is an uncommon complication of advanced breast cancer. The prognosis is poor, and although radiotherapy (RT), systemic and intra-thecal (IT) chemotherapy are accepted treatment modalities, efficacy data are limited. This study was designed to evaluate potential predictors of survival in this patient group. Breast cancer patients with LMD diagnosed by MRI in a 10-year period (2004-2014) were identified from electronic patient records. PFS and OS estimates were calculated using Kaplan-Meier method, with planned sub-group analysis by treatment modality. Cox regression was employed to identify significant prognostic variables. We identified 182 eligible patients; all female, median age at LMD diagnosis 52.5 years (range 23-80). Ninety patients (49.5%) were ER positive/HER2 negative; 48 (26.4%) were HER2 positive, and 27 (14.8%) were triple negative. HER2 status was unknown in 17 (9.3%). Initial management of LMD was most commonly whole or partial brain RT in...

Journal of Clinical Oncology

1120 Background: Anthracyclines are among the most active drugs in breast cancer. Because of exce... more 1120 Background: Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxicity, their use in combination with trastuzumab has been discouraged in patients with HER2-positive metastatic breast cancer. We sought to describe how this treatment paradigm influenced the utilization of anthracyclines in this patient setting. Methods: Analysis of a multi-institutional database containing the treatment history of 450 patients who received trastuzumab- based therapy for HER2-positive metastatic breast cancer. Eligibility to anthracyclines for metastatic disease was retrospectively assessed based on prior history of exposure. The use of anthracycline-based therapy after failure to the first trastuzumab-based regimen was assessed in eligible patients. Results: Three-hundred twenty-one patients (71%, 95% C.I. 67%-75%) were considered eligible to anthracyclines either because of no prior exposure (171 patients), or because of prior exposure in the neo- or adjuvant setting and meta...

Tumori Journal, 2015

Aim To assess patient perception toward oral chemotherapy for solid tumors, the Italian Associati... more Aim To assess patient perception toward oral chemotherapy for solid tumors, the Italian Association of Medical Oncology performed a large multi-institutional national survey. Methods A 17-item anonymous questionnaire including 7 general and 10 investigational questions with free-text, single-choice, or multiple-choice answers was administered. Analysis of response distribution according to predefined factors was described by summary measures and conducted by χ2 test and other nonparametric tests. Results From January to June 2010, 581 patients completed the questionnaire; data of 404 patients constituted the final study sample. Three groups could be distinguished according to treatment: IV chemotherapy (IV group, n = 313), oral chemotherapy (oral group, n = 48), or combined therapy (combined group, n = 43). Thirty-one (72%) patients in the combined group and 187 (60%) in the IV group expressed preference for oral therapy (p = 0.028). Limitations in family and work commitment were mo...

Oncology reports, 2005

Although HER2 gene status determines the eligibility of breast cancer patients to trastuzumab the... more Although HER2 gene status determines the eligibility of breast cancer patients to trastuzumab therapy, only a fraction of HER2 gene-amplified cancers are actually responsive, indicating that complex genotypical profiles might sustain HER2-targeted therapy responsiveness. To identify genetic factors modulating the response to HER2-targeted therapy, the numerical status of chromosome 17 was evaluated in HER2 gene-amplified tumor specimens from 43 patients who received trastuzumab-based treatment for advanced breast cancer, and in 60 unamplified breast carcinomas. Archival tumor specimens were analyzed by interphase fluorescence in situ hybridization (FISH) using a centromeric probe for chromosome 17 simultaneously with the HER2/neu human gene-specific probe. In the 43 patients who received trastuzumab-based treatment, response rate and time to progression (TTP) were compared between subgroups according to chromosome 17 status. Numerical aberrations of chromosome 17 were found in 65% o...

Diagnostic, Prognostic and Therapeutic Value of Gene Signatures, 2011

The Breast, 2014

(AAM) is copyrighted and published by Elsevier. It is posted here by agreement between Elsevier a... more (AAM) is copyrighted and published by Elsevier. It is posted here by agreement between Elsevier and the University of Turin. Changes resulting from the publishing process-such as editing, corrections, structural formatting, and other quality control mechanisms-may not be reflected in this version of the text. The definitive version of the text was subsequently published in THE BREAST, Jun 30, 2014, 10.1016/j.breast.2014.06.009. You may download, copy and otherwise use the AAM for non-commercial purposes provided that your license is limited by the following restrictions: (1) You may use this AAM for non-commercial purposes only under the terms of the CC-BY-NC-ND license. (2) The integrity of the work and identification of the author, copyright owner, and publisher must be preserved in any copy.

The oncologist, 2012

Background. Human epidermal growth factor receptor (HER)-2 testing in patients with operable brea... more Background. Human epidermal growth factor receptor (HER)-2 testing in patients with operable breast cancer is aimed at identifying candidates for adjuvant anti-HER-2 treatment. However, commonly defined "HER-2(-)" tumors express variable levels of the HER-2 protein, which can influence prognosis. We compared the clinical outcomes of operable breast cancer patients stratified according to a common HER-2 testing algorithm.Methods. We studied 1,150 women (median age, 58 years; range, 22-94 years) undergoing surgery for early breast cancer at our institution. HER-2 status was determined using the HercepTest™ (Dako, Glostrup, Denmark) and, when needed, by fluorescence in situ hybridization (FISH). Patients receiving adjuvant trastuzumab were excluded. The impact of HER-2 status on the disease-free survival (DFS) time was studied using multivariate Cox proportional regression analysis.Results. Four hundred-fifty seven (40%), 454 (39%), 116 (10%), and 123 (11%) patients were cons...

The Oncologist, 2010

Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxic... more Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxicity, their use in combination with trastuzumab has been discouraged in patients with human epidermal growth factor receptor (HER)-2+ metastatic breast cancer. We sought to describe how this treatment paradigm influenced the use of anthracyclines in this patient setting. We analyzed a multi-institutional database containing the treatment history of 450 patients who received at least one trastuzumab-based regimen for HER-2+ metastatic breast cancer. Patients were considered eligible for anthracyclines for metastatic disease if they were never exposed (NE) or had been previously exposed (PE) to an anthracycline in the neoadjuvant or adjuvant setting and had relapsed after 12 months from the last dose. We then assessed the use of anthracycline-based therapy after failure with the first trastuzumab-based regimen in eligible patients. Three-hundred twenty-one patients were considered eligible ...

the World Wide Web at: The online version of this article, along with updated information and ser... more the World Wide Web at: The online version of this article, along with updated information and services, is located on by guest on M arch 3, 2014

Trastuzumab with either docetaxel or vinorelbine as first-line treatment for patients with HER2po... more Trastuzumab with either docetaxel or vinorelbine as first-line treatment for patients with HER2positive advanced breast cancer: a retrospective comparison

Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxic... more Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxicity, their use in combination with trastuzumab has been discouraged in patients with human epidermal growth factor receptor (HER)-2 ؉ metastatic breast cancer. We sought to describe how this treatment paradigm influenced the use of anthracyclines in this patient setting. We analyzed a multi-institutional database containing the treatment history of 450 patients who received at least one trastuzumab-based regimen for HER-2 ؉ metastatic breast cancer. Patients were considered eligible for anthracyclines for metastatic disease if they were never exposed (NE) or had been previously exposed (PE) to an anthracycline in the neoadjuvant or adjuvant setting and had relapsed after 12 months from the last dose. We then assessed the use of anthracycline-based therapy after failure with the first trastuzumab-based regimen in eligible patients. Three-hundred twenty-one patients were considered eligibl...

Journal of Clinical Oncology

576Background: EXE-EVE significantly improved progression free survival (PFS) in patients (pts) w... more 576Background: EXE-EVE significantly improved progression free survival (PFS) in patients (pts) with HR+ MBC progressing on a nonsteroidal aromatase inhibitor regardless of age, at the expenses of acceptable toxicities. The majority of elderly MBC pts have HR+ disease and EXE-EVE is a valuable treatment option. Toxicities are likely to be more frequent in non-trial populations, and tolerability in elderly pts is of particular interest. Methods: We retrospectively analysed efficacy and safety of EXE-EVE in 63 elderly ( ≥ 70 years of age) MBC pts treated at 5 UK Institutions between May 2012 and April 2015. Efficacy end points: PFS, response rate (complete CR + partial response PR), clinical benefit rate (CBR = CR + PR + stabilization ≥ 24 weeks), overall survival (OS). Safety end points: dose reductions and interruptions, toxicities. Results: Median age is 74 (range 70-85) years. 24% of pts had ECOG PS 2; 21% had bone only disease. 21% of pts received EXE-EVE as 1st line treatment for MBC, 40% as 3rd line ...

Breast (Edinburgh, Scotland), Jan 29, 2017

Leptomeningeal disease (LMD) is an uncommon complication of advanced breast cancer. The prognosis... more Leptomeningeal disease (LMD) is an uncommon complication of advanced breast cancer. The prognosis is poor, and although radiotherapy (RT), systemic and intra-thecal (IT) chemotherapy are accepted treatment modalities, efficacy data are limited. This study was designed to evaluate potential predictors of survival in this patient group. Breast cancer patients with LMD diagnosed by MRI in a 10-year period (2004-2014) were identified from electronic patient records. PFS and OS estimates were calculated using Kaplan-Meier method, with planned sub-group analysis by treatment modality. Cox regression was employed to identify significant prognostic variables. We identified 182 eligible patients; all female, median age at LMD diagnosis 52.5 years (range 23-80). Ninety patients (49.5%) were ER positive/HER2 negative; 48 (26.4%) were HER2 positive, and 27 (14.8%) were triple negative. HER2 status was unknown in 17 (9.3%). Initial management of LMD was most commonly whole or partial brain RT in...

Journal of Clinical Oncology

1120 Background: Anthracyclines are among the most active drugs in breast cancer. Because of exce... more 1120 Background: Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxicity, their use in combination with trastuzumab has been discouraged in patients with HER2-positive metastatic breast cancer. We sought to describe how this treatment paradigm influenced the utilization of anthracyclines in this patient setting. Methods: Analysis of a multi-institutional database containing the treatment history of 450 patients who received trastuzumab- based therapy for HER2-positive metastatic breast cancer. Eligibility to anthracyclines for metastatic disease was retrospectively assessed based on prior history of exposure. The use of anthracycline-based therapy after failure to the first trastuzumab-based regimen was assessed in eligible patients. Results: Three-hundred twenty-one patients (71%, 95% C.I. 67%-75%) were considered eligible to anthracyclines either because of no prior exposure (171 patients), or because of prior exposure in the neo- or adjuvant setting and meta...

Tumori Journal, 2015

Aim To assess patient perception toward oral chemotherapy for solid tumors, the Italian Associati... more Aim To assess patient perception toward oral chemotherapy for solid tumors, the Italian Association of Medical Oncology performed a large multi-institutional national survey. Methods A 17-item anonymous questionnaire including 7 general and 10 investigational questions with free-text, single-choice, or multiple-choice answers was administered. Analysis of response distribution according to predefined factors was described by summary measures and conducted by χ2 test and other nonparametric tests. Results From January to June 2010, 581 patients completed the questionnaire; data of 404 patients constituted the final study sample. Three groups could be distinguished according to treatment: IV chemotherapy (IV group, n = 313), oral chemotherapy (oral group, n = 48), or combined therapy (combined group, n = 43). Thirty-one (72%) patients in the combined group and 187 (60%) in the IV group expressed preference for oral therapy (p = 0.028). Limitations in family and work commitment were mo...

Oncology reports, 2005

Although HER2 gene status determines the eligibility of breast cancer patients to trastuzumab the... more Although HER2 gene status determines the eligibility of breast cancer patients to trastuzumab therapy, only a fraction of HER2 gene-amplified cancers are actually responsive, indicating that complex genotypical profiles might sustain HER2-targeted therapy responsiveness. To identify genetic factors modulating the response to HER2-targeted therapy, the numerical status of chromosome 17 was evaluated in HER2 gene-amplified tumor specimens from 43 patients who received trastuzumab-based treatment for advanced breast cancer, and in 60 unamplified breast carcinomas. Archival tumor specimens were analyzed by interphase fluorescence in situ hybridization (FISH) using a centromeric probe for chromosome 17 simultaneously with the HER2/neu human gene-specific probe. In the 43 patients who received trastuzumab-based treatment, response rate and time to progression (TTP) were compared between subgroups according to chromosome 17 status. Numerical aberrations of chromosome 17 were found in 65% o...

Diagnostic, Prognostic and Therapeutic Value of Gene Signatures, 2011

The Breast, 2014

(AAM) is copyrighted and published by Elsevier. It is posted here by agreement between Elsevier a... more (AAM) is copyrighted and published by Elsevier. It is posted here by agreement between Elsevier and the University of Turin. Changes resulting from the publishing process-such as editing, corrections, structural formatting, and other quality control mechanisms-may not be reflected in this version of the text. The definitive version of the text was subsequently published in THE BREAST, Jun 30, 2014, 10.1016/j.breast.2014.06.009. You may download, copy and otherwise use the AAM for non-commercial purposes provided that your license is limited by the following restrictions: (1) You may use this AAM for non-commercial purposes only under the terms of the CC-BY-NC-ND license. (2) The integrity of the work and identification of the author, copyright owner, and publisher must be preserved in any copy.

The oncologist, 2012

Background. Human epidermal growth factor receptor (HER)-2 testing in patients with operable brea... more Background. Human epidermal growth factor receptor (HER)-2 testing in patients with operable breast cancer is aimed at identifying candidates for adjuvant anti-HER-2 treatment. However, commonly defined "HER-2(-)" tumors express variable levels of the HER-2 protein, which can influence prognosis. We compared the clinical outcomes of operable breast cancer patients stratified according to a common HER-2 testing algorithm.Methods. We studied 1,150 women (median age, 58 years; range, 22-94 years) undergoing surgery for early breast cancer at our institution. HER-2 status was determined using the HercepTest™ (Dako, Glostrup, Denmark) and, when needed, by fluorescence in situ hybridization (FISH). Patients receiving adjuvant trastuzumab were excluded. The impact of HER-2 status on the disease-free survival (DFS) time was studied using multivariate Cox proportional regression analysis.Results. Four hundred-fifty seven (40%), 454 (39%), 116 (10%), and 123 (11%) patients were cons...

The Oncologist, 2010

Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxic... more Anthracyclines are among the most active drugs in breast cancer. Because of excessive cardiotoxicity, their use in combination with trastuzumab has been discouraged in patients with human epidermal growth factor receptor (HER)-2+ metastatic breast cancer. We sought to describe how this treatment paradigm influenced the use of anthracyclines in this patient setting. We analyzed a multi-institutional database containing the treatment history of 450 patients who received at least one trastuzumab-based regimen for HER-2+ metastatic breast cancer. Patients were considered eligible for anthracyclines for metastatic disease if they were never exposed (NE) or had been previously exposed (PE) to an anthracycline in the neoadjuvant or adjuvant setting and had relapsed after 12 months from the last dose. We then assessed the use of anthracycline-based therapy after failure with the first trastuzumab-based regimen in eligible patients. Three-hundred twenty-one patients were considered eligible ...