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Journal of Clinical Oncology, 2016

e15633Background: Biliary tumors is a group of related but distinct malignancies, accounting for ... more e15633Background: Biliary tumors is a group of related but distinct malignancies, accounting for only 3% of gastrointestinal cancers. Little is known about their biological behavior, pattern of fai...

Journal of Pharmacy and Pharmacology, 2017

Currently, multiple lines of cytotoxic chemotherapy for treatment of metastatic breast cancer are... more Currently, multiple lines of cytotoxic chemotherapy for treatment of metastatic breast cancer are available, and Taxanes, used as monotherapy or in combination with anti-angiogenic drugs, such as Bevacizumab, are one of the most used schemes in clinical practice. These drugs have different side effects and the liver is one of the most affected organs. The objective of this paper is to report three cases of metastatic breast cancer with positive expression of hormone receptors and without amplification of HER-2 protein that were treated with Taxane and Bevacizumab, developed pseudocirrosis probably caused by these drugs and died due to liver failure. It can be drawn from the study that liver failure, as a pseudocirrhosis evolution, is an unusual but lethal event that may occur during the treatment of metastatic breast cancer with Taxanes and Bevacizumab. This warns the importance of diagnostic suspicion of this pathology.

Advances in Experimental Medicine and Biology, 2020

Pregnancy and lactation represent the most effective protective elements against breast cancer; c... more Pregnancy and lactation represent the most effective protective elements against breast cancer; counter-intuitively breast cancer incidence shows a small but noticeable increase up to 5 years after delivery. The cumulative effect is however favourable and women show a reduction in breast cancer risk which is proportional to the total duration of lactation and to the number of full-term pregnancies.

Lung Cancer, 2019

Objectives: to report outcomes of four cases of chemo-refractory RET-rearranged non-small cell lu... more Objectives: to report outcomes of four cases of chemo-refractory RET-rearranged non-small cell lung carcinomas (NSCLCs) treated with alectinib in a single center. Materials and methods: we retrospectively assessed and reported the activity and tolerability of alectinib 600 mg twice daily in advanced and chemo-refractory RET-rearranged NSCLC patients treated in a Brazilian institution. Identification of RET rearrangements was performed using the FoundationOne® next-generation sequencing (NGS) platform. Results: The four patients herein reported were white, female and non-smokers, ranging between 59-66 years of age. All patients had been previously treated with chemotherapy and were TKI naïve; three of them presented disease progression to nivolumab as well. Molecular tumor profiling showed a KIF5B-RET fusion in three patients and a CCDC6-RET in the fourth. One patient exhibited disease progression and clinical deterioration two months after treatment initiation. Disease control was documented in two patients with PFS ranging from 4 to 5 months (one partial metabolic response and one stable disease). In one of the cases, which developed oligoprogression on alectinib, radiation therapy plus post-progression alectinib were able to provide additional disease control for 9 more months. No grade 3/4 adverse events, dose reductions or discontinuation due to toxicity were documented. Conclusion: Although this is a small single center evaluation, alectinib was well tolerated and demonstrated clinical activity against advanced RET-rearranged NSCLCs, suggesting its potential role in this specific subset of malignancies. Clinical trials addressing its efficacy and the optimal dosing schedule in the present context are underway, and results are eagerly awaited.

Expert Opinion on Biological Therapy, 2019

ABSTRACT Introduction: Cancer treatment has evolved significantly with the introduction of biolog... more ABSTRACT Introduction: Cancer treatment has evolved significantly with the introduction of biologic agents, especially in the breast cancer (BC) area. The use of trastuzumab for HER2 amplified BCsignificantly improves survival in both metastatic and early stage disease. Although the efficacy of biologics is undeniable, their high costs increased the expenses of cancer care, becoming a problem to health-care systems, mainly in low and middle-income, but also for high-income countries. In an attempt to lower the costs and allow a greater access of biologics to cancer patients, biosimilars are rapidly being developed as an alternative to the reference biologics. Areas covered: A literature review based on the MEDLINE/PubMed search about biosimilars allied with the FDA and EMA’s latest statements of this topic were conducted to summarize the development and the use of currently available biosimilars for BC, with a focus on trastuzumab. Expert opinion: Biosimilars are drugs that have similar efficacy and safety profile to those of the original biological product with equivalent immunogenicity and, as these agents hold the potential to improve patient´s access to monoclonal antibodies because their production costs are estimated to be 20–30% lower compared to the reference product, they are progressively being incorporated into clinical practice.

The Breast, 2018

Histone deacetylase inhibitors (HDACi) are a relatively new class of drug that plays an important... more Histone deacetylase inhibitors (HDACi) are a relatively new class of drug that plays an important role in the epigenetic and non-epigenetic regulation in cancer, inducing death, apoptosis and cell cycle arrest in cancer cells. Although HDACi are approved only for hematologic malignancies, there are several trials in the breast cancer setting with promising results. In this review, we summarize the latest studies with HDACi in breast cancer from the emerging data in the translational research until its possible applicability in the clinical practice.

Journal of Global Oncology, 2017

A 68-year-old Japanese woman was referred for evaluation to our service in September 2013; she co... more A 68-year-old Japanese woman was referred for evaluation to our service in September 2013; she complained of abnormal uterine bleeding. She was 10 years postmenopausal, nulliparous, and otherwise healthy except for a corneal transplantation in her right eye in 2002.

Advances in Experimental Medicine and Biology, 2020

Breastfeeding is an important aspect of mother-newborn relationship and is of great benefit for t... more Breastfeeding is an important aspect of mother-newborn relationship and is of great benefit for the baby. Unfortunately, many drugs taken by the mother may pass into her milk and exert an effect on the newborn. Very limited data is available and a cautionary approach is warranted especially when the woman receives anticancer treatment including chemotherapy , hormonal treatment and the recently introduced target agents as well as monoclonal antibodies. In all these conditions breastfeeding should be put on hold.More and more often physicians are faced with women that are pregnant years after the diagnosis of cancer: this has long been considered dangerous for the mother, but data show that prognosis is definitely not worse. If the woman is no longer being actively treated, breastfeeding is advisable every time it is possible, even if patients that received breast radiation may be unable to produce a sufficient amount of milk on that side.

Poster Presentations - Proffered Abstracts

Journal of Clinical Oncology, 2016

e15633Background: Biliary tumors is a group of related but distinct malignancies, accounting for ... more e15633Background: Biliary tumors is a group of related but distinct malignancies, accounting for only 3% of gastrointestinal cancers. Little is known about their biological behavior, pattern of fai...

Journal of Pharmacy and Pharmacology, 2017

Currently, multiple lines of cytotoxic chemotherapy for treatment of metastatic breast cancer are... more Currently, multiple lines of cytotoxic chemotherapy for treatment of metastatic breast cancer are available, and Taxanes, used as monotherapy or in combination with anti-angiogenic drugs, such as Bevacizumab, are one of the most used schemes in clinical practice. These drugs have different side effects and the liver is one of the most affected organs. The objective of this paper is to report three cases of metastatic breast cancer with positive expression of hormone receptors and without amplification of HER-2 protein that were treated with Taxane and Bevacizumab, developed pseudocirrosis probably caused by these drugs and died due to liver failure. It can be drawn from the study that liver failure, as a pseudocirrhosis evolution, is an unusual but lethal event that may occur during the treatment of metastatic breast cancer with Taxanes and Bevacizumab. This warns the importance of diagnostic suspicion of this pathology.

Advances in Experimental Medicine and Biology, 2020

Pregnancy and lactation represent the most effective protective elements against breast cancer; c... more Pregnancy and lactation represent the most effective protective elements against breast cancer; counter-intuitively breast cancer incidence shows a small but noticeable increase up to 5 years after delivery. The cumulative effect is however favourable and women show a reduction in breast cancer risk which is proportional to the total duration of lactation and to the number of full-term pregnancies.

Lung Cancer, 2019

Objectives: to report outcomes of four cases of chemo-refractory RET-rearranged non-small cell lu... more Objectives: to report outcomes of four cases of chemo-refractory RET-rearranged non-small cell lung carcinomas (NSCLCs) treated with alectinib in a single center. Materials and methods: we retrospectively assessed and reported the activity and tolerability of alectinib 600 mg twice daily in advanced and chemo-refractory RET-rearranged NSCLC patients treated in a Brazilian institution. Identification of RET rearrangements was performed using the FoundationOne® next-generation sequencing (NGS) platform. Results: The four patients herein reported were white, female and non-smokers, ranging between 59-66 years of age. All patients had been previously treated with chemotherapy and were TKI naïve; three of them presented disease progression to nivolumab as well. Molecular tumor profiling showed a KIF5B-RET fusion in three patients and a CCDC6-RET in the fourth. One patient exhibited disease progression and clinical deterioration two months after treatment initiation. Disease control was documented in two patients with PFS ranging from 4 to 5 months (one partial metabolic response and one stable disease). In one of the cases, which developed oligoprogression on alectinib, radiation therapy plus post-progression alectinib were able to provide additional disease control for 9 more months. No grade 3/4 adverse events, dose reductions or discontinuation due to toxicity were documented. Conclusion: Although this is a small single center evaluation, alectinib was well tolerated and demonstrated clinical activity against advanced RET-rearranged NSCLCs, suggesting its potential role in this specific subset of malignancies. Clinical trials addressing its efficacy and the optimal dosing schedule in the present context are underway, and results are eagerly awaited.

Expert Opinion on Biological Therapy, 2019

ABSTRACT Introduction: Cancer treatment has evolved significantly with the introduction of biolog... more ABSTRACT Introduction: Cancer treatment has evolved significantly with the introduction of biologic agents, especially in the breast cancer (BC) area. The use of trastuzumab for HER2 amplified BCsignificantly improves survival in both metastatic and early stage disease. Although the efficacy of biologics is undeniable, their high costs increased the expenses of cancer care, becoming a problem to health-care systems, mainly in low and middle-income, but also for high-income countries. In an attempt to lower the costs and allow a greater access of biologics to cancer patients, biosimilars are rapidly being developed as an alternative to the reference biologics. Areas covered: A literature review based on the MEDLINE/PubMed search about biosimilars allied with the FDA and EMA’s latest statements of this topic were conducted to summarize the development and the use of currently available biosimilars for BC, with a focus on trastuzumab. Expert opinion: Biosimilars are drugs that have similar efficacy and safety profile to those of the original biological product with equivalent immunogenicity and, as these agents hold the potential to improve patient´s access to monoclonal antibodies because their production costs are estimated to be 20–30% lower compared to the reference product, they are progressively being incorporated into clinical practice.

The Breast, 2018

Histone deacetylase inhibitors (HDACi) are a relatively new class of drug that plays an important... more Histone deacetylase inhibitors (HDACi) are a relatively new class of drug that plays an important role in the epigenetic and non-epigenetic regulation in cancer, inducing death, apoptosis and cell cycle arrest in cancer cells. Although HDACi are approved only for hematologic malignancies, there are several trials in the breast cancer setting with promising results. In this review, we summarize the latest studies with HDACi in breast cancer from the emerging data in the translational research until its possible applicability in the clinical practice.

Journal of Global Oncology, 2017

A 68-year-old Japanese woman was referred for evaluation to our service in September 2013; she co... more A 68-year-old Japanese woman was referred for evaluation to our service in September 2013; she complained of abnormal uterine bleeding. She was 10 years postmenopausal, nulliparous, and otherwise healthy except for a corneal transplantation in her right eye in 2002.

Advances in Experimental Medicine and Biology, 2020

Breastfeeding is an important aspect of mother-newborn relationship and is of great benefit for t... more Breastfeeding is an important aspect of mother-newborn relationship and is of great benefit for the baby. Unfortunately, many drugs taken by the mother may pass into her milk and exert an effect on the newborn. Very limited data is available and a cautionary approach is warranted especially when the woman receives anticancer treatment including chemotherapy , hormonal treatment and the recently introduced target agents as well as monoclonal antibodies. In all these conditions breastfeeding should be put on hold.More and more often physicians are faced with women that are pregnant years after the diagnosis of cancer: this has long been considered dangerous for the mother, but data show that prognosis is definitely not worse. If the woman is no longer being actively treated, breastfeeding is advisable every time it is possible, even if patients that received breast radiation may be unable to produce a sufficient amount of milk on that side.

Poster Presentations - Proffered Abstracts