MARIA IGNEZ FREITAS MELRO BRAGHIROLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
16 resultados
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conferenceObject A phase II trial of metformin and fluorouracil (MetFU) for patients (pts) with metastatic colorectal cancer (mCRC) refractory to standard treatment(2014) MIRANDA, Vanessa Costa; FARIA, Luiza Dib; BRAGHIROLI, Maria Ignez Freitas Melro; JACOBS, Monica; SABBAGA, Jorge; HOFF, Paulo Marcelo; RIECHELMANN, Rachel Pimenta- Phase II trial of metformin and paclitaxel for patients with gemcitabine-refractory advanced adenocarcinoma of the pancreas(2015) BRAGHIROLI, Maria Ignez; FERRARI, Anezka C. R. de Celis; PFIFFER, Tulio Eduardo; ALEX, Alexandra Kichfy; NEBULONI, Daniela; CARNEIRO, Allyne S.; CAPARELLI, Fernanda; SENNA, Luiz; LOBO, Juliana; HOFF, Paulo Marcelo; RIECHELMANN, Rachel P.Background: In patients with adenocarcinoma of the pancreas, there are no standard second-line regimens. Many pre-clinical studies have shown that metformin alone or when combined with paclitaxel has antitumour effects on this tumour. We have tested here the combination of paclitaxel and metformin for patients with gemcitabine-refractory pancreatic cancer. Methods: An uncontrolled phase II trial was carried out based on a two-stage Simon's design, with metformin and paclitaxel for patients with locally advanced or metastatic pancreatic cancer whose disease had progressed during first line treatment with a gemcitabine-based regimen. The primary endpoint was the disease control rate at eight weeks as per response evaluation criteria in solid tumours (RECIST) 1.1. Patients received paclitaxel 80 mg/m(2) weekly for three weeks every 28 days and metformin 850 mg p.o. t.i.d. continuously until progression or intolerance state was reached. Results: Twenty patients were enrolled from July 2011 to January 2014: N = 6 (31.6%) achieved the primary endpoint, with all presenting stable disease. Median overall survival (OS) was 128 days (range 17-697) and the median progression free survival (PFS) was 44 days (range 14-210). Eight patients (40%) presented treatment-related G3-4 toxicities with the most common one being diarrhoea. Conclusions: Despite the encouraging pre-clinical evidence of the antitumour activity of metformin in adenocarcinoma of the pancreas, the primary endpoint of the disease control rate was not met. Besides, the treatment combination was poorly tolerated and could not be studied further. This study highlights the importance of performing clinical trials to reassure preclinical or observational data.
conferenceObject Prospective study of biomarkers in squamous cell carcinoma of the anal canal (SCCAC) and their influence on treatment outcomes: Five-year long-term results.(2020) MONIZ, Camila Motta Venchiarutti; RIECHELMANN, Rachel Pimenta; BRAGHIROLI, Maria Ignez; RIBEIRO, Suilane Coelho; RIVELLI, Thomas Giollo; BARIANI, Giovanni M.; CHEN, Andre Tsin Chih; NAHAS, Caio; BONADIO, Renata Colombo; ORTEGA, Cinthia; FRANCO, Rejane; MEIRELES, Sibele; PEREIRA, Allan Andresson Lima; SABBAGA, Jorge; COUDRY, Renata A.; HOFF, Paulo MarceloconferenceObject Bevacizumab (BEV)-based therapy in the treatment of recurrent glioblastoma (GBM) in patients (PTS) treated at a Brazilian cancer center(2012) MUNHOZ, Rodrigo Ramella; BRAGHIROLI, Maria Ignez Freitas Melro; REGO, Juliana Florinda De Mendonga; HOFF, Paulo Marcelo; FEHER, Olavo; KATZ, ArturBackground: Temozolomide (TMZ) both concurrently and after radiation therapy constitutes the standard of care for newly diagnosed GBM PTS. BEV is FDA approved option for recurrent high-grade gliomas PTS based on the results phase II trials. Reports of the use of BEV in these setting have been limited to USA and European academic centers thus far. Methods: We conducted a cross sectional retrospective study of 39 consecutive PTS with histologically confirmed GBM that received BEV in the second or third line setting. The main objective of this analysis was to assess the efficacy and safety of BEV given "off protocol" in an unselected cohort of PTS treated at a Brazilian teaching hospital cancer center and to compare our results to those reported by North American and European academic centers. PTS received first-line treatment with TMZ plus radiotherapy and most received maintenance TMZ and received Bev-based therapy at the time of disease progression. Main endpoints were the evaluation of progression-free survival (PFS), overall survival (OS) and safety. Results: Between 2007 and 2011, 39 PTS with recurrent GBM that received BEV in second (92%) or third-line (8%) were identified. Seven PTS progressed during concomitant RT and TMZ, and 40 during or after TMZ maintenance. 72% were male; median age: 56 years (range 22-79). Most patients (89,7%) received BEV in combination with irinotecan, and the median number of cycles, regardless of combination, was 14. Reasons for BEV discontinuation were disease progression in 79,5% and toxicity in 4 patients. There was one treatment related death due to thrombocytopenia and bleeding. Twenty-four PTS (61,5%) achieved an objective response with BEV. Median PFS of the patients that received BEV in either second or third line was 7.5 months and median OS was 22.6 months. No bowel perforations or any unexpected toxicities occurred. Conclusions: This constitutes the first report of recurrent GBM PTS treated with Bev in the Southern Hemisphere. In this unselected "real life" cohort of PTS with recurrent GBM we have been able to reproduce and confirm the efficacy and safety of this agent used in the treatment of GBM in the second and third line setting.- Proton pump inhibitors and antibiotics impact on toxicities and clinical outcomes in cancer patients treated with immunotherapy.(2021) ARAUJO, Haniel Alves; MONIZ, Camila Motta Venchiarutti; BRAGHIROLI, Oddone Freitas Melro; MAK, Milena Perez; URATANI, Lucas Fernando; TIECHER, Ricardo Dahmer; MORAES, Priscila Muniz; BARBOSA, Ingrid; CAMARGO, Veridiana Pires De; BRAGHIROLI, Maria Ignez Freitas Melro; CASTRO, Gilberto; HOFF, Paulo Marcelo; DIZ, Maria Del Pilar
conferenceObject Does cytotoxic chemotherapy (CT) have a role in palliative treatment of hepatocellular carcinoma (HCC)?(2018) MARTA, Guilherme Nader; FONSECA, Leonardo Gomes da; BRAGHIROLI, Maria Ignez Freitas Melro; HOFF, Paulo Marcelo; SABBAGA, Jorge- Definitive chemoradiotherapy for squamous cell carcinoma of the anal canal (SCCAC) with cisplatin and capecitabine: A prospective cohort-preliminary results.(2021) DORNELLAS, Abraao; MORAES, Priscila Muniz; VICTOR, Carolina Ribeiro; BONADIO, Renata Colombo; BRAGHIROLI, Maria Ignez; CHEN, Andre Tsin Chih; ORTEGA, Cinthia; NAHAS, Caio; HOFF, Paulo Marcelo; MOTTA, Camila; MONIZ, Venchiarutti
- A Prospective Cohort Study of Biomarkers in Squamous Cell Carcinoma of the Anal Canal (SCCAC) and their Influence on Treatment Outcomes(2021) MONIZ, Camila Motta Venchiarutti; RIECHELMANN, Rachel Pimenta; OLIVEIRA, Suilane Coelho Ribeiro; BARIANI, Giovanni Mendonca; RIVELLI, Thomas Giollo; ORTEGA, Cintia; PEREIRA, Allan Andresson Lima; MEIRELES, Sibele Inacio; FRANCO, Rejane; CHEN, Andre; BONADIO, Renata Colombo; NAHAS, Caio; SABBAGA, Jorge; COUDRY, Renata Almeida; BRAGHIROLI, Maria Ignez; HOFF, Paulo MarceloBackground: Although Chemoradiation (CRT) is the curative treatment for SCCAC, many patients present primary resistance. Since it is a rare tumor, response predictors remain unknown. Methods: We performed a prospective cohort study to evaluate biomarkers associated with CRT response, progression-free survival (PFS), and overall survival (OS). The primary endpoint was response at 6 months (m). Tumor DNA and HPV were analyzed by next-generation sequencing, while KI-67 and PD-L1 by immunohistochemistry in tumor tissue. Results: Seventy-eight patients were recruited between October/2011 and December/2015, and 75 were response evaluable. The median age was 57 years, 65% (n=49) were stage III and 12% (n=9) were HIV positive (HIV+). At 6m, 62.7% (n=47) presented CR. On multivariate analyses, stage II patients were 4.7 more likely to achieve response than stage III (OR, 4.70; 95%CI, 1.36-16.30; p=0.015). HIV+ was associated with a worse response (OR, 5.72; 95%CI, 2.5-13.0; p<0.001). 5-year PFS and OS rates were 63.3% and 76.4%, respectively, with a median follow up of 66m. On multivariate analyses, older age (HR 1.06, p=0.022, 95%IC 1.01-1.11) and absence of CR at 6m (HR 3.36, p=0.007, 95%IC 1.39-8.09) were associated with inferior OS. The 5-year OS rate was 62.5% in HIV+ group compared to 78% among HIVpts, although this difference was not statistically significant (p=0.4). PIK3CA, MET and TP53 mutations, HPV, Ki-67 expression, and PD-L1 expression, were not associated with PFS and OS. Conclusions: Clinical stage III and HIV+ were associated with worse response to CRT at 6m. The absence of CR was the main factor associated with poor 5-year OS.
conferenceObject Phase II trial of inetforrnin and paclitaxel for patients with gemcitabine-refractory advanced adenocarcinoma of the pancreas(2014) FERRARI, Anezlca Carvalho Rubin De Celia; PFIFFER, Tulio Eduardo Flesch; ALEX, Alexandra Khichfy; NEBULONL, Danielle R.; CARNELRO, Allyne Q.; CAPARELL, Fernanda Cunha; LEITE, Luiz Antonio Senna; BRAGHIROLI, Maria Ignez Freitas Meiro; LOBO, Juliana; HOFF, Paulo Marcelo; RIECHELMANN, Rachel PimentaconferenceObject High-grade extrapulmonary neuroendocrine carcinomas and small cell lung cancer: Different entities, same treatment.(2015) REGO, Juliana Florinda De Mendonga; MEDEIROS, Raphael Salles S.; BRAGHIROLI, Maria Ignez Freitas Melro; GALVAO, Breno; BEZERRA NETO, Joao Evangelista; MUNHOZ, Rodrigo Ramella; GUERRA, Juliana Mariotti; KIMURA, Lidia; NONOGAKI, Suely; PFIFFER, Tulio Eduardo Flesch; CASTRO, Gilberto; HOFF, Paulo Marcelo; ROCHA FILHO, Duilio; COSTA, Frederico; RIECHELMANN, Rachel Pimenta