MAX SENNA MANO

(Fonte: Lattes)
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Projetos de Pesquisa
Unidades Organizacionais
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 62
  • article 25 Citação(ões) na Scopus
    MRI to Predict Nipple Involvement in Breast Cancer Patients
    (2016) PIATO, Jose Roberto Morales; ANDRADE, Roberta Dantas Jales Alves de; CHALA, Luciano Fernandes; BARROS, Nestor de; MANO, Max Senna; MELITTO, Alexandre Santos; GONCALVES, Rodrigo; SOARES JUNIOR, Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose Roberto
    OBJECTIVE. The selection of breast cancer patients as candidates for nipple-sparing mastectomy (NSM) is dependent on the preoperative detection of neoplastic involvement of the nipple-areola complex (NAC). This cross-sectional study was designed to evaluate the accuracy of preoperative breast MRI as a noninvasive method to predict neoplastic involvement of the nipple. MATERIALS AND METHODS. We included 165 female breast cancer patients with a surgical plan that included total mastectomy or breast conservation surgery with the removal of the NAC. All patients underwent MRI before surgery on a 1.5-T unit with a 4-channel in vivo dedicated surface breast coil. One radiologist who was blinded to the results of the histologic evaluations of the specimens evaluated the MRI studies. RESULTS. Of the 170 mastectomy specimens evaluated, 37 (21.8%) had neoplastic involvement of the NAC. The MRI findings of enhancement between the index lesion and the NAC and of nipple retraction were considered statistically significant predictors of nipple involvement in breast cancer patients (p < 0.01 and p = 0.01, respectively). The negative predictive value of the combination of these MRI findings was 83.3%. CONCLUSION. Breast MRI is a safe noninvasive method to preoperatively evaluate breast cancer patients eligible for NSM with a high specificity and a high negative predictive value when enhancement between the index lesion and the nipple and nipple retraction are analyzed.
  • conferenceObject
    Peripheral neuropathy (PN), thrombocytopenia (TCP) and central nervous system (CNS) recurrence: An update of the phase III KATHERINE trial of post-neoadjuvant trastuzumab emtansine (T-DM1) or trastuzumab (H) in patients (pts) with residual invasive HER2-positive breast cancer (BC)
    (2019) UNTCH, M.; GEYER, C. E.; HUANG, C.; LOIBL, S.; WOLMARK, N.; MANO, M. S.; MINCKWITZ, G. von; BRUFSKY, A.; PIVOT, X.; POLIKOFF, J.; FONTANA, A.; KAUFMAN, B.; ALCEDO, J. C.; BOULET, T.; LIU, H.; SONG, C.; MAMOUNAS, E. P.
  • article 32 Citação(ões) na Scopus
    Return to work after breast cancer diagnosis: An observational prospective study in Brazil
    (2018) LANDEIRO, Luciana C. G.; GAGLIATO, Debora M.; FEDE, Angelo B.; FRAILE, Natalia M.; LOPEZ, Rossana M.; FONSECA, Leonardo G. da; PETRY, Vanessa; TESTA, Laura; HOFF, Paulo M.; MANO, Max S.
    Background In North America and Europe, return-to-work (RTW) rates vary among breast cancer (BC) survivors, from 24% to 66% and from 53% to 82% at 6 and 36 months after diagnosis, respectively. To date, there is a lack of data on RTW rates after BC diagnosis in Latin America. Therefore, the primary objectives of this study were to define RTW rates at 12 and 24 months after BC diagnosis and to identify the factors associated with RTW in this population. Methods In total, 125 employed women from a single institution with newly diagnosed BC were interviewed by telephone at 6, 12, and 24 months after diagnosis. Those who had inoperable or metastatic disease were excluded. Results Overall, RTW rates were 30.3% and 60.4% at 12 and 24 months after BC diagnosis, respectively. Most women reported that they received support from their employer, but only 29.1% reported having been offered work adjustments. In multivariate analysis, the factors associated with positive RTW outcomes included higher household income (odds ratio [OR], 17.76; 95% confidence interval [CI], 3.33-94.75; P = .001), breast-conserving surgery (OR, 9.77; 95% CI, 2.03-47.05; P = .004), and work adjustments (OR, 37.62; 95% CI, 2.03-47.05; P = .004). The factors associated with negative RTW outcomes included adjuvant endocrine therapy (OR, 0.11; 95% CI, 0.02-0.74; P = .023), and depression diagnosed after BC (OR, 0.07; 95% CI, 0.01-0.63; P = .017). Conclusions RTW rates in the current study were lower than those observed in developed countries but similar to the rates among low-income Americans. Workplace adjustments, higher income, breast-conserving surgery, endocrine therapy, and depression after BC played an important role in the RTW decision. Cancer 2018;124:4700-4710. (C) 2018 American Cancer Society.
  • conferenceObject
    Patterns of post-operative radiotherapy in breast cancer patients after neoadjuvant chemotherapy
    (2017) LOPES, K. M.; FREITAS, T. B. De; CARVALHO, H. A.; PEREIRA, A. A.; SILVA, S. B.; STUART, S. R.; MANO, M. S.; FILASSI, J. R.; MARTA, G. N.
  • conferenceObject
    Incidence and mortality rates of breast and gynecologic cancers and human development index in the pan-American region
    (2014) MARTINEZ-MESA, Jeovany; WERUTSKY, Gustavo; MICHIELS, Stefan; SAMPAIO-FILHO, Carlos Alberto; DUENAS, Alfonso; ZARBA, Juan Jose; MANO, Max S.; VILLARREAL-GARZA, Cynthia Mayte; GOMEZ, Henry Leonidas; BARRIOS, Carlos H.
  • article
    BRAZILIAN DIRECTOR OF CARDIO-ONCOLOGY OF THE BRAZILIAN CARDIOLOGY SOCIETY ACHIEVEMENT
    (2011) KALIL FILHO, Roberto; HAJJAR, Ludhmila Abrahao; BACAL, Fernando; HOFF, Paulo Marcelo Gehm; DIZ, Maria Del Pilar Estevez; GALAS, Filomena Regina Barbosa Gomes; FUKUSHIMA, Julia Tizue; ALMEIDA, Juliano Pinheiro de; NAKAMURA, Rosana Ely; TRIELLI, Thalia Rodrigues; BITTAR, Cristina Salvadori; SANTOS, Marilia Harumi dos; GALDEANO, Flavia Gomes; AULER JUNIOR, Jose Otavio da Costa; SILVESTRINI, Anderson Arantes; ALENCAR, Aristoteles; MOTA, Augusto Cesar de Andrade; GUSMAO, Cid Abreu Buarque de; ALMEIDA, Dirceu Rodrigues; SIMOES, Claudia Marques; BOCCHI, Edimar Alcides; LIMA, Enaldo Melo de; FERNANDES, Fabio; SILVEIRA, Fabio Serra; VILAS-BOAS, Fabio; SILVA NETO, Luis Beck da; ROHDE, Luis Eduardo Paim; MONTERA, Marcelo Westerlund; BARBOSA, Marcia; MANO, Max Senna; RIECHELMANN, Rachel Simoes; ARAI, Roberto Jun; MARTINS, Silvia M.; FERREIRA, Silvia Moreira Ayub; SANTOS, Veronica
  • conferenceObject
    THE ENCHANTTM TRIAL: AN OPEN LABEL MULTICENTER PHASE 2 WINDOW OF OPPORTUNITY STUDY EVALUATING GANETESPIB (STA-9090) MONOTHERAPY IN WOMEN WITH PREVIOUSLY UNTREATED METASTATIC HER2 POSITIVE OR TRIPLE NEGATIVE BREAST CANCER (TNBC)
    (2012) CAMERON, D.; MANO, M. S.; VUKOVIC, V.; TEOFILOVICI, F.; BRADLEY, R.; AWADA, A.
    Background Hsp90 is a molecular chaperone required for proper folding and activation of many cancer-promoting proteins. Several Hsp90 clients are oncoproteins known to play a key role in the pathobiology of breast cancer, including HER2, p95-HER2, EGFR, ER, PI3K, AKT, and VEGFR. The inactivation of these oncoproteins by Hsp90 inhibition is a promising approach for breast cancer therapy. Ganetespib is an Hsp90 inhibitor which has shown anti-tumor activity in heavily pretreated patients with lung, breast, and other cancers. Ganetespib is well tolerated without severe liver or common ocular toxicities. In a phase 2 trial, 22 breast cancer patients who had received up to 3 prior lines of chemotherapy including trastuzumab were treated with ganetespib monotherapy. In patients with HER2+ disease, the objective response rate (ORR) was 15% (2/13) and the SD rate was 46% (6/13). Only 3 patients presented with TNBC; one of those patients achieved SD with substantial tumor shrinkage on treatment. Methods This is a single arm international open-label Phase 2 study in patients with HER2 amplified, or triple negative breast cancer. Patients must not have received any prior therapy in the metastatic setting. Prior adjuvant therapy is allowed. Primary endpoint: ORR. Main secondary endpoints include disease control rate, and progression free survival. Additionally, fresh biopsies and serum samples are collected from all patients for determination of predictors of response and mechanisms of resistance to treatment. Patients are treated with ganetespib 150 mg/m2 is given twice weekly of a 4-week cycle for up to 12 weeks. A total of 70 patients are planned for accrual. At the time of submission, the study is receiving IRB approvals in several centers.
  • article 81 Citação(ões) na Scopus
    HER2-targeted therapy in breast cancer: A systematic review of neoadjuvant trials
    (2013) DENT, Susan; OYAN, Basak; HONIG, Amd; MANO, Max; HOWELL, Sacha
    Targeting human epidermal growth factor receptor 2 (HER2) during or in sequence with chemotherapy improves overall survival in metastatic and early HER2-overexpressing breast cancer. In this paper we systematically review neoadjuvant clinical trial data in HER2-positive breast cancer and discuss key unanswered clinical questions. All trials of HER2-targeted neoadjuvant therapy were identified through non-date-limited searches of PubMED (R) and Biosis (R) and congress abstract book searches from 2000-2011. Eligible trials were prospective, had at least 10 patients and a clear definition of pathological complete response (pCR) rate. A total of 50 trials fulfilled the eligibility criteria; 41 single-arm phase II studies were identified, 37 with trastuzumab and 4 with lapatinib, with significant variability in baseline tumour characteristics and pCR rates (range 12-66.7%). Of 9 randomised phase II/III trials, 4 assessed the addition of trastuzumab to chemotherapy and a further 5 randomised trials assessed different HER2-targeting approaches. Four of these studies assessed dual HER2-targeting approaches, which universally increased pCR at the expense of increased non-cardiac toxicity when lapatinib, but not pertuzumab, was added to trastuzumab. Significant advances have been made in HER2 targeting, resulting in a marked increase in the number of breast cancer patients experiencing tumour pCR. Mature data from randomised neoadjuvant and adjuvant studies are awaited for survival outcomes with combination targeted approaches. Unanswered questions centre on the individualisation of therapy and include; which, if any, chemotherapy backbone should be used, and which patients need dual HER2 blockade? (C) 2013 Elsevier Ltd. All rights reserved.
  • article 23 Citação(ões) na Scopus
    Effects of locoregional radiotherapy in patients with metastatic breast cancer
    (2016) MAURO, Geovanne Pedro; CARVALHO, Heloisa de Andrade; STUART, Silva Radwanski; MANO, Max Senna; MARTA, Gustavo Nader
    Objectives: This study aims to assess the clinical outcomes of patients with metastatic breast cancer (MBC) who underwent local radiation therapy (RT) for the primary site. Material and methods: Between 2005 and 2013, we retrospectively evaluated patients with MBC who received breast or chest wall RT with or without regional lymph node irradiation. Results: 2761 patients with breast cancer were treated with RT. Of them, 125 women with stage IV breast carcinoma were included. The median follow-up was 15 months (ranging from 3.8 to 168 months), when 54.7% of the patients had died; local progression was observed in 22.8% of the patients. The mean overall survival (OS) and local progression free survival (LoPFS) were 23.4 +/- 2.4 months and 45.1 +/- 2.9 months, respectively. Three-and five-year overall survival rates were, respectively, 21.2% and 13.3%. Local progression free survival was the same, 67.3%, at three and five years, respectively. Karnofsky Performance Status (KPS) (p = 0.015), number of metastatic sites (p = 0.031), RT dose (p = 0.0001) and hormone therapy (p = 0.0001) were confirmed as independent significant variables correlated with OS. The variables that were independently correlated with LoPFS were the number of previous chemotherapy lines (p = 0.038) and RT dose (p = 0.0001). Conclusion: RT of the primary site in patients with MBC is well tolerated. The factors that presented positive impact on survival were good KPS, low disease burden (1-3 metastatic sites), and the use of hormone therapy.
  • article 7 Citação(ões) na Scopus
    Value of Systemic Staging in Asymptomatic Early Breast Cancer
    (2018) SOARES, Gregorio Pinheiro; PEREIRA, Allan Andresson Lima; BOAS, Mariana Silva Vilas; VAISBERG, Victor Van; MAGALHAES, Maria Cristina Figueroa; LINCK, Rudinei Diogo Marques; MANO, Max Senna
    Objective Metastases are rare in early breast cancer (EBC), and international guidelines recommend against routine systemic staging for asymptomatic patients. However, imaging exams remain widely employed in the clinical practice. The aim of the present study is to evaluate the value of imaging for systemic staging in EBC. Methods A retrospective analysis of newly-diagnosed breast cancer (BC) patients was performed. Clinical data including BC subtype, stage, presence of symptoms at diagnosis and instrumental procedures performed for staging were recorded. Results A total of 753 patients were included, with a median age of 57 years. The majority of the patients underwent at least 1 imaging procedure (91%); had invasive ductal carcinoma (83.5%); histological grade 2 (51.4%); stage II (61.8%); and luminal subtype (67.9%). Among the 685 (91%) patients who underwent any radiologic staging, distant metastases (DMs) were detected in 32 (4.7%). In the univariate analyses, stage IIb and pathological lymph node involvement (pN1) showed a statistically significant association with the presence of DMs, versus only a trend for triple negative and human epidermal growth factor receptor 2 (Her2) positive subtype. In an exploratory analysis performed in this same subgroup, when unfavorable biology (triple negative or Her2 positive) was present, patients had a DM rate of 14.4%, one of the highest reported at this stage of the disease. Conclusion Early breast cancer has a low prevalence of DM at the initial evaluation, and systemic staging of asymptomatic, unselected patients is not warranted as a routine practice. However, we have identified subgroups of patients to whom a full staging could be indicated. Resumo Objetivo Metastases sAo de ocorrencia rara no cancer de mama precoce, e as diretrizes internacionais nAo recomendam o estadiamento sistemico de rotina para pacientes assintomaticos. Apesar disso, exames de imagem continuam sendo largamente empregados na pratica clinica. O objetivo do presente estudo e avaliar o valor do estadiamento por imagem no cancer de mama precoce. Metodos Analise retrospectiva de pacientes recem-diagnosticados com cancer de mama. Foram registrados os dados clinicos dos pacientes, incluindo subtipo da neoplasia de mama, estadiamento, presenca de sintomas no momento do diagnostico e procedimentos de estadiamento. Resultados Um total de 753 pacientes foram incluidos, com idade media de 57 anos. Grande parte deles se submeteu a pelo menos um exame de imagem (91%); tinha carcinoma ductal invasivo (83,5%); grau histologico 2 (51,4%); estadio II (61,8%); e subtipo luminal (67,9%). Entre os 685 (91%) pacientes que realizaram algum exame de imagem, metastases a distancia foram detectadas em 32 (4,7%). Na analise univariada, estadio IIb e acometimento linfonodal (pN1) tiveram uma associacAo estatisticamente significativa com a presenca de metastase, enquanto os subtipos triplo negativo e receptor tipo 2 do fator de crescimento epidermico humano (Her2) positivo demonstraram apenas uma tendencia para a identificacAo de metastases. Na analise exploratoria deste mesmo subgrupo, diante da presenca de biologia desfavoravel (triplo negativo e Her2 positivo), os pacientes apresentaram uma taxa de metastase a distancia de 14,4%, uma das mais altas relatadas nesse estadio. ConclusAo Neoplasia de mama precoce apresenta baixa baixa prevalencia de metastase a distancia no momento do diagnostico, e o estadiamento sistemico de rotina de pacientes assintomaticos e nAo selecionados nAo e justificavel. Contudo, identificamos subgrupos de pacientes para os quais o estadiamento completo poderia ser indicado.