ANDREA MARIA MARINI

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • conferenceObject
    Characterization of EGFR Activating Mutations in Brazilian Patients with Pulmonary Adenocarcinoma
    (2015) YEN, Cheng T.; BITTON, Rafael C.; LIMA, Luiz G. C. A. De; AMADIO, Alex V.; TAKAHASHI, Tiago K.; MARINI, Andrea M.; TAKAGAKI, Tereza Y.; TERRA, Ricardo M.; MELLO, Evandro S.; CASTRO JR., Gilberto De
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    Long term toxicities after cisplatin-based concurrent chemoradiation in head & neck squamous cell carcinoma (HNSCC) disease-free patients: A cross-sectional study
    (2015) RIVELLI, T. G.; SIMAO, E. F.; MAK, M. P.; MARTINS, R. Eiras; TAKAHASHI, T. K.; MARINI, A. M.; ROITBERG, F. S. R.; MESQUITA, C.; KULCSAR, M. A. V.; CASTRO JR., G.
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    EGFR GENOTYPING AND EPIDEMIOLOGY, CLINICAL AND PATHOLOGICAL FEATURES IN 191 PATIENTS WITH METASTATIC PULMONARY ADENOCARCINOMA IN SAO PAULO - BRAZIL.
    (2013) CASTRO JR., Gilberto; TAKAHASHI, Tiago K.; CAIRES-LIMA, Rafael; PROTASIO, Bruno M.; MAIA, Manuel C. D. F.; SOARES, Ibere C.; ROITBERG, Felipe S. R.; MARINI, Andrea M.; MARTINS, Renata E.; TAKAGAKI, Teresa Y.; ARAUJO, Pedro H. X. N.; TERRA, Ricardo M.; SHIANG, Christina; SIQUEIRA, Sheila A. C.; MELLO, Evandro S.; ALVES, Venancio A.; HOFF, Paulo M.
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    REFERRAL OF LUNG CANCER PATIENTS TO SPECIALIZED CLINICAL ONCOLOGY CARE: INSTITUTO DO CANCER DO ESTADO DE SAO PAULO 2010-2011
    (2012) CAIRES-LIMA, Rafael; TAKAHASHI, Tiago K.; MAK, Milena P.; ROITBERG, Felipe S. R.; TEIXEIRA, Carlos H. A.; MESQUITA, Cristiane S.; MARINI, Andrea M.; MARTINS, Renata E.; TAKAGAKI, Tereza Y.; ARAUJO, Pedro N.; FEHER, Olavo; HOFF, Paulo M.; CASTRO JR., Gilberto De
    Background: Lung cancer is the leading cause of death from malignancy in Western countries. To achieve better outcomes and improve quality of care, it is essential to know both patients and disease characteristics. Here we aim to describe epidemiological and tumor characteristics and their impact on survival outcomes, of patients admitted at Instituto do Câncer de Estado de São Paulo (ICESP) between January 2010 and July 2011. Methods: It is a retrospective, descriptive, and uninstitutional study, of patients diagnosed histologically with lung cancer, consecutively admitted at ICESP between January 2010 and July 2011. Overall survival was the main endpoint. Frequencies were compared using chi-square test. Survival was estimated using the Kaplan-Meier methods, and the curves were compared by the log-rank test. This study was approved by the local IRB. Results and Conclusion: 232 patients (pts) were included in this analysis: median age 65y (24-91), 57% male, 56% ECOG 0 - 1, and 83% previous or current smokers. Non small cell lung cancer (NSCLC) was the most common histologic type (213 pts, 92%). Small cell lung cancer (SCLC) was diagnosed in 18 pts (7.6%) and only one (0.4%) was a case of a carcinoid tumor. Regarding NSCLC histologic subtypes, adenocarcinoma was the most common (130 pts, 61%), followed by squamous cell carcinoma (63 pts, 30%) and large cell carcinoma (5 pts, 2%). In 17 pts (7%), it was not possible to determine the subtype, even with immunohistochemistry. In terms of staging, 155 pts (71%) with NSCLC presented metastatic disease (stage IV) at diagnosis, 27 pts (12%) were staged as IIIB, 15 pts (10%) IIIA, 8 pts (3.5%) II and 8 pts (3.5%) I. Among patients with SCLC, six (33%) had localized disease (LD) and 12 (67%) had extensive disease (ED). Analyzing only stage IV NSCLC pts, 123 (79%) were treated with first line chemotherapy, 56 (36%)with second line and 13 (8%) with third line systemic therapies; ECOG 0 - 2 NSCLC pts were more likely to be exposed to second-line therapies (46% vs 36%; p = 0.0002). In a median follow-up of 9.5 mo, median overall survival (mOS) was 9 mo for all pts in this analysis. Regarding NSCLC, in patients with stage I and II mOS was not reached (100% and 68% in 2 years for stage I and II, respectively). In patients with stage IIIA, IIIB and IV, the median OS was 15.2, 11.4 and 7 mo, respectively (p-trend = 0.0002). According to ECOG-PS, mOS was 11.3, 6.3, 4.1, and 2.2 mo for NSCLC pts with ECOG 1, 2, 3 and 4, respectively (p-trend < 0.0001). For SCLC pts, mOS was 12.9 mo among those with LD versus 4.9 mo in ED (HR 3.1; 95% CI 1.1 - 8.6; p = 0.02). Lung cancer survival rate remains poor. As expected, clinical stage and performance status were important prognostic factors. Primary prevention strategies (quitting smoking) and early diagnosis (screening) may be useful in this scenario.
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    EGFR ACTIVATING MUTATIONS IN NSCLC: IMPORTANCE OF ROUTINE TESTING
    (2012) TAKAHASHI, Tiago K.; SOARES, Ibere C.; MARINI, Andrea M.; MAK, Milena P.; TEIXEIRA, Carlos H.; ROITBERG, Felipe S. R.; TAKAGAKI, Teresa Y.; MARTINS, Renata E.; MESQUITA, Cristiane; HOFF, Paulo M. G.; CASTRO JR., Gilberto
    Background: EGFR activating mutations in NSCLC confer better prognosis and are also predictive of response to both chemotherapy and EGFR-tyrosine kinase inhibitors. Therefore, EGFR genotyping in NSCLC patients (pts) is very helpful in treatment decision. Here we report the first 25 pts whose tumors samples were tested for EGFR activating mutations in our Institution. Methods: It is an observational study on all consecutively tested NSCLC samples from pts treated at ICESP. Briefly, all samples were formalin-fixed and paraffin-embedded. Tumor areas were selected and macrodissected, followed by whole DNA extraction and amplification by PCR. DNA sequencing (exons 18, 19, 20 and 21) was performed by Sanger´s methodology. Frequencies were compared by Fisher´s exact test. Results and Conclusion: Results: 25 tumor samples were tested from Aug/2011 up to now: 20 pts were caucasian, 13 were male, 14 ex-smoker, 10 never smoker; 15 pts ECOG-PS 0-1 and 5 PS 2. Regarding histologic subtype, 22 were classified as adenocarcinoma and 2 SCC. Staging: 3 IIIA, 2 IIIB and 20 IV. Activating mutations were detected in 6 pts (24%): 4 in exon 19 (del 19), 1 in exon 21 (L858R) and in 1 pt two mutations were found (T790M and L858R). The frequency of these activating mutations was not related to gender (p=0.378), race (p=0.540) or smoking habits (p=0.350). In a short follow-up of 6 mo., no deaths occurred in pts whose samples were positive for activating mutations. Conclusions: In this very selected population, the frequency of EGFR activating mutations was 24%, with no correlation with gender, race or smoking habits. This reinforces the importance of testing EGFR activating mutations in all pts with lung adenocarcinoma. Disclosure: No significant relationships.