RENATA EIRAS MARTINS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
12 resultados
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conferenceObject 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.article 30 Citação(ões) na Scopus Cisplatin Based Chemoradiation Late Toxicities in Head and Neck Squamous Cell Carcinoma Patients(2015) RIVELLI, Thomas Giollo; MAK, Milena Perez; MARTINS, Renata Eiras; SILVA, Veronica Torres da Costa e; CASTRO JR., Gilberto deBackground: Cisplatin-based chemoradiation (CRT) offers head and neck squamous cell carcinoma (HNSCC) patients better overall survival when compared to radiation alone. However, it also increases acute and late toxicity (LT). Here we aimed to review the main aspects of diagnosis and treatment of long-term toxicities in HNSCC patients after CRT. Methods: We crossed-searched PubMed MeshTerms: Survivors, Deglutition Disorders, Xerostomia, Hypothyroidism, Cisplatin, Kidney, Hearing, and Osteoradionecrosis, with keywords: ""Head and Neck Neoplasms"" and ""Chemoradiotherapy."" A total of 5,541 publications were retrieved and 48 were selected for this systematic review. Results: Dysphagia (25%), xerostomia (40-80%, depending on the technique used), hypothyroidism (42%), ototoxicity (27%), and osteoradionecrosis (4%) were the most commonly reported LT and were related to compromised quality of life aspects in HNSCC patients. Concurrent cisplatin and higher radiation doses, especially to normal tissue, increased the rates of LT. Conclusions: Late CRT toxicities were reported mostly in retrospective studies. Addressing these adverse effects as endpoints in future clinical trials is necessary to provide tools to prevent and treat them adequately, allowing better quality of life and survival results.conferenceObject 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.- Valproic acid combined with cisplatin-based chemoradiation in locally advanced head and neck squamous cell carcinoma patients and associated biomarkers(2020) MAK, Milena Perez; PASINI, Fatima Solange; DIAO, Lixia; GARCIA, Fabyane O. Teixeira; TAKAHASHI, Tiago Kenji; NAKAZOTO, Denyei; MARTINS, Renata Eiras; ALMEIDA, Cristiane Maria; KULCSAR, Marco Aurelio Vamondes; LAMOUNIER, Valdelania Aparecida; NUNES, Emily Montosa; SOUZA, Isabela Cristina de; GARCIA, Marcio Ricardo Taveira; AMADIO, Alex Vieira; SIQUEIRA, Sheila Aparecida C.; SNITCOVSKY, Igor Moyses Longo; SICHERO, Laura; WANG, Jing; JR, Gilberto de CastroBackground: Cisplatin-based chemoradiation (CCRT) offers locally advanced head and neck squamous cell carcinoma (LAHNSCC) patients high local control rate, however, relapses are frequent. Our goal was to evaluate if association of valproic acid (VPA), a histone deacetylase (HDAC) inhibitor, with CCRT improved response rate (RR) and associated biomarkers. Methods: This phase II trial included patients with unresectable locally advanced (LA) oropharynx (OP) squamous cell carcinoma. CCRT began after 2 weeks of VPA (P1). Primary goal was RR at 8 weeks after chemoradiation (CRT)+VPA (P2). Biomarkers included microRNA (miR) polymerase chain reaction (PCR)-array profiling in plasma compared to healthy controls by two-sample t-test. Distribution of p-values was analysed by beta-uniform mixture. Findings were validated by real-time PCR quantitative polymerase chain reaction (qPCR) for selected miRs in plasma and saliva. p16, HDAC2 and RAD23 Homolog B, Nucleotide Excision Repair Protein (HR23B) tumour immunohistochemistry were evaluated. Results: Given significant toxicities, accrual was interrupted after inclusion of ten LA p16 negative OP patients. All were male, smokers/ex-smokers, aged 41-65 and with previous moderate/high alcohol intake. Nine evaluable patients yielded a RR of 88%. At false discovery rate of 5%, 169 miRs were differentially expressed between patients and controls, including lower expression of tumour suppressors (TSs) such as miR-31, -222, -let-7a/b/e and -145. miR-let-7a/e expression was validated by qPCR using saliva. A HDAC2 H-score above 170 was 90% accurate in predicting 6-month disease-free survival. Conclusions: VPA and CRT offered high RR; however, with prohibitive toxicities, which led to early trial termination. Patients and controls had a distinct pattern of miR expression, mainly with low levels of TS miRs targeting Tumor protein P53 (TP53). miR-let-7a/e levels were lower in patients compared to controls, which reinforces the aggressive nature of such tumours (NCT01695122).
conferenceObject 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 DeBackground: 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.- Cachexia in head and neck squamous cell carcinoma (HNSCC) patients (pts) after cisplatin-based chemoradiation (CRT): A cross-sectional study.(2019) CASTRO, Gilberto; NEVES, Willian das; RIVELLI, Thomas Giollo; SIMAO, Eduardo Furquim; MARTINS, Renata Eiras; KULCSAR, Marco Aurelio Vamondes
- Cystic brain metastases in ALK-rearranged non-small cell lung cancer(2018) MARTA, Guilherme Nader; BONADIO, Renata Rodrigues da Cunha Colombo; MARTINS, Renata Eiras; ZUPPANI, Henrique Bortot; CASTRO JUNIOR, Gilberto deThe central nervous system (CNS) is a common site of disease progression in patients with non-small-cell lung cancer (NSCLC) with anaplastic lymphoma kinase (ALK)-rearrangement treated with crizotinib. Cystic brain metastases (CBM) have been recently identified as one possible variant of this disease. An illustrative case report is presented along with a literature review performed in order to track relevant papers about CBM in ALK-rearranged NSCLC, including possible pathophysiology, differential diagnosis and treatment options for this condition. Three case reports have been published describing six ALK-rearranged NSCLC patients presenting with CBM, all of which were under treatment with crizotinib by the time of CBM diagnosis. Treatment with CNS-penetrating tyrosine kinase inhibitors (TKIs) resulted in CNS disease control in three of the six cases reported either as single therapy or in combination with radiation therapy (RT). Investigation of differential diagnoses of CBM might be necessary, which include inflammatory and demyelinating disorders, primary brain tumours and infectious diseases, especially neurocysticercosis that might mimic CBM images. Treatment options include RT, CNS-penetrating TKIs and invasive procedures, such as stereotactic drainage. Thus, CBM are associated with ALK-rearranged NSCLC, particularly in patients who use crizotinib and should prompt investigation of differential diagnosis. CNS-penetrating TKIs are effective in the control of solid brain metastases and also seem to be active in CBM as single therapy or in combination with RT.
bookPart Tratamento sistêmico do câncer(2013) MARTINS, Renata Eiras; CUBERO, Daniel I. G.; SAMANO, Eliana; GIGLIO, Auro DelconferenceObject 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., GilbertoBackground: 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.conferenceObject Risk factors for severe complications during febrile neutropenic episodes in patients with solid tumors(2013) MARTINS, R.; CECOTTI, H. C.; PIERROTTI, L. C.; ABDALA, E.; HOFF, P. M.; CASTRO, G.