MARCELO VAILATI NEGRAO
Projetos de Pesquisa
Unidades Organizacionais
PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico
20 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 20
bookPart Toxicidades do tratamento e seu manejo(2016) MATUTINO, Adriana Reis Brandão; NEGRãO, Marcelo V.; MAK, Milena Perez- Management of Para-aortic Lymph Node Disease in Patients With Cervical Cancer What Is the Best Approach?(2017) NEGRAO, Marcelo Vailati; LIMA, Julianne Maria da Silva; SILVA, Samantha Cabral Severino; DIZ, Maria Del Pilar Estevez; MIRANDA, Vanessa da CostaCervical cancer remains a prevalent and deadly disease in low-income countries, especially among young and otherwise healthy women. Multimodality treatment has led to a significant improvement in outcomes for patients with locally advanced disease, and this is mainly because of the incorporation of platinum-based chemoradiotherapy in current treatment protocols. However, locally advanced tumors are associated with a greater risk for para-aortic lymph node (PALN) involvement, which is an important adverse prognostic factor. Most staging techniques have low accuracy for detection of disease in this area, which could lead to understaging and undertreatment. Meanwhile, patients with PALN disease are underrepresented in trials addressing the treatment of advanced cervical cancer and a few studies have been directed at this population. The aim of this review is to analyze the current data regarding staging and treatment of cervical cancer with PALN disease to determine which strategy is best when managing these patients.
- Sorafenib for the Treatment of Progressive Metastatic Medullary Thyroid Cancer: Efficacy and Safety Analysis(2016) CASTRONEVES, Luciana Audi de; NEGRAO, Marcelo Vailati; FREITAS, Ricardo Miguel Costa de; PAPADIA, Carla; LIMA JR., Jose Viana; FUKUSHIMA, Julia T.; SIMAO, Eduardo Furquim; KULCSAR, Marco Aurelio Vamondes; TAVARES, Marcos Roberto; JORGE, Alexander Augusto de Lima; CASTRO, Gilberto de; HOFF, Paulo Marcelo; HOFF, Ana OliveiraBackground: Treatment of advanced medullary thyroid carcinoma (MTC) was recently improved with the approval of vandetanib and cabozantinib. However, there is still a need to explore sequential therapy with more than one tyrosine kinase inhibitor (TKI) and to explore alternative therapies when vandetanib and cabozantinib are not available. This study reports the authors' experience with sorafenib as a treatment for advanced MTC. Methods: This is a retrospective longitudinal study of 13 patients with progressive metastatic MTC treated with sorafenib 400mg twice daily between December 2011 and January 2015. The primary endpoints were to evaluate response and progression-free survival (PFS) in patients treated with sorafenib outside a clinical trial. The secondary endpoint was an assessment of the toxicity profile. One patient was excluded because of a serious allergic skin rash one week after starting sorafenib. Results: The analysis included 12 patients with metastatic MTC (median age 48 years), 10 with sporadic and 2 with hereditary disease. The median duration of treatment was 11 months, and the median follow-up was 15.5 months. At data cutoff, 2/12 (16%) patients were still on treatment for 16 and 34 months. According to Response Evaluation Criteria in Solid Tumors analysis, 10 (83.3%) patients showed stable disease, and two (16.6%) had progression of disease; no partial response was observed. The median PFS was nine months. However, three patients with extensive and rapidly progressive disease died within three months of sorafenib treatment. The median PFS excluding these three patients was 12 months. Adverse events (AE) occurred in nine (75%) patients. The main AEs were skin toxicity, weight loss, and fatigue. Five (41.6%) patients needed dose reduction, and one patient discontinued treatment because of toxicity. Conclusions: Treatment with sorafenib in progressive metastatic MTC is well tolerated and resulted in disease control and durable clinical benefit in 75% of patients. Sorafenib treatment could be considered when vandetanib and cabozantinib are not available or after failing these drugs.
conferenceObject Concurrent nivolumab and ipilimumab with brain stereotactic radiosurgery for brain metastases from non-small cell lung cancer: A phase I trial.(2020) LI, Jing; WANG, Yan; TANG, Chad; WELSH, James William; GUHA-THAKURTA, Nandita; CARTER, Brett W.; WEFEL, Jeffrey Scott; GHIA, Amol J.; YEBOA, Debra; MCALEER, Mary Frances; CHUNG, Caroline; WOODHOUSE, Kristina D.; ELAMIN, Yasir; LE, Xiuning; CASCONE, Tina; NEGRAO, Marcelo Vailati; SKOULIDIS, Ferdinandos; FERRAROTTO, Renata; HEYMACH, John; ALTAN, MehmetconferenceObject Palliative chemotherapy for patient with advanced tumor and poor performance status: Are oncologists' hopes of benefit justified?(2018) VASCONCELLOS, V. F.; BONADIO, R. R. C. C.; AVANCO, G.; NEGRAO, M. V.; RIECHELMANN, R.- Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer(2019) SALES, Allan Robson Kluser; NEGRAO, Marcelo Vailati; TESTA, Laura; FERREIRA-SANTOS, Larissa; GROEHS, Raphaela Villar Ramalho; CARVALHO, Bruna; TOSCHI-DIAS, Edgar; ROCHA, Natalia Galito; LAURINDO, Francisco Rafael Martins; DEBBAS, Victor; RONDON, Maria Urbana P. B.; MANO, Max Sena; HAJJAR, Ludhmila Abrahao; HOFF, Paulo Marcelo Gehm; KALIL FILHO, Roberto; NEGRAO, Carlos EduardoThe purpose of the present study was to test the hypothesis that doxorubicin (DX) and cyclophosphamide (CY) adjuvant chemotherapy (CHT) acutely impairs neurovascular and hemodynamic responses in women with breast cancer. Sixteen women (age: 47.0 +/- 2.0 yr; body mass index: 24.2 +/- 1.5 kg/m) with stage II-III breast cancer and indication for adjuvant CHT underwent two experimental sessions, saline (SL) and CHT. In the CHT session, DX (60 mg/m (2)) and CY (600 mg/m(2)) were administered over 45 min. In the SL session, a matching SL volume was infused in 45 min. Muscle sympathetic nerve activity (MSNA) from peroneal nerve (microneurography), calf blood flow (CBF; plethysmography) and calf vascular conductance (CVC), heart rate (HR; electrocardiography), and beat-to-beat blood pressure (BP: finger plethysmography) were measured at rest before, during, and after each session. Venous blood samples (5 ml) were collected before and after both sessions for assessment of circulating endothelial microparticles (EMPs: flow cytometry). a surrogate marker for endothelial damage. MSNA and BP responses were increased (P < 0.001), whereas CBF and CVC responses were decreased (P < 0.001), during and after CHT session when compared with SL session. Interestingly, the vascular alterations were also observed at the molecular level through an increased EMP response to CHT (P = 0.03, CHT vs. SL session). No difference in HR response was observed (P > 0.05). Adjuvant CHT with DX and CY in patients treated for breast cancer increases sympathetic nerve activity and circulating EMP levels and, in addition, reduces muscle vascular conductance and elevates systemic BP. These responses may be early signs of CHT-induced cardiovascular alterations and may represent potential targets for preventive interventions. NEW & NOTEWORTHY It is known that chemotherapy regimens increase the risk of cardiovascular events in patients treated for cancer. Here, we identified that a single cycle of adjuvant chemotherapy with doxorubicin and cyclophosphamide in women treated for breast cancer dramatically increases sympathetic nerve activity and circulating endothelial microparticle levels, reduces the muscle vascular conductance, and elevates systemic blood pressure.
- Definitive chemoradiotherapy for advanced cervical cancer: should it be different in the elderly?(2015) CAIRES, Inacelli Queiroz de Souza; SOUZA, Karla Teixeira; NEGRAO, Marcelo Vailati; OLIVEIRA, Julia Andrade de; BARROSO-SOUSA, Romualdo; LIMA, Rafael Caires Alvino de; HOFF, Paulo Marcelo Gehm; DIZ, Maria del Pilar EstevezBackground: Cervical cancer (CC) is the second most common cancer in Brazilian women, and approximately 10% of cases occur in elderly patients (pts). In this age group, disease is usually diagnosed in more advanced stages and oncological therapies are usually less intensive, due to comorbidities and impaired performance status. Methods: Retrospective analysis of pts >= 65 years old with CC admitted at a Brazilian University Cancer Center from August 2008 to February 2012. We performed a descriptive analysis of baseline performance status (PS), disease stage (FIGO), histology, body mass index (BMI), treatment received and overall survival, using the Kaplan-Meier method. Results: 900 medical records were analyzed and 75 pts (8%) fulfilled the inclusion criteria. Median age was 73.4 years old (+/- 5.5 years). Squamous cell carcinoma (SCC) was the most common histology (71 pts, 94.7%). 67 (89.3%) had PS 0 or 1 and 52 pts (69.3%) were eutrophic (BMI 18.5-25 kg/m(2)). At presentation, disease staging consisted of 18 pts (24%) stage I, 35 pts (46.7%) stage II, 8 pts (10.7%) stage III, 12 pts (16%) stage IVa and 2 pts (2.7%) stage IVb. 24 pts (32%) underwent surgery (hysterectomy, adnexectomy, pelvic and paraaortic lymphadenectomy). Adjuvant treatment with radiotherapy (RT) was performed in 13 pts (total dose of external RT in pelvis ranged from 39.6 to 45 Gy, parametrial boost ranged from 14 to 20 Gy and 4 inserts from 7 to 7.5 Gy of brachytherapy); 8 of them received concomitant platinum-based chemotherapy (CT). 30 pts underwent definitive CRT, 17 definitive RT, 1 palliative CT and 3 best supportive care. In the CRT group, 18 pts received cisplatin (CDDP 40 mg/m(2)/w/6w) and 12 carboplatin (AUC 2/w/6w). During definitive CRT, treatment was discontinued in 39% of pts who received CDDP and 25% of pts who received carboplatin, all due to treatment toxicities. CDDP was associated with more nefrotoxicity (5 pts, 28%) than carboplatin (1 Pt, 8.3%). The CDDP group also presented more radiodermatitis and stroke. However, myelosuppression and diarrhea were similar in both groups. After a 26.1-month follow-up, median OS was not reached. Conclusions: Despite advanced age, more than 60% of pts underwent complete CRT treatment. Thus, age should not be the only factor to guide therapeutic decisions in CC. Carboplatin was better tolerated than CDDP in CRT group, but prospective trials are necessary to evaluate the best treatment option in this population.
- A retrospective study of chemoradiotherapy (CRT) versus chemotherapy (CT) as adjuvant treatment for localized gastric cancer (LGC)(2016) GIRARDI, D. D. M.; PEREIRA, G. C.; NEGRAO, M.; LIMA, M. A.; FELIZOLA, M. M.; FOGACE, R. N.; CAPARELI, F. C.; SABBAGA, J.; HOFF, P. M.
conferenceObject Chemotheraphy acutely impairs neurovascular and hemodynamic responses in patients with breast cancer(2019) SALES, Allan Kluser; NEGRAO, Marcelo; TESTA, Laura; FERREIRA-SANTOS, Larissa; GROEHS, Raphaela; CARVALHO, Bruna; TOSCHI-DIAS, Edgar; ROCHA, Natalia; LAURINDO, Francisco; DEBBAS, Victor Kluser; RONDON, Maria Kluser; MANO, Max; HAJJAR, Ludhmila; HOFF, Paulo; FILHO, Robero; NEGRAO, CarlosconferenceObject Perioperative chemotherapy with cisplatin (CP) and doxorubicin (DOX) with and without high-dose methotrexate (HDM) in adult osteosarcoma (AOT): Is methotrexate warranted?(2015) ROCHA, Lucila Soares Da Silva; NEGRAO, Marcelo Vailati; GIRARDI, Daniel da Motta; CAMARGO, Veridiana Pires De; ALBAN, Luciana Bastos Valente; HOFF, Paulo Marcelo; FEHER, Olavo