CAMILA MOTTA VENCHIARUTTI MONIZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
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- Effects of Palliative Chemotherapy in Unresectable or Metastatic Colorectal Cancer Patients With Poor Performance Status(2023) ROCHA, Lucila Soares da Silva; MONIZ, Camila Motta Venchiarutti; SILVA, Marilia Polo Mingueti e; FREITAS, Guilherme Fialho de; SILVA, Virgilio Souza e; HOFF, Paulo Marcelo Gehm; RIECHELMANN, Rachel P.Chemotherapy's benefit in frail (ECOG PS 3 and 4) patients with metastatic colorectal cancer (mCRC) is uncertain. We evaluated symptom improvement, quality of life, clinical improvement, toxicity, response rate, improvement of ECOG PS, and overall survival in these patients. Multiagent chemotherapy improved symptoms in 42.8% without grade 3 to 4 toxicity, but 46% of patients presented early clinical deterioration. Palliative multiagent chemotherapy in poor-performance mCRC patients resulted in mild impact in symptoms with no benefit in OS and a high risk of toxicity and treatment-related death.Introduction: Colorectal cancer is the second most common cancer in both genders and often presents as a metastatic, unresectable, or recurrent disease in early follow-up. It is uncertain the benefit of oxaliplatin-based palliative chemotherapy (CT) in the first line of treatment in patients with compromised performance status (PS), Eastern Cooperative Oncology Group (ECOG) 3 and 4. These patients are systematically excluded from clinical trials but may be treated in clinical practice. Methods: We conducted a prospective observational cohort whose primary outcome was improving at least 2 points in the worst symptom in the Edmonton Symptom Assessment System Scale (ESAS-r), without grade 3 to 4 toxicity, comparing baseline and fourth week of treatment. Secondary endpoints included quality of life using the European Quality of Life-5 dimensions questionnaire, toxicity, response rate, clinical improvement of ECOG PS, and overall survival (OS). Results: We included 28 patients, and 12 (42.8%) achieved the primary endpoint. Median overall survival was 86 days, 46% of patients did not respond to the fourth-week reevaluation due to clinical deterioration, and 17.8% presented toxicity grade & GE;3, with 5 patients dying from toxicity. In addition, ECOG PS 4 or cholestasis had poorer overall survival. Finally, 25% and 53.6% of patients received these treatments in the last 14 and 30 days of life, respectively. Conclusion: In the present study, palliative multiagent chemotherapy in poor performance status patients with non-molecularly selected colorectal cancer tended to impact tumor symptoms control; however, there is no benefit in OS and a considerable risk of toxicity and treatment-related death.
- Real-world Data for High-risk Stage II Colorectal Cancer - The Role of Tumor Side in the Adjuvant Setting(2021) ARAUJO, Camila S.; MONIZ, Camila M. Venchiarutti; BONADIO, Renata C.; WATARAI, Gabriel Y.; ROJAS, Jessica; NOGUEIRA, Pedro V. S.; MARTINEZ, Jessica K.; MORAES, Priscila M. G.; I, Maria Braghiroli; SABBAGA, Jorge; HOFF, Paulo M.The impact of sidedness in the high-risk stage II colorectal cancer setting is uncertain. Although controversial, data suggest a modest benefit of adjuvant chemotherapy in this scenario. This study analyzes the overall survival and recurrence-free survival according to the tumor side and considers adjuvant chemotherapy exposure and clinical and molecular features. In this retrospective cohort, the tumor side did not influence overall survival. Background: The impact of sidedness in the high-risk stage II colorectal cancer (CRC) setting is uncertain. Although controversial, available data suggest a possible modest benefit of adjuvant chemotherapy (CT) in the adjuvant scenario. The aim of this study is to analyze the overall survival (OS) and recurrence-free survival (RFS) according to the tumor side. Patients and Methods: In this single-center retrospective cohort, we analyzed patients treated between January 2011 and December 2018. We evaluated OS and RFS of high-risk patients according to the tumor side and considering adjuvant CT exposure and clinical and molecular features. Results: A total of 1047 patients with stage II CRC were evaluated. Of these, 540 had high-risk criteria and microsatellite stability (MSS) or unknown status. One hundred fifty-seven (29%) patients had right-sided tumors, and 352 (65.2%) had left-sided tumors. Most patients received adjuvant CT, and the majority of them had T3 stage tumors, >= 12 lymph node resection, left tumor, MSS, and moderate differentiation. OS did not differ according to tumor side (5-year OS rates: 81.9% for right-sided tumors vs. 83% for left-sided tumors; hazard ratio, 0.91; 95% confidence interval, 0.55-1.53; P = .744). Adjuvant CT was associated with a superior RFS and OS, with 5-year OS rates of 87.7% versus 76.1% in the no-adjuvant group (hazard ratio, 0.46; 95% CI, 0.28-0.73; P = .001). Conclusion: The tumor side did not influence the outcomes in this study. Adjuvant CT was associated with improved RFS and OS in patients with high-risk stage II CRC, with a total gain of 11.6% in 5-year OS.