PAULO MARCELO GEHM HOFF
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Applying mucosal barrier injury laboratory-confirmed bloodstream infection criteria in patients with solid tumors and hematologic malignancies: A retrospective cohort study looking for the real source of infection(2023) SILVA, Ana Carolina Puin da; VIEIRA, Michely Fernandes; FREIRE, Maristela Pinheiro; VAZ, Lumena; BONAZZI, Patricia Rodrigues; IBRAHIM, Karim Yaqub; DIZ, Maria Del Pilar Esteves; HOFF, Paulo Marcelo; PEREIRA, Juliana; ROCHA, Vanderson Geraldo; ABDALA, EdsonWe evaluated the interference of the mucosal barrier injury (MBI) laboratory-confirmed bloodstream infection (MBI-LCBI) criteria on the central-line-associated bloodstream infection (CLABSI) incidence density, and the proportion of catheter-related bloodstream infections (CRBSIs) among those classified as MBI. We detected 339 CLABSIs: 15.0% were classified as MBI-LCBIs, and among these, 19.6% were classified as CRBSIs.
- Post-hoc analyses of overall survival (OS) and progression-free survival (PFS) in the TRIO-013/LOGiC trial of lapatinib (L) in combination with capecitabine plus oxaliplatin (CapeOx)(2015) BANG, Yung-Jue; QIN, Shukui; CHUNG, Hyun-Choel; XU, Jian-Ming; PARK, Joon Oh; JEZIORSKI, Krzysztof; SHPARYK, Yaroslav; HOFF, Paulo M.; SOBRERO, Alberto F.; SALMAN, Pamela; LI, Jin; PROTSENKO, Svetlana; BUYSE, Marc E.; AFENJAR, Karen; HOUE, Vincent; GARCIA, Agathe; HUANG, Yingjie; ARMOUR, Alison; SLAMON, Dennis J.; HECHT, J. Randolph
- Predictors of in-hospital mortality after unplanned admissions among adults with cancer aged 80 years and older(2022) NETO, F. Lazar; HIDALGO FILHO, C. M. T.; ROCHA, J. W. D.; SOBOTTKA, V. P.; STANGLER, L. T. B.; BENFATTI, G.; GUEDES, H.; CLARO, M. Z.; BONADIO, R. C.; DIZ, M. D. P. E.; HOFF, P. M.
- INTRAPERITONEAL CHEMOTHERAPY FOR GASTRIC CANCER WITH PERITONEAL CARCINOMATOSIS: STUDY PROTOCOL OF A PHASE II TRIAL(2023) RAMOS, Marcus Fernando Kodama Pertille; PEREIRA, Marina Alessandra; CHARRUF, Amir Zeide; VICTOR, Carolina Ribeiro; GREGORIO, Joao Vitor Antunes Marques; ALBAN, Luciana Bastos Valente; MONIZ, Camila Motta Venchiarutti; ZILBERSTEIN, Bruno; MELLO, Evandro Sobroza De; HOFF, Paulo Marcelo Gehm; JUNIOR, Ulysses Ribeiro; DIAS, Andre RonconBackground: Peritoneal carcinomatosis in gastric cancer is considered a fatal disease, without expectation of definitive cure. As systemic chemotherapy is not sufficient to contain the disease, a multimodal approach associating intraperitoneal chemotherapy with surgery may represent an alternative for these cases.Aims: The aim of this study was to investigate the role of intraperitoneal chemotherapy in stage IV gastric cancer patients with peritoneal metastasis.Methods: This study is a single institutional single-arm prospective clinical trial phase II (NCT05541146). Patients with the following inclusion criteria undergo implantation of a peritoneal catheter for intraperitoneal chemotherapy: Stage IV gastric adenocarcinoma; age 18-75 years; Peritoneal carcinomatosis with peritoneal cancer index<12; Eastern Cooperative Oncology Group 0/1; good clinical status; and lab exams within normal limits. The study protocol consists of four cycles of intraperitoneal chemotherapy with paclitaxel associated with systemic chemotherapy. After treatment, patients with peritoneal response assessed by staging laparoscopy undergo conversion gastrectomy.Results: The primary outcome is the rate of complete peritoneal response. Progression-free and overall survivals are other outcomes evaluated. The study started in July 2022, and patients will be screened for inclusion until 30 are enrolled.Conclusions: Therapies for advanced gastric cancer patients have been evaluated in clinical trials but without success in patients with peritoneal metastasis. The treatment proposed in this trial can be promising, with easy catheter implantation and ambulatory intraperitoneal chemotherapy regime. Verifying the efficacy and safety of paclitaxel with systemic chemotherapy is an important progress that this study intends to investigate.
- 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.
- Evaluation of Intratumoral Response Heterogeneity in Metastatic Colorectal Cancer and Its Impact on Patient Overall Survival: Findings from 10,551 Patients in the ARCAD Database(2023) OU, Fang-Shu; AHN, Daniel H.; DIXON, Jesse G.; GROTHEY, Axel; LOU, Yiyue; KASI, Pashtoon M.; HUBBARD, Joleen M.; CUTSEM, Eric Van; SALTZ, Leonard B.; SCHMOLL, Hans-Joachim; GOLDBERG, Richard M.; VENOOK, Alan P.; HOFF, Paulo; DOUILLARD, Jean-Yves; HECHT, J. Randolph; HURWITZ, Herbert; PUNT, Cornelis J. A.; KOOPMAN, Miriam; BOKEMEYER, Carsten; FUCHS, Charles S.; DIAZ-RUBIO, Eduardo; TEBBUTT, Niall C.; CREMOLINI, Chiara; KABBINAVAR, Fairooz F.; BEKAII-SAAB, Tanios; CHIBAUDEL, Benoist; YOSHINO, Takayuki; ZALCBERG, John; ADAMS, Richard A.; GRAMONT, Aimery de; SHI, QianMetastatic colorectal cancer (mCRC) is a heterogeneous disease that can evoke discordant responses to therapy among different lesions in individual patients. The Response Evaluation Criteria in Solid Tumors (RECIST) criteria do not take into consideration response heterogeneity. We explored and developed lesion-based measurement response criteria to evaluate their prognostic effect on overall survival (OS). Patients and Methods: Patients enrolled in 17 first-line clinical trials, who had mCRC with & GE; 2 lesions at baseline, and a restaging scan by 12 weeks were included. For each patient, lesions were categorized as a progressing lesion (PL: > 20% increase in the longest diameter (LD)), responding lesion (RL: > 30% decrease in LD), or stable lesion (SL: neither PL nor RL) based on the 12-week scan. Lesion-based response criteria were defined for each patient as follows: PL only, SL only, RL only, and varied responses (mixture of RL, SL, and PL). Lesion-based response criteria and OS were correlated using stratified multivariable Cox models. The concordance between OS and classifications was measured using the C statistic. Results: Among 10,551 patients with mCRC from 17 first-line studies, varied responses were noted in 51.6% of patients, among whom, 3.3% had RL/PL at 12 weeks. Among patients with RL/SL, 52% had stable disease (SD) by RECIST 1.1, and they had a longer OS (median OS (mOS) = 19.9 months) than those with SL only (mOS = 16.8 months, HR (95% CI) = 0.81 (0.76, 0.85), p < 0.001), although a shorter OS than those with RL only (mOS = 25.8 months, HR (95% CI) = 1.42 (1.32, 1.53), p < 0.001). Among patients with SL/PL, 74% had SD by RECIST 1.1, and they had a longer OS (mOS = 9.0 months) than those with PL only (mOS = 8.0 months, HR (95% CI) = 0.75 (0.57, 0.98), p = 0.040), yet a shorter OS than those with SL only (mOS = 16.8 months, HR (95% CI) = 1.98 (1.80, 2.18), p < 0.001). These associations were consistent across treatment regimen subgroups. The lesion-based response criteria showed slightly higher concordance than RECIST 1.1, although it was not statistically significant. Conclusion: Varied responses at first restaging are common among patients receiving first-line therapy for mCRC. Our lesion-based measurement criteria allowed for better mortality discrimination, which could potentially be informative for treatment decision-making and influence patient outcomes.
- Long-term outcomes of neoadjuvant immunotherapy plus chemotherapy in patients with early-stage triple-negative breast cancer: an extracted individual patient data and trial-level meta-analysis(2024) CUNHA, Mateus Trinconi; GOUVEIA, Mariana Carvalho; LAZAR NETO, Felippe; TESTA, Laura; HOFF, Paulo Marcelo; AZAMBUJA, Evandro de; BONADIO, Renata ColomboBackground: Neoadjuvant immunotherapy (nIO) has emerged as a treatment option for stage II-III triple-negative breast cancer (TNBC). While randomised clinical trials (RCTs) demonstrated pathological complete response rate benefit to nIO added to chemotherapy, additional data on long-term outcomes is warranted. We performed this analysis to evaluate long-term efficacy outcomes of nIO in TNBC.Methods: We searched databases for RCTs evaluating nIO in early-stage TNBC. A meta-analysis of extracted individual patient data (EIPD) was performed to evaluate EFS and OS, with data from reported Kaplan-Meier plots. Additionally, we conducted a trial-level meta-analysis using fixed and random effects models.Results: The literature search resulted in four included RCTs with available EFS or OS (KEYNOTE-522, IMpassion031, I-SPY2 and GeparNuevo). EIPD showed that the addition of nIO to chemotherapy provides statistically significant benefits in EFS (HR 0.62, 0.50-0.76; p < 0.001) and OS (HR 0.62, 0.46-0.82, p < 0.001). Number needed to treat to avoid one EFS or OS event in 4 years was 9 and 14, respectively. Trial-level meta-analysis yielded similar results (EFS: HR 0.64, 0.51-0.79; OS: 0.57, 0.37-0.89).Conclusions: Results show that nIO combined with chemotherapy can provide significant EFS and OS benefits, supporting its use as standard treatment for early-stage TNBC.
- Modified endoscopic vacuum therapy for duodenal hemorrhage in patients with severe acute respiratory syndrome coronavirus 2(2022) MOURA, Diogo Turiani Hourneaux de; MOURA, Eduardo Guimaraes Hourneaux de; HIRSCH, Bruno Salomao; SILVA, Gustavo L. Rodela; RIZK, Stephanie I.; HOFF, Paulo M.; HAJJAR, Ludhmila A.
conferenceObject Prognostic impact of primary tumor sidedness in stage III colorectal cancer(2023) PROTASIO, Bruno Mendonca; CASTRIA, Tiago Biachi de; SARAGIOTTO, Daniel Fernandes; NATALINO, Renato Jose Mendonca; MANGONE, Flavia Regina Rotea; SABBAGA, Jorge; HOFF, Paulo M.; CHAMMAS, Roger- Causes of unplanned hospitalizations and factors associated with in-hospital mortality among patients receiving chemotherapy treatment(2022) HIDALGO FILHO, C. M. T.; LAZAR NETO, F.; ROCHA, J. W. D.; SOBOTTKA, V. P.; STANGLER, L. T. B.; BENFATTI, G.; GUEDES, H.; CLARO, M. Z.; BONADIO, R. C.; DIZ, M. D. P. E.; HOFF, P. M.