DANIEL DA MOTTA GIRARDI
Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- 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 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- Perioperative chemotherapy with and without high-dose methotrexate in adult osteosarcoma(2017) NEGRAO, Marcelo Vailati; ROCHA, Lucila S. da Silva; GIRARDI, Daniel da Motta; FEHER, OlavoTreatment of adult osteosarcoma (AOS) includes perioperative chemotherapy and surgery. Standard chemotherapy consists of cisplatin (CP) and doxorubicin (DOX). Although considered the standard of care for pediatric patients, high-dose methotrexate (HDM) remains controversial in adults. We aimed to evaluate the role of HDM in AOS treated with curative intent. This study included patients with AOS who received perioperative chemotherapy with DOX and CP (group 1; N=16) and DOX, CP, and HDM (group 2; N=10). The primary endpoint was grade 3 or superior toxicities. The secondary endpoints included overall survival (OS) and disease-free survival. Despite lower average age (35.0 +/- 12.1 vs. 18.9 +/- 2.1 years), group 2 presented more grade 3-4 thrombocytopenia (0 vs 50%) and mucositis (0 vs 40%), whereas group 1 presented more grade 3-4 neutropenia (43.75 vs 40%). No grade 3-4 renal toxicities occurred. Two grade 5 toxicities occurred in group 2, both after the first HDM cycle. Disease-free survival (4.38 +/- 0.61 vs. 2.3 +/- 0.54 years, P=0.228) and OS (4.70 +/- 0.56 vs 2.52 +/- 0.57 years, P=0.107) were not statistically different, but presented a trend toward better outcomes in group 1. The 4-year OS was 65.6 and 32.8% for groups 1 and 2, respectively. In conclusion, HDM was associated with greater severe and lethal toxicity when added to CP and DOX in AOS. Also, it does not seem to impact on treatment efficacy. These data do not support the use of HDM for the perioperative treatment of AOS.
bookPart Urgências oncológicas(2016) TESTA, Laura; GIRARDI, Daniel da Motta; VIVEIROS, Pedro Antonio Hermida de; SILVA, Saulo Brito; SANTOS, Vanessa Montes- Drug interactions in cancer patients: A hidden risk?(2016) RIECHELMANN, Rachel; GIRARDI, Daniel
- Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?(2017) FERNANDES, Gustavo S.; MARQUES, Daniel F.; GIRARDI, Daniel M.; BRAGHIROLI, Maria Ignez F.; COUDRY, Renata A.; MEIRELES, Sibele I.; KATZ, Artur; HOFF, Paulo M.OBJECTIVES: With the development of next-generation sequencing (NGS) technologies, DNA sequencing has been increasingly utilized in clinical practice. Our goal was to investigate the impact of genomic evaluation on treatment decisions for heavily pretreated patients with metastatic cancer. METHODS: We analyzed metastatic cancer patients from a single institution whose cancers had progressed after all available standard-of-care therapies and whose tumors underwent next-generation sequencing analysis. We determined the percentage of patients who received any therapy directed by the test, and its efficacy. RESULTS: From July 2013 to December 2015, 185 consecutive patients were tested using a commercially available next-generation sequencing-based test, and 157 patients were eligible. Sixty-six patients (42.0%) were female, and 91 (58.0%) were male. The mean age at diagnosis was 52.2 years, and the mean number of pre-test lines of systemic treatment was 2.7. One hundred and seventy-seven patients (95.6%) had at least one identified gene alteration. Twenty-four patients (15.2%) underwent systemic treatment directed by the test result. Of these, one patient had a complete response, four (16.7%) had partial responses, two (8.3%) had stable disease, and 17 (70.8%) had disease progression as the best result. The median progression-free survival time with matched therapy was 1.6 months, and the median overall survival was 10 months. CONCLUSION: We identified a high prevalence of gene alterations using an next-generation sequencing test. Although some benefit was associated with the matched therapy, most of the patients had disease progression as the best response, indicating the limited biological potential and unclear clinical relevance of this practice.
- Unraveling molecular pathways of poorly differentiated neuroendocrine carcinomas of the gastroenteropancreatic system: A systematic review(2017) GIRARDI, Daniel M.; SILVA, Andrea C. B.; REGO, Juliana Florinda M.; COUDRY, Renata A.; RIECHELMANN, Rachel P.Background: Poorly differentiated neuroendocrine carcinomas (NECs) are rare and aggressive tumors. Their molecular pathogenesis is still largely unknown, and consequently, the best therapeutic management also remains to be determined. We conducted a systematic review on molecular alterations found in gastroenteropancreatic NECs (GEP-NECs) and discuss potential applications of targeted therapies in setting. Materials and methods: Systematic review of studies about molecular features in tumor tissues of patients with GEP-NECs. The Medline, Lilacs, Embase, Cochrane, Scopus and Opengrey databases were sought, without time, study design or language restrictions. Results: Of the 1.564 studies retrieved, 41 were eligible: 33 were retrospective studies and eight were case reports. The studies spanned the years 1997-2017 and involved mostly colorectal, stomach and pancreas primary tumors. Molecular alterations in the TP53 gene and the p53 protein expression were the most commonly observed, regardless of the primary site. Other consistently found molecular alterations were microsatellite instability (MSI) in approximately 10% of gastric and colorectal NEC, and altered signaling cascades of p16/Rb/cyclin D1, Hedgehog and Notch pathways, and somatic mutations in KRAS, BRAF, RBI and Bcl2. In studies of mixed adeno-neuroendocrine carcinomas (MANECs) the molecular features of GEP-NEC largely resemble their carcinoma/adenocarcinomas tumor counterparts. Conclusions: Despite the paucity of data about the molecular drivers associated with GEP-NEC, some alterations may be potentially targeted with new cancer-directed therapies. Collaborative clinical trials for patients with advanced GEP-NEC are urgently needed.