RENATA DE ALMEIDA COUDRY
Projetos de Pesquisa
Unidades Organizacionais
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Phase II study of capecitabine in substitution of 5-FU in the chemoradiotherapy regimen for patients with squamous cell carcinoma of the anal canal.(2012) RIBEIRO, Suilane Coelho; VENCHIARUTTI, Camila; RIECHELMANN, Rachel; GIL, Erlon; NAHAS, Caio; COUDRY, Renata; FREITAS, Daniela; SARAGIOTTO, Daniel F.; ARRUDA, Fernando; AZAMBUJA, Rodrigo; HOFF, Paulo
- Extended preoperative chemotherapy, extent of liver resection and blood transfusion are predictive factors of liver failure following resection of colorectal liver metastasis(2013) RIBEIRO, H. S. C.; COSTA JR., W. L.; DINIZ, A. L.; GODOY, A. L.; HERMAN, P.; COUDRY, R. A.; BEGNAMI, M. D. F. S.; MELLO, C. A. L.; SILVA, M. J. B.; ZURSTRASSEN, C. E.; COIMBRA, F. J. F.Aim: The aim of this study was to determine the incidence and prognostic factors of postoperative liver failure in patients submitted to liver resection for colorectal metastases. Method: Patients with CLM who underwent hepatectomy from 1998 to 2009 were included in retrospective analysis. Postoperative liver failure was defined using either the 50-50 criteria or the peak of serum bilirubin level above 7 mg/dL independently. Results: Two hundred and nine (209) procedures were performed in 170 patients. 120 surgeries were preceded by chemotherapy within six months. The overall morbidity rate was 53.1% and 90-day mortality was 2.3%. Postoperative liver failure occurred in 10% of all procedures, accounting for a mortality rate of 9.5% among this group of patients. In multivariate analysis, extent of liver resection, need of blood transfusion and more than eight preoperative chemotherapy cycles were independent prognostic factors of postoperative liver insufficiency. This complication was not related with the chemotherapy regimen used. Conclusion: We conclude that postoperative liver failure has a relatively low incidence (10%) after CLM resection, but a remarkable impact on postoperative mortality rate. The amount of liver resected, the need of blood transfusion and extended preoperative chemotherapy are independent predictors of its occurrence and this knowledge can be used to prevent postoperative liver failure in a multidisciplinary approach.
- HER2 in situ hybridization in breast cancer: clinical implications of polysomy 17 and genetic heterogeneity(2014) HANNA, Wedad M.; RUESCHOFF, Josef; BILOUS, Michael; COUDRY, Renata A.; DOWSETT, Mitch; OSAMURA, Robert Y.; PENAULT-LLORCA, Frederique; VIJVER, Marc van de; VIALE, GiuseppeTrastuzumab-containing therapy is a standard of care for patients with HER2+ breast cancer. HER2 status is routinely assigned using in situ hybridization to assess HER2 gene amplification, but interpretation of in situ hybridization results may be challenging in tumors with chromosome 17 polysomy or intratumoral genetic heterogeneity. Apparent chromosome 17 polysomy, defined by increased chromosome enumeration probe 17 (CEP17) signal number, is a common genetic aberration in breast cancer and represents an alternative mechanism for increasing HER2 copy number. Some studies have linked elevated CEP17 count ('polysomy') with adverse clinicopathologic features and HER2 overexpression, although there are numerous discrepancies in the literature. There is evidence that elevated CEP17 ('polysomy') count might account for trastuzumab response in tumors with normal HER2: CEP17 ratios. Nonetheless, recent studies establish that apparent 'polysomy' (CEP17 increase) is usually related to focal pericentromeric gains rather than true polysomy. Assigning HER2 status may also be complex where multiple cell subclones with distinct HER2 amplification characteristics coexist within the same tumor. Such genetic heterogeneity affects up to 40% of breast cancers when assessed according to a College of American Pathologists guideline, although other definitions have been proposed. Recent data have associated heterogeneity with unfavorable clinicopathologic variables and poor prognosis. Genetically heterogeneous tumors harboring HER2-amplified subclones have the potential to benefit from trastuzumab, but this has yet to be evaluated in clinical studies. In this review, we discuss the implications of apparent polysomy 17 and genetic heterogeneity for assigning HER2 status in clinical practice. Among our recommendations, we support the use of mean HER2 copy number rather than HER2: CEP17 ratio to define HER2 positivity in cases where coamplification of the centromere might mask HER2 amplification. We also highlight a need to harmonize in situ hybridization scoring methodology to support accurate HER2 status determination, particularly where there is evidence of heterogeneity.
- Response to Chemotherapy and Prognosis in Metastatic Colorectal Cancer With DNA Deficient Mismatch Repair(2017) ALEX, Alexandra Khichfy; SIQUEIRA, Sheila; COUDRY, Renata; SANTOS, Juliana; ALVES, Michel; HOFF, Paulo M.; RIECHELMANN, Rachel P.This study suggests that the DNA deficient mismatch repair (dMMR) phenotype is predictive of resistance to oxaliplatin-based chemotherapy in metastatic colorectal cancer. Patients with dMMR had numerically lower response rate compared with patients with proficient MMR (11.7% vs. 28.6%; P = .088). Furthermore, dMMR was associated with BRAF mutations and was factor of poor prognostic, particularly in sporadic versus Lynch-related tumors. Background: DNA deficient mismatch repair (dMMR) genes are associated with microsatellite instability and good prognosis in early-stage colorectal cancer (CRC). However dMMR is rare in metastatic CRC (mCRC) and little is known about its influence on treatment response rate (RR). The primary objective of this study was to compare the RR of patients with mCRC according to dMMR status. Methods: This was a retrospective study that compared the RR by Response Evaluation Criteria In Solid Tumors 1.1 criteria in patients with mCRC treated with chemotherapy according to dMMR status. All digital images were retrieved for RR evaluation by a single radiologist blinded to dMMR results. dMMR was defined as loss of immunohistochemistry expression of at least 1 of the MMR genes (MLH1, MSH2, MSH6, or PMS2). Cases were dMMR patients, and controls were proficient MMR (pMMR) patients (1: 2 fashion). Based on clinical and molecular features, dMMR patients were classified as probable Lynch or sporadic. Results: From January 2009 to January 2013, 762 out of 1270 patients were eligible and screened for dMMR: n = 27 (3.5%) had dMMR mCRC and n = 735 (96.5%) had pMMR mCRC. Given the rarity, 14 dMMR cases outside the inclusion period were included (total 41 dMMR cases) and 84 controls (pMMR). By intention-to-treat analysis, considering all patients who received at least 1 dose of oxaliplatin-based chemotherapy (N dMMR = 34), those with dMMR had lower RR compared with those with pMMR (RR, 11.7% vs. 28.6%; odds ratio, 0.33; 95% confidence interval, 0.08-1.40; P = .088); patients with probable Lynch-related mCRC presented higher RR than subjects with probable sporadic dMMR (22.2% vs. 0%). dMMR was associated with BRAF mutations and poor prognosis, particularly in the sporadic subgroup (median survival, 29.8 vs. 5.9 months; P = .025). Conclusion: This study suggests that the dMMR phenotype is predictive of resistance to oxaliplatin-based chemotherapy. Apparently, such resistance is more pronounced in the sporadic dMMR phenotype, suggesting biological heterogeneity within the dMMR mCRC subgroup.
- Common chromosomal imbalances and stemness-related protein expression markers in endometriotic lesions from different anatomical sites: the potential role of stem cells(2012) SILVEIRA, Cassia G. T.; ABRAO, Mauricio S.; DIAS JR., Joao A.; COUDRY, Renata A.; SOARES, Fernando A.; DRIGO, Sandra A.; DOMINGUES, Maria A. C.; ROGATTO, Silvia R.Endometriosis is a multifactorial gynecological disease characterized by the presence of functional endometrium-like tissue in ectopic sites. Several studies have focused on elucidating the immunological, endocrine, environmental and genetic factors involved in endometriosis. However, its pathogenesis is still unclear. High-resolution comparative genomic hybridization was applied to screen for genomic imbalances in laser microdissected stromal and epithelial cells from 20 endometriotic lesions and three samples of eutopic endometrium derived from eight patients. The expression of seven stemness-related markers (CD9, CD13, CD24, CD34, CD133, CD117/c-Kit and Oct-4) in endometrial tissue samples was evaluated by immunohistochemistry. Samples of eutopic endometrium showed normal genomic profiles. In ectopic tissues, an average of 68 genomic imbalances was detected per sample. DNA losses were more frequently detected and involved mainly 3p, 5q, 7p, 9p, 11q, 16q, 18q and 19q. Many of the genomic imbalances detected were common to endometriotic stroma and epithelia and also among different endometriotic sites from the same patient. These findings suggested a clonal origin of the endometriotic cells and the putative involvement of stem cells. Positive immunostaining for CD9, CD34, c-Kit and Oct-4 markers was detected in isolated epithelial and/or stromal cells in eutopic and ectopic endometrium in the majority of cases. The presence of shared genomic alterations in stromal and epithelial cells from different anatomical sites of the same patient and the expression of stemness-related markers suggested that endometriosis arises as a clonal proliferation with the putative involvement of stem cells.
conferenceObject RESECTABLE PANCREATIC NEUROENDOCRINE NEOPLASMS: CLINICOPATHOLOGICAL CHARACTERISTICS AND IMMUNOHISTOCHEMICAL CORRELATION(2017) NAVA, Carolin D.; COUDRY, Renata; MACHADO, Marcel C. C.; MEIRELLES, Luciana; GONCALVES, Marianne de Castro; PADUANI, Gabriela F.; CABRAL, Joao Guilherme G.; HYBNER, Luciano D.; ARDENGH, Jose CelsobookPart Imunogenética no Câncer Gastrintestinal(2015) JúNIOR, Ulysses Ribeiro; SAFATLE-RIBEIRO, Adriana Vaz; COUDRY, Renata de Almeida- The expression profile of biomarkers in squamous cell carcinoma of the anal canal and their influence on treatment outcomes: Preliminary results(2016) MONIZ, Camila Motta Venchiarutti; RIECHELMANN, Rachel Pimenta; RIBEIRO, Suilane Coelho; BARIANI, Giovanni Mendonca; RIVELLI, Thomas Giollo; ORTEGA, Cintia; PEREIRA, Allan Andresson Lima; MEIRELES, Sibele Inacio; CHEN, Andre; NAHAS, Caio; SABAGGA, Jorge; COUDRY, Renata A.; HOFF, Paulo Marcelo
conferenceObject Phase II study of capecitabine in substitution of 5-FU in the chemoradiotherapy regimen for patients with squamous cell carcinoma of the anal canal(2014) RIBEIRO, Suilane Coelho; MONIZ, Camila Motta Venchiarutti; RIECHELMANN, Rachel; BARIANI, Giovanni Mendonca; BRAGHIROLI, Maria Ignez; NAHAS, Caio; COUDRY, Renata; ALEX, Alexandra Khichfy; CARNEIRO, Allyne Q.; NEBULONI, Daniela R.; GLASBERG, Joao; HOFF, PaulobookPart Mecanismos moleculares da carcinogênese colorretal(2017) COUDRY, Renata de Almeida