MARIA IGNEZ FREITAS MELRO BRAGHIROLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
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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conferenceObject A phase II trial of metformin and fluorouracil (MetFU) for patients (pts) with metastatic colorectal cancer (mCRC) refractory to standard treatment(2014) MIRANDA, Vanessa Costa; FARIA, Luiza Dib; BRAGHIROLI, Maria Ignez Freitas Melro; JACOBS, Monica; SABBAGA, Jorge; HOFF, Paulo Marcelo; RIECHELMANN, Rachel Pimenta- Young-age onset colorectal cancer in Brazil: Analysis of incidence, clinical features, and outcomes in a tertiary cancer center(2019) SILVA, Andrea C. B.; VICENTINI, Maria Fernanda B.; MENDOZA, Elizabeth Z.; FUJIKI, Fernanda K.; FONSECA, Leonardo G. da; BRAGHIROLI, Maria Ignez F. M.; HOFF, Paulo M.Background: Recent studies report increasing incidence of colorectal cancer (CRC) in the young-age population, but data concerning clinical behavior, pathologic findings, and prognosis are controversial for this group. Early recognition of CRC in young patients is a challenge and diagnosis at advanced stage is clearly associated with worse outcomes. Materials and methods: We retrospectively reviewed medical records of 5806 patients diagnosed with CRC between January/2011 and November/2016 and identified 781 patients aged less than 50-years-old. Results: We found an absolute increasing in the incidence of CRC in patients <50 years old of 1.88%-2.23% annually, with a relative increasing of 35.3% between 2011 and 2016. Median age was 42 years, 57.4% were female and 20.9% reported family history of CRC. Left-sided tumors were more frequent and the majority of patients were symptomatic. The most common stages at diagnosis were III (34.1%) and IV (37.3%). The median overall survival (OS) for stage IV was 25 months (95% Cl 20.7-29.3) and was not reached for Stages I-III (P < 0.001). Family history of CRC was independently associated with better OS in stage IV(P= 0.02). For stages I-III, wild-type KRAS, family history of CRC, and absence of angiolymphatic invasion were associated with better OS (P.0.02, P=0.01 and P < 0.001, respectively). Conclusions: In our cohort, the incidence of early-onset CRC is increasing over the past years. Young patients were more likely to be diagnosed with metastatic disease, left-sided and/or rectum site and symptoms at presentation. These findings highlight the emerging importance of young-age onset CRC and the need to discuss strategies to early diagnosis.
- Phase II trial of metformin and paclitaxel for patients with gemcitabine-refractory advanced adenocarcinoma of the pancreas(2015) BRAGHIROLI, Maria Ignez; FERRARI, Anezka C. R. de Celis; PFIFFER, Tulio Eduardo; ALEX, Alexandra Kichfy; NEBULONI, Daniela; CARNEIRO, Allyne S.; CAPARELLI, Fernanda; SENNA, Luiz; LOBO, Juliana; HOFF, Paulo Marcelo; RIECHELMANN, Rachel P.Background: In patients with adenocarcinoma of the pancreas, there are no standard second-line regimens. Many pre-clinical studies have shown that metformin alone or when combined with paclitaxel has antitumour effects on this tumour. We have tested here the combination of paclitaxel and metformin for patients with gemcitabine-refractory pancreatic cancer. Methods: An uncontrolled phase II trial was carried out based on a two-stage Simon's design, with metformin and paclitaxel for patients with locally advanced or metastatic pancreatic cancer whose disease had progressed during first line treatment with a gemcitabine-based regimen. The primary endpoint was the disease control rate at eight weeks as per response evaluation criteria in solid tumours (RECIST) 1.1. Patients received paclitaxel 80 mg/m(2) weekly for three weeks every 28 days and metformin 850 mg p.o. t.i.d. continuously until progression or intolerance state was reached. Results: Twenty patients were enrolled from July 2011 to January 2014: N = 6 (31.6%) achieved the primary endpoint, with all presenting stable disease. Median overall survival (OS) was 128 days (range 17-697) and the median progression free survival (PFS) was 44 days (range 14-210). Eight patients (40%) presented treatment-related G3-4 toxicities with the most common one being diarrhoea. Conclusions: Despite the encouraging pre-clinical evidence of the antitumour activity of metformin in adenocarcinoma of the pancreas, the primary endpoint of the disease control rate was not met. Besides, the treatment combination was poorly tolerated and could not be studied further. This study highlights the importance of performing clinical trials to reassure preclinical or observational data.
- Pembrolizumab with or without chemotherapy versus chemotherapy for advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma: The phase III KEYNOTE-062 study.(2019) TABERNERO, Josep; CUTSEM, Eric Van; BANG, Yung-Jue; FUCHS, Charles S.; WYRWICZ, Lucjan; LEE, Keun Wook; KUDABA, Iveta; GARRIDO, Marcelo; CHUNG, Hyun Cheol; SALGUERO, Hugo Raul Castro; MANSOOR, Wasat; BRAGHIROLI, Maria Ignez Freitas Melro; GOEKKURT, Eray; CHAO, Joseph; WAINBERG, Zev A.; KHER, Uma; SHAH, Sukrut; KANG, SoonMo Peter; SHITARA, Kohei
- Pembrolizumab with or without chemotherapy versus chemotherapy alone for patients with PD-L1-positive advanced gastric or gastroesophageal junction adenocarcinoma: Update from the phase 3 KEYNOTE-062 trial(2022) WAINBERG, Zev A.; SHITARA, Kohei; CUTSEM, Eric Van; WYRWICZ, Lucjan; LEE, Keun Wook; KUDABA, Iveta; GARRIDO, Marcelo; CHUNG, Hyun Cheol Cheol; LEE, Jeeyun; CASTRO-SALGUERO, Hugo Raul; MANSOOR, Wasat; BRAGHIROLI, Maria Ignez; KARASEVA, Nina; GOEKKURT, Eray; SATAKE, Hironaga; CHAO, Joseph; KHER, Uma; SHAH, Sukrut; BHAGIA, Pooja; TABERNERO, Josep
bookPart Síndromes paraneoplásicas(2013) BRAGHIROLI, Ignez; OLIVEIRA, Suliane Coelho RibeiroconferenceObject Nivolumab (NIVO) plus chemotherapy (chemo) or ipilimumab (IPI) versus chemo as first-line (1L) treatment for advanced esophageal squamous cell carcinoma (ESCC): Expanded efficacy and safety analyses from CheckMate 648.(2022) CHAU, Ian; AJANI, Jaffer A.; DOKI, Yuichiro; XU, Jianming; WYRWICZ, Lucjan; MOTOYAMA, Satoru; OGATA, Takashi; KAWAKAMI, Hisato; HSU, Chih-Hung; ADENIS, Antoine; HAJBI, Farid El; BARTOLOMEO, Maria Di; BRAGHIROLI, Maria Ignez Freitas Melro; HOLTVED, Eva; MURPHY, Mariela A. Blum; ABDULLAEV, Sandzhar; SOLEYMANI, Samira; LEI, Ming; KATO, Ken; KITAGAWA, YukoconferenceObject Prospective study of biomarkers in squamous cell carcinoma of the anal canal (SCCAC) and their influence on treatment outcomes: Five-year long-term results.(2020) MONIZ, Camila Motta Venchiarutti; RIECHELMANN, Rachel Pimenta; BRAGHIROLI, Maria Ignez; RIBEIRO, Suilane Coelho; RIVELLI, Thomas Giollo; BARIANI, Giovanni M.; CHEN, Andre Tsin Chih; NAHAS, Caio; BONADIO, Renata Colombo; ORTEGA, Cinthia; FRANCO, Rejane; MEIRELES, Sibele; PEREIRA, Allan Andresson Lima; SABBAGA, Jorge; COUDRY, Renata A.; HOFF, Paulo Marcelo- Poor Evidence to Standardize Adjuvant Treatment for Patients With Biliary Tract Cancer(2012) BARIANI, Giovanni M.; BRAGHIROLI, Maria Ignez; RIECHELMANN, Rachel P.
conferenceObject Bevacizumab (BEV)-based therapy in the treatment of recurrent glioblastoma (GBM) in patients (PTS) treated at a Brazilian cancer center(2012) MUNHOZ, Rodrigo Ramella; BRAGHIROLI, Maria Ignez Freitas Melro; REGO, Juliana Florinda De Mendonga; HOFF, Paulo Marcelo; FEHER, Olavo; KATZ, ArturBackground: Temozolomide (TMZ) both concurrently and after radiation therapy constitutes the standard of care for newly diagnosed GBM PTS. BEV is FDA approved option for recurrent high-grade gliomas PTS based on the results phase II trials. Reports of the use of BEV in these setting have been limited to USA and European academic centers thus far. Methods: We conducted a cross sectional retrospective study of 39 consecutive PTS with histologically confirmed GBM that received BEV in the second or third line setting. The main objective of this analysis was to assess the efficacy and safety of BEV given "off protocol" in an unselected cohort of PTS treated at a Brazilian teaching hospital cancer center and to compare our results to those reported by North American and European academic centers. PTS received first-line treatment with TMZ plus radiotherapy and most received maintenance TMZ and received Bev-based therapy at the time of disease progression. Main endpoints were the evaluation of progression-free survival (PFS), overall survival (OS) and safety. Results: Between 2007 and 2011, 39 PTS with recurrent GBM that received BEV in second (92%) or third-line (8%) were identified. Seven PTS progressed during concomitant RT and TMZ, and 40 during or after TMZ maintenance. 72% were male; median age: 56 years (range 22-79). Most patients (89,7%) received BEV in combination with irinotecan, and the median number of cycles, regardless of combination, was 14. Reasons for BEV discontinuation were disease progression in 79,5% and toxicity in 4 patients. There was one treatment related death due to thrombocytopenia and bleeding. Twenty-four PTS (61,5%) achieved an objective response with BEV. Median PFS of the patients that received BEV in either second or third line was 7.5 months and median OS was 22.6 months. No bowel perforations or any unexpected toxicities occurred. Conclusions: This constitutes the first report of recurrent GBM PTS treated with Bev in the Southern Hemisphere. In this unselected "real life" cohort of PTS with recurrent GBM we have been able to reproduce and confirm the efficacy and safety of this agent used in the treatment of GBM in the second and third line setting.