GILBERTO DE CASTRO JUNIOR

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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 - Líder

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  • article 61 Citação(ões) na Scopus
    Lung cancer in Brazil
    (2018) ARAUJO, Luiz Henrique; BALDOTTO, Clarissa; CASTRO JR., Gilberto de; KATZ, Artur; FERREIRA, Carlos Gil; MATHIAS, Clarissa; MASCARENHAS, Eldsamira; LOPES, Gilberto de Lima; CARVALHO, Heloisa; TABACOF, Jaques; MARTINEZ-MESA, Jeovany; VIANA, Luciano de Souza; CRUZ, Marcelo de Souza; ZUKIN, Mauro; MARCHI, Pedro De; TERRA, Ricardo Mingarini; RIBEIRO, Ronaldo Albuquerque; LIMA, Vladmir Claudio Cordeiro de; WERUTSKY, Gustavo; BARRIOS, Carlos Henrique
    Lung cancer is one of the most incident types of cancer and a leading cause of cancer mortality in Brazil. We reviewed the current status of lung cancer by searching relevant data on prevention, diagnosis, and treatment in the country. This review highlights several issues that need to be addressed, including smoking control, patient lack of awareness, late diagnosis, and disparities in the access to cancer health care facilities in Brazil. We propose strategies to help overcome these limitations and challenge health care providers, as well as the society and governmental representatives, to work together and to take a step forward in fighting lung cancer.
  • article 20 Citação(ões) na Scopus
    Exercise prescription for symptoms and quality of life improvements in lung cancer patients: a systematic review
    (2021) CODIMA, Alberto; SILVA, Willian das Neves; BORGES, Ana Paula de Souza; JR, Gilberto de Castro
    Purpose The purpose of this study was to conduct a systematic review to assess the effect of exercise on symptoms and quality of life in lung cancer patients. Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Medline, Embase, Scopus, Web of Science, and SciELO were searched for studies published from January 1998 to January 2019. The review included all randomized controlled trials that evaluated the effect of exercise on symptoms and quality of life of lung cancer patients. Two reviewers independently assessed the quality of all the included studies using the Physiotherapy Evidence Database scale. Results In total, ten studies (835 participants) met all inclusion criteria. Three studies investigated the effect of exercise after lung resection, whereas four studies investigated it as a pre-surgery intervention. Two studies investigated the effect of exercise in patients under systemic treatment only, and one study included patients on diverse treatment plans. Exercise protocols consisted of different combinations of strength, aerobic, and inspiratory muscle training. Two trials, including 101 participants, found significant difference in quality of life between groups, favoring the intervention group; and five trials, including 549 participants, found significant inter-group differences in isolated symptoms, also favoring the intervention group. Conclusions Exercise can lead to improvements of symptoms and of quality of life in lung cancer survivors. Providing resistance training combined with high-intensity interval aerobic exercise after lung resection seems to be particularly effective. Further studies are warranted to investigate exercise for patients with poor performance status.
  • article 11 Citação(ões) na Scopus
    Criteria for eligibility to cisplatin in the curative treatment of head and neck cancer: Consensus opinion from a panel of experts
    (2018) CASTRO JR., Gilberto de; ALVES, Gustavo V.; CASTRO, Ana F.; CHAVES, Aline L. F.; MARCHI, Pedro De; OLIVEIRA, Thiago B. de; DIAS, Fernando L.; GUINDALINI, Rodrigo S. C.; NICOLAU, Ulisses R.; SOARES, Andrey; MORA, Paulo A. R.
    Squamous-cell carcinoma of the head and neck (SCCHN) is an important problem in Brazil, where epidemiological and socioeconomic features often create barriers to the implementation of combined modalities with curative potential. Cisplatin improves the efficacy of radiotherapy in the adjuvant treatment of localized SCCHN and in the definitive therapy of locally advanced disease. However, the addition of high-dose cisplatin to radiotherapy increases treatment toxicity and is not always warranted. A panel of experts convened in Sao Paulo, Brazil, for discussions and recommendations regarding the use of high-dose cisplatin in combination with radiotherapy in SCCHN. In addition to discussing their professional experience, panel members used the current literature to provide evidence-based, practical recommendations regarding sociodemographic or medical criteria that may preclude safe administration of cisplatin. It is hoped that the application of these recommendations in clinical practice may improve therapeutic results in Brazil and other countries with similar health-care environments.
  • article 9 Citação(ões) na Scopus
    Induction Chemotherapy for Advanced Oral Cavity Cancer
    (2021) OLIVEIRA, Thiago Bueno de; MARTA, Gustavo Nader; CASTRO JUNIOR, Gilberto de; KOWALSKI, Luiz Paulo
    Purpose of Review Head and neck cancer is a heterogeneous disease, comprising multiple subsites with diverse etiologic factors, pathology and molecular features, response to treatment, and prognosis. Systemic treatment is usually incorporated in the management of locally advanced head and neck squamous cell carcinoma, and the use of induction chemotherapy has theoretical benefits on reducing the risk of distant metastasis, provide an in vivo testing of response and tumor biology and the potential to allow a more personalized and less toxic local treatment after downstaging. The aim of this review is to access the role of induction chemotherapy in patients with locally advanced oral cavity cancer. Recent Findings Clinical trials analyzing this treatment strategy in patients with resectable disease, followed by surgery, and in unresectable disease, followed by (chemo)radiotherapy or surgery are discussed, pointing out strengths and limitations of this data and highlighting the standard treatment in each clinical scenario. Future perspectives, including the incorporation of checkpoint inhibitors and biomarkers for patient selection are discussed. Surgery followed by (chemo)radiation is the standard of care for resectable oral cavity cancer patients, and chemoradiation is the standard for those considered as unresectable. Future trials with the incorporation of immunotherapy and better patient selection based on clinical and molecular biomarkers can bring new hopes for better therapeutic results in these patients.
  • article 11 Citação(ões) na Scopus
    Oral leukoplakia and erythroplakia in young patients: a systematic review
    (2021) ROZA, Ana Luiza Oliveira Correa; KOWALSKI, Luiz Paulo; JR, William Nassib William; JR, Gilberto de Castro; CHAVES, Aline Lauda Freitas; ARAUJO, Anna Luiza Damaceno; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; LOPES, Marcio Ajudarte; VARGAS, Pablo Agustin; SANTOS-SILVA, Alan Roger
    Objective. The aim of this study was to estimate the frequency of oral leukoplakia and oral erythroplakia in young patients. Study Design. The systematic review was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and performed in the following electronic databases: PubMed, Scopus, and Embase. The studies included were cross-sectional, cohort, and diagnostic, which provided with clinical and microscopic data of patients younger than 40 years. The Critical Appraisal Checklist for Prevalence Studies from the Joanna Briggs Institute and the Quality Assessment Tool for Diagnostic Accuracy Studies were used to assess the risk of bias. Results. Five studies met eligibility criteria and were included. The total number of patients from the studies was 1246, of which 115 were young patients (9.2%) with oral leukoplakia as the only oral potentially malignant disorder reported. Oral epithelial dysplasia was identified in 40 cases (34.7%), of which 8 (6.9%) presented malignant transformation. Conclusions. The frequency of oral leukoplakia is low in young patients. Observational studies are necessary for understanding oral leukoplakia and other oral potentially malignant disorders in younger patients.
  • article 17 Citação(ões) na Scopus
    BRAF mutations in non-small cell lung cancer: has finally Janus opened the door?
    (2016) CAPARICA, Rafael; CASTRO JR., Gilberto de; GIL-BAZO, Ignacio; CAGLEVIC, Christian; CALOGERO, Raffaele; GIALLOMBARDO, Marco; SANTOS, Edgardo S.; RAEZ, Luis E.; ROLFO, Christian
    B-Raf mutations occur in about 1-2% of non-small cell lung cancers (NSCLC). These mutations generate a permanent activation of the mitogen activated protein kinase (MAPK) pathway, which promotes tumor growth and proliferation. In the present review, we discuss B-Raf mutation epidemiology, diagnostic methods to detect B-Raf mutations, the role of B-Raf as a driver mutation and a potential therapeutic target in NSCLC. The results of clinical trials involving B-Raf or MAPK pathway inhibitors for the treatment of NSCLC are also discussed. Clinical trials evaluating B-Raf inhibitors in BRAF mutated NSCLC patients have shown promising results, and larger prospective studies are warranted to validate these findings. Enrollment of these patients in clinical trials is an interesting strategy to offer a potentially more effective and less toxic targeted therapy.
  • article 33 Citação(ões) na Scopus
    Global prevalence of human papillomavirus-driven oropharyngeal squamous cell carcinoma following the ASCO guidelines: A systematic review and meta-analysis
    (2020) MARIZ, Bruno Augusto Linhares Almeida; KOWALSKI, Luiz Paulo; JR, William Nassib William; CASTRO, Gilberto de; CHAVES, Aline Lauda Freitas; SANTOS, Marcos; OLIVEIRA, Thiago Bueno de; ARAUJO, Anna Luiza Damaceno; NORMANDO, Ana Gabriela Costa; RIBEIRO, Ana Carolina Prado; BRANDAO, Thais Bianca; VARGAS, Pablo Agustin; LOPES, Marcio Ajudarte; SANTOS-SILVA, Alan Roger
    Objectives: to provide accurate information about the global prevalence of human papillomavirus (HPV) in oropharyngeal squamous cell carcinomas (OPSCC). Material and methods: a systematic review was performed using three main electronic databases. Studies were independently assessed by two reviewers based on established eligibility criteria, to identify the prevalence of HPV-driven OPSCC following criteria defined by the American Society of Clinical Oncology. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Statistical software MedCalc was used to perform meta-analyses. Results: from 2215 records found, 15 were included, reporting data from 6009 patients (time period range: 1980-2016), distributed in 11 countries. Eleven studies were considered as presenting low risk, and four as moderate risk of bias. Using proportion meta-analysis, pooled prevalence of HPV-driven OPSCC was 44.8 % (95 %CI: 36.4-53.5 %; i(2) = 97.6 %), with the highest rates in New Zealand (74.5 %; 95 %CI: 60.9-85.3 %), and the lowest in Brazil (11.1 %; 95 %CI: 4.5-21.5 %). HPV prevalence was similar between males (45.7 %; 95 %CI: 36.5-55.0 %; i(2) = 96.4 %) and females (42.2 %; 95 %CI: 34.3- 50.5 %; i(2) = 85.4 %). Mean/median age ranged from 59.1-67.1 years in the HPV-negative group, and from 55.7-63.5 years in the HPV-positive group. There was an overall discordance between testing by p16 (49.4 %; 95 %CI, 38.2-60.5 %; i(2) = 96.2 %) and p16+ISH/PCR (44.7 %; 95 %CI, 33.5-56.2 %; i(2) = 96.4 %). Conclusion: Overall pooled prevalence of HPV-driven OPSCC was approximately 45 %, with similar distribution among males and females. Double p16/HPV-DNA/RNA testing may be considered to increase specificity and prognostic accuracy.
  • article 12 Citação(ões) na Scopus
    Lung Cancer and the COVID-19 pandemic: Recommendations from the Brazilian Thoracic Oncology Group
    (2020) BALDOTTO, Clarissa; GELATTI, Ana; ACCIOLY, Arthur; MATHIAS, Clarissa; MASCARENHAS, Eldsamira; CARVALHO, Heloisa; FARONI, Lilian; ARAUJO, Luiz Henrique; ZUKIN, Mauro; GADIA, Rafael; TERRA, Ricardo Mingarini; HADDAD, Rui; LIMA, Vladmir Cordeiro de; CASTRO-JUNIOR, Gilberto de
    New cases of the novel coronavirus disease 2019 (COVID-19), also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continue to rise worldwide following the declaration of a pandemic by the World Health Organization (WHO). The current pandemic has completely altered the workflow of health services worldwide. However, even during this critical period, patients with other diseases, like cancer, need to be properly treated. A few reports have shown that mortality due to SARS-CoV-2 is higher in elderly patients and those with other active comorbidities, including cancer. Patients with lung cancer are at risk of pulmonary complications from COVID-19, and as such, the risk/benefit ratio of local and systemic anticancer treatment has to be considered. For each patient, several factors, including age, comorbidities, and immunosuppression, as well as the number of hospital visits for treatment, can influence this risk. The number of cases is rising exponentially in Brazil, and it is important to consider the local characteristics when approaching the pandemic. In this regard, the Brazilian Thoracic Oncology Group has developed recommendations to guide decisions in lung cancer treatment during the SARS-CoV-2 pandemic. Due to the scarcity of relevant data, discussions based on disease stage, evaluation of surgical treatment, radiotherapy techniques, systemic therapy, follow-up, and supportive care were carried out, and specific suggestions issued. All recommendations seek to reduce contagion risk by decreasing the number of medical visits and hospitalization, and in the case of immunosuppression, by adapting treatment schemes when possible. This statement should be adjusted according to the reality of each service, and can be revised as new data become available.
  • article 11 Citação(ões) na Scopus
    Economic Analyses in Squamous Cell Carcinoma of the Head and Neck: A Review of the Literature From a Clinical Perspective
    (2014) SOUZA, Jonas A. de; SANTANA, Iuri A.; CASTRO JR., Gilberto de; LOPES JR., Gilberto de Lima; SHIH, Ya-Chen Tina
    The purpose of this review was to describe cost-effectiveness and cost analysis studies across treatment modalities for squamous cell carcinoma of the head and neck (SCCHN), while placing their results in context of the current clinical practice. We performed a literature search in PubMed for English-language studies addressing economic analyses of treatment modalities for SCCHN published from January 2000 to March 2013. We also performed an additional search for related studies published by the National Institute for Health and Clinical Excellence in the United Kingdom. Identified articles were classified into 3 clinical approaches (organ preservation, radiation therapy modalities, and chemotherapy regimens) and into 2 types of economic studies (cost analysis and cost-effectiveness/cost-utility studies). All cost estimates were normalized to US dollars, year 2013 values. Our search yielded 23 articles: 13 related to organ preservation approaches, 5 to radiation therapy modalities, and 5 to chemotherapy regimens. In general, studies analyzed different questions and modalities, making it difficult to reach a conclusion. Even when restricted to comparisons of modalities within the same clinical approach, studies often yielded conflicting findings. The heterogeneity across economic studies of SCCHN should be carefully understood in light of the modeling assumptions and limitations of each study and placed in context with relevant settings of clinical practices and study perspectives. Furthermore, the scarcity of comparative effectiveness and quality-of-life data poses unique challenges for conducting economic analyses for a resource-intensive disease, such as SCCHN, that requires a multimodal care. Future research is needed to better understand how to compare the costs and cost-effectiveness of different modalities for SCCHN. (C) 2014 Elsevier Inc.
  • article 38 Citação(ões) na Scopus
    Molecular basis of oral squamous cell carcinoma in young patients: Is it any different from older patients?
    (2018) COSTA, Sara Ferreira dos Santos; BRENNAN, Peter A.; GOMEZ, Ricardo Santiago; FREGNANI, Eduardo Rodrigues; SANTOS-SILVA, Alan Roger; MARTINS, Manoela Domingues; CASTRO-JUNIOR, Gilberto de; RAHIMI, Siavash; FONSECA, Felipe Paiva
    Oral squamous cell carcinoma (OSCC) is the commonest subtype of oral cancer, mainly affecting older patients. It used to be a rare disease among individuals younger than 40years, but recently increased incidences in this age group are being reported worldwide. The pathogenesis of OSCC affecting young patients remains controversial, and the well-known etiological factors for oral cancer, tobacco, and alcohol use are believed to play a minor role in the carcinogenesis of the neoplasm, suggesting that the etiology and the molecular basis of OSCC may differ between younger and older patients. Although several molecular markers and chromosomal abnormalities have been demonstrated to differ between both groups, most of the studies have failed to find significant differences. Moreover, divergent results have also been obtained regarding the presence of high-risk human papillomavirus infection in OSCC of young patients. Given these contradictory results and the limited methodological approaches of the majority of the studies, the exact difference between both age groups remains to be fully established. In this review, we evaluate the available data to establish the current evidence that might support the hypothesis that the molecular basis of OSCC in young patients (especially those under 40years) differ from the older patients.