RODRIGO RAMELLA MUNHOZ
Projetos de Pesquisa
Unidades Organizacionais
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
bookPart Tumores de partes moles(2021) ZATTAR, Luciana; MUNHOZ, Rodrigo; FERREIRA, Fábio de Oliveira- A phase 2 study of first-line nivolumab in patients with locally advanced or metastatic cutaneous squamous-cell carcinoma(2022) MUNHOZ, Rodrigo R.; NADER-MARTA, Guilherme; CAMARGO, Veridiana P. de; QUEIROZ, Marcello M.; CURY-MARTINS, Jade; RICCI, Herminia; MATTOS, Marcela R. de; MENEZES, Thiago A. F. de; MACHADO, Guilherme U. C.; BERTOLLI, Eduardo; BARROS, Milton; SOUZA, Carina E. de; FRANKE, Fabio; FERREIRA, Fabio O.; FEHER, Olavo; JR, Gilberto de CastroBackground Cutaneous squamous-cell carcinoma (CSCC) is among the most frequent malignancies worldwide. For those not amenable to treatment with curative intent, immune checkpoint inhibition (ICI) with anti-programmed death receptor 1 (PD-1) antibodies has emerged as a novel therapeutic option. In this study, the authors sought to investigate the activity of the anti-PD-1 agent nivolumab in patients with advanced CSCC (aCSCC). Methods CA209-9JC was an open-label, single-arm, phase 2 study to evaluate the safety and/or efficacy of nivolumab in systemic treatment-naive patients with aCSCC. Nivolumab (3 mg/kg) was administered every 2 weeks until disease progression, unacceptable toxicity, or 12 months of treatment. The primary end point was the best objective response rate (BORR) as per RECIST 1.1 criteria. Secondary end points included safety, progression-free survival (PFS), and overall survival (OS). Results Twenty-four patients with aCSCC were enrolled with a median age of 74 years (range, 48-93). Among the 24 patients evaluable for response, the BORR was 58.3% (14/24); there were no complete responses. With a median follow-up of 17.6 months, median duration of response has not been reached, and the estimated median PFS and OS were 12.7 and 20.7 months, respectively. Prior exposure to radiotherapy was associated with worse outcomes (p = .035, univariate analysis). Treatment-related adverse events of any grade and grade >= 3 occurred in 21 (87.5%) and six (25%) patients, respectively, and one patient discontinued nivolumab due to toxicities. Conclusions Nivolumab resulted in robust antitumor activity, sustained responses, and good tolerability in systemic treatment-naive patients with aCSCC. These data provide further evidence to support the use of ICI as the standard treatment of aCSCC.
- Neoadjuvant stereotactic ablative radiotherapy (SABR) for soft tissue sarcomas of the extremities(2021) LEITE, Elton Trigo Teixeira; MUNHOZ, Rodrigo Ramella; CAMARGO, Veridiana Pires de; LIMA, Luiz Guilherme Cernaglia Aureliano de; REBOLLEDO, Daniel Cesar Seguel; MAISTRO, Carlos Eduardo Bravin; BUSNARDO, Fabio de Freitas; FERREIRA, Fabio de Oliveira; SALVAJOLI, Joao Victor; CARVALHO, Heloisa de AndradeBackground: Soft tissue sarcomas (STS) comprise a diverse group of mesenchymal malignancies that require multidisciplinary care. Although surgery remains the primary form of treatment for those with localized disease, radiation therapy (RT) is often incorporated either in the neo-or adjuvant setting. Given the development of modern RT techniques and alternative dosing schedules, stereotactic ablative radiotherapy (SABR) has emerged as a promising technique. However, the current role of SABR in the treatment of STS of the extremities remains uncertain. Methods and Materials: This was a single-center, prospective, single-arm phase II trial. Patients with localized STS who were candidates for limb-preservation surgery were included. Experimental treatment consisted of SABR with 40 Gy in 5 fractions, administered on alternate days, followed by surgery after a minimum interval of 4 weeks. The primary outcome was the rate of wound complication. Secondary outcomes included 2-year local control (LC), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) rates (and other toxicities). Results: Twenty-five patients were enrolled between October 2015 and November 2019 and completed the treatment protocol. The median rate of histopathologic regression was 65% (range 0-100) and 20.8% of tumors presented pathologic complete response (pCR). Wound complications were observed in 7/25 patients (28%). Three patients underwent disarticulation by vascular occlusion after plastic reconstruction and one patient was amputated by grade 3 limb dysfunction. After a median follow up of 20.7 months, the 2-year estimated risk of local recurrence, distant metastasis and cause-specific death were 0%, 44.7% and 10.6% respectively. Conclusions: Neoadjuvant SABR appears to improve the pCR for patients with eSTS, with acceptable rate of wound complications. Nevertheless, this benefit should be weighed against the risk of late of vascular toxicity with SABR regimen since, even in a short median follow-up, a higher rate of amputation than expected was observed. A larger sample size with longer follow-up is necessary to conclude the overall safety of this strategy.
conferenceObject Impact of histopathological revision and molecular pathology in the diagnosis of sarcomas in a reference center in Brazil.(2022) LOPES, Carlos Diego Holanda; QUEIROZ, Marcello Moro; SAMPAIO, Luana Alencar Fernandes; PERINA, Andre; AKAISHI, Eduardo Hiroshi; TEIXEIRA, Frederico Ribeiro; FERREIRA, Fabio Oliveira; HANNA, Samir Abdallah; SILVA, Joao Luis da; LIMA, Luiz Guilherme C. A. De; OLIVEIRA, Claudia Regina G. C. M. De; MUNHOZ, Rodrigo Ramella