RACHEL SIMOES PIMENTA RIECHELMANN
Projetos de Pesquisa
Unidades Organizacionais
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
14 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 14
bookPart Tumores neuroendócrinos do pâncreas(2013) HOFF, Ana Oliveira; RIECHELMANN, Rachel Simões Pimenta; PFIFFER, Tulio Eduardo FleschbookPart Etiologia do cancer(2013) MIRANDA, Vanessa da Costa; RIECHELMANN, Rachel- Conflicts of Interest in Editorials in High-Impact Journals Reply(2013) BARIANI, Giovanni M.; RIECHELMANN, Rachel P.
bookPart Tumores de cólon(2013) SARAGIOTTO, Daniel Fernandes; RIECHELMANN, Rachel; RIBEIRO JUNIOR, Ulysses; HOFF, Paulo Marcelo Gehm- Self-Reported Conflicts of Interest of Authors, Trial Sponsorship, and the Interpretation of Editorials and Related Phase III Trials in Oncology(2013) BARIANI, Giovanni M.; FERRARI, Anezka C. R. de Celis; HOFF, Paulo M.; KRZYZANOWSKA, Monika K.; RIECHELMANN, Rachel P.Purpose Growing participation by industry in cancer research has resulted in increased reporting of conflicts of interest (COI). We aimed to test any association between authors' conclusions and self-reported COI or trial sponsorship in cancer studies. Methods Editorials and related phase III trials published in six clinical oncology journals in the last 3.5 years were analyzed independently by two investigators who classified study conclusions according to authors' endorsement of the experimental therapy. Logistic regression multivariable models were used to assess predictors of favorable conclusions of editorialists and of phase III authors. Results From January 2008 to October 2011, 1,485 articles were retrieved: 150 phase III trials and 150 editorials were eligible. Among the phase III trials, 82 (54.7%) had positive results, and 78 (52.0%) were entirely or partially funded by industry. Any COI were disclosed in 103 phase III trials (68.7%) and in 71 editorials (47.3%). Multivariable analysis showed that phase III trial results were the only significant predictor for a positive conclusion by trial authors (odds ratio [OR], 92.2; 95% CI, 19.7 to 431.6; P < .001). Sponsorship did not predict for positive conclusion by phase III authors (OR, 0.86; 95% CI, 0.3 to 2.5; P = .788). The only factor associated with positive conclusions by editorial authors was a positive conclusion by phase III trial authors (OR, 36.3; 95% CI, 6.8 to 194.2; P < .001). Conclusion The interpretation of recently published phase III cancer trials by their authors or by editorialists was not influenced by financial relationships or industry sponsorship. Increased awareness of COI policies may have led to more integrity in cancer research reporting. (C) 2013 by American Society of Clinical Oncology
conferenceObject Factors associated with mortality rates of patients with advanced cancer admitted to a specialized intensive care unit(2013) BARIANI, G. M.; CASTRIA, T. B.; ANDRADE, A. M.; FARIA, L. D.; SILVA, D. F.; BRAGHIROLI, M. I.; MIRANDA, V. C.; FEDE, A. B.; HAJJAR, L.; RIECHELMANN, R.bookPart Interações medicamentosas em oncologia(2013) RIECHELMANN, Rachel Simões Pimenta- Antitumor Effect of Everolimus in a Patient with Type 3 Gastric Neuroendocrine Tumor(2013) BARIANI, Giovanni M.; CARVALHEIRA, Jose B.; RIECHELMANN, Rachel P.Background: Gastric neuroendocrine tumors (NET) are rare and are classified into 3 types: type 1 and 2 (characterized by hypergastrinemia), and type 3 (characterized by normal gastrin). Surgery is the standard procedure, and systemic treatment is reserved for unresectable disease. Currently, targeted therapies are being evaluated in NET. The activity of everolimus, an mTOR inhibitor, has been shown in pancreatic NET but not reported in type 3 gastric carcinoid tumors. Case Report: Here we report a case of a patient who, after multiple lines of systemic therapy, had a prolonged disease control of nearly 1 year, significant clinical benefit, and minor tumor shrinkage with oral everolimus 10 mg continuously. Conclusion: There is no effective treatment for type 3 gastric carcinoid tumors. The frequency of mTOR expression in these tumors is not known, but the case reported here suggests that inhibition of this pathway may play an important role.
- Formal Statistical Testing and Inference in Randomized Phase II Trials in Medical Oncology(2013) SAAD, Everardo D.; SASSE, Emma C.; BORGHESI, Gustavo; MIRANDA, Vanessa C.; FEDE, Angelo B. S.; SAAD, Lucas S.; OLIVEIRA, Vinicius; BARROS, Eduardo A. C.; PASCOIN, Maira; GIGLIO, Auro del; RIECHELMANN, RachelObjectives: With the growing number of new anticancer therapies, randomized phase II trials have been used more often in oncology. Although the primary objective of such trials is not to formally compare results between arms, this practice seems frequent. We sought to quantify the frequency of use of formal statistical testing or inference through the use of P values and confidence intervals (CIs) in randomized phase II trials. Methods: We searched PubMed for randomized phase II trials assessing systemic cancer therapies published in the years 1995/1996 and 2005/2006. For each study, 2 reviewers independently abstracted data, including reporting of P values and CIs for the primary endpoint. Results: We retrieved 288 articles, 107 of which were eligible for analysis. The median number of patients per trial was 94, the primary endpoint was response rate in 71 (66.4%) cases, and a control arm was present in 55 (51.4%) trials. Either P values or CIs for the primary endpoint were reported in 85 (79.4%; 95% CI, 70.8%-86.1%) cases. Year of publication, source of funding, and use of a control group were not associated with this practice. Conclusions: Formal statistical comparisons between arms of randomized phase II trials are frequently undertaken in medical oncology. The extent to which such a practice abrogates phase III testing is unknown.
- Non-inferiority cancer clinical trials: scope and purposes underlying their design(2013) RIECHELMANN, R. P.; ALEX, A.; CRUZ, L.; BARIANI, G. M.; HOFF, P. M.Background: Non-inferiority clinical trials (NIFCTs) aim to demonstrate that the experimental therapy has advantages over the standard of care, with acceptable loss of efficacy. We evaluated the purposes underlying the selection of a non-inferiority design in oncology and the size of their non-inferiority margins (NIFm's). Patients and methods: All NIFCTs of cancer-directed therapies and supportive care agents published in a 10-year period were eligible. Two investigators extracted the data and independently classified the trials by their purpose to choose a non-inferiority design. Results: Seventy-five were included: 43% received funds from industry, overall survival was the most common primary end point and 73% reported positive results. The most frequent purposes underlying the selection of a non-inferiority design were to test more conveniently administered schedules and/or less toxic treatments. In 13 (17%) trials, a clear purpose was not identified. Among the trials that reported a pre-specified NIFm, the median value was 12.5% (range 4%-25%) for trials with binary primary end points and Hazard Ratio of 1.25 (range 1.10-1.50) for trials that used time-to-event primary outcomes. Conclusion: Cancer NIFCT harbor serious methodological and ethical issues. Many use large NIFm and nearly one-fifth did not state a clear purpose for selecting a non-inferiority design.