LEONARDO GOMES DA FONSECA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
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- Outcome of liver cancer patients with SARS-CoV-2 infection: An International, Multicentre, Cohort Study(2022) MUNOZ-MARTINEZ, Sergio; SAPENA, Victor; FORNER, Alejandro; BRUIX, Jordi; SANDUZZI-ZAMPARELLI, Marco; RIOS, Jose; BOUATTOUR, Mohamed; EL-KASSAS, Mohamed; LEAL, Cassia R. G.; MOCAN, Tudor; NAULT, Jean-Charles; ALVES, Rogerio C. P.; REEVES, Helen L.; FONSECA, Leonardo da; GARCIA-JUAREZ, Ignacio; PINATO, David J.; VARELA, Maria; ALQAHTANI, Saleh A.; ALVARES-DA-SILVA, Mario R.; BANDI, Juan C.; RIMASSA, Lorenza; LOZANO, Mar; SANTIAGO, Jesus M. Gonzalez; TACKE, Frank; SALA, Margarita; ANDERS, Maria; LACHENMAYER, Anja; PINERO, Federico; FRANCA, Alex; GUARINO, Maria; ELVEVI, Alessandra; CABIBBO, Giuseppe; PECK-RADOSAVLJEVIC, Markus; ROJAS, Angela; VERGARA, Mercedes; BRACONI, Chiara; PASCUAL, Sonia; PERELLO, Christie; MELLO, Vivianne; RODRIGUEZ-LOPE, Carlos; ACEVEDO, Juan; VILLANI, Rosanna; HOLLANDE, Clemence; VILGRAIN, Valerie; TAWHEED, Ahmed; THEODORO, Carmem Ferguson; SPARCHEZ, Zeno; BLAISE, Lorraine; VIERA-ALVES, Daniele E.; WATSON, Robyn; CARRILHO, Flair J.; MOCTEZUMA-VELAZQUEZ, Carlos; D'ALESSIO, Antonio; IAVARONE, Massimo; REIG, MariaBackground & Aims Information about the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with liver cancer is lacking. This study characterizes the outcomes and mortality risk in this population. Methods Multicentre retrospective, cross-sectional, international study of liver cancer patients with SARS-CoV-2 infection registered between February and December 2020. Clinical data at SARS-CoV-2 diagnosis and outcomes were registered. Results Two hundred fifty patients from 38 centres were included, 218 with hepatocellular carcinoma (HCC) and 32 with intrahepatic cholangiocarcinoma (iCCA). The median age was 66.5 and 64.5 years, and 84.9% and 21.9% had cirrhosis in the HCC and iCCA cohorts respectively. Patients had advanced cancer stage at SARS-CoV-2 diagnosis in 39.0% of the HCC and 71.9% of the iCCA patients. After a median follow-up of 7.20 (IQR: 1.84-11.24) months, 100 (40%) patients have died, 48% of the deaths were SARS-CoV-2-related. Forty (18.4%) HCC patients died within 30-days. The death rate increase was significantly different according to the BCLC stage (6.10% [95% CI 2.24-12.74], 11.76% [95% CI 4.73-22.30], 20.69% [95% CI 11.35-31.96] and 34.52% [95% CI 17.03-52.78] for BCLC 0/A, B, C and D, respectively; p = .0017). The hazard ratio was 1.45 (95% CI 0.49-4.31; p = .5032) in BCLC-B versus 0/A, and 3.13 (95% CI 1.29-7.62; p = .0118) in BCLC-C versus 0/A in the competing risk Cox regression model. Nineteen out of 32 iCCA (59.4%) died, and 12 deaths were related to SARS-CoV-2 infection. Conclusions This is the largest cohort of liver cancer patients infected with SARS-CoV-2. It characterizes the 30-day mortality risk of SARS-CoV-2 infected patients with HCC during this period.
conferenceObject A multicenter international study of sorafenib treatment in patients with hepatocellular carcinoma and chronic kidney disease undergoing hemodialysis(2019) DIAZ-GONZALEZ, Alvaro; SANDUZZI-ZAMPARELLI, Marco; FONSECA, Leonardo Gomes da; COSTANZO, Giovan Giuseppe Di; ALVES, Rogerio; IAVARONE, Massimo; LEAL, Cassia Regina G.; SACCO, Rodolfo; MATILLA, Ana M.; GUERRA, Manuel Hernandez; SOTERAS, Gabriel Alejandro Aballay; MARCUS, Worns; PINTER, Matthias; VARELA, Maria; LADEKARL, Morten; CHAGAS, Aline Lopes; MINGUEZ, Beatriz; RUIZ-TAPIADOR, Juan Ignacio Arenas; GRANITO, Alessandro; SANCHEZ, Yolanda; ROJAS, Angela; LOPE, Carlos Rodriguez De; ALVARES-DA-SILVA, Mario Reis; PASCUAL, Sonia; RIMASSA, Lorenza; LLEDO, Jose Luis; HUERTAS, Carlos; SANGRO, Bruno; GIANNINI, Edoardo Giovanni; DELGADO, Manuel; GOMEZ, Mercedes Vergara; PERELLO, Christie; LUE, Alberto; SALA, Margarita; MOYA, Adolfo Gallego; COLL, Susana; ALSINA, Tania Hernaez; PINERO, Federico; PEREIRA, Gustavo; FRANCA, Alex Vianey Callado; MARIN, Juan; ANDERS, Maria Margarita; MELLO, Vivianne; LOZANO, Maria Del Mar; NAULT, Jean Charles; MENENDEZ, Jose Maria; JUAREZ, Ignacio Garcia; BRUIX, Jordi; REIG, Maria- Immunotherapy-Based Treatments of Hepatocellular Carcinoma: AJR Expert Panel Narrative Review(2022) CANNELLA, Roberto; LEWIS, Sara; FONSECA, Leonardo da; RONOT, Maxime; RIMOLA, JordiThe advent of immunotherapy for patients with hepatocellular carcinoma (HCC) has changed the treatment landscape and conferred a survival benefit on patients with advanced HCC, who typically have a very poor prognosis. The most pronounced improvements in response, as documented by standardized response criteria based on CT or MRI, have been achieved when immunotherapy is combined with other systemic or locoregional therapies. Immune checkpoint inhibitor treatments result in unique patterns on CT and MRI that challenge the application of conventional response criteria such as RECIST, modified RECIST, and European Association for the Study of the Liver criteria. Thus, newer criteria have been developed to gauge therapy response or disease progression for patients receiving immunotherapy, including immune-related RECIST (iRECIST) and immune-modified RECIST (imRECIST), though these remain unvalidated. In this review, we describe the current landscape of immunotherapeutic agents used for HCC, summarize the results of published studies, review the pathobiologic mechanisms that provide a rationale for the use of these agents, and report on the status of response assessment for immunotherapy either alone or in combination with other treatment options. Finally, consensus statements are provided to inform radiologists about essential considerations in the era of a rapidly changing treatment paradigm for patients with HCC.
conferenceObject Early SARS-CoV-2-related mortality of liver cancer patients: Cancer stage matters(2021) MUNOZ-MARTINEZ, Sergio; SAPENA, Victor; FORNER, Alejandro; BRUIX, Jordi; ZAMPARELLI, Marco Sanduzzi; BOUATTOUR, Mohamed; LEAL, Cassia Regina Guedes; THEODORO, Carmem Ferguson; EL-KASSAS, Mohammed; NAULT, Jean Charles; BLAISE, Lorraine; MOCAN, Tudor; FONSECA, Leonardo Gomes da; REEVES, Helen L.; ALVES, Rogerio; JUAREZ, Ignacio Garcia; VARELA, Maria; PINATO, David J.; GARDINI, Andrea Casadei; ALVARES-DA-SILVA, Mario Reis; SANTIAGO, Jesus Gonzalez; LOZANO, Maria del Mar; BANDI, Juan Carlos; RIMASSA, Lorenza; SALA, Margarita; ALQAHTANI, Saleh; ANDERS, Maria Margarita; PINERO, Federico; LACHENMAYER, Anja; TACKE, Frank; RODERBURG, Christoph; GOMEZ, Manuel Romero; PECK-RADOSAVLJEVIC, Markus; CABIBBO, Giuseppe; ELVEVI, Alessandra; GUARINO, Maria; FRANCA, Alex Vianey Callado; VILLANI, Rosanna; GOMEZ, Mercedes Vergara; ACEVEDO, Juan; LOPE, Carlos Rodriguez de; MELLO, Vivianne; PERELLO, Christie; PASCUAL, Sonia; BRACONI, Chiara; IAVARONE, Massimo; REIG, Maria