Gabriel Prolla

Centro de Pesquisas Oncológicas

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Renata D’Alpino Peixoto

BC Cancer Agency

Rui Weschenfelder

Hospital Moinhos de Vento

Anelisa K. Coutinho

Hospital Ana Nery

Rachel P. Riechelmann

AC Camargo Hospital

Gustavo dos Santos Fernandes

Expro (United Kingdom)

Alexandre A. Jácome

Centro de Pesquisas Oncológicas

Paulo M. Hoff

Instituto do Câncer do Estado de São Paulo

Eduardo Dias de Moraes

Fleury S.A. (Brazil)

Bernardo Garicochea

Centro de Pesquisas Oncológicas

Aline Chaves Andrade

Expro (United Kingdom)

Cooperative Institutions

Universidade de São Paulo

Sociedade Brasileira de Oncologia Clínica

AC Camargo Hospital

Instituto do Câncer do Estado de São Paulo

Fleury S.A. (Brazil)

Hospital Sírio-Libanês

Society of Surgical Oncology

Universidade Federal do Rio Grande do Sul

Centro de Pesquisas Oncológicas

Hospital São Paulo

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Reversal by Interleukin-2 of Alopecia Universalis, Mucocutaneous Candidiasis, and Sexual Impotence in a Patient With Malignant Thymoma

JNCI Journal of the National Cancer Institute (1993)

E Sander Gabriel Prolla Adriana Marques T. ZELMANOWITZ Marcia Salete Zampese

Mucocutaneous zone

Chronic mucocutaneous candidiasis

10.1093/jnci/85.8.673

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Citations (11)

Capítulo 9 - Câncer de cólon localizado

Mariana Vargas Gil Roberto Gil Gabriel Prolla

Uma pequena parcela dos pacientes com câncer colorretal (CCR) metastático pode ser curada com ressecção da doença metastática, especialmente pacientes com doença de pouco volume hepático e/ou pulmonar.

10.56271/978-85-8400-180-4-cap9

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Current clinical practice in the management of Brazilian patients with potentially resectable pancreatic ductal adenocarcinoma (PDAC)

Journal of Surgical Oncology (2023)

Victor Hugo Fonseca de Jesus Renata D’Alpino Peixoto Héber Salvador de Castro Ribeiro Rodrigo Nascimento Pinheiro Alexandre Ferreira Oliveira

Abstract Background and Objectives We aimed to describe the routine clinical practice of physicians involved in the treatment of patients with localized pancreatic ductal adenocarcinoma (PDAC) in Brazil. Methods Physicians were invited through email and text messages to participate in an electronic survey sponsored by the Brazilian Gastrointestinal Tumor Group (GTG) and the Brazilian Society of Surgical Oncology (SBCO). We evaluated the relationship between variable categories numerically with false discovery rate‐adjusted Fisher's exact test p values and graphically with Multiple Correspondence Analysis. Results Overall, 255 physicians answered the survey. Most (52.5%) were medical oncologists, treated patients predominantly in the private setting (71.0%), and had access to multidisciplinary tumor boards (MTDTB; 76.1%). Medical oncologists were more likely to describe neoadjuvant therapy as beneficial in the resectable setting and surgeons in the borderline resectable setting. Most physicians would use information on risk factors for early recurrence, frailty, and type of surgery to decide treatment strategy. Doctors working predominantly in public institutions were less likely to have access to MTDTB and to consider FOLFIRINOX the most adequate regimen in the neoadjuvant setting. Conclusions Considerable differences exist in the management of localized PDAC, some of them possibly explained by the medical specialty, but also by the funding source of health care.

Specialty

Regimen

FOLFIRINOX

10.1002/jso.27453

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Relato de caso de pansinusite por Aspergilus flavus em paciente com leucemia aguda bifenotípica

Roger Heisler Melissa Orzechowski Xavier Flávio de Mattos Oliveira Valdir de Almeida Gabriel Prolla

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SURVEY NEN INQUÉRITO NEN

Brazilian Journals Editora eBooks (2023)

Carla Andressa Rodrigues Dias Fleury de Lima Renata D’Alpino Peixoto Rui Weschenfelder Gabriel Prolla Juliana F Rego

pela Brazilian Journals Publicações de Periódicos e Editora, apresenta um conjunto de dezoito capítulos que reúnem diversas temáticas da área da saúde como um todo.Como um estudo com objetivo de analisar a produção científica sobre a violência obstétrica em mulheres negras, visando avaliar a influência atribuída ao viés racial na determinação da violência obstétrica dentro do contexto do período gravídico-puerperal.Também, um trabalho sobre um relato de perda auditiva irreversível, associada ao uso de paclitaxel, adriamicina e ciclofosfamida, utilizando a revisão de literatura e bases de dados, como: Scielo, Pubmed e Lilacs, e prontuário.Juntamente, uma pesquisa que aborda a percepção da população sobre a relação existente entre o uso de Cannabis sativa, a maconha, e a sua interferência no desenvolvimento de doenças que acometem a saúde mental, utilizando um formulário online, divulgado em território nacional, por meio da ferramenta do Google Forms, para a população adulta, utilizando redes sociais digitais.Também, uma pesquisa que tem como finalidade relatar a experiência de um atendimento clínico em diabetes efetivado por acadêmicos de medicina e docente médica da atenção primária à saúde em uma Unidade Básica de Saúde do município de Marabá/PA.Uma ação de intervenção em saúde foi realizada e, a partir disto, uma análise descritiva do ocorrido foi levantada pelos acadêmicos.Além do mais, um trabalho sobre a influência da perfusão sanguínea e do volume de oxigênio nos índices de agravo em pacientes acometidos pelo vírus da covid-19.Agradecemos os autores que com empenho e dedicação colaboraram para a construção dessa obra.Ansiamos que a mesma contribua de forma significativa no conhecimento das temáticas aqui abordadas.

10.35587/brj.ed.0002047

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Literature Review and Practical Aspects on the Management of Oxaliplatin-Associated Toxicity

Clinical Colorectal Cancer (2011)

Paulo M. Hoff Everardo D. Saad Frederico Costa Anelisa K. Coutinho Ricardo Caponero

Neurotoxicity

FOLFOX

10.1016/j.clcc.2011.10.004

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Citations (78)

BRCA1 germline mutation presenting as an adenocarcinoma of unknown primary.

PubMed (2000)

Pamela Klein Gabriel Prolla Robert C. Wallach Jonathan Melamed Franco M. Muggia

The work-up of adenocarcinoma of unknown primary usually includes history, physical examination, radiographic imaging, tumor markers, and more recently molecular and genetic information. We report here on how the suggestion by family history of a BRCA1 mutation guided the diagnostic and therapeutic approach in a patient with metastatic carcinoma of unknown primary.BRCA1 mutation was screened for by polymerase chain reaction (PCR) and single-strand conformational polymorphism analysis. Primers for PCR amplification included selected BRCA1 exons 2, 110, 11L, 13, and 20. The PCR product was cloned into a PCRII vector and sequenced with a Sequenase Version 2.0 Sequencing Kit.Single-strand conformational polymorphism analysis suggested a mutation in the region of exon 20 and sequencing confirmed the presence of a germline mutation 5382insC.This case illustrates an unusual presentation of adenocarcinoma of unknown primary in a patient with a germline BRCA1 mutation, the use of a suspected germline mutation to guide the work-up and treatment, and finally the value of positron emission tomography scanning in the work-up of an unknown primary.

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Tuberous Sclerosis Complex with rare associated findings in the gastrointestinal system: a case report and review of the literature

BMC Gastroenterology (2020)

Larissa Brussa Reis Daniele Konzen Cristina Brinckmann Oliveira Netto Pedro Moacir Braghirolli Braghini Gabriel Prolla

Abstract Background Tuberous Sclerosis Complex (TSC) is a complex and heterogeneous genetic disease that has well-established clinical diagnostic criteria. These criteria do not include gastrointestinal tumors. Case presentation We report a 45-year-old patient with a clinical and molecular diagnosis of TSC and a family history of cancer, presenting two rare associated findings: gastrointestinal polyposis and pancreatic neuroendocrine tumor. This patient was subjected to a genetic test with 80 cancer predisposing genes. The genetic panel revealed the presence of a large pathogenic deletion in the TSC2 gene, covering exons 2 to 16 and including the initiation codon. No changes were identified in the colorectal cancer and colorectal polyposis genes. Discussion and conclusions We describe a case of TSC that presented tumors of the gastro intestinal tract that are commonly unrelated to the disease. The patient described here emphasizes the importance of considering polyposis of the gastrointestinal tract and low grade neuroendocrine tumor as part of the TSC syndromic phenotype.

Gastrointestinal cancer

TSC2

Rare disease

Gastrointestinal disease

10.1186/s12876-020-01481-y

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Citations (3)

Efficacy and Safety Associated With Immune Checkpoint Inhibitors in Unresectable Hepatocellular Carcinoma

JAMA Network Open (2021)

Alexandre A. Jácome Ana Carolina G. Castro João Paulo Solar Vasconcelos Maria Helena C. R. Silva Marco Antônio Oliveira Lessa

Importance

Immune checkpoint inhibitors (ICIs) have yielded conflicting results in hepatocellular carcinoma (HCC). The overall effect of ICIs compared with standard therapies in unresectable HCC requires more research.

Objective

To estimate the efficacy and safety associated with ICIs compared with standard therapies in patients with unresectable HCC.

Data Sources

PubMed, Cochrane Library, Web of Science, Latin American and Caribbean Health Sciences Literature, and American Society of Clinical Oncology and European Society of Medical Oncology meeting proceedings were systematically searched. Reference lists from studies selected by electronic searching were manually searched to identify additional relevant studies. The search included literature published or presented from February 2010 to February 2020.

Study Selection

From December 2019 to February 2020, independent reviewers evaluated each database, scanning the title, abstract, and keywords of every record retrieved. Full articles were further assessed if the information given suggested that the study was a randomized clinical trial (RCT) comparing ICIs vs standard therapies in the treatment of unresectable HCC.

Data Extraction and Synthesis

The full text of the resulting studies and extracted data were reviewed independently according to PRISMA guidelines. Summary hazard ratios (HRs) of overall survival (OS) and progression-free survival (PFS) were calculated by a random-effects model. The likelihood of ICIs being associated with overall response rate (ORR) and treatment-related adverse events (TRAEs) was expressed by odds ratios (ORs) using a random-effects model.

Main Outcomes and Measures

The main outcomes were OS, PFS, ORR, and TRAEs.

Results

Of 1836 studies yielded by the search, 3 were retained, totaling 1657 patients (985 treated with ICIs vs 672 receiving standard treatment). Two studies evaluated ICIs as monotherapy, and 1 study investigated the combination of ICIs with bevacizumab. Compared with standard therapies (sorafenib in first-line therapy or placebo in second-line therapy), ICIs were associated with significantly improved OS (HR, 0.75; 95% CI, 0.62-0.92;P = .006), PFS (HR, 0.74; 95% CI, 0.56-0.97;P = .03), and ORR (OR, 2.82; 95% CI 2.02-3.93;P < .001). The probability of grade 3 or 4 TRAEs was lower with ICIs than with sorafenib (OR, 0.44; 95% CI, 0.20-0.96;P = .04).

Conclusions and Relevance

This meta-analysis found superior efficacy and safety associated with ICIs compared with standard therapies and highlights the survival benefit associated with the combination of antiangiogenic therapy with ICIs in first-line systemic therapy of unresectable HCC.

10.1001/jamanetworkopen.2021.36128

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Citations (41)

Triplets versus doublets in the treatment of right-sided metastatic colorectal cancer in real-world setting: A propensity-score weighting analysis.

Journal of Clinical Oncology (2023)

Mariana Gil Renata D’Alpino Peixoto Thais Passarini Maria Cecilia Mathias Eduardo Dias de Moraes

55 Background: Right-sided metastatic colorectal cancer (mCRC) has a worse prognosis and the best first-line treatment is still uncertain. The aim of this study was to analyze progression-free survival (PFS) and overall survival (OS) comparing triplet versus doublet backbone chemotherapy in first-line setting for right-sided mCRC. Methods: Retrospective study evaluating 510 patients with mCRC who were treated in a private institution in Brazil from January 2011 to December 2019. Information of 118 patients with right-sided primary tumor was analyzed in this study. Demographic and clinical data were retrieved from electronic medical records. PFS and OS were calculated in months (m) using propensity-score weighting analysis (PSWA) due to expected disparity between the number of patients treated with triplet and doublet regimens. Variables used to balance patient groups were age; metastasectomy; primary tumor resection; bevacizumab use; BRAF and RAS mutation status. Results: The median follow-up was 31 months. Our population was mostly composed of elderly (64%) and female (52%) patients. First-line treatment with triplet backbone chemotherapy was done in 16 patients (14%). Primary tumor resection was done in 14% of the cases, 55% underwent metastasectomy, and 57% received anti-VEGF treatment. BRAF mutation was found in 9% of the patients and RAS mutation in 46%. After PSWA we found a significant better median PFS among patients treated with triplet regimen: 12.7m versus 8.9m compared to those receiving doublet backbone chemotherapy, with a hazard ratio of 0.64 (CI 95%: 0.42 – 0.97); p-value: 0.037. No significant difference was found in OS (29.8m versus 45.5m) between triplet and doublet therapy groups, respectively. Conclusions: In our study we found a significantly better PFS with triplet backbone chemotherapy in first-line setting for right-sided mCRC, encouraging the use of this regimen in treatment-naive selected patients. However, no difference in OS was found, probably due to subsequent treatments. PSWA is an acceptable and needed tool to enable retrospective real world studies involving treatments with expected uneven distribution. More studies are needed to answer the best strategy to target right-sided mCRC, which remains a challenge for oncologists, with unmet needs.

Metastasectomy

Regimen

Chemotherapy regimen

Primary tumor

10.1200/jco.2023.41.4_suppl.55

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