Biomedical subjects

E Cerri

Publications and source records attributed to E Cerri.

17 recordsLinked to original sources

PubMed2006

First-line 5-fluorouracil/folinic acid, oxaliplatin and irinotecan (FOLFOXIRI) does not impair the feasibility and the activity of second line treatments in metastatic colorectal cancer.

BACKGROUND: We conducted two phase II trials evaluating the combination of 5-fluorouracil/folinic acid, oxaliplatin and irinotecan (FOLFOXIRI) as first-line treatment in 74 metastatic colorectal cancer patients. Results were very promising with an overall response rate of 71% and 72%, a median PFS of 10.4 and 10.8 months and an overall survival of 26.5 and 28.4 months, respectively. A concern about the use of all three active agents up-front is the possibility that this might limit, after progression, disease control with second-line treatments. Therefore, we conducted the present analysis to evaluate the outcome of second-line treatments in these 74 patients. METHODS: Among the 71 patients so far progressed 54 (76%) received second line chemotherapy (23: FOLFIRI, 17: FOLFOXIRI, five: 5-FU protracted infusion, three: FOLFOX, three: 5-FU+MMC, two: CPT-11, one: CPT-11+LOHP, one: raltitrexed). Seventeen patients (24%) did not receive second line treatments: 10 because of deterioration of performance status (PS), four because of patient refusal and three because of death. Patients' characteristics at the time of second-line treatment were: M/F 36 of 18 patients, median age 64 yrs (range 44-75), ECOG PS>or=1 21 (39%) patients, multiple sites of disease 33 (61%) patients. RESULTS: A median of 4.1 months of second-line chemotherapy per patient were administered (range 1-8). Overall response rate (52 out of 54 evaluable patients) was 33% and stable disease were 19 (37%). Median duration of response was 8.1 months. At a median follow up of 15.1 months from the start of salvage chemotherapy median PFS and overall survival were respectively 6.7 and 15.2 months. CONCLUSIONS: First-line FOLFOXIRI does not impair the possibility to obtain objective responses and delay tumor progression with second line treatments containing the same agents used in first-line.

Adult↗

PubMed2004

First-line treatment of metastatic colorectal cancer with irinotecan, oxaliplatin and 5-fluorouracil/leucovorin (FOLFOXIRI): results of a phase II study with a simplified biweekly schedule.

BACKGROUND: In a previous phase I-II study we demonstrated that the FOLFOXIRI regimen [irinotecan 125-175 mg/m2 day 1, oxaliplatin 100 mg/m2 day 1, l-leucovorin (l-LV) 200 mg/m2 day 1, 5-fluorouracil (5-FU) 3800 mg/m2 as a 48-h chronomodulated continuous infusion starting on day 1, repeated every 2 weeks] has promising activity and efficacy in metastatic colorectal cancer. However, this regimen required a chronomodulated infusion of 5-FU, and because neutropenia occurred in 32% of cycles, granulocyte colony-stimulating factor (G-CSF) was used and the delivered dose intensity was only approximately 78% of planned. Therefore, we conducted the present phase II study in order to develop a simplified FOLFOXIRI regimen that could be more easily administered in clinical practice as well as in multicenter settings. PATIENTS AND METHODS: A total of 32 patients with unresectable metastatic colorectal cancer received irinotecan 165 mg/m2 day 1, oxaliplatin 85 mg/m2 day 1, l-LV 200 mg/m2 day 1 and 5-FU 3200 mg/m2 as a 48-h continuous (not chronomodulated) infusion starting on day 1, repeated every 2 weeks. RESULTS: All 32 patients were evaluated for safety and the incidence of grade 3-4 toxic effects, and the use of G-CSF seemed to be lower than with the previous FOLFOXIRI regimen: grade 4 neutropenia (34%), grade 3 diarrhea (16%), grade 3 stomatitis (6%) and grade 2-3 peripheral neurotoxicity (37%) were reported, and G-CSF was used in 23% of cycles. Delivered dose intensity was 88% of that planned, and no toxic deaths occurred. The intention-to-treat analysis for activity showed four complete responses, 19 partial responses, seven stable disease and two progressive disease, for an overall response rate of 72% (95% confidence interval 53% to 86%). Eight (25%) patients with residual liver or lung metastases were radically resected after chemotherapy. After a median follow-up of 18.1 months, the median progression-free survival is 10.8 months and median survival is 28.4 months. CONCLUSIONS: This simplified FOLFOXIRI combination can be delivered easily in outpatient settings, with manageable toxic effects, and has very promising antitumor activity. While the safety profile seems to be improved in comparison with our previous FOLFOXIRI regimen, antitumor activity and efficacy appear to be maintained.

Adult↗

PubMed1993

Rescue of a "hopeless" second premolar.

We present a case of a young male who was referred to our clinic because of a deep caries on the first lower left molar. The patient refused conservative treatment, and the caries progressed. After 2 years the first lower left molar had to be extracted. During standard x-ray procedures, a deeply impacted second lower left premolar was diagnosed. The boy was followed by our staff, and surgery was performed at proper time to enable eruption of the second lower left premolar. Orthodontic treatment allowed us to bring the element in a suitable position to place a provisional Maryland bridge. At a later stage the missing element (first lower left molar) will be replaced by an osteointegrated implant.

Bicuspid↗

PubMed1988

[Macrophage-lymphocyte alveolitis in pulmonary sarcoidosis. The role of T-lymphocytes and alveolar macrophages in the pathogenesis and monitoring of this disease].

Modern studies undertaken to aid the understanding of the pathogenesis of pulmonary sarcoidosis have shown that the initial lesions of this disease are characterised by an accumulation of T lymphocytes and of macrophages in the alveolar structure (the alveolitis). In patients with active disease these cells are seen to be not only increased but apparently "activated". In effect, in sarcoidosis the greater part of the T lymphocytes of the lung express surface markers associated with helper/inducer phenotype and they spontaneously secrete mediators which seem to play a central role in the formation of the typical lesions of this disease: a lymphocytic alveolitis, granulomas and interstitial fibrosis. As with the T lymphocytes, the alveolar macrophages of patients suffering from active sarcoidosis appear to be activated and are important in the initiation and maintenance of the inflammatory phenomena which lead to a modification of alveolar structures which are typical of this disease. However, although the immune and inflammatory cells situated in the lung modulate the lesions in the respiratory tree, it may be reasonable to propose the hypothesis that the evaluation of the clinical state of patients with sarcoidosis might take into account the degree of the alveolitis. The parameters of this alveolitis, which may help to establish the prognosis and need for therapy in pulmonary sarcoidosis, have not yet been discovered.

Humans↗

PubMed1988