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1.
Breast ; 41: 51-56, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30007268

RESUMO

BACKGROUND: Despite the availability of different strategies for ovarian function and/or fertility preservation in young breast cancer patients candidates for chemotherapy, limited data are available on patients' actual need of these options. PATIENTS AND METHODS: The PREFER study is a prospective cohort study including premenopausal women with newly diagnosed early stage breast cancer between the age of 18 and 45 years and candidates for chemotherapy. The study aimed to investigate patients' preferences and their choices of the different available strategies for ovarian function and/or fertility preservation (i.e. acceptance rate) and reasons for refusal. RESULTS: A total of 131 consecutive patients referred from a single breast unit were included. Median age was 38.9 years with 92 patients (70.3%) diagnosed at ≤ 40 years. The majority of patients (122, 93.1%) were concerned about the risk of treatment-induced premature ovarian insufficiency (POI) and/or infertility. A total of 120 (91.6%) patients underwent temporary ovarian suppression with gonadotropin-releasing hormone agonists during chemotherapy for ovarian function preservation. Among patients with ≤40 years, only 11 (12.0%) decided to access cryopreservation strategies for fertility preservation. The main reason for not accessing the fertility unit was completion of family planning before breast cancer diagnosis; for patients who accessed the fertility unit, fear of the procedure was the main reason to refuse the proposed cryopreservation strategies. CONCLUSION: Despite the majority of young breast cancer patients are concerned about the risk of treatment-induced POI and/or infertility, only a limited number of them required to access the fertility unit to undergo cryopreservation strategies.


Assuntos
Antineoplásicos/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Preservação da Fertilidade/estatística & dados numéricos , Preferência do Paciente/estatística & dados numéricos , Insuficiência Ovariana Primária/induzido quimicamente , Adulto , Estudos de Coortes , Feminino , Preservação da Fertilidade/métodos , Humanos , Pessoa de Meia-Idade , Ovário/fisiopatologia , Projetos Piloto , Gravidez , Estudos Prospectivos , Adulto Jovem
2.
Carbohydr Polym ; 196: 348-358, 2018 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-29891306

RESUMO

In this paper, a carboxyl-functionalized organophosphorus oligomer was immobilized onto cotton fabrics using 1,2,3,4-butanetetracarboxylic acid as an environmentally-friendly binder, in the presence of sodium hypophosphite, used as a catalyst, and triethanolamine, which contributes to phosphorous-nitrogen synergism. Moreover, with the aim of reducing the formation of insoluble calcium salt during home laundering, due to the free carboxylic acid groups bound to the cotton fabric, the treated samples were recoated employing three sol-gel precursors, namely 3-aminopropyltriethoxysilane, tetraethoxysilane and 3-glycidyloxypropyltriethoxysilane. Samples were thoroughly characterized to understand the bonding between coatings and substrate, as well as the related surface morphology. The thermal behaviour was investigated by thermogravimetric analysis, flame and combustion tests. The results revealed that the treated fabrics were able to achieve self-extinction. Comparing to the untreated sample, tearing strength of PMIDA/BTCA/SHP fabric was reduced in both warp and weft directions, while fabrics coated with an additional sol-gel layer were affected more significantly.

3.
BMC Cancer ; 17(1): 346, 2017 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-28526012

RESUMO

BACKGROUND: Fertility and pregnancy issues are of key importance for young breast cancer patients. Despite several advances in the field, there are still multiple unmet needs and barriers in discussing and dealing with these concerns. To address the significant challenges related to fertility and pregnancy issues, the PREgnancy and FERtility (PREFER) study was developed as a national comprehensive program aiming to optimize care and improve knowledge around these topics. METHODS: The PREFER study is a prospective cohort study conducted across several Italian institution affiliated with the Gruppo Italiano Mammella (GIM) group evaluating patterns of care and clinical outcomes of young breast cancer patients dealing with fertility and pregnancy issues. It is composed of two distinctive studies: PREFER-FERTILITY and PREFER-PREGNANCY. The PREFER-FERTILITY study is enrolling premenopausal patients aged 18-45 years, diagnosed with non-metastatic breast cancer, who are candidates to (neo)adjuvant chemotherapy and not previously exposed to anticancer therapies. The primary objective is to obtain and centralize data about patients' preferences and choices towards the available fertility preserving procedures. The success and safety of these strategies and the hormonal changes during chemotherapy and study follow-up are secondary objectives. The PREFER-PREGNANCY study is enrolling survivors achieving a pregnancy after prior history of breast cancer and patients diagnosed with pregnancy-associated breast cancer (PABC). The primary objectives are to obtain and centralize data about the management and clinical outcomes of these women. Patients' survival outcomes, and the fetal, obstetrical and paediatric care of their children are secondary objectives. For both studies, the initial planned recruitment period is 5 years and patients will remain in active follow-up for up to 15 years. The PREFER-FERTILITY study was first activated in November 2012, and the PREFER-PREGNANCY study in May 2013. DISCUSSION: The PREFER study is expected to support and improve oncofertility counseling in Italy, to explore the real need of fertility preserving procedures, and to acquire prospectively more robust data on the efficacy and safety of the available strategies for fertility preservation, on the management of breast cancer survivors achieving a pregnancy and of women with PABC (including the possible short- and long-term complications in their children). TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02895165 (Retrospectively registered in August 2016).


Assuntos
Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/fisiopatologia , Preservação da Fertilidade , Fertilidade/efeitos dos fármacos , Adolescente , Adulto , Neoplasias da Mama/complicações , Quimioterapia Adjuvante/efeitos adversos , Feminino , Humanos , Itália , Pessoa de Meia-Idade , Gravidez , Sobreviventes
4.
Oncotarget ; 8(27): 44800-44810, 2017 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-28108743

RESUMO

Introduction Although hormonal-therapy is the preferred first-line treatment for hormone-responsive, HER2 negative metastatic breast cancer, no data from clinical trials support the choice between hormonal-therapy and chemotherapy.Methods Patients were divided into two groups according to the treatment: chemotherapy or hormonal-therapy. Outcomes in terms of clinical benefit and median overall survival (OS) were retrospectively evaluated in the two groups. To calculate the time spent in chemotherapy with respect to OS in the two groups, the proportion of patients in chemotherapy relative to those present in either group was computed at every day from the start of therapy.Results From 1999 to 2013, 119 patients received first-line hormonal-therapy (HT-first group) and 100 first-line chemotherapy (CT-first group). Patients in the CT-first group were younger and with poorer prognostic factors as compared to those in HT-first group. Clinical benefit (77 vs 81%) and median OS (50.7 vs 51.1 months) were similar in the two groups. Time spent in chemotherapy was significantly longer during the first 3 years in CT-first group (54-34%) as compared to the HT-first group (11-18%). This difference decreased after the third year and overall was 28% in the CT-first group and 18% in the HT-first group.Conclusions The sequence first-line chemotherapy followed by hormonal-therapy, as compared with the opposite sequence, is associated with a longer time of OS spent in chemotherapy. However, despite the poorer prognostic factors, patients in the CT-first group had a superimposable OS than those in the HT-first group.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/administração & dosagem , Biomarcadores Tumorais , Neoplasias da Mama/metabolismo , Neoplasias da Mama/mortalidade , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Estudos Observacionais como Assunto , Razão de Chances , Receptor ErbB-2/metabolismo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Anticancer Res ; 34(7): 3715-20, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24982392

RESUMO

AIM/BACKGROUND: Few data are available about the prevalence of hepatitis B and C infections in early breast cancer patients and its impact on systemic treatments. The objectives of this study were to determine the incidence of positive serology for hepatitis B and C in women with early breast cancer and to assess the clinical course and its impact on liver function during adjuvant treatments. PATIENTS AND METHODS: we retrospectively reviewed hepatitis B and C serology [HBs antigen (HBsAg), HBc antibodies (HBcAb), HBs antibodies (HBsAb) and HC (HCV) antibodies] in 746 consecutive patients with early breast cancer treated at our Institution between 2009 and 2011. RESULTS: Among 375 evaluable patients, we identified 312 controls (83.2%) and 63 patients (16.8%) with positive serology (cases): 15 patients (4%) with HCV, 8 (2.1%) with resolved HBV without anti-HBs (HBsAg-negative, HBsAgAb-negative, HBcAgAb-positive), 36 (9.6%) with resolved HBV with anti-HBs (HBsAg-negative, HBsAgAb-positive, HBcAgAb-positive) and 4 (1%) with chronic HBV (HBsAg-positive, HBsAgAb-negative, HBcAgAb-positive). During systemic treatments, hepatitis (defined as at least a three-fold increase in serum alanine aminotransferase level) occurred in nine (20.4%) out of 44 evaluable cases and in 14 (5.9%) out of 234 evaluable controls. CONCLUSION: Approximately 20% of patients with early breast cancer with positive serology for viral hepatitis may develop hepatitis during systemic treatment. Pre-treatment serum detection of viral hepatitis B and C antigens and antibodies may be useful in the adjuvant therapy decision-making process and for adequate monitoring of liver function during antineoplastic therapy.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/virologia , Hepatite B/fisiopatologia , Hepatite C Crônica/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/epidemiologia , Estudos de Casos e Controles , Feminino , Hepatite B/sangue , Hepatite B/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Hepatite C Crônica/sangue , Hepatite C Crônica/imunologia , Humanos , Incidência , Itália/epidemiologia , Fígado/fisiopatologia , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
Anal Bioanal Chem ; 406(18): 4557-61, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24828979

RESUMO

Trastuzumab, a humanized monoclonal antibody directed against the epidermal growth factor receptor 2 (HER2), is a milestone in the treatment of HER2-overexpressing breast cancer patients. An enzyme-linked immunosorbent assay (ELISA) for trastuzumab has been developed for routine use in the laboratory to support clinical and pharmacokinetic studies to optimize therapy. The method relies on an antigen peptide linked to a 96-well plate via the streptavidin/biotin system. The peptide sequence mimics the extracellular portion of the HER2 receptor that is recognized by trastuzumab. The calibration range of the assay is 10 to 360 ng/mL per well, corresponding to a trastuzumab serum concentration from 5 to 180 µg/mL with a lower limit of quantification of 10 µg/mL. Validation results demonstrate that trastuzumab can be accurately and precisely quantified in human serum using this assay. The procedure was also tested in sera obtained from breast cancer patients to evaluate trastuzumab serum levels, confirming the applicability of method that could be a valid assay to use in daily laboratory practice.


Assuntos
Anticorpos Monoclonais Humanizados/sangue , Anticorpos Monoclonais Humanizados/uso terapêutico , Neoplasias da Mama/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Peptídeos/imunologia , Anticorpos Monoclonais Humanizados/imunologia , Antígenos/química , Antígenos/imunologia , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Calibragem , Feminino , Humanos , Limite de Detecção , Mimetismo Molecular , Peptídeos/metabolismo , Controle de Qualidade , Receptor ErbB-2/imunologia , Receptor ErbB-2/metabolismo , Reprodutibilidade dos Testes , Trastuzumab
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