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A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility

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Asian Journal of Andrology 2020年第4期22卷 360-367页

作者： Francesco Del Giudice Gian Maria Busetto Ettore De Berardinis isabella sperduti Matteo Ferro Martina Maggi Martin S Gross Alessandro Sciarra Michael L Eisenberg Department of Urology Sapienza Rome UniversityPoliclinico Umberto IRome 00161Italy Biostatistical Unit IRCCSRegina Elena National Cancer InstituteRome 00128Italy Division of Urology European Institute of OncologyMilan 20141Italy Section of Urology Dartmouth-Hitchcock Medical CenterLebanonNH 03766USA Department of Urology Stanford UniversitySchool of MedicineStanfordCA 94305USA

Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol *** this subset of patients,and particularly in those with hypogonadism,elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic–pituitary–testicular axis by suppressing follicle-stimulating hormone(FSH)and luteinizing hormone(LH)production and impaired *** manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for *** carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic ***,eight original articles were included and critically *** steroidal(Testolactone)or nonsteroidal(Anastrozole and Letrozole)aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability *** the evidence is promising,future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.

关键词： aromatase inhibitor hypogonadism male infertility meta-analysis systematic review

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First-line erlotinib and fixed dose-rate gemcitabine for advanced pancreatic cancer

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World Journal of Gastroenterology 2013年第28期19卷 4511-4519页

作者： Vanja Vaccaro Emilio Bria isabella sperduti Alain Gelibter Luca Moscetti Giovanni Mansueto Enzo Maria Ruggeri Teresa Gamucci Francesco Cognetti Michele Milella Department of Medical Oncology Regina Elena National Cancer Institute 00144 Rome Italy Medical Oncology Azienda Ospedaliera Universitaria Integrata 37134 Verona Italy Department of Biostatistics and Scientific Direction Regina Elena National Cancer Institute 00144 Rome Italy Medical Oncology Ospedale "Belcolle" 01100 Viterbo Italy S.S. Trinità Hospital Sora 03039 Frosinone Italy Department of Medical Oncology Regina Elena National Cancer Institute 00144 Rome Italy

AIM: To investigate activity, toxicity, and prognostic factors for survival of erlotinib and fixed dose-rate gemcitabine (FDR-Gem) in advanced pancreatic cancer.METHODS: We designed a single-arm prospective, multicentre, open-label phase II study to evaluate the combination of erlotinib (100 mg/d, orally) and weekly FDR-Gem (1000 mg/m2, infused at 10 mg/m2 per minute) in a population of previously untreated patients with locally advanced, inoperable, or metastatic pancreatic cancer. Primary endpoint was the rate of progression-free survival at 6 mo (PFS-6); secondary endpoints were overall response rate (ORR), response duration, tolerability, overall survival (OS), and clinical benefit. Treatment was not considered to be of further interest if the PFS-6 was 40% would be of considerable interest (p1 = 40%); with a 5% rejection error (α = 5%) and a power of 80%, 35 fully evaluable patients with metastatic disease were required to be enrolled in order to complete the study. Analysis of prognostic factors for survival was also carried out.RESULTS: From May 2007 to September 2009, 46 patients were enrolled (male/female: 25/21; median age: 64 years; median baseline carbohydrate antigen 19-9 (CA 19-9): 897 U/mL; locally advanced/metastatic disease: 5/41). PFS-6 and median PFS were 30.4% and 14 wk (95%CI: 10-19), respectively; 1-year and median OS were 20.2% and 26 wk (95%CI: 8-43). Five patients achieved an objective response (ORR: 10.9%, 95%CI: 1.9-19.9); disease control rate was 56.5% (95%CI: 42.2-70.8); clinical benefit rate was 43.5% (95%CI: 29.1-57.8). CA 19-9 serum levels were decreased by > 25% as compared to baseline in 14/23 evaluable patients (63.6%). Treatment was well-tolerated, with skin rash being the most powerful predictor of both longer PFS (P < 0.0001) and OS (P = 0.01) at multivariate analysis (median OS for patients with or without rash: 42 wk vs 15 wk, respectively, Log-rank P = 0.03). Additional predictors of bett

关键词： Pancreatic cancer Gemcitabine Fixed dose-rate Erlotinib Prognostic factors Cutaneous rash Phase II trial

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Metastatic pancreatic cancer: Is there a light at the end of the tunnel?

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World Journal of Gastroenterology 2015年第16期21卷 4788-4801页

作者： Vanja Vaccaro isabella sperduti Sabrina Vari Emilio Bria Davide Melisi Carlo Garufi Carmen Nuzzo Aldo Scarpa Giampaolo Tortora Francesco Cognetti Michele Reni Michele Milella Medical Oncology A Regina Elena National Cancer Institute Medical Oncology A and Biostatistics Regina Elena National Cancer Institute Medical Oncology University of VeronaAzienda Ospedaliera Universitaria Integrata ARC-Net Research Centre and Department of Pathology Diagnostics and SurgeryUniversity of Verona Medical Oncology Unit Department of OncologySan Raffaele Scientific Institute

Due to extremely poor prognosis,pancreatic cancer(PDAC)represents the fourth leading cause of cancerrelated death in Western *** more than a decade,gemcitabine(Gem)has been the mainstay of first-line PDAC *** efforts aimed at improving single-agent Gem efficacy by either combining it with a second cytotoxic/molecularly targeted agent or pharmacokinetic modulation provided disappointing ***,the field of systemic therapy of advanced PDAC is finally moving *** has shown promise over single-agent Gem:regimens like PEFG-PEXG-PDXG and GTX provide significant potential advantages in terms of survival and/or disease control,although sometimes at the cost of poor *** PRODIGE 4/ACCORD 11 was the first phaseⅢtrial to provide unequivocal benefit using the polychemotherapy regimen FOLFIRINOX;however the less favorable safety profile and the characteristics of the enrolled population,restrict the use of FOLFIRINOX to young and fit PDAC *** nanoparticle albumin-bound paclitaxel(nab-Paclitaxel)formulation was developed to overcome resistance due to the desmoplastic stroma surrounding pancreatic cancer *** of whether or not this is its main mechanisms of action,the combination of nabPaclitaxel plus Gem showed a statistically and clinically significant survival advantage over single agent Gem and significantly improved all the secondary ***,recent findings on maintenance therapy are opening up potential new avenues in the treatment of advanced PDAC,particularly in a new era in which highly effective first-line regimens allow patients to experience prolonged disease ***,we provide an overview of recent advances in the systemic treatment of advanced PDAC,mostly focusing on recent findings that have set new standards in metastatic *** avenues for further development in the metastatic setting and current efforts to integratenew effective chemotherapy regimens

关键词： Pancreatic cancer Metastatic disease Chemotherapy Folfirinox nab -Paclitaxel

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Proficiency score as a predictor of early trifecta achievement during the learning curve of robot-assisted radical prostatectomy for high-risk prostate cancer:Results of a multicentric series

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Current Urology 2024年第2期18卷 110-114页

作者： Umberto Anceschi Rocco Simone Flammia Antonio Tufano Michele Morelli Antonio Galfano Lorenzo Giuseppe Luciani Leonardo Misuraca Paolo Dell’Oglio Gabriele Tuderti Aldo Brassetti Maria Consiglia Ferriero Alfredo Maria Bove Riccardo Mastroianni Francesco Prata isabella sperduti Giovanni Petralia SilviaSecco Ettore Di Trapani DanieleMattevi Tommaso Cai Aldo Massimo Bocciardi Giuseppe Simone Department of Urology IRCCS“Regina Elena”National Cancer InstituteRomeItaly Urologic Clinic Department of Maternal-Child and Urologic SciencesSapienza University of RomeItaly Ospedale Niguarda Ca’Granda Department of UrologyMilanItaly Department of Urology APSS Santa Chiara Regional HospitalTrentoItaly Department of Biostatistical Unit IRCCS Regina Elena National Cancer InstituteRomeItaly

Background:Recently,an innovative tool called“proficiency score”was introduced to assess the learning curve for robot-assisted radical prostatectomy(RARP).However,the initial study only focused on patients with low-risk prostate cancer forwhompelvic lymph node dissection(PLND)was not *** address this issue,we aimed to validate proficiency scores of a contemporarymulticenter cohort of patients with high-risk prostate cancer treated with RARP plus extended PLND by trainee *** andmethods:Between 2010 and 2020,4 Italian institutional prostate-cancer datasets weremerged and queried for“RARP”and“high-risk prostate cancer.”High-risk prostate cancer was defined according to the most recent European Association of Urology guidelines as follows:prostate-specific antigen>20 ng/mL,International Society ofUrological Pathology≥4,and/or clinical stage(cT)≥2c on preoperative *** selected cohort(n=144)included clinical cases performed by trainee surgeons(n=4)after completing their RARP learning curve(50 procedures for low-risk prostate cancer).The outcome of interest,the proficiency score,was defined as the coexistence of all the following criteria:a comparable operation time to the interquartile range of the mentor surgeon at each center,absence of any significant perioperative complications Clavien-Dindo Grade 3–5,no perioperative blood transfusions,and negative surgical margins.A logistic binary regression model was built to identify the predictors of 1-year trifecta achievement in the trainee *** all statistical analyses,a 2-sided p<0.05 was considered ***:A proficiency score was achieved in 42.3%*** univariable level,proficiency score was associated with 1-year trifecta achievement(odds ratio,8.77;95%confidence interval,2.42–31.7;p=0.001).After multivariable adjustments for age,nerve-sparing,and surgical technique,the proficiency score independently predicted 1-year trifecta achievement(odds ratio,9.58;95%confidence i

关键词： Trifecta Learning curve Robot-assisted radical prostatectomy High-risk prostate cancer

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眶上锁孔入路能有效切除前颅底中线部位脑膜瘤(英文)

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中华神经外科疾病研究杂志 2011年第4期10卷 291-291页

作者： Telera S Carapella CM Caroli F Crispo F Cristalli G Raus L sperduti I Pompili A

The paper describes a retrospective study of a consecutive series of 20 midline anterior cranial fossa meningiomas(five of the olfactory groove,14 of the tuberculum sellae,and one clinoidal),which were operated on via... 详细信息

关键词：摘要编辑部编辑工作读者

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