A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type
Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Guadagni, Stefano [verfasserIn] Zoras, Odysseas [verfasserIn] Fiorentini, Giammaria [verfasserIn] Masedu, Francesco [verfasserIn] Lasithiotakis, Konstantinos [verfasserIn] Sarti, Donatella [verfasserIn] Farina, Antonietta Rosella [verfasserIn] Mackay, Andrew Reay [verfasserIn] Clementi, Marco [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2021 |
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| Schlagwörter: |
Hyperthermic isolated limb perfusion |
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| Übergeordnetes Werk: |
Enthalten in: Journal of surgical research - Orlando, Fla. : Academic Press, 1961, 268, Seite 737-747 |
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| Übergeordnetes Werk: |
volume:268 ; pages:737-747 |
| DOI / URN: |
10.1016/j.jss.2021.05.054 |
|---|
| Katalog-ID: |
ELV056230753 |
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| 245 | 1 | 0 | |a A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type |
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| 520 | |a Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. | ||
| 650 | 4 | |a Recurrent melanoma | |
| 650 | 4 | |a Locoregional metastases | |
| 650 | 4 | |a Hyperthermic isolated limb perfusion | |
| 650 | 4 | |a Isolated limb infusion | |
| 650 | 4 | |a Hypoxic pelvic and limb perfusion | |
| 650 | 4 | |a Melphalan | |
| 650 | 4 | |a Novel immunotherapies | |
| 700 | 1 | |a Zoras, Odysseas |e verfasserin |0 (orcid)0000-0001-8805-2494 |4 aut | |
| 700 | 1 | |a Fiorentini, Giammaria |e verfasserin |4 aut | |
| 700 | 1 | |a Masedu, Francesco |e verfasserin |0 (orcid)0000-0003-0290-5324 |4 aut | |
| 700 | 1 | |a Lasithiotakis, Konstantinos |e verfasserin |4 aut | |
| 700 | 1 | |a Sarti, Donatella |e verfasserin |0 (orcid)0000-0002-8031-7846 |4 aut | |
| 700 | 1 | |a Farina, Antonietta Rosella |e verfasserin |4 aut | |
| 700 | 1 | |a Mackay, Andrew Reay |e verfasserin |4 aut | |
| 700 | 1 | |a Clementi, Marco |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of surgical research |d Orlando, Fla. : Academic Press, 1961 |g 268, Seite 737-747 |h Online-Ressource |w (DE-627)267836821 |w (DE-600)1470806-1 |w (DE-576)104193948 |x 1095-8673 |7 nnns |
| 773 | 1 | 8 | |g volume:268 |g pages:737-747 |
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10.1016/j.jss.2021.05.054 doi (DE-627)ELV056230753 (ELSEVIER)S0022-4804(21)00381-4 DE-627 ger DE-627 rda eng 610 VZ 44.65 bkl Guadagni, Stefano verfasserin aut A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. Recurrent melanoma Locoregional metastases Hyperthermic isolated limb perfusion Isolated limb infusion Hypoxic pelvic and limb perfusion Melphalan Novel immunotherapies Zoras, Odysseas verfasserin (orcid)0000-0001-8805-2494 aut Fiorentini, Giammaria verfasserin aut Masedu, Francesco verfasserin (orcid)0000-0003-0290-5324 aut Lasithiotakis, Konstantinos verfasserin aut Sarti, Donatella verfasserin (orcid)0000-0002-8031-7846 aut Farina, Antonietta Rosella verfasserin aut Mackay, Andrew Reay verfasserin aut Clementi, Marco verfasserin aut Enthalten in Journal of surgical research Orlando, Fla. : Academic Press, 1961 268, Seite 737-747 Online-Ressource (DE-627)267836821 (DE-600)1470806-1 (DE-576)104193948 1095-8673 nnns volume:268 pages:737-747 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.65 Chirurgie VZ AR 268 737-747 |
| spelling |
10.1016/j.jss.2021.05.054 doi (DE-627)ELV056230753 (ELSEVIER)S0022-4804(21)00381-4 DE-627 ger DE-627 rda eng 610 VZ 44.65 bkl Guadagni, Stefano verfasserin aut A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. Recurrent melanoma Locoregional metastases Hyperthermic isolated limb perfusion Isolated limb infusion Hypoxic pelvic and limb perfusion Melphalan Novel immunotherapies Zoras, Odysseas verfasserin (orcid)0000-0001-8805-2494 aut Fiorentini, Giammaria verfasserin aut Masedu, Francesco verfasserin (orcid)0000-0003-0290-5324 aut Lasithiotakis, Konstantinos verfasserin aut Sarti, Donatella verfasserin (orcid)0000-0002-8031-7846 aut Farina, Antonietta Rosella verfasserin aut Mackay, Andrew Reay verfasserin aut Clementi, Marco verfasserin aut Enthalten in Journal of surgical research Orlando, Fla. : Academic Press, 1961 268, Seite 737-747 Online-Ressource (DE-627)267836821 (DE-600)1470806-1 (DE-576)104193948 1095-8673 nnns volume:268 pages:737-747 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.65 Chirurgie VZ AR 268 737-747 |
| allfields_unstemmed |
10.1016/j.jss.2021.05.054 doi (DE-627)ELV056230753 (ELSEVIER)S0022-4804(21)00381-4 DE-627 ger DE-627 rda eng 610 VZ 44.65 bkl Guadagni, Stefano verfasserin aut A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. Recurrent melanoma Locoregional metastases Hyperthermic isolated limb perfusion Isolated limb infusion Hypoxic pelvic and limb perfusion Melphalan Novel immunotherapies Zoras, Odysseas verfasserin (orcid)0000-0001-8805-2494 aut Fiorentini, Giammaria verfasserin aut Masedu, Francesco verfasserin (orcid)0000-0003-0290-5324 aut Lasithiotakis, Konstantinos verfasserin aut Sarti, Donatella verfasserin (orcid)0000-0002-8031-7846 aut Farina, Antonietta Rosella verfasserin aut Mackay, Andrew Reay verfasserin aut Clementi, Marco verfasserin aut Enthalten in Journal of surgical research Orlando, Fla. : Academic Press, 1961 268, Seite 737-747 Online-Ressource (DE-627)267836821 (DE-600)1470806-1 (DE-576)104193948 1095-8673 nnns volume:268 pages:737-747 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.65 Chirurgie VZ AR 268 737-747 |
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10.1016/j.jss.2021.05.054 doi (DE-627)ELV056230753 (ELSEVIER)S0022-4804(21)00381-4 DE-627 ger DE-627 rda eng 610 VZ 44.65 bkl Guadagni, Stefano verfasserin aut A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. Recurrent melanoma Locoregional metastases Hyperthermic isolated limb perfusion Isolated limb infusion Hypoxic pelvic and limb perfusion Melphalan Novel immunotherapies Zoras, Odysseas verfasserin (orcid)0000-0001-8805-2494 aut Fiorentini, Giammaria verfasserin aut Masedu, Francesco verfasserin (orcid)0000-0003-0290-5324 aut Lasithiotakis, Konstantinos verfasserin aut Sarti, Donatella verfasserin (orcid)0000-0002-8031-7846 aut Farina, Antonietta Rosella verfasserin aut Mackay, Andrew Reay verfasserin aut Clementi, Marco verfasserin aut Enthalten in Journal of surgical research Orlando, Fla. : Academic Press, 1961 268, Seite 737-747 Online-Ressource (DE-627)267836821 (DE-600)1470806-1 (DE-576)104193948 1095-8673 nnns volume:268 pages:737-747 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.65 Chirurgie VZ AR 268 737-747 |
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10.1016/j.jss.2021.05.054 doi (DE-627)ELV056230753 (ELSEVIER)S0022-4804(21)00381-4 DE-627 ger DE-627 rda eng 610 VZ 44.65 bkl Guadagni, Stefano verfasserin aut A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. Recurrent melanoma Locoregional metastases Hyperthermic isolated limb perfusion Isolated limb infusion Hypoxic pelvic and limb perfusion Melphalan Novel immunotherapies Zoras, Odysseas verfasserin (orcid)0000-0001-8805-2494 aut Fiorentini, Giammaria verfasserin aut Masedu, Francesco verfasserin (orcid)0000-0003-0290-5324 aut Lasithiotakis, Konstantinos verfasserin aut Sarti, Donatella verfasserin (orcid)0000-0002-8031-7846 aut Farina, Antonietta Rosella verfasserin aut Mackay, Andrew Reay verfasserin aut Clementi, Marco verfasserin aut Enthalten in Journal of surgical research Orlando, Fla. : Academic Press, 1961 268, Seite 737-747 Online-Ressource (DE-627)267836821 (DE-600)1470806-1 (DE-576)104193948 1095-8673 nnns volume:268 pages:737-747 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.65 Chirurgie VZ AR 268 737-747 |
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English |
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Enthalten in Journal of surgical research 268, Seite 737-747 volume:268 pages:737-747 |
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Guadagni, Stefano @@aut@@ Zoras, Odysseas @@aut@@ Fiorentini, Giammaria @@aut@@ Masedu, Francesco @@aut@@ Lasithiotakis, Konstantinos @@aut@@ Sarti, Donatella @@aut@@ Farina, Antonietta Rosella @@aut@@ Mackay, Andrew Reay @@aut@@ Clementi, Marco @@aut@@ |
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2021-01-01T00:00:00Z |
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Guadagni, Stefano |
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610 VZ 44.65 bkl A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type Recurrent melanoma Locoregional metastases Hyperthermic isolated limb perfusion Isolated limb infusion Hypoxic pelvic and limb perfusion Melphalan Novel immunotherapies |
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Guadagni, Stefano Zoras, Odysseas Fiorentini, Giammaria Masedu, Francesco Lasithiotakis, Konstantinos Sarti, Donatella Farina, Antonietta Rosella Mackay, Andrew Reay Clementi, Marco |
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a prospective study of intraarterial infusion chemotherapy in advanced wild-type |
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A Prospective Study of Intraarterial Infusion Chemotherapy in Advanced Wild-Type |
| abstract |
Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. |
| abstractGer |
Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. |
| abstract_unstemmed |
Background: Treatment strategies for advanced cutaneous melanoma (CM) patients, resistant or not treatable with novel target and immunotherapeutic drugs, remain a significant challenge, particularly for patients with unresectable stage IIIC/D disease localized to inferior limbs and pelvis, for whom specific outcomes are rarely considered.Materials and Methods: This is a prospective study of multidisciplinary treatments, including locoregional melphalan chemotherapy, in 62 BRAF wild-type CM patients with locoregional metastases in the inferior limbs and pelvis, including inguinal regions. Patients were either in progression following or ineligible for, or not treatable with novel immunotherapy. For exclusively inferior limb-localised disease, patients received locoregional melphalan chemotherapy performed by hyperthermic isolated limb perfusion (n = 19) or isolated limb infusion (n = 19), and for synchronous lesions localised to inferior limbs and pelvis, received hypoxic pelvic and limb perfusion (n = 24). Additional multidisciplinary therapy included local, locoregional and systemic treatments and the primary endpoint was tumour response.Results: The objective response rate following first cycle of locoregional chemotherapy was 37.1% at 3 mo and median progression-free survival was 4-mo, with 12.9% procedure-related complications, 30.6% low-grade haematological toxicity and 11.3% severe limb toxic tissue reactions. Multivariate logistic regression showed that the odds of response were significantly higher for patients ≤ 75 y of age and for patients with locoregional metastases exclusively located in the inferior limbs.Conclusion: In this subgroup of CM patients with BRAF wild-type status, locoregional metastases localized to inferior limbs and pelvis, in progression following or ineligible for immunotherapy, melphalan locoregional chemotherapy demonstrated a safe and effective profile.Trial Registration: ClinicalTrials.gov Identifier NCT01920516; date of trial registration: August 6, 2013. |
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| score |
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