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Dive into the research topics where Alfredo Tartarone is active.

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Featured researches published by Alfredo Tartarone.


European Journal of Haematology | 2007

Rituximab for warm‐type idiopathic autoimmune hemolytic anemia: a retrospective study of 11 adult patients

Giovanni D'Arena; Catello Califano; Mario Annunziata; Alfredo Tartarone; Silvana Capalbo; Oreste Villani; Giovanni Amendola; Giuseppe Pietrantuono; Felicetto Ferrara; Antonio Pinto; Pellegrino Musto; Alfonso Maria D'Arco; Nicola Cascavilla

Warm‐type idiopathic autoimmune hemolytic anemia (AIHA) is a relatively common hematologic disorder resulting from autoantibody production against red blood cells. Steroids represent the first‐line therapeutic option, and immunosuppressive agents as well as splenectomy are used for refractory cases. Recently, the anti‐CD20 monoclonal antibody rituximab has been shown to control autoimmune hemolysis in patients with refractory chronic disease. We report results from a retrospective analysis of 11 adult patients receiving rituximab for steroid‐refractory AIHA of the warm type at a mean age of 55 yr (range 23–81 yr). All patients were given methyl‐prednisolone as first‐line treatment and some of them also received azathioprine and intravenous high‐dose immunoglobulins. One patient underwent splenectomy. All patients were considered refractory to steroids and/or immunosuppressive drugs and all were then given weekly rituximab (375 mg/m2) for four consecutive weeks. An increase in hemoglobin (Hgb) levels in response to rituximab, with a mean increment of 3.3 g/dL (95% CI 2.1–4.4), was observed in all cases. Four patients required packed red cell transfusions before starting rituximab and all became transfusion‐free. At a mean follow‐up of 604 d (range 30–2884 d) since the treatment of AIHA with rituximab, all patients are alive, eight (73%) of them in complete remission (CR) and three (27%) in partial remission (PR). A moderate hemolysis still persisted in six (54%) patients. In conclusion, our experience clearly demonstrates that anti‐CD20 monoclonal antibody rituximab is an effective and safe alternative treatment option for idiopathic AIHA, in particular, for steroid‐refractory disease.


Lung Cancer | 2013

Mechanisms of resistance to EGFR tyrosine kinase inhibitors gefitinib/erlotinib and to ALK inhibitor crizotinib

Alfredo Tartarone; Chiara Lazzari; Rosa Lerose; Vincenza Conteduca; Giuseppina Improta; Angela Zupa; Alessandra Bulotta; Michele Aieta; Vanesa Gregorc

The discovery of several molecular alterations that underlie non-small cell lung cancer (NSCLC) pathogenesis has led to the development of targeted therapies. In particular, gefitinib and erlotinib have become the standard of care in patients harboring epidermal growth factor receptor mutations, while crizotinib showed an impressive efficacy in patients with ALK-positive NSCLC. Nevertheless, the occurrence of clinical resistance limits the long term results of these novel agents. The identification of the molecular mechanisms responsible for acquired resistance to targeted therapy is crucial in order to pursue the creation of rational strategies to overcome resistance. In the current review, we will focus on the acquired resistance mechanisms to EGFR-TKIs and crizotinib and the therapeutic strategies currently under study to overcome resistance.


Critical Reviews in Oncology Hematology | 2013

The cardiovascular risk of gonadotropin releasing hormone agonists in men with prostate cancer: An unresolved controversy

Vincenza Conteduca; Giuseppe Di Lorenzo; Alfredo Tartarone; Michele Aieta

Gonadotropin-releasing hormone agonists (GnRH) play an important role in the treatment of prostate cancer, improving significantly overall survival. GnRH agonists belong to androgen deprivation therapy (ADT) together with surgical castration and, recently, GnRH antagonists. ADT has several side effects, such as sexual dysfunction and osteoporosis. Recently, changes in body composition, obesity, insulin resistance, hyperglycemia, dyslipidemia, and hypertension have emerged as complications of ADT, perhaps responsible for cardiovascular events, but discussion is still open. Since the majority of men with prostate cancer die of conditions other than their malignancy, recognition of these adverse effects is important. This review serves to focus attention on the pathogenetic mechanisms of ADT-related cardiovascular toxicity with also reference to the possible direct role of GnRH agonist on the cardiac receptors. Furthermore, this paper would generate recommendations for the management of patients treated with GnRH agonists balancing the potential benefits against the possible risks in prostate cancer men.


Bone Marrow Transplantation | 2003

Should we continue to study high-dose chemotherapy in metastatic breast cancer patients? A critical review of the published data

Alfredo Tartarone; Gianpiero Romano; R Galasso; Giovanni Iodice; Giovanni D'Arena; Mariarosa Coccaro; Annamaria Bochicchio; A Sgambato; N Di Renzo

Summary:Data from eight randomised trials on high-dose chemotherapy (HDC) for metastatic breast cancer (MBC) have been published, but only seven studies are evaluable after the Bezwoda trial was discredited. Moreover, overall survival (OS) has been evaluated in only four out of seven studies since three had a crossover design. OS was similar for the HDC and standard-dose chemotherapy (SDC) group in the four evaluable trials, while disease-free survival (DFS) was improved in the HDC group in six of the seven trials. The delay in relapse for patients with metastatic disease represents an important clinical outcome; furthermore, since none of the reported studies randomised more than 220 patients, their statistical power may have been too limited to detect meaningful survival differences. Finally, preliminary experiences have shown that HDC seems to be the ideal platform upon which to build novel therapies. In conclusion, HDC remains an important field of clinical research for breast cancer patients with stage IV disease and, from the studies reported in this article, there is some evidence for offering this therapeutic modality to selected patients who are interested in a medically aggressive approach.


Leukemia & Lymphoma | 2005

Prevention of high-dose melphalan-induced mucositis by cryotherapy.

Alfredo Tartarone; Rosella Matera; Gianpiero Romano; Maria Luigia Vigliotti; Nicola Di Renzo

Oral mucositis is a frequent and significant sideeffect of both chemotherapy and radiation treatment. It is an especially severe problem in the setting of patients undergoing high-dose chemotherapy (HDC) followed by peripheral blood progenitor cell transplantation. In fact, in the presence of neutropenia, severe mucositis predisposes patients to infections. Rapaport et al. [1] reported that a higher peak of oral mucositis and the duration of parenteral nutrition support are correlated with the occurrence of bacteremias and transplant-related mortality; a relationship between oral mucositis and hepatic veno-occlusive disease has been reported by Wingard et al. [2]. Furthermore, the management of infectious complications and mucositis-related pain result in increased hospitalization and increased cost [3]. There are many grading scales for diagnosing oral mucositis and assessing its severity. The most commonly used is that of the World Health Organization, which is similar to that of the National Cancer Institute and the Eastern Cooperative Oncology Group [4 – 6]. Recently, a new scoring system, the Oral Mucosal Assessment Score, was developed and validated in a large study [3]. Considering that once mucositis has occurred the main treatment consists of measures to palliate symptoms, the need for prevention or early intervention is obvious. Recommendations that can be made include oral decontamination, oral cryotherapy, the administration of amifostine and agents directed to the epithelial mucosa, such as mitogens and epithelial growth factors. Oral cryotherapy, through vasoconstriction, can decrease the mucosal damage induced by agents with short half-lives, such as 5-fluorouracil (5-FU) or melphalan (L-PAM) [7]. Here we report our experience regarding the prevention of high-dose L-PAM-induced mucositis by cryotherapy. From December 2001 22 patients (5 with multiple myeloma, 9 with non-Hodgkin’s lymphoma, 7 with breast cancer, 1 with ovarian cancer) underwent HDC including L-PAM; 5 patients received L-PAM (140 – 160 mg/m) alone and 17 patients a L-PAM including regimen. All these patients were asked to suck on ice chips for 30 min, starting 5 min prior to the L-PAM infusion. These patients also received anti-mycotic and antibiotic prophylaxis with fluconazole 200 mg/ day and ciprofloxacin 500 mg 6 2/day, respectively. We observed oral mucositis (NCI-CTC) G0 in 2/22 patients (9%), G1 in 12/22 patients (55%), G2 in 3/22 patients (13%) and G3 in 5/22 patients (23%). In our experience, the incidence of severe mucositis was significantly lower with respect to data reported in the literature. Therefore, we suggest that prophylaxis with cryotherapy should be considered in patients receiving HDC including L-PAM.


European Journal of Clinical Pharmacology | 2012

Off-label use of anti-cancer drugs between clinical practice and research: the Italian experience

Rosa Lerose; Pellegrino Musto; Michele Aieta; Carla Papa; Alfredo Tartarone

BackgroundOff-label use is the practice of prescribing a drug outside the terms of its official labeling. Worldwide, about 20% of the commonly prescribed medications are off-label, and the percentage increases in specific patient populations, such as children, pregnant women, and cancer patients. Off-label use is particularly widespread in oncology for many reasons, including the wide variety of cancer subtypes, the difficulties involved in performing clinical trials, the rapid diffusion of preliminary results, and delays in the approval of new drugs by regulatory organizations/agencies.ObjectiveThe aim of this article is to describe the use of off-label drugs in oncology, with an emphasis on the role of the world’s leading regulatory agencies and an assessment of current Italian legislation.ConclusionOff-label drug utilization is essential in oncology when based on evidence. However, off-label drugs must be prescribed in accordance with existing national laws and only when the potential benefit outweighs the potential toxic effects.


Therapeutic Advances in Respiratory Disease | 2015

Clinical approaches to treat patients with non-small cell lung cancer and epidermal growth factor receptor tyrosine kinase inhibitor acquired resistance

Alfredo Tartarone; Rosa Lerose

The discovery of epidermal growth factor receptor activating mutations (EGFR Mut+) has determined a paradigm shift in the treatment of non-small cell lung cancer (NSCLC). In several phase III studies, patients with NSCLC EGFR Mut+ achieved a significantly better progression-free survival when treated with a first- (gefitinib, erlotinib) or second-generation (afatinib) EGFR tyrosine kinase inhibitor (TKI) compared with standard chemotherapy. However, despite these impressive results, most patients with NSCLC EGFR Mut+ develop acquired resistance to TKIs. This review will discuss both the mechanisms of resistance to TKIs and the therapeutic strategies to overcome resistance, including emerging data on third-generation TKIs.


Future Oncology | 2015

Crizotinib-induced cardiotoxicity: The importance of a proactive monitoring and management

Alfredo Tartarone; Giuseppina Gallucci; Chiara Lazzari; Rosa Lerose; Lucia Lombardi; Michele Aieta

Crizotinib is a multitarget tyrosine kinase inhibitor and it represents the standard of care in patients with anaplastic lymphoma kinase translocated non-small-cell lung cancer. Crizotinib is generally well tolerated and the most frequent adverse events include gastrointestinal effects, visual disorders, edema, fatigue and liver enzyme abnormalities. However, due to the increasing clinical experience with crizotinib, other toxicities are emerging, such as Q-wave T-wave interval prolongation and bradycardia. In the current review we will focus on the management of crizotinib-related cardiotoxicity.


Leukemia & Lymphoma | 2004

Guillain-Barré Syndrome complicating mobilization therapy in a case of B-cell chronic lymphocytic leukemia

Giovanni D'Arena; Maria Luigia Vigliotti; Vincenzo Pizza; Alfredo Tartarone; Giampiero Volpe; Giovanni Iodice; Nicola Di Renzo

We report a case of Guillain-Barré Syndrome (GBS) which appeared after mobilization therapy in a patient with B-cell chronic lymphocytic leukemia (B-CLL). After obtaining a partial remission with four cycles of fludarabine at standard dose, the patient underwent to high-dose Cytoxan in order to mobilize CD34+ hematopoietic progenitor cells. During neutropenia the patient experienced fever of unknown origin (FUO) and subsequently developed GBS with normalization of his neurologic condition after 2 months. It is possible that a viral-induced activation of an antigen-specific T and B-cell clone caused a local inflammation and toxicity of Schwann cells with demyelination and axonal damage with a self-limited course.


Future Oncology | 2012

Anal metastasis from breast cancer: A case report and review of the literature

Annamaria Bochicchio; Alfredo Tartarone; Orazio Ignomirelli; Giuseppe Latorre; Rodolfo Cangiano; Giuseppina Gallucci; Mariarosa Coccaro; Elisa Feudale; Michele Aieta

Breast cancer usually metastasizes towards the lymph nodes, lung, bone, liver or brain; metastatic gastrointestinal involvement is rare and anal metastases are extremely rare. Necroscopic studies report a 6-18% incidence of extra-hepatic gastrointestinal metastases, and the most frequent sites of the GI tract involved are the stomach and the small intestine. We report a case with anal metastasis from breast cancer and a review of the associated literature.

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Michele Aieta

Casa Sollievo della Sofferenza

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Nicola Di Renzo

Catholic University of the Sacred Heart

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Gianpiero Romano

Catholic University of the Sacred Heart

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Raffaele Ardito

Catholic University of the Sacred Heart

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Giovanni D'Arena

Casa Sollievo della Sofferenza

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Rosella Matera

Casa Sollievo della Sofferenza

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Chiara Lazzari

Vita-Salute San Raffaele University

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Angela Zupa

George Mason University

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