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Ploumaki I, Triantafyllou E, Koumprentziotis IA, Karampinos K, Drougkas K, Karavolias I, Kotteas E. Cyclin-Dependent Kinase 4/6 Inhibitors as Neoadjuvant Therapy of Hormone Receptor-Positive/HER2-Negative Early Breast Cancer: What do we Know so Far? Clin Breast Cancer 2024; 24:e177-e185. [PMID: 38320891 DOI: 10.1016/j.clbc.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 02/08/2024]
Abstract
The introduction of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors to the treatment of hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer is regarded as one of the greatest achievements of the last decades in breast oncology. To date, palbociclib, abemaciclib and ribociclib are the 3 approved CDK4/6 inhibitors that combined with endocrine therapy are now considered as the standard first-line treatment of metastatic HR+/HER2- breast cancer. The great success of these drugs in the setting of metastatic disease and the need to combat the high risk of recurrence have paved the way for a number of clinical trials to explore the use of CDK4/6 inhibitors in the neoadjuvant treatment of early breast cancer. In this review, we summarize the main findings of clinical trials that examined the use of CDK4/6 inhibitors in combination with hormone therapy or chemotherapy as neoadjuvant treatment of hormone receptor-positive and HER2-negative breast cancer. Active clinical trials that investigate different treatment schemes are also briefly presented and current limitations and future goals are discussed.
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Affiliation(s)
- Ioanna Ploumaki
- Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Αthens, Greece.
| | - Efthymios Triantafyllou
- Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Αthens, Greece
| | - Ioannis-Alexios Koumprentziotis
- Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Αthens, Greece
| | - Konstantinos Karampinos
- Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Αthens, Greece
| | - Konstantinos Drougkas
- Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Αthens, Greece
| | - Ioannis Karavolias
- Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Αthens, Greece
| | - Elias Kotteas
- Oncology Unit, 3rd Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Αthens, Greece
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Vasilakaki S, Vathiotis I, Panagiotou E, Dimakakos E, Gomatou G, Kotteas E. Molecular interactions of antibodies with PD-1/PD-L1 proteins. Immunotherapy 2024; 16:21-28. [PMID: 38054258 DOI: 10.2217/imt-2023-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Aim: To compare the protein-protein interactions of antibodies targeting PD-1 and its ligand (PD-L1) with their targets in an attempt to explain the antibodies' binding affinity. Materials & methods: The structural features of complexes between pembrolizumab, nivolumab, durvalumab, atezolizumab, avelumab and PD-1/PD-L1 are described, with the use of software and based on crystallographic data. Results: Pembrolizumab has more structural features, including the number and type of the bonds and total binding surface area, which could rationalize its different clinical behavior compared with nivolumab. Similarly, protein-protein interactions with PD-L1 differ among durvalumab, atezolizumab and avelumab. Conclusion: Differential protein-protein interactions between antibodies and PD-1/PD-L1 may indicate differential clinical activity; however, further research is needed to provide evidence.
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Affiliation(s)
- Sofia Vasilakaki
- Chemistry Department, National & Kapodistrian University of Athens, Panepistimiopolis, Athens, 15771, Greece
| | - Ioannis Vathiotis
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, 152 Mesogeion Avenue, Athens, 11527, Greece
| | - Emmanouil Panagiotou
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, 152 Mesogeion Avenue, Athens, 11527, Greece
| | - Evangelos Dimakakos
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, 152 Mesogeion Avenue, Athens, 11527, Greece
| | - Georgia Gomatou
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, 152 Mesogeion Avenue, Athens, 11527, Greece
| | - Elias Kotteas
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, 152 Mesogeion Avenue, Athens, 11527, Greece
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Malainou CP, Stachika N, Damianou AK, Anastopoulos A, Ploumaki I, Triantafyllou E, Drougkas K, Gomatou G, Kotteas E. Estrogen-Receptor-Low-Positive Breast Cancer: Pathological and Clinical Perspectives. Curr Oncol 2023; 30:9734-9745. [PMID: 37999126 PMCID: PMC10670665 DOI: 10.3390/curroncol30110706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023] Open
Abstract
The expression of estrogen receptors (ERs) in breast cancer (BC) represents a strong prognostic and predictive biomarker and directs therapeutic decisions in early and advanced stages. ER-low-positive BC, defined by the immunohistochemical (IHC) expression of ERs from 1% to 9%, constitutes a distinct subset of total BC cases. Guidelines recommend that a low expression of ERs be reported in pathology reports since the benefit of endocrine therapy in patients with ER-low-positive BC is uncertain. Recently, several cohorts, mostly of a retrospective nature, have been published, reporting the clinicopathological characteristics and outcomes of ER-low-positive BC. However, the majority of the data focus on early-stage BC and the use of (neo)adjuvant therapy, and there is a significant lack of data regarding metastatic ER-low-positive BC. Further factors, including tumor heterogeneity as well as the potential loss of ER expression due to endocrine resistance, should be considered. Including patients with ER-low-positive BC in clinical trials for triple-negative breast cancer (TNBC) might improve the understanding of this entity and allow novel therapeutic approaches. The design and conduction of randomized clinical trials regarding this subgroup of patients are greatly anticipated.
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Affiliation(s)
- Christina Panagiotis Malainou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
| | - Nikolina Stachika
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
| | - Aikaterini Konstantina Damianou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
| | - Aristotelis Anastopoulos
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
| | - Ioanna Ploumaki
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
| | - Efthymios Triantafyllou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
| | - Konstantinos Drougkas
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
| | - Georgia Gomatou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
| | - Elias Kotteas
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, 11527 Athens, Greece
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Karaviti E, Kontogiannis A, Anastopoulos A, Kotteas E, Gomatou G. An overview of the role of telomeres and telomerase in pre‑neoplastic lesions (Review). Mol Clin Oncol 2023; 19:61. [PMID: 37424625 PMCID: PMC10326563 DOI: 10.3892/mco.2023.2657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/14/2023] [Indexed: 07/11/2023] Open
Abstract
Telomeres are tandem repeats of DNA sequences protecting the end of linear chromosomes. Replicative senescence due to telomere attrition is considered a tumor-preventing mechanism in differentiated somatic cells. However, telomere shortening is associated with genome instability and several disease entities. During carcinogenesis, the development of a telomere maintenance mechanism, predominately through the activation of the telomerase enzyme, represents a hallmark of cancer, since it enables cancer cells to avert senescence and divide indefinitely. Although research of the involvement of telomeres and telomerase in various malignant neoplasms has gained a large amount of interest, the timing and relevance of their role in pre-neoplastic lesions remain to be determined. The present narrative review aims to summarize the evidence regarding the role of telomeres and telomerase in pre-neoplasia across different types of tissues.
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Affiliation(s)
- Eleftheria Karaviti
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital of Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Athanasios Kontogiannis
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital of Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Aristotelis Anastopoulos
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital of Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Elias Kotteas
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital of Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Georgia Gomatou
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital of Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
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Sollena P, Vasiliki N, Kotteas E, Stratigos AJ, Fattore D, Orlandi A, Mannino M, Di Pumpo M, Fida M, Starace M, Apalla Z, Romano MC, Riganti J, Segura S, Martinez AF, Fabbrocini G, Sibaud V, Peris K, On Behalf Of The Eadv Task Force Dermatology For Cancer Patients. Cyclin-Dependent Kinase 4/6 Inhibitors and Dermatologic Adverse Events: Results from the EADV Task Force "Dermatology for Cancer Patients" International Study. Cancers (Basel) 2023; 15:3658. [PMID: 37509319 PMCID: PMC10377938 DOI: 10.3390/cancers15143658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/29/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The introduction of cyclin-dependent kinase inhibitors (CDK4/6i) was a great advance in therapeutics for patients with estrogen receptor+/human epidermal growth factor receptor (HER2) locally advanced and metastatic breast cancer. Despite the increasing use of these agents, their adverse drug-related events have not yet been fully characterized. We describe the spectrum of cutaneous adverse reactions occurring in advanced breast cancer patients treated with cyclin-dependent kinase inhibitors, analyzing types, severity, time to onset, and possible treatment outcomes. METHODS We performed a multicentric retrospective study including patients with advanced breast cancer who developed cutaneous lesions during treatment with CDK4/6i in the period from June 2020 to June 2021. Patients > 18 years were recruited at eleven onco-dermatology units located in Albania (1), Argentina (1), France (1), Greece (3), Italy (3), and Spain (2). We evaluated patients' epidemiological and clinical characteristics, types of cutaneous adverse events, their time to onset, and treatment outcomes. The severity of the skin reactions was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 score. RESULTS Seventy-nine patients (median age: 62.3 years; range 39-83 years) were included in the study, and, collectively, we recorded a total of 165 cutaneous adverse events during follow-up visits. The most frequent cutaneous reactions were pruritus (49/79 patients), alopecia (25/79), and eczematous lesions (24/79). Cutaneous toxicities were usually mild in severity (>65%) and occurred after a median of 6.5 months. Only four patients (5%) required treatment discontinuation due to the severity of the skin lesions. The majority of the skin reactions were managed with topical treatments. CONCLUSIONS To the best of our knowledge, we present the largest case series of cutaneous adverse events developing in advanced breast cancer patients treated with CDK4/6i. We showed that cutaneous toxicities are usually mild in severity, and manageable with standard supportive care; however, in selected cases, they can lead to treatment discontinuation with possible implications for patients' clinical outcomes.
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Affiliation(s)
- Pietro Sollena
- UOC Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Nikolaou Vasiliki
- Dermato-Oncology Department, Cutaneous Toxicities Clinic, Andreas Sygros Hospital, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Elias Kotteas
- Oncology Unit, 3rd Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, "Sotiria" General Hospital, 16121 Athens, Greece
| | - Alexander J Stratigos
- Dermato-Oncology Department, Cutaneous Toxicities Clinic, Andreas Sygros Hospital, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80126 Naples, Italy
| | - Armando Orlandi
- Medical Oncology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Maria Mannino
- Dermatologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marcello Di Pumpo
- Department of Scienza della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Monika Fida
- Dermatology Service, University Hospital Center "Mother Theressa", 1005 Tirana, Albania
| | - Michela Starace
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Zoe Apalla
- Second Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | | | - Julia Riganti
- Dermatology Department, Hospital Italiano de Buenos Aires, 1199 Buenos Aires, Argentina
| | - Sonia Segura
- Department of Dermatology, Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), 08003 Barcelona, Spain
| | - Azael Freites Martinez
- Oncodermatology Clinic at Hospital Ruber Juan Bravo and Universidad Europea, 28006 Madrid, Spain
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80126 Naples, Italy
| | - Vincent Sibaud
- Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, 31500 Toulouse, France
| | - Ketty Peris
- UOC Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Kotteas E, Bielo LB, Valenza C, Santoro C, Koukoutzeli C, Trapani D, Curigliano G. Treatment optimization in early triple negative breast cancer. Expert Rev Anticancer Ther 2023; 23:1107-1116. [PMID: 37873652 DOI: 10.1080/14737140.2023.2268840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION The treatment of early-stage triple-negative breast cancer (TNBC) has radically changed in recent years. Response to neoadjuvant treatment has provided prognostic information, and the achievement of a pathological complete response (pCR) is associated with improved prognosis. An exact treatment algorithm that embraces the trade-off of efficacy and toxicity in a risk-adapted manner has, however, not been consolidated. AREAS COVERED In this review, we focused on the current treatments used for patients with early triple negative breast cancer, aiming at framing a therapeutic approach toward risk-adapted treatment optimization. We reviewed the clinical trials and other evidence at the foundation of the current clinical practice in early TNBC and identified possible areas of clinical implementation. EXPERT OPINION In our opinion, treatment optimization will ensure improved patient-centric outcomes, with less toxicities, better long-term quality of life and risk-adapted treatment modulation. Presently, treatment modulation can be applied in some patients through de-intensification, for small TNBC, informed by novel biomarkers and based on the response to neoadjuvant treatments, especially in the case of pCR. Innovative approaches should incorporate baseline risk and cancer biology, treatment response, and post-surgery biomarkers of prognosis, to deliver risk-adapted treatments for patients with early TNBC.
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Affiliation(s)
- Elias Kotteas
- Oncology Unit, 3rd Department of Internal Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Luca Boscolo Bielo
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Carmine Valenza
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Celeste Santoro
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Chrysanthi Koukoutzeli
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
| | - Dario Trapani
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giuseppe Curigliano
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Drougkas K, Karampinos K, Karavolias I, Koumprentziotis IA, Ploumaki I, Triantafyllou E, Trontzas I, Kotteas E. Comprehensive clinical evaluation of CAR-T cell immunotherapy for solid tumors: a path moving forward or a dead end? J Cancer Res Clin Oncol 2023; 149:2709-2734. [PMID: 36564524 PMCID: PMC10129996 DOI: 10.1007/s00432-022-04547-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/16/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Chimeric Antigen Receptor (CAR)-T cell therapy is a form of adoptive cell therapy that has demonstrated tremendous results in the treatment of hematopoietic malignancies, leading to the US Food and Drug Administration (FDA) approval of four CD19-targeted CAR-T cell products. With the unprecedented success of CAR-T cell therapy in hematological malignancies, hundreds of preclinical studies and clinical trials are currently undergoing to explore the translation of this treatment to solid tumors. However, the clinical experience in non-hematologic malignancies has been less encouraging, with only a few patients achieving complete responses. Tumor-associated antigen heterogeneity, inefficient CAR-T cell trafficking and the immunosuppressive tumor microenvironment are considered as the most pivotal roadblocks in solid tumor CAR-T cell therapy. MATERIALS AND METHODS We reviewed the relevant literature/clinical trials for CAR-T cell immunotherapy for solid tumors from Pubmed and ClinicalTrials.gov. CONCLUSION Herein, we provide an update on solid tumor CAR-T cell clinical trials, focusing on the studies with published results. We further discuss some of the key hurdles that CAR-T cell therapy is encountering for solid tumor treatment as well as the strategies that are exploited to overcome these obstacles.
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Affiliation(s)
- Konstantinos Drougkas
- Oncology Unit, Sotiria General Hospital, National and Kapodistrian University of Athens, 152 Mesogeion Avenue, 11527, Athens, Greece.
- Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece.
| | - Konstantinos Karampinos
- Oncology Unit, Sotiria General Hospital, National and Kapodistrian University of Athens, 152 Mesogeion Avenue, 11527, Athens, Greece
- Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Ioannis Karavolias
- Oncology Unit, Sotiria General Hospital, National and Kapodistrian University of Athens, 152 Mesogeion Avenue, 11527, Athens, Greece
- Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Ioannis-Alexios Koumprentziotis
- Oncology Unit, Sotiria General Hospital, National and Kapodistrian University of Athens, 152 Mesogeion Avenue, 11527, Athens, Greece
- Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Ioanna Ploumaki
- Oncology Unit, Sotiria General Hospital, National and Kapodistrian University of Athens, 152 Mesogeion Avenue, 11527, Athens, Greece
- Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Efthymios Triantafyllou
- Oncology Unit, Sotiria General Hospital, National and Kapodistrian University of Athens, 152 Mesogeion Avenue, 11527, Athens, Greece
- Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Ioannis Trontzas
- Oncology Unit, Sotiria General Hospital, National and Kapodistrian University of Athens, 152 Mesogeion Avenue, 11527, Athens, Greece
- Department of Pathology, Yale University School of Medicine, New Haven, USA, CT
| | - Elias Kotteas
- Oncology Unit, Sotiria General Hospital, National and Kapodistrian University of Athens, 152 Mesogeion Avenue, 11527, Athens, Greece
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Gomatou G, Karachaliou A, Veloudiou OZ, Karvela A, Syrigos N, Kotteas E. The Role of REV-ERB Receptors in Cancer Pathogenesis. Int J Mol Sci 2023; 24:ijms24108980. [PMID: 37240325 DOI: 10.3390/ijms24108980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
REV-ERB receptors are members of the nuclear receptor superfamily of proteins, which act as both intracellular receptors and transcription factors, therefore modulating the expression of target genes. REV-ERBs act as transcription repressors because of their unique structure. Their predominant role involves the control of peripheral circadian rhythmicity by participating in a transcription-translation feedback loop with other major clock genes. Regarding their role in cancer pathogenesis, recent studies in various cancerous tissues have revealed that their expression was downregulated in the majority of the cases. Dysregulation of their expression was also implicated in cancer-associated cachexia. The pharmacological restoration of their effects is feasible with synthetic agonists, which have been explored in preclinical studies but with scarce data. There is a need for further investigation, primarily with mechanistic studies, on the effect of the REV-ERB-induced circadian rhythm deregulation in carcinogenesis and cancer-related systemic effects, such as cachexia, in order to address the potential of relevant therapeutic implications.
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Affiliation(s)
- Georgia Gomatou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Anastasia Karachaliou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Orsalia-Zoi Veloudiou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Alexandra Karvela
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Nikolaos Syrigos
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Elias Kotteas
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, 115 27 Athens, Greece
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Karvela A, Veloudiou OZ, Karachaliou A, Kloukina T, Gomatou G, Kotteas E. Lung microbiome: an emerging player in lung cancer pathogenesis and progression. Clin Transl Oncol 2023:10.1007/s12094-023-03139-z. [PMID: 36995519 DOI: 10.1007/s12094-023-03139-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/26/2023] [Indexed: 03/31/2023]
Abstract
The microbiome of the lungs, although until recently neglected, is now emerging as a potential contributor to chronic lung diseases, including cancer. Preclinical evidence suggests that the microbial burden of the lungs shapes the host immunity mechanisms and affects local antitumor immune responses. Studies of cohorts of patients with lung cancer reveal that different microbiome profiles are detected in patients with lung cancer compared to controls. In addition, an association between differential lung microbiome composition and distinct responses to immunotherapy has been suggested, yet, with limited data. Scarce evidence exists on the role of the lung microbiome in the development of metastases in the lungs. Interestingly, the lung microbiome is not isolated and interacts with the gut microbiome through a dynamic axis. Future research on the involvement of the lung microbiome in lung cancer pathogenesis and potential therapeutic implications is greatly anticipated.
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Affiliation(s)
- Alexandra Karvela
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Messogion Ave 152, 11527, Athens, Greece
| | - Orsalia-Zoi Veloudiou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Messogion Ave 152, 11527, Athens, Greece
| | - Anastasia Karachaliou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Messogion Ave 152, 11527, Athens, Greece
| | - Theoni Kloukina
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Messogion Ave 152, 11527, Athens, Greece
| | - Georgia Gomatou
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Messogion Ave 152, 11527, Athens, Greece.
| | - Elias Kotteas
- Oncology Unit, Third Department of Medicine, "Sotiria" General Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Messogion Ave 152, 11527, Athens, Greece
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Magiouf KS, Fragiadaki K, Charpidou A, Syrigos A, Kotteas E, Kourlaba G. Impact of biologic therapies on risk of adverse cardiovascular events in patients with Ankylosing Spondylitis or Psoriatic Arthritis: A systematic literature review. ARP Rheumatol 2023; 2:53-63. [PMID: 36809367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Recent evidence highlights increased mortality and morbidity due to cardiovascular disease (CVD), especially within the two major forms of Spondyloarthropathies (SpAs), Ankylosing Spondylitis (AS) and Psoriatic Arthritis (PsA). Healthcare professionals and patients in these populations should be alerted regarding the high risk of cardiovascular (CV) events and thus, customize the treatment strategy accordingly. OBJECTIVE This systematic literature review aimed to determine the effects of biological therapies on serious CV events in AS and PsA. METHODS Screening for the study was carried out using PubMed and Scopus databases from the database's inception to the 17th of July 2021. The literature search strategy for this review is based on the Population, Intervention, Comparator, Outcomes (PICOs) framework. Randomized controlled trials (RCTs) of biologic therapies for the treatment of AS and/or PsA were included. The primary outcome measure was the number of serious CV events reported during the placebo-controlled phase. RESULTS 4,422 articles were generated from keywords, eligibility criteria, and databases. Following the screening, we retained 13 studies for analysis: 3 in AS and 10 in PsA. Meta-analysis of results was not feasible due to the small number of the identified studies, the heterogeneity of the biologic treatment and the included populations, as well as the infrequently reported requested endpoint. According to our review, biologic treatments are safe options as for CV risk in patients with PsA or AS. CONCLUSION Further and more extensive trials in AS/PsA patients at high risk of CV events are needed before firm conclusions can be drawn.
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Affiliation(s)
| | - Kalliopi Fragiadaki
- National and Kapodistrian University of Athens School of Health Sciences, Athens, Greece
| | - Adrianni Charpidou
- "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Syrigos
- "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Kotteas
- "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
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Panagiotou E, Vamvakaris I, Syrigos NK, Kotteas E. Pulmonary benign metastasizing leiomyoma: a case report. Monaldi Arch Chest Dis 2023; 94. [PMID: 36807647 DOI: 10.4081/monaldi.2023.2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/13/2023] [Indexed: 02/23/2023] Open
Abstract
Benign metastasizing leiomyoma is a metastasizing form of leiomyoma, which is a benign uterine tumor that typically affects women of reproductive age. A hysterectomy is typically performed 10-15 years before the disease's metastatic progression. We present a case of a postmenopausal woman who presented to the emergency department with worsening dyspnea and a history of hysterectomy due to leiomyoma. A computed tomography scan of the chest revealed diffuse bilateral lesions. An open-lung biopsy was performed, and the lung lesions were found to have leiomyoma cells. The patient began letrozole treatment and showed clinical improvement without any serious adverse events.
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Affiliation(s)
| | - Ioannis Vamvakaris
- Department of Pathology, Athens School of Medicine, Sotiria General Hospital, Athens.
| | - Nikolaos K Syrigos
- Oncology Unit, Athens School of Medicine, Sotiria General Hospital, Athens.
| | - Elias Kotteas
- Oncology Unit, Athens School of Medicine, Sotiria General Hospital, Athens.
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12
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Kyriakoulis KG, Trontzas IP, Kyriakoulis IG, Terentes-Printzios D, Papageorgiou NG, Fyta E, Kotteas E, Kollias A. ST-Segment Elevation Myocardial Infarction (STEMI) Management in the Era of COVID-19: A Systematic and Critical Review of Published Guidance Reports. Rev Cardiovasc Med 2023. [DOI: 10.31083/j.rcm2402054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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13
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Lanitis S, Chortis P, Lainas S, Gkanis V, Sekadakis D, Badagionis M, Ntalaperas K, Agianni E, Samaras V, Kontos M, Kotteas E. The role of ki67 as assessed by core biopsy in the preoperative classification of breast cancer according to the prognostic factors. European Journal of Surgical Oncology 2023. [DOI: 10.1016/j.ejso.2022.11.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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14
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Dapergola A, Gomatou G, Trontzas I, Panagiotou E, Dimakakos E, Syrigos N, Kotteas E. Emerging therapies in thymic epithelial tumors (Review). Oncol Lett 2023; 25:84. [PMID: 36760515 PMCID: PMC9877504 DOI: 10.3892/ol.2023.13670] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/13/2022] [Indexed: 01/18/2023] Open
Abstract
Thymic epithelial tumors (TETs), including thymomas and thymic carcinomas, are rare malignancies arising from the thymus gland. The optimal management requires a multidisciplinary approach. Standard first-line systemic treatment involves cytotoxic chemotherapeutic regimens; however, alternative options for systemic treatment are required. Current research focuses on the unique profile of immune-related pathogenic mechanisms of TETs, involving an overlap with certain autoimmune phenotypes, as well as on determining the landscape of oncogenic molecular alterations and the role of tumor angiogenesis. The aim of the present review is to summarize the current clinical investigation on immunotherapy and targeted agents in the management of TETs. Regarding immune checkpoint inhibitors, efficacy results are promising in certain subsets of patients; however, caution is required concerning their toxicity. Anti-angiogenic agents, mainly potent small-molecule inhibitors, have demonstrated antitumor activity in TETs, whereas other targeted agents, including KIT inhibitors and epigenetic agents, are associated with encouraging, yet still modest results for unselected populations, in the absence of predictive biomarkers. Future research should focus on identifying predictive biomarkers for patients with TETs, and should implement multicenter collaborations and appropriate clinical trials tailored for rare tumor types.
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Affiliation(s)
- Athina Dapergola
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital for Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Georgia Gomatou
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital for Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece,Correspondence to: Dr Georgia Gomatou, Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital for Diseases of The Chest, National and Kapodistrian University of Athens, 152 Messogion Avenue, Athens 11527, Greece, E-mail:
| | - Ioannis Trontzas
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital for Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Emmanouil Panagiotou
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital for Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Evangelos Dimakakos
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital for Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Nikolaos Syrigos
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital for Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Elias Kotteas
- Oncology Unit, Third Department of Medicine, ‘Sotiria’ General Hospital for Diseases of The Chest, National and Kapodistrian University of Athens, Athens 11527, Greece
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15
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Tsiakos K, Gavrielatou N, Vathiotis IA, Chatzis L, Chatzis S, Poulakou G, Kotteas E, Syrigos NK. Programmed Cell Death Protein 1 Axis Inhibition in Viral Infections: Clinical Data and Therapeutic Opportunities. Vaccines (Basel) 2022; 10:vaccines10101673. [PMID: 36298538 PMCID: PMC9611078 DOI: 10.3390/vaccines10101673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
A vital function of the immune system is the modulation of an evolving immune response. It is responsible for guarding against a wide variety of pathogens as well as the establishment of memory responses to some future hostile encounters. Simultaneously, it maintains self-tolerance and minimizes collateral tissue damage at sites of inflammation. In recent years, the regulation of T-cell responses to foreign or self-protein antigens and maintenance of balance between T-cell subsets have been linked to a distinct class of cell surface and extracellular components, the immune checkpoint molecules. The fact that both cancer and viral infections exploit similar, if not the same, immune checkpoint molecules to escape the host immune response highlights the need to study the impact of immune checkpoint blockade on viral infections. More importantly, the process through which immune checkpoint blockade completely changed the way we approach cancer could be the key to decipher the potential role of immunotherapy in the therapeutic algorithm of viral infections. This review focuses on the effect of programmed cell death protein 1/programmed death-ligand 1 blockade on the outcome of viral infections in cancer patients as well as the potential benefit from the incorporation of immune checkpoint inhibitors (ICIs) in treatment of viral infections.
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Affiliation(s)
- Konstantinos Tsiakos
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 157 72 Athens, Greece
- Correspondence:
| | - Niki Gavrielatou
- Department of Pathology, School of Medicine, Yale University, New Haven, CT 06520, USA
| | - Ioannis A. Vathiotis
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Loukas Chatzis
- Pathophysiology Department, Athens School of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Stamatios Chatzis
- Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, “Hippokration” Hospital, 115 27 Athens, Greece
| | - Garyfallia Poulakou
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Elias Kotteas
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Nikolaos K. Syrigos
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 157 72 Athens, Greece
- Dana-Farber Brigham Cancer Center, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02215, USA
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16
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Gomatou G, Ramfidis V, Bakogeorgos M, Nikolaidou V, Evangelou G, Kotteas E, Gkiozos I, Papafili A, Charpidou A. EP14.01-022 Immune Thrombocytopenia in a Patient with Large Cell Neuroendocrine Carcinoma Under Dual Immune Checkpoint Inhibition. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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17
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Panagiotou E, Syrigos NK, Charpidou A, Kotteas E, Vathiotis IA. CD24: A Novel Target for Cancer Immunotherapy. J Pers Med 2022; 12:jpm12081235. [PMID: 36013184 PMCID: PMC9409925 DOI: 10.3390/jpm12081235] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 12/31/2022] Open
Abstract
Cluster of differentiation 24 (CD24) is a small, highly glycosylated cell adhesion protein that is normally expressed by immune as well as epithelial, neural, and muscle cells. Tumor CD24 expression has been linked with alterations in several oncogenic signaling pathways. In addition, the CD24/Siglec-10 interaction has been implicated in tumor immune evasion, inhibiting macrophage-mediated phagocytosis as well as natural killer (NK) cell cytotoxicity. CD24 blockade has shown promising results in preclinical studies. Although there are limited data on efficacy, monoclonal antibodies against CD24 have demonstrated clinical safety and tolerability in two clinical trials. Other treatment modalities evaluated in the preclinical setting include antibody–drug conjugates and chimeric antigen receptor (CAR) T cell therapy. In this review, we summarize current evidence and future perspectives on CD24 as a potential target for cancer immunotherapy.
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18
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Syrigos N, Kollias A, Grapsa D, Fyta E, Kyriakoulis KG, Vathiotis I, Kotteas E, Syrigou E. Significant Increase in Blood Pressure Following BNT162b2 mRNA COVID-19 Vaccination among Healthcare Workers: A Rare Event. Vaccines (Basel) 2022; 10:vaccines10050745. [PMID: 35632501 PMCID: PMC9143263 DOI: 10.3390/vaccines10050745] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/05/2022] [Indexed: 12/10/2022] Open
Abstract
This brief report examined the frequency and characteristics of a significant blood-pressure (BP) increase after Pfizer-BioNTech BNT162b2 vaccination among healthcare workers who were advised to measure their BP at home. A total of 797 participants (mean age 48.1 ± 10.8 years, 63% women, 39% smokers) were included in the analysis. Seven participants reported an increase in their BP (three in the range of grade 2 and four in the range of grade 3 hypertension). Only one participant had a history of treated hypertension. The BP increase was observed at the end of the first week after the first dose, lasted for 3 to 4 days, and recurred promptly after the second dose. Only one case required hospitalization, mainly due to a history of cardiovascular disease (follow-up). Individuals experiencing a BP increase compared with those not reporting issues with their BP had a higher mean age and similar distribution of sex and non-smoking status. In conclusion, a significant BP increase after Pfizer-BioNTech vaccination seems to be rare and of a benign and transient nature. Monitoring the BP before and after vaccination might be advisable only for selected individuals with a high cardiovascular risk.
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Affiliation(s)
- Nikolaos Syrigos
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece; (N.S.); (A.K.); (D.G.); (E.F.); (K.G.K.); (I.V.); (E.K.)
| | - Anastasios Kollias
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece; (N.S.); (A.K.); (D.G.); (E.F.); (K.G.K.); (I.V.); (E.K.)
| | - Dimitra Grapsa
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece; (N.S.); (A.K.); (D.G.); (E.F.); (K.G.K.); (I.V.); (E.K.)
| | - Eleni Fyta
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece; (N.S.); (A.K.); (D.G.); (E.F.); (K.G.K.); (I.V.); (E.K.)
| | - Konstantinos G. Kyriakoulis
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece; (N.S.); (A.K.); (D.G.); (E.F.); (K.G.K.); (I.V.); (E.K.)
| | - Ioannis Vathiotis
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece; (N.S.); (A.K.); (D.G.); (E.F.); (K.G.K.); (I.V.); (E.K.)
| | - Elias Kotteas
- Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece; (N.S.); (A.K.); (D.G.); (E.F.); (K.G.K.); (I.V.); (E.K.)
| | - Ekaterini Syrigou
- Department of Allergy, Sotiria Hospital, 11527 Athens, Greece
- Correspondence: ; Tel./Fax: +30-210-7751063
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19
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Grammoustianou M, Syrigos K, Sarropoulou F, Patriarcheas V, Ptohis N, Charpidou A, Gkiozos I, Kouvela M, Gerotziafas G, Kainis E, Kotteas E, Dimakakos E. PO-39: Superior vena cava stenting: an effective and safe therapeutic choice for the treatment of superior vena cava syndrome in lung cancer patients. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00229-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Dimakakos E, Grammoustianou M, Sarropoulou F, Kouvela M, Gkiozos I, Kotteas E, Gerotziafas G, Mavroudis D, Syrigos K. PO-40: Therapeutic approaches of superior vena cava syndrome in patients with non-small cell lung cancer (NSCLC). Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00230-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Gomatou G, Masaoutis C, Vamvakaris I, Kotteas E, Bouros E, Tzilas V, Bouros D. Differential immunohistochemical expression of hTERT in lung cancer patients with and without idiopathic pulmonary fibrosis. Pulmonology 2022:S2531-0437(22)00002-2. [PMID: 35153179 DOI: 10.1016/j.pulmoe.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/05/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Human telomerase reverse transcriptase (hTERT) is the catalytic subunit of telomerase enzyme, which adds nucleotides to telomeres and counteracts their length shortening. The development of a telomere maintenance mechanism represents a hallmark of cancer. On the other hand, idiopathic pulmonary fibrosis (IPF) is associated with mutations in telomerase genes and shorter telomeres. IPF is frequently complicated with lung cancer. AIM To investigate the expression of hTERT in lung cancer with co-existing IPF and to compare with lung cancer without fibrosis. METHODS Diagnostic lung cancerous biopsies were retrieved from 18 patients with lung cancer and concomitant IPF, as well as 18 age and gender matched controls with lung cancer without pulmonary fibrosis. The expression of hTERT was studied with immunohistochemistry. ImajeJ software was used to quantitate subcellular stain intensity. Immunohistochemical investigation of two senescence-associated markers, p16 and p21, was also performed in all 36 cases. RESULTS Both groups highly expressed hTERT, without significant difference (100% vs 95%, p = 0.521). Evaluation of p16 and p21 immunostaining revealed negative to minimal immunoreactivity in both groups. hTERT localization exhibited higher median nuclear intensity in the group of lung cancer with IPF (0.62 vs 0.45, p = 0.016), while cytoplasmic intensity did not differ significantly (0.17 vs 0.15, p = 0.463). Higher median nuclear intensity was also correlated with small cell lung cancer subtype in the whole study sample (0.69 vs 0.45, p = 0.09). CONCLUSION hTERT is highly expressed in lung cancer with concomitant IPF, but with differential localization compared to lung cancer without IPF, implying differences in pathogenicity and requiring further investigation.
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Affiliation(s)
- G Gomatou
- Interstitial Lung Diseases Unit, 1st Department of Respiratory Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece; Oncology Unit, Third Department of Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece.
| | - C Masaoutis
- 1st Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - I Vamvakaris
- Department of Pathology, "Sotiria" Hospital for Diseases of the Chest, Athens, Greece
| | - E Kotteas
- Oncology Unit, Third Department of Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - E Bouros
- Interstitial Lung Diseases Unit, 1st Department of Respiratory Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - V Tzilas
- Center for Diseases of the Chest, Athens Medical Center, Athens, Greece
| | - D Bouros
- Interstitial Lung Diseases Unit, 1st Department of Respiratory Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece; Center for Diseases of the Chest, Athens Medical Center, Athens, Greece
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22
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Patriarcheas V, Grammoustianou M, Ptohis N, Thanou I, Kostis M, Gkiozos I, Charpidou A, Trontzas I, Syrigos N, Kotteas E, Dimakakos E. Malignant Superior Vena Cava Syndrome: State of the Art. Cureus 2022; 14:e20924. [PMID: 35004083 PMCID: PMC8727327 DOI: 10.7759/cureus.20924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 11/05/2022] Open
Abstract
Superior vena cava syndrome (SVCS) is a clinical entity characterized by signs and symptoms arising from the obstruction or occlusion of the thin-walled superior vena cava (SVC) and can result in significant morbidity and mortality. Despite the rise of benign cases of SVCS, as a thrombotic complication of intravascular devices, it is most commonly seen secondary to malignancy as a consequence of thrombosis, direct invasion of tumor cells inside the vessel, or external compression. SVCS can be the initial presentation of a previously undiagnosed tumor in up to 60% of cases. Lung cancer and non-Hodgkin lymphoma (NHL) are responsible for up to 85%-90% of malignancy-related SVCS, while metastatic cancers account for approximately 10%. Herein, we review the pathophysiology, etiology, clinical presentation, diagnosis, and management of malignancy-related SVCS.
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23
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Tsamis I, Chachali SP, Gomatou G, Trontzas I, Mitsogianni M, Syrigos N, Vamvakaris I, Kotteas E. Pulmonary blastoma: a comprehensive overview of a rare entity. Adv Respir Med 2021; 89:511-519. [PMID: 34725809 DOI: 10.5603/arm.a2021.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/09/2021] [Accepted: 04/30/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Pulmonary blastoma is a rare malignancy, accounting for less than 0.5% of primary lung tumors. It belongs to the group of pulmonary sarcomatoid carcinomas, and it is typically characterized by a biphasic pattern of an epithelial and a mesenchymal component. Only a few hundred cases have been reported worldwide. The aim of this study is to review and critically assess the literature regarding pulmonary blastoma. MATERIAL AND METHODS A narrative literature review of PubMed database from the inception of the database up to January 2021, limited to the English language, was conducted, using combinations of the following keywords: "pulmonary blastoma", "biphasic pulmonary blastoma", "sarcomatoid carcinoma". RESULTS Pulmonary blastoma is composed of an epithelial and a mesenchymal malignant component. Regarding pathogenesis, the origin of the biphasic cell population remains elusive. Characteristic immunohistochemical stains are supportive of diagnosis.Clinically, the symptomatology is non-specific, while 40% of the cases are asymptomatic. It is diagnosed at a younger agecompared to other types of lung cancer, and it is often non-metastatic at diagnosis allowing for surgical treatment. Data on management and survival are scarce and mainly come from isolated cases. Advances on targeted therapy may provide novel treatment options. Given the rarity of the cases, multicenter collaboration is needed in order to establish therapeutic guidelines.
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Affiliation(s)
- Ioannis Tsamis
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Messogion, Athens, Greece
| | - Stavroula-Porfyria Chachali
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Georgia Gomatou
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Messogion, Athens, Greece.
| | - Ioannis Trontzas
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Messogion, Athens, Greece
| | - Maria Mitsogianni
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Messogion, Athens, Greece
| | - Nikolaos Syrigos
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Messogion, Athens, Greece
| | - Ioannis Vamvakaris
- Pathology Department, Sotiria General Hospital, Messogion, Athens, Greece
| | - Elias Kotteas
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, Messogion, Athens, Greece
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24
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Panagiotou E, Gomatou G, Trontzas IP, Syrigos N, Kotteas E. Cyclin-dependent kinase (CDK) inhibitors in solid tumors: a review of clinical trials. Clin Transl Oncol 2021; 24:161-192. [PMID: 34363593 DOI: 10.1007/s12094-021-02688-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/27/2021] [Indexed: 12/24/2022]
Abstract
Cyclin-dependent kinases (CDKs) play a key regulating role in the cell cycle, which is almost universally altered in cancer, leading to sustained proliferation. Early pan-CDK inhibitors showed poor results in clinical trials for solid malignancies, as the lack of selectivity produced significant toxicity. The production of more selective inhibitors led to significant developments in cancer therapy, as CDK4/6 inhibitors in combination with endocrine therapy changed the landscape of the treatment of hormone-receptor positive (HR +) metastatic breast cancer. Recently, Trilaciclib demonstrated benefits regarding hematological toxicity compared to placebo when administered in combination with chemotherapy in small cell lung cancer. Newer agents, such as SY-5609, a selective CDK7 inhibitor, have also shown promising results in early clinical trials. In this paper, we review the data from clinical trials of CDK inhibitors in solid tumors, either as a monotherapy or in combination with other agents, with an emphasis on novel agents and potential new indications for this drug class.
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Affiliation(s)
- E Panagiotou
- Oncology Unit, Sotiria General Hospital, Athens School of Medicine, 152 Mesogeion Avenue, 11527, Athens, Greece.
| | - G Gomatou
- Oncology Unit, Sotiria General Hospital, Athens School of Medicine, 152 Mesogeion Avenue, 11527, Athens, Greece
| | - I P Trontzas
- Oncology Unit, Sotiria General Hospital, Athens School of Medicine, 152 Mesogeion Avenue, 11527, Athens, Greece
| | - N Syrigos
- Oncology Unit, Sotiria General Hospital, Athens School of Medicine, 152 Mesogeion Avenue, 11527, Athens, Greece
| | - E Kotteas
- Oncology Unit, Sotiria General Hospital, Athens School of Medicine, 152 Mesogeion Avenue, 11527, Athens, Greece
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Fountzilas E, Lampaki S, Koliou GA, Koumarianou A, Levva S, Vagionas A, Christopoulou A, Laloysis A, Psyrri A, Binas I, Mountzios G, Kentepozidis N, Kotsakis A, Saloustros E, Boutis A, Nikolaidi A, Fountzilas G, Georgoulias V, Chrysanthidis M, Kotteas E, Vo H, Tsiatas M, Res E, Linardou H, Daoussis D, Bompolaki I, Andreadou A, Papaxoinis G, Spyratos D, Gogas H, Syrigos KN, Bafaloukos D. Real-world safety and efficacy data of immunotherapy in patients with cancer and autoimmune disease: the experience of the Hellenic Cooperative Oncology Group. Cancer Immunol Immunother 2021; 71:327-337. [PMID: 34164709 PMCID: PMC8783878 DOI: 10.1007/s00262-021-02985-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/08/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Data on the safety and efficacy of immune checkpoint inhibitors (ICI) in patients with concurrent autoimmune diseases (AID) are limited. METHODS We performed a retrospective multicenter review of medical records of patients with cancer and underlying AID who received ICI. The primary endpoint was progression-free survival (PFS). RESULTS Among 123 patients with pre-existing AID who received ICI, the majority had been diagnosed with non-small cell lung cancer (NSCLC, 68.3%) and melanoma (14.6%). Most patients had a rheumatologic (43.9%), or an endocrine disorder (21.1%). Overall, 74 (60.2%) patients experienced an immune-related adverse event (irAE) after ICI initiation, AID flare (25.2%), or new irAE (35%). Frequent irAEs included thyroiditis, dermatitis and colitis. ICI was permanently discontinued due to unacceptable (8.1%) or fatal (0.8%) toxicity. In patients with NSCLC, corticosteroid treatment at the initiation of immunotherapy was associated with poor PFS (HR = 2.78, 95% CI 1.40-5.50, p = 0.003). The occurrence of irAE was associated with increased PFS (HR = 0.48, 95% CI 0.25-0.92, p = 0.026). Both parameters maintained their independent prognostic significance. CONCLUSIONS ICI in patients with cancer and pre-existing AID is associated with manageable toxicity that infrequently requires treatment discontinuation. However, since severe AID flare might occur, expected ICI efficacy and toxicity must be balanced. CLINICAL TRIAL IDENTIFIER NCT04805099.
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Affiliation(s)
- Elena Fountzilas
- Second Department of Medical Oncology, Euromedica General Clinic of Thessaloniki, Gravias 5, 54645, Thessaloniki, Greece. .,European University Cyprus, Engomi, Cyprus.
| | - Sofia Lampaki
- Pulmonary Department, Lung Cancer Oncology Unit, Aristotle University of Thessaloniki, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Anna Koumarianou
- Hematology-Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Levva
- Department of Medical Oncology, Bioclinic of Thessaloniki, Thessaloniki, Greece.,Department of Medical Oncology, Interbalkan Medical Center, Thessaloniki, Greece
| | | | | | | | - Amanda Psyrri
- Section of Medical Oncology, Department of Internal Medicine, Attikon University Hospital, Faculty of Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Ioannis Binas
- Second Department of Medical Oncology, Metropolitan Hospital, Piraeus, Greece
| | - Giannis Mountzios
- Fourth Department of Medical Oncology and Clinical Trials Unit, Henry Dunant Hospital Center, Athens, Greece
| | | | - Athanassios Kotsakis
- Department of Oncology, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Emmanouil Saloustros
- Department of Oncology, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Anastasios Boutis
- First Department of Clinical Oncology, Theagenio Hospital, Thessaloniki, Greece
| | | | - George Fountzilas
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki, Greece.,Aristotle University of Thessaloniki, Thessaloniki, Greece.,German Oncology Center, Limassol, Cyprus
| | | | | | - Elias Kotteas
- Oncology Unit GPP, Sotiria General Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Henry Vo
- Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marinos Tsiatas
- Department of Oncology, Athens Medical Center, Athens, Greece
| | - Eleni Res
- Third Department of Medical Oncology, Agii Anargiri Cancer Hospital, Athens, Greece
| | - Helena Linardou
- Fourth Oncology Department, Metropolitan Hospital, Piraeus, Greece
| | - Dimitrios Daoussis
- Department of Internal Medicine, Division of Rheumatology, University of Patras Medical School, Patras University Hospital, Rion, Greece
| | | | - Anna Andreadou
- Third Department of Medical Oncology, Theagenio Hospital, Thessaloniki, Greece
| | - George Papaxoinis
- Second Department of Internal Medicine, Agios Savvas Cancer Hospital, Athens, Greece
| | - Dionisios Spyratos
- Pulmonary Department, Lung Cancer Oncology Unit, Aristotle University of Thessaloniki, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Helen Gogas
- First Department of Medicine, Laiko General Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Konstantinos N Syrigos
- Oncology Unit GPP, Sotiria General Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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Dimakakos E, Livanios K, Vathiotis I, Gomatou G, Gkiozos I, Kotteas E, Kainis E, Syrigos K. Risk Factors for Venous Thromboembolism in Patients With Small Cell Lung Cancer. Anticancer Res 2021; 41:1523-1528. [PMID: 33788745 DOI: 10.21873/anticanres.14911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Small cell lung cancer (SCLC) accounts for 13% of all lung cancers. Venous thromboembolism (VTE) is a frequent complication. The purpose of this study was to investigate the incidence and risk factors for VTE in SCLC patients. PATIENTS AND METHODS Retrospective analysis of patients with histologically confirmed SCLC treated between January 2015 and June 2018 at Sotiria General Hospital, Athens, Greece. RESULTS Two hundred and seventeen patients were included in the analysis. The incidence of VTE was 4.1%. Increased body mass index (BMI) was correlated with the development of VTE. Moreover, VTE appeared more frequently in patients with major vessel infiltration and with poor Eastern Cooperative Oncology Group Performance Status. Other factors, including gender, age, stage, presence of metastasis, treatment, immobilization, anticoagulation, comorbidities, and laboratory values did not correlate with the development of VTE. CONCLUSION Factors associated with the development of VTE were BMI, major vessel infiltration and PS. Identifying factors that predispose to VTE could help physicians detect high-risk patients who would benefit from prophylactic anticoagulation therapy.
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Affiliation(s)
- Evangelos Dimakakos
- Oncology Unit, 3 Department of Medicine, "Sotiria" General Hospital, Schoolof Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Livanios
- Oncology Unit, 3 Department of Medicine, "Sotiria" General Hospital, Schoolof Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Vathiotis
- Oncology Unit, 3 Department of Medicine, "Sotiria" General Hospital, Schoolof Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Gomatou
- Oncology Unit, 3 Department of Medicine, "Sotiria" General Hospital, Schoolof Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Gkiozos
- Oncology Unit, 3 Department of Medicine, "Sotiria" General Hospital, Schoolof Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Kotteas
- Oncology Unit, 3 Department of Medicine, "Sotiria" General Hospital, Schoolof Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Kainis
- Oncology Unit, 3 Department of Medicine, "Sotiria" General Hospital, Schoolof Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Syrigos
- Oncology Unit, 3 Department of Medicine, "Sotiria" General Hospital, Schoolof Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Dimakakos E, Cholidou K, Mpakakos P, Anagnostopoulos N, Gkiozos I, Syrigos N, Kotteas E, Gerotziafas G. PO-50 The role of the blood factors in the survival of patients with non-small cell lung cancer. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00223-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dimakakos E, Basdeki K, Gkiozos I, Tsagkouli S, Rovina N, Mpakakos P, Ptohis N, Trontzas I, Kotteas E, Syrigos K. PO-17 Mesothelioma: a retrospective study of thromboembolism events. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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29
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Dimakakos E, Livanios K, Kainis E, Vassias A, Stefanou D, Kotteas E, Gerotziafas G, Syrigos K. PO-16 Venous thromboembolism in small cell lung cancer patients: an epidemiological study. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00189-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dimakakos E, Vathiotis J, Toki M, Charpidou A, Pantazopoulos K, Kotteas E, Syrigos K. PO-62 Tinzaparin: anti-cancer properties? Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00235-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gomatou G, Trontzas I, Ioannou S, Drizou M, Syrigos N, Kotteas E. Mechanisms of resistance to cyclin-dependent kinase 4/6 inhibitors. Mol Biol Rep 2021; 48:915-925. [PMID: 33409716 DOI: 10.1007/s11033-020-06100-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Abstract
Cyclin-dependent kinase (CDK) 4/6 inhibitors have emerged in the treatment of metastatic hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer. However, most patients will eventually present disease progression, highlighting the inevitable resistance of cancer cells to CDK4/6 inhibition. Several studies have suggested that resistance mechanisms involve aberrations of the molecules that regulate the cell cycle, and the re-wiring of the cell to escape CDK4/6 dependence and turn to alternative pathways. Loss of retinoblastoma function, overexpression of CDK 6, upregulation of cyclin E, overexpression of CDK 7, and dysregulation of several signaling pathways, notably the PI3/AKT/mTOR pathway, have been implicated in the development of resistance to CDK4/6 inhibitors. Overlap with endocrine resistance mechanisms might be possible. Combinational therapeutic strategies should be explored in order to prevent resistance and optimize the management of patients after progression under CDK 4/6 inhibition.
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Affiliation(s)
- Georgia Gomatou
- Oncology Unit, 3rd Department of Medicine, 'Sotiria' General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Ioannis Trontzas
- Oncology Unit, 3rd Department of Medicine, 'Sotiria' General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stephanie Ioannou
- Oncology Unit, 3rd Department of Medicine, 'Sotiria' General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Drizou
- Oncology Unit, 3rd Department of Medicine, 'Sotiria' General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Syrigos
- Oncology Unit, 3rd Department of Medicine, 'Sotiria' General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Kotteas
- Oncology Unit, 3rd Department of Medicine, 'Sotiria' General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Gomatou G, Tzilas V, Kotteas E, Syrigos K, Bouros D. Immune Checkpoint Inhibitor-Related Pneumonitis. Respiration 2020; 99:932-942. [PMID: 33260191 DOI: 10.1159/000509941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/04/2020] [Indexed: 11/19/2022] Open
Abstract
Immune checkpoint inhibitors are novel agents that have been proved efficacious in a variety of cancer types, but they are associated with a unique set of organ-specific, immune-related adverse events. Among them, immune-related pneumonitis requires special attention because it is difficult to diagnose and potentially lethal. Accumulating real-world epidemiological data suggest that immune-related pneumonitis is more frequent than previously reported. Its diagnosis requires exclusion of other causes and assessment of radiographic features on high-resolution CT of the chest. Management of immune-related pneumonitis is based on the use of immunosuppressants. Future research should be focused on finding predictive biomarkers for immune-related pneumonitis as well as optimizing its management.
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Affiliation(s)
- Georgia Gomatou
- Interstitial Lung Diseases Unit, 1st Department of Respiratory Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece, .,Oncology Unit, 3rd Department of Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece,
| | - Vasilios Tzilas
- Interstitial Lung Diseases Unit, 1st Department of Respiratory Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Kotteas
- Oncology Unit, 3rd Department of Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Syrigos
- Oncology Unit, 3rd Department of Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - Demosthenes Bouros
- Interstitial Lung Diseases Unit, 1st Department of Respiratory Medicine, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
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Theodoropoulos AS, Gkiozos I, Kontopyrgias G, Charpidou A, Kotteas E, Kyrgias G, Tolia M. Modern radiopharmaceuticals for lung cancer imaging with positron emission tomography/computed tomography scan: A systematic review. SAGE Open Med 2020; 8:2050312120961594. [PMID: 33062275 PMCID: PMC7534078 DOI: 10.1177/2050312120961594] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 08/27/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction: In this study, we evaluated the use and the contribution of radiopharmaceuticals to the field of lung neoplasms imaging using positron emission tomography/computed tomography. Methods: We conducted review of the current literature at PubMed/MEDLINE until February 2020. The search language was English. Results: The most widely used radiopharmaceuticals are the following: Experimental/pre-clinical approaches: (18)F-Misonidazole (18F-MISO) under clinical development, D(18)F-Fluoro-Methyl-Tyrosine (18F-FMT), 18F-FAMT (L-[3-18F] (18)F-Fluorothymidine (18F-FLT)), (18)F-Fluoro-Azomycin-Arabinoside (18F-FAZA), (68)Ga-Neomannosylated-Human-Serum-Albumin (68Ga-MSA) (23), (68)Ga-Tetraazacyclododecane (68Ga-DOTA) (as theranostic agent), (11)C-Methionine (11C-MET), 18F-FPDOPA, ανβ3 integrin, 68Ga-RGD2, 64Cu-DOTA-RGD, 18F-Alfatide, Folate Radio tracers, and immuno-positron emission tomography radiopharmaceutical agents. Clinically approved procedures/radiopharmaceuticals agents: (18)F-Fluoro-Deoxy-Glucose (18F-FDG), (18)F-sodium fluoride (18F-NaF) (bone metastases), and (68)Ga-Tetraazacyclododecane (68Ga-DOTA). The quantitative determination and the change in radiopharmaceutical uptake parameters such as standard uptake value, metabolic tumor volume, total lesion glycolysis, FAZA tumor to muscle ratio, standard uptake value tumor to liver ratio, standard uptake value tumor to spleen ratio, standard uptake value maximum ratio, and the degree of hypoxia have prognostic and predictive (concerning the therapeutic outcome) value. They have been associated with the assessment of overall survival and disease free survival. With the positron emission tomography/computed tomography radiopharmaceuticals, the sensitivity and the specificity of the method have increased. Conclusion: In terms of lung cancer, positron emission tomography/computed tomography may have clinical application and utility (a) in personalizing treatment, (b) as a biomarker for the estimation of overall survival, disease free survival, and (c) apply a cost-effective patient approach because it reveals focuses of the disease, which are not found with the other imaging methods.
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Affiliation(s)
- Athanasios S Theodoropoulos
- Third Department of Medicine, Oncology Unit, School of Medicine, Sotiria General Hospital, University of Athens, Athens, Greece.,Interventional Department of Cardiology-Cardiac Catheterization Laboratory, Thriassio General Hospital of Elefsina, Athens, Greece
| | - Ioannis Gkiozos
- Third Department of Medicine, Oncology Unit, School of Medicine, Sotiria General Hospital, University of Athens, Athens, Greece
| | - Georgios Kontopyrgias
- Third Department of Medicine, Oncology Unit, School of Medicine, Sotiria General Hospital, University of Athens, Athens, Greece
| | - Adrianni Charpidou
- Third Department of Medicine, Oncology Unit, School of Medicine, Sotiria General Hospital, University of Athens, Athens, Greece
| | - Elias Kotteas
- Third Department of Medicine, Oncology Unit, School of Medicine, Sotiria General Hospital, University of Athens, Athens, Greece
| | - George Kyrgias
- Department of Radiotherapy/Radiation Oncology, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larissa, Biopolis, Larisa, Greece
| | - Maria Tolia
- Department of Radiotherapy/Radiation Oncology, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larissa, Biopolis, Larisa, Greece
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Sollena P, Nikolaou V, Soupos N, Kotteas E, Voudouri D, Stratigos AJ, Fattore D, Annunziata MC, Orlandi A, Di Nardo L, Apalla Z, Deilhes F, Romano MC, Fabbrocini G, Sibaud V, Peris K. Vitiligo-like lesions in patients with advanced breast cancer treated with cycline-dependent kinases 4 and 6 inhibitors. Breast Cancer Res Treat 2020; 185:247-253. [PMID: 32914354 DOI: 10.1007/s10549-020-05914-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/01/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Introduction of cyclin-dependent inhibitors was a milestone in therapeutics for patients with estrogen receptor+/HER2- metastatic breast cancer. Despite the wide use of such agents and remarkable improvement of survival rates, drug-related adverse events are not yet fully characterized. We describe vitiligo-like lesions as a new adverse event occurring in patients with advanced breast cancer treated with cyclin-dependent inhibitors. METHODS We performed an international retrospective study including patients with advanced breast cancer who developed vitiligo-like lesions during treatment with cyclin-dependent kinases 4 and 6 inhibitors, in the period January 2018-December 2019. Patients > 18 years, both males and females, were recruited at six Dermatology Departments located in Italy (3), France (1) and Greece (2). We evaluated epidemiological and clinical characteristics, impact on quality of life and outcome of vitiligo-like lesions in patients treated with cyclin-dependent 4 and 6 inhibitors. The percentage of skin involved by vitiligo-like lesions was assessed using the Body Surface Area (BSA) score. Changes in patients' quality of life were investigated through the evaluation of the Dermatology Life Quality Index (DLQI) questionnaire. RESULTS Sixteen women (median age: 62.5 years; range 40-79 years) treated with cyclin-dependent kinases 4 and 6 inhibitors for advanced breast cancer presented with vitiligo-like lesions during follow-up visits. Cutaneous lesions consisted of white, irregular macules and patches located mainly on sun-exposed areas in 11/16 patients or diffuse to the entire body surface in 5/16. Cutaneous lesions clearly impaired the quality of life of patients tested (DLQI ≥ 10). CONCLUSIONS We present for the first time, to our knowledge, a case series of vitiligo-like lesions developing in patients with advanced breast cancer treated with cyclin-dependent kinases 4 and 6 inhibitors. We showed that such lesions further impair the patients' quality of life and their treatment is challenging.
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Affiliation(s)
- Pietro Sollena
- UOC Dermatologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS, L.go Agostino Gemelli 8, 00168, Rome, Italy.
| | - Vasiliki Nikolaou
- Dermato-Oncology Department, Cutaneous Toxicities Clinic, Andreas Sygros Hopital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Soupos
- Second Department of Medical Oncology, Agii Anargiri General Oncological Hospital of Kifissia, Athens, Greece
| | - Elias Kotteas
- Third Department of Medicine, Oncology Unit, Sotiria General HospitalNational and Kapodistrian University, Athens School of Medicine, Athens, Greece
| | - Dimitra Voudouri
- Dermato-Oncology Department, Cutaneous Toxicities Clinic, Andreas Sygros Hopital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros J Stratigos
- Dermato-Oncology Department, Cutaneous Toxicities Clinic, Andreas Sygros Hopital, National and Kapodistrian University of Athens, Athens, Greece
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maria Carmela Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Armando Orlandi
- Medical Oncology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - Lucia Di Nardo
- Dermatologia,, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Zoe Apalla
- Second Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Florian Deilhes
- Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | | | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Vincent Sibaud
- Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | - Ketty Peris
- UOC Dermatologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS, L.go Agostino Gemelli 8, 00168, Rome, Italy
- Dermatologia,, Università Cattolica del Sacro Cuore, Rome, Italy
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Dimakakos E, Kotteas E, Gomatou G, Katsarou T, Vlahakos V, Vathiotis I, Talagani S, Dimitroulis I, Syrigos K. Do we need prophylactic anticoagulation in ambulatory patients with lung cancer? A review. Vasc Med 2020; 25:255-262. [PMID: 32146869 DOI: 10.1177/1358863x19899160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Venous thromboembolism is a common complication of malignancy. Lung cancer is considered one of the most thrombogenic cancer types. Primary thromboprophylaxis is not currently recommended for all ambulatory patients with active cancer. In the present narrative review we aim to summarize recent data on the safety and efficacy of primary thromboprophylaxis as well as on venous thromboembolism risk assessment, focusing on ambulatory patients with lung cancer. A potential benefit from prophylactic anticoagulation with low molecular weight heparins in terms of venous thromboembolism risk reduction and increased overall survival in patients with lung cancer, without a significant increase in bleeding risk, has been reported in several studies. Recent studies also reveal promising results of direct oral anticoagulants regarding their efficacy as primary thromboprophylaxis in patients with cancer, including those with lung cancer. However, the use of different study methodologies and the heterogeneity of study populations among the trials limit the extraction of definite results. More randomized, controlled trials, restricted to a well-characterized population of patients with lung cancer, are greatly anticipated. The use of risk assessment tools for stratification of venous thromboembolic risk is warranted. The development of an accurate and practical risk assessment model for patients with lung cancer represents an unmet need.
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Affiliation(s)
- Evangelos Dimakakos
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Elias Kotteas
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Georgia Gomatou
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Theodora Katsarou
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Vassilis Vlahakos
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Ioannis Vathiotis
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Sofia Talagani
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Ioannis Dimitroulis
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Konstantinos Syrigos
- Oncology Unit, 3rd Department of Medicine, National and Kapodistrian University of Athens, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
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Charpidou A, Kotteas E, Gaga M. Towards precision medicine: CCL2, another brick in the wall? Eur Respir J 2019; 53:53/3/1802327. [PMID: 30846448 DOI: 10.1183/13993003.02327-2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/11/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Andriani Charpidou
- Oncology Unit, 3rd Internal Medicine Dept, Medical School, National Kapodistrian University of Athens, Athens Chest Hospital Sotiria, Athens, Greece
| | - Elias Kotteas
- Oncology Unit, 3rd Internal Medicine Dept, Medical School, National Kapodistrian University of Athens, Athens Chest Hospital Sotiria, Athens, Greece
| | - Mina Gaga
- 7th Respiratory Medicine Dept, Athens Chest Hospital Sotiria, Athens, Greece
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Syrigos K, Grapsa D, Sangare R, Evmorfiadis I, Larsen AK, Van Dreden P, Boura P, Charpidou A, Kotteas E, Sergentanis TN, Elalamy I, Falanga A, Gerotziafas GT. Prospective Assessment of Clinical Risk Factors and Biomarkers of Hypercoagulability for the Identification of Patients with Lung Adenocarcinoma at Risk for Cancer-Associated Thrombosis: The Observational ROADMAP-CAT Study. Oncologist 2018; 23:1372-1381. [PMID: 30104289 DOI: 10.1634/theoncologist.2017-0530] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 03/22/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of this prospective study was to identify the most clinically relevant hypercoagulability biomarkers in lung adenocarcinoma patients for elaboration of an improved risk assessment model (RAM) for venous thromboembolism (VTE). SUBJECTS, MATERIALS, AND METHODS One hundred fifty ambulatory patients with lung adenocarcinoma were prospectively enrolled. Thrombin generation, procoagulant phospholipid-dependent clotting time (Procoag-PPL), tissue factor activity (TFa), factor VIIa (FVIIa), factor V (FV), antithrombin, D-Dimers, P-selectin, and heparanase levels were assessed in platelet-poor plasma at inclusion (baseline) and at the end of the third chemotherapy cycle (third chemotherapy). Cox regression analysis was used to identify independent VTE predictors. RESULTS At baseline, patients had significantly attenuated thrombin generation, shorter Procoag-PPL, higher levels of TFa, D-Dimers, and heparanase, and lower levels of FVIIa and P-selectin, compared with controls. A significant increase in Procoag-PPL, FV, and FVIIa and a decrease of P-selectin levels were observed between baseline and third chemotherapy. Hospitalization within the last 3 months prior to assessment, time since cancer diagnosis less than 6 months, mean rate index (MRI) of thrombin generation, and Procoag-PPL were independently associated with symptomatic VTE. Accordingly, a prediction model including Procoag-PPL and MRI showed significant discriminating capacity (area under the curve: 0.84). CONCLUSION Ambulatory patients with lung adenocarcinoma may display pronounced blood hypercoagulability due to decreased Procoag-PPL, increased endothelial cell activation, and increased degradation of fibrin. Incorporation of Procoag-PPL and MRI of thrombin generation may improve the accuracy of a VTE-RAM in the above setting. IMPLICATIONS FOR PRACTICE The prospective ROADMAP-CAT study identified two biomarkers of hypercoagulability, the procoagulant phospholipid-dependent clotting time (Procoag-PPL) and the mean rate index (MRI) of the propagation phase of thrombin generation assessed with the Calibrated Automated Thrombinoscope, as being clinically relevant for the classification of ambulatory patients with lung adenocarcinoma receiving a maximum of one cycle of chemotherapy into high and intermediate/low risk for venous thromboembolism. Measurement of Procoag-PPL and MRI within 1 month after the administration of the first chemotherapy cycle provides significant accuracy of the assessment. Association of the Procoag-PPL and MRI with the clinical risk assessment model for cancer-associated thrombosis in ambulatory patients with solid tumors (COMPASS-CAT RAM) further improved its accuracy.
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Affiliation(s)
- Konstantinos Syrigos
- Oncology Unit, 3rd Dept. of Medicine, National and Kapodistrian University of Athens, School of Medicine, "Sotiria" General Hospital, Athens, Greece
| | - Dimitra Grapsa
- Oncology Unit, 3rd Dept. of Medicine, National and Kapodistrian University of Athens, School of Medicine, "Sotiria" General Hospital, Athens, Greece
| | - Rabiatou Sangare
- Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, INSERM U938, Institut Universitaire de Cancérologie (IUC), Faculté de Médecine, Sorbonne Université, Paris, France
| | - Ilias Evmorfiadis
- Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, INSERM U938, Institut Universitaire de Cancérologie (IUC), Faculté de Médecine, Sorbonne Université, Paris, France
| | - Annette K Larsen
- Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, INSERM U938, Institut Universitaire de Cancérologie (IUC), Faculté de Médecine, Sorbonne Université, Paris, France
| | | | - Paraskevi Boura
- Oncology Unit, 3rd Dept. of Medicine, National and Kapodistrian University of Athens, School of Medicine, "Sotiria" General Hospital, Athens, Greece
| | - Andriani Charpidou
- Oncology Unit, 3rd Dept. of Medicine, National and Kapodistrian University of Athens, School of Medicine, "Sotiria" General Hospital, Athens, Greece
| | - Elias Kotteas
- Oncology Unit, 3rd Dept. of Medicine, National and Kapodistrian University of Athens, School of Medicine, "Sotiria" General Hospital, Athens, Greece
| | - Theodoros N Sergentanis
- Service d'Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Ismail Elalamy
- Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, INSERM U938, Institut Universitaire de Cancérologie (IUC), Faculté de Médecine, Sorbonne Université, Paris, France
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Falanga
- Department of Immunohematology and Transfusion Medicine, & the Hemostasis and Thrombosis Center, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Grigoris T Gerotziafas
- Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, INSERM U938, Institut Universitaire de Cancérologie (IUC), Faculté de Médecine, Sorbonne Université, Paris, France
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Syrigos K, Ntineri A, Bakakos P, Grapsa D, Dalakou E, Kotteas E, Charpidou A. 229P Clinical and laboratory markers of prognosis in lung cancer patients with hypercalcemia. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Syrigos KN, Vassos D, Gkiozos I, Boura P, Kaltsas S, Kotteas E, Charpidou A. Bone metastases in patients with small cell lung carcinoma: Rate of development, modality of treatment, and their impact on survival. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e18559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Dimitrios Vassos
- Oncology Unit GPP, "Sotiria" General Hospital, Athens School of Medicine, Athens, Greece
| | - Ioannis Gkiozos
- Oncology Unit, 3rd University Department of Medicine, General and Chest Diseases Hospital "Sotiria", Athens, Greece
| | - Paraskevi Boura
- Oncology Unit GPP, "Sotiria" General Hospital, Athens School of Medicine, Athens, Greece
| | - Serafeim Kaltsas
- Oncology Unit GPP, "Sotiria" General Hospital, Athens School of Medicine, Athens, Greece
| | - Elias Kotteas
- Oncology Unit GPP, "Sotiria" General Hospital, Athens School of Medicine, Athens, Greece
| | - Andriani Charpidou
- Oncology Unit GPP, "Sotiria" General Hospital, Athens School of Medicine, Athens, Greece
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Abstract
BACKGROUND Coexistence of an adrenocortical carcinoma and pregnancy is extremely rare with only 25 described cases so far, and has a poor prognosis. CASE REPORT We report the case of a 28-year-old patient with adrenocortical carcinoma initially presenting with Cushing's syndrome and pre-eclampsia in the 22nd week of gestation, treated in our department. She underwent adrenalectomy, but eventually died from metastatic disease. We focus on existing treatment options and concerns for this rare malignancy during pregnancy. CONCLUSION Early diagnosis and surgery are the cornerstones for better outcome.
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Affiliation(s)
- Elias Kotteas
- Department of Medical Oncology, School of Medicine, University of Ioannina, Greece.
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Syrigou E, Makrilia N, Kotteas E, Psarros F, Syrigos K. Hypersensitivity To Docetaxel: Retrospective Study And Desensitization Protocol. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Syrigou E, Dannos I, Kotteas E, Makrilia N, Tourkantonis I, Dilana K, Gkiozos I, Saif MW, Syrigos KN. Hypersensitivity Reactions to Docetaxel: Retrospective Evaluation and Development of a Desensitization Protocol. Int Arch Allergy Immunol 2011; 156:320-4. [DOI: 10.1159/000324454] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 01/17/2011] [Indexed: 11/19/2022] Open
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Ralli M, Tourkantonis I, Makrilia N, Gkini E, Kotteas E, Gkiozos I, Katirtzoglou N, Syrigos K. Docetaxel plus gemcitabine as first-line treatment in malignant pleural mesothelioma: a single institution phase II study. Anticancer Res 2009; 29:3441-3444. [PMID: 19661370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND The cisplatin-pemetrexed and cisplatin-gemcitabine combinations are considered the standard treatment for malignant pleural mesothelioma. The purpose of this study was to examine the efficacy of gemcitabine plus docetaxel in the first-line setting, as this combination has not been investigated in mesothelioma before. PATIENTS AND METHODS Twenty-five consecutive patients with malignant pleural mesothelioma were enrolled. They received 80 mg/m(2) of docetaxel and 1,000 mg/m(2) of gemcitabine on days 1 and 14 of a 28-day cycle. The treatment was scheduled for a maximum of 6 cycles or until disease progression or unacceptable toxicity. RESULTS A total of 7 out of our 25 patients (28%) responded to treatment. In 14 patients (56%), the disease remained stable, while in 4 (16%) it progressed. The median time to progression was 7 months (range: 5.4-8.6 months) and the median overall survival was 15 months (range: 12.4-17.5 months). CONCLUSION The administration of gemcitabine and doctaxel appears to be promising first-line therapy for patients with mesothelioma, as it is well tolerated and appears to improve survival.
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Affiliation(s)
- Maria Ralli
- Oncology Unit, 3rd Department of Medicine, Athens University School of Medicine, Building Z, Sotiria General Hospital, Mesogion 152, 11527 Athens, Greece.
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Syrigos K, Katirtzoglou N, Kotteas E, Harrington K. Adhesion Molecules in Lung Cancer: Implications in the Pathogenesis and Management. Curr Pharm Des 2008; 14:2173-83. [DOI: 10.2174/138161208785740162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Karapanagiotou EM, Charpidou A, Tzannou I, Dilana K, Kotteas E, Tourkantonis I, Kosmas E, Provata A, Syrigos K. A phase II study of sequential docetaxel and gemcitabine followed by docetaxel and carboplatin as first-line therapy for non-small cell lung cancer. Med Oncol 2008; 25:303-8. [PMID: 18204976 DOI: 10.1007/s12032-007-9036-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Accepted: 12/14/2007] [Indexed: 01/11/2023]
Abstract
Our study involves a preliminary phase II trial, which evaluates the activity, feasibility and tolerability of a sequential combination of docetaxel and gemcitabine followed by docetaxel and carboplatin, as first-line treatment for inoperable NSCLC. Twenty-six chemo-naïve patients aged less than 75 years with histologically or cytologically confirmed unresectable stage IIIB, IV or relapsed post-operative metastatic NSCLC were included in the study. Gemcitabine 1,250 mg/m(2) was administered and was followed by docetaxel 65 mg/m(2). Treatment was administered on days 1 and 14 in a 28-day cycle for three consecutive cycles. If patients had no progressive disease after three cycles of chemotherapy, they received another three cycles of docetaxel 65 mg/m(2) followed by carboplatin AUC5 on day 1 in a 21-day cycle. Recombinant human granocyte colony-stimulating factor (rhG-CSF) was given prophylactically. In addition, all patients received standard pre- and post- treatment with oral dexamethasone. Response rates at three cycles were: 19% achieved a partial response (PR), 46% had stable disease (SD) and 23% had progressive disease. At six cycles, 8% of the patients maintained PR, 19% showed SD and 35% had progressive disease. The median time-to-disease progression was 6 months. The median survival time of patients was 10 months while, at the end of the first year, the patients who managed to get through the complete therapy (20 patients) had a survival rate of 38%. This detailed analysis of 20 patients showed that 80% of the patients survived for up to 6 months, 38% up to 12 months and 19% for more than a year. The only risk factor associated with the hazard of death among the factors studied was the performance status of the patients. Patients with PS=0 presented a median survival time of 13 months and those with PS=1, it was only 9 months. Non-haematological and haematological toxic effects were generally mild to moderate and entirely manageable.
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Affiliation(s)
- Eleni M Karapanagiotou
- Oncology Unit, Third Department of Medicine, Sotiria General Hospital, Athens University School of Medicine, Building Z, 152 Mesogion Avenue, Athens 115 27, Greece.
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Kotteas E, Alamara C, Kiagia M, Pantazopoulos K, Boufas A, Provata A, Charpidou A, Syrigos KN. Safety and efficacy of zoledronic acid rapid infusion in lung cancer patients with bone metastases: a single institution experience. Anticancer Res 2008; 28:529-533. [PMID: 18383897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Zoledronic acid (Zometa, Novartis, Basel, Switzerland) is a new generation of bisphosphonates (BPs) with demonstrated clinical benefit in breast and prostate cancer patients with bone metastases. The safety and efficacy of intravenous zoledronic acid in lung cancer patients was assessed. In 86 patients with newly diagnosed non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC) and bone metastases, 4 mg of zoledronic acid was administered with rapid 15-minute intravenous infusion every 3-4 weeks. A total of 414 infusions were administered over a 24-month period during which a statistically significant decrease in serum calcium levels (p = 0.03) was observed. Serum alkaline phosphatase (ALP) also decreased but not significantly. With regard to clinical efficacy, 55 of our patients stabilized or reduced their need for analgesic treatment. No significant side-effects, including fever, hemodynamic instability and renal dysfunction, were seen. We conclude that the rapid infusion of zoledronic acid is safe and convenient for lung cancer patients even after the 3rd and 6th months follow-up.
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Affiliation(s)
- Elias Kotteas
- Athens University School of Medicine, Oncology Unit, Third Department of Medicine, Sotiria General Hospital, Building Z, 152 Mesogion Avenue, 115 27 Athens, Greece.
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Syrigos K, Pantazopoulos K, Charpidou A, Gkiozos I, Tzannou I, Alamara C, Dilana K, Kotteas E, Katirtzoglou N. 6606 POSTER Three drug regimen in SCLC-ED patients: a phase II study. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Charpidou A, Hatzidarellis EP, Alamara C, Dilana K, Pantazopoulos K, Kotteas E, Georgatou N, Syrigos KN. Pegylated Liposomal Doxorubicin HCL (Caelyx) in combination with Sandostatin LAR as salvage therapy in patients with small-cell lung cancer. In Vivo 2006; 20:553-7. [PMID: 16900789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND The aim of the present study was to evaluate the efficacy of Pegylated Liposomal Doxorubicin (Caelyx) combined with Sandostatin LAR as salvage treatment of small cell lung cancer (SCLC) in platinum-pretreated patients. PATIENTS AND METHODS Nine pretreated patients (median age 53.5 years, PS: 0-1) with histologically confirmed SCLC were treated with Caelyx 40 mg/m2 (i.v.) on day 1 and Sandostatin LAR 30 mg (i.m.) on day 1 every 28 days. Four (44%) out of the nine patients had received two prior regimens and five (55%) were refractory to front-line chemotherapy. RESULTS No complete or partial responses were observed. Disease stabilization was obtained in two (22%) patients. The median overall survival was 18.7 months and the median time to progression was 9.1 months. CONCLUSION The combination of Caelyx and Sandostatin LAR was inactive as salvage treatment in this poor prognosis group of patients with relapsed SCLC. However, the combination would merit further investigation in patients pretreated with one prior regimen.
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Affiliation(s)
- Adrianni Charpidou
- Oncology Unit, Third Department of Medicine, Athens School of Medicine, Greece
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