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Schipilliti FM, Drittone D, Mazzuca F, La Forgia D, Guven DC, Rizzo A. Datopotamab deruxtecan: A novel antibody drug conjugate for triple-negative breast cancer. Heliyon 2024; 10:e28385. [PMID: 38560142 PMCID: PMC10981107 DOI: 10.1016/j.heliyon.2024.e28385] [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: 05/16/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Triple negative breast cancer (TNBC) represents the breast cancer subtype with least favorable outcome because of the lack of effective treatment options and its molecular features. Recently, ADCs have dramatically changed the breast cancer treatment landscape; the anti-TROP2 ADC Sacituzumab Govitecan has been approved for treatment of previously treated, metastatic TNBC patients. The novel ADC Datopotecan-deruxtecan (Dato-DXd) has recently shown encouraging results for TNBC. In the current paper, we summarize and discuss available data regarding this TROP-2 directed agent mechanism of action and pharmacologic activity, we describe first results on efficacy and safety of the drug and report characteristics, inclusion criteria and endpoints of the main ongoing clinical trials.
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Affiliation(s)
| | - Denise Drittone
- Oncological Department, Sant'Andrea Hospital, University Sapienza in Rome, Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Sapienza University, Oncology Unit, Azienda Ospedialiera Universitaria Sant'Andrea, Rome, Italy
| | | | - Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, 06100, Sihhiye, Ankara, Turkey
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2
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Arrivi G, Specchia M, Pilozzi E, Rinzivillo M, Caruso D, Santangeli C, Prosperi D, Ascolese AM, Panzuto F, Mazzuca F. Diagnostic and Therapeutic Management of Primary Orbital Neuroendocrine Tumors (NETs): Systematic Literature Review and Clinical Case Presentation. Biomedicines 2024; 12:379. [PMID: 38397981 PMCID: PMC10886459 DOI: 10.3390/biomedicines12020379] [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: 12/01/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The ocular involvement of neuroendocrine neoplasms (NENs) is uncommon and mainly represented by metastases from gastrointestinal and lung neuroendocrine tumors. Primary orbital NENs are even less common and their diagnostic and therapeutic management is a challenge. METHODS A systematic review of the literature was conducted from 1966 to September 2023 on PubMed to identify articles on orbital NENs and to summarize their clinical-pathological features, diagnosis and therapeutic management. Furthermore, we presented a case of a locally advanced retro-orbital primary neuroendocrine tumor that was referred to the certified Center of Excellence of Sant'Andrea Hospital, La Sapienza University of Rome, Italy. RESULTS The final analysis included 63 records on orbital NENs and 11 records focused on primary orbital NENs. The localization was mostly unilateral and in the right orbit; proptosis or exophthalmos represented the initial symptoms. The diagnostic work-up and therapeutic management was discussed and a diagnostic algorithm for the suspicion of primary orbital NENs was proposed. CONCLUSIONS A multidisciplinary approach is required for the management of primary orbital NENs, emphasizing the importance of early referral to dedicated centers for prompt differential diagnosis, tailored treatment, and an improved quality of life and survival.
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Affiliation(s)
- Giulia Arrivi
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, Grottarossa Street 1035-1039, 00189 Rome, Italy; (M.S.); (F.M.)
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, PhD School in Translational Medicine and Oncology, Sapienza University of Rome, 00189 Rome, Italy
| | - Monia Specchia
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, Grottarossa Street 1035-1039, 00189 Rome, Italy; (M.S.); (F.M.)
| | - Emanuela Pilozzi
- Anatomia Patologica Unit, Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Maria Rinzivillo
- European Neuroendocrine Tumor Society (ENETS) Center of Excellence, Digestive Disease Unit, Sant’Andrea University Hospital, 00189 Rome, Italy; (M.R.); (F.P.)
| | - Damiano Caruso
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.C.); (C.S.)
| | - Curzio Santangeli
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.C.); (C.S.)
| | - Daniela Prosperi
- Nuclear Medicine Unit, Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Anna Maria Ascolese
- Radiotherapy Oncology Unit, Department of Surgical Medical Sciences and Translational Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Francesco Panzuto
- European Neuroendocrine Tumor Society (ENETS) Center of Excellence, Digestive Disease Unit, Sant’Andrea University Hospital, 00189 Rome, Italy; (M.R.); (F.P.)
- European Neuroendocrine Tumor Society (ENETS) Center of Excellence, Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Federica Mazzuca
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, Sapienza University of Rome, Grottarossa Street 1035-1039, 00189 Rome, Italy; (M.S.); (F.M.)
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3
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Zerunian M, Nacci I, Caruso D, Polici M, Masci B, De Santis D, Mercantini P, Arrivi G, Mazzuca F, Paolantonio P, Pilozzi E, Vecchione A, Tarallo M, Fiori E, Iannicelli E, Laghi A. Is CT Radiomics Superior to Morphological Evaluation for pN0 Characterization? A Pilot Study in Colon Cancer. Cancers (Basel) 2024; 16:660. [PMID: 38339411 PMCID: PMC10854865 DOI: 10.3390/cancers16030660] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/02/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
The aim of this study was to compare CT radiomics and morphological features when assessing benign lymph nodes (LNs) in colon cancer (CC). This retrospective study included 100 CC patients (test cohort) who underwent a preoperative CT examination and were diagnosed as pN0 after surgery. Regional LNs were scored with a morphological Likert scale (NODE-SCORE) and divided into two groups: low likelihood (LLM: 0-2 points) and high likelihood (HLM: 3-7 points) of malignancy. The T-test and the Mann-Whitney test were used to compare 107 radiomic features extracted from the two groups. Radiomic features were also extracted from primary lesions (PLs), and the receiver operating characteristic (ROC) was used to test a LN/PL ratio when assessing the LN's status identified with radiomics and with the NODE-SCORE. An amount of 337 LNs were divided into 167 with LLM and 170 with HLM. Radiomics showed 15/107 features, with a significant difference (p < 0.02) between the two groups. The comparison of selected features between 81 PLs and the corresponding LNs showed all significant differences (p < 0.0001). According to the LN/PL ratio, the selected features recognized a higher number of LNs than the NODE-SCORE (p < 0.001). On validation of the cohort of 20 patients (10 pN0, 10 pN2), significant ROC curves were obtained for LN/PL busyness (AUC = 0.91; 0.69-0.99; 95% C.I.; and p < 0.001) and for LN/PL dependence entropy (AUC = 0.76; 0.52-0.92; 95% C.I.; and p = 0.03). The radiomics ratio between CC and LNs is more accurate for noninvasively discriminating benign LNs compared to CT morphological features.
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Affiliation(s)
- Marta Zerunian
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (M.Z.); (I.N.); (M.P.); (B.M.); (D.D.S.); (E.I.); (A.L.)
- Ph.D. School in Translational Medicine and Oncology, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Giorgio Nicola Papanicolau–ang. Via di Grottarossa 1035, 00189 Rome, Italy
| | - Ilaria Nacci
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (M.Z.); (I.N.); (M.P.); (B.M.); (D.D.S.); (E.I.); (A.L.)
| | - Damiano Caruso
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (M.Z.); (I.N.); (M.P.); (B.M.); (D.D.S.); (E.I.); (A.L.)
| | - Michela Polici
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (M.Z.); (I.N.); (M.P.); (B.M.); (D.D.S.); (E.I.); (A.L.)
- Ph.D. School in Translational Medicine and Oncology, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Via Giorgio Nicola Papanicolau–ang. Via di Grottarossa 1035, 00189 Rome, Italy
| | - Benedetta Masci
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (M.Z.); (I.N.); (M.P.); (B.M.); (D.D.S.); (E.I.); (A.L.)
| | - Domenico De Santis
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (M.Z.); (I.N.); (M.P.); (B.M.); (D.D.S.); (E.I.); (A.L.)
| | - Paolo Mercantini
- Surgery Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy;
| | - Giulia Arrivi
- Oncology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (G.A.); (F.M.)
| | - Federica Mazzuca
- Oncology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (G.A.); (F.M.)
| | - Pasquale Paolantonio
- Department of Radiology, San Giovanni Addolorata Hospital Complex, Via dell’Amba Aradam 8, 00184 Rome, Italy;
| | - Emanuela Pilozzi
- Pathology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (E.P.); (A.V.)
| | - Andrea Vecchione
- Pathology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (E.P.); (A.V.)
| | - Mariarita Tarallo
- Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, Via Giovanni Maria Lancisi 2, 00161 Rome, Italy; (M.T.); (E.F.)
| | - Enrico Fiori
- Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, Via Giovanni Maria Lancisi 2, 00161 Rome, Italy; (M.T.); (E.F.)
| | - Elsa Iannicelli
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (M.Z.); (I.N.); (M.P.); (B.M.); (D.D.S.); (E.I.); (A.L.)
| | - Andrea Laghi
- Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa 1035–1039, 00189 Rome, Italy; (M.Z.); (I.N.); (M.P.); (B.M.); (D.D.S.); (E.I.); (A.L.)
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Bergamaschi L, Vincini MG, Zaffaroni M, Pepa M, Angelicone I, Astone A, Bergamini C, Buonopane S, Conte M, De Rosa N, Deantoni C, Dell'Oca I, Di Gennaro D, Di Muzio N, Osti MF, Federico M, Ferini G, Franzese C, Gatti M, Grillo A, Iorio V, Manzo R, Marmiroli L, Martin G, Mazzuca F, Molinaro MA, Muto M, Pacelli R, Pepe A, Perillo A, Russo D, Salerno F, Spadaro P, Viola A, Iorio GC, Muto P, Ricardi U, Alterio D. Management of radiation-induced oral mucositis in head and neck cancer patients: a real-life survey among 25 Italian radiation oncology centers. Support Care Cancer 2023; 32:38. [PMID: 38110572 PMCID: PMC10728275 DOI: 10.1007/s00520-023-08185-5] [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: 07/19/2023] [Accepted: 11/12/2023] [Indexed: 12/20/2023]
Abstract
AIM Radiation-induced oral mucositis (RIOM) is the most frequent side effect in head and neck cancer (HNC) patients treated with curative radiotherapy (RT). A standardized strategy for preventing and treating RIOM has not been defined. Aim of this study was to perform a real-life survey on RIOM management among Italian RT centers. METHODS A 40-question survey was administered to 25 radiation oncologists working in 25 different RT centers across Italy. RESULTS A total of 1554 HNC patients have been treated in the participating centers in 2021, the majority (median across the centers 91%) with curative intent. Median treatment time was 41 days, with a mean percentage of interruption due to toxicity of 14.5%. Eighty percent of responders provide written oral cavity hygiene recommendations. Regarding RIOM prevention, sodium bicarbonate mouthwashes, oral mucosa barrier agents, and hyaluronic acid-based mouthwashes were the most frequent topic agents used. Regarding RIOM treatment, 14 (56%) centers relied on literature evidence, while internal guidelines were available in 13 centers (44%). Grade (G)1 mucositis is mostly treated with sodium bicarbonate mouthwashes, oral mucosa barrier agents, and steroids, while hyaluronic acid-based agents, local anesthetics, and benzydamine were the most used in mucositis G2/G3. Steroids, painkillers, and anti-inflammatory drugs were the most frequent systemic agents used independently from the RIOM severity. CONCLUSION Great variety of strategies exist among Italian centers in RIOM management for HNC patients. Whether different strategies could impact patients' compliance and overall treatment time of the radiation course is still unclear and needs further investigation.
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Affiliation(s)
- Luca Bergamaschi
- Division of Radiation Oncology, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Maria Giulia Vincini
- Division of Radiation Oncology, European Institute of Oncology IRCCS, 20141, Milan, Italy.
| | - Mattia Zaffaroni
- Division of Radiation Oncology, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Matteo Pepa
- Division of Radiation Oncology, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Ilaria Angelicone
- Radiotherapy Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Astone
- Division of Medical Oncology, Fatebenefratelli San Pietro Hospital, 00189, Rome, Italy
| | - Cristiana Bergamini
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sergio Buonopane
- Radiation Oncology Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy
| | - Mario Conte
- Fondazione Muto Onlus, Casavatore, Naples, Italy
| | - Nicola De Rosa
- Centro Aktis Diagnostica e Terapia, Marano, Naples, Italy
| | - Chiara Deantoni
- Radiotherapy Department, IRCCS San Raffaele Scientific Institute, Vita Salute S. Raffaele University, Milan, Italy
| | - Italo Dell'Oca
- Radiotherapy Department, IRCCS San Raffaele Scientific Institute, Vita Salute S. Raffaele University, Milan, Italy
| | | | - Nadia Di Muzio
- Radiotherapy Department, IRCCS San Raffaele Scientific Institute, Vita Salute S. Raffaele University, Milan, Italy
| | - Mattia Falchetto Osti
- Radiotherapy Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Manuela Federico
- Casa di cura Macchiarella, U.O. Radioterapia Oncologica, Palermo, Italy
| | | | - Ciro Franzese
- Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Marco Gatti
- Radiotherapy Unit, Candiolo Cancer Institute, FPO-IRCCS, Torino, Italy
| | - Antonietta Grillo
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico, Bari, Italy
| | | | - Roberto Manzo
- Radiation Oncology Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy
| | - Luca Marmiroli
- U.O. Radioterapia, Ospedale Fatebenefratelli S. Giovanni Calibita, Isola Tiberina, 00186, Rome, Italy
| | | | - Federica Mazzuca
- Radiotherapy Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Matteo Muto
- Department of Onco-Hematological Diseases, U.O.C. Radiotherapy-Azienda Ospedaliera San Giuseppe Moscati-(AV), 83100, Avellino, Italy
| | - Roberto Pacelli
- Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy
| | | | - Annarita Perillo
- Centro Aktis Diagnostica e Terapia, Marano, Naples, Italy
- Department of Radiation Oncology, San Pio Hospital, Benevento, Italia
| | | | | | - Pietro Spadaro
- U.O. di Oncologia ed Ematologia, Casa di Cura Villa Salus, Messina, Italy
| | - Anna Viola
- Fondazione IOM, Viagrande, Catania, Italy
| | | | - Paolo Muto
- Radiation Oncology Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy
| | - Daniela Alterio
- Division of Radiation Oncology, European Institute of Oncology IRCCS, 20141, Milan, Italy
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Signorelli C, Chilelli MG, Giannarelli D, Basso M, Calegari MA, Anghelone A, Lucchetti J, Minelli A, Angotti L, Zurlo IV, Schirripa M, Morelli C, Dell’Aquila E, Cosimati A, Gemma D, Ribelli M, Emiliani A, Corsi DC, Arrivi G, Mazzuca F, Zoratto F, Morandi MG, Santamaria F, Saltarelli R, Ruggeri EM. Retrospective Correlation between First Drug Treatment Duration and Survival Outcomes in Sequential Treatment with Regorafenib and Trifluridine/Tipiracil in Refractory Metastatic Colorectal Cancer: A Real-World Subgroup Analysis. Cancers (Basel) 2023; 15:5758. [PMID: 38136304 PMCID: PMC10741389 DOI: 10.3390/cancers15245758] [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: 11/10/2023] [Revised: 12/03/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Background: Patients with refractory metastatic colorectal cancer (mCRC) rarely receive third-line or further treatment. In this context, regorafenib (R) and trifluridine/tipiracil (T) are two important novel therapeutic choices with statistically significant increases in overall survival (OS), progression-free survival (PFS), and disease control, with different toxicity profiles. This study is a subgroup analysis of our larger retrospective study, already published, whose objective was to assess the outcomes of patients when R and T were given sequentially. Patients and Methods: The study involved thirteen Italian cancer centers on a 10-year retrospective observation (2012-2022). In this subgroup analysis, we focused our attention on the correlation between the first drug treatment duration (<3 months, 3 to <6 months and ≥6 months) and survival outcomes in patients who had received the sequence regorafenib-to-trifluridine/tipiracil, or vice versa. Results: The initial study included 866 patients with mCRC who received sequential T/R, or R/T, or T or R alone. This analysis is focused on evaluating the impact of the duration of the first treatment in the sequence on clinical outcomes (OS, PFS) and includes 146 and 116 patients of the T/R and R/T sequences, respectively. Based on the duration of the first drug treatment, subgroups for the T/R sequence included 27 patients (18.4%) who received T for <3 months, 86 (58.9%) treated for 3 to <6 months, and 33 (22.6%) treated for ≥6 months; in the reverse sequence (R as the first drug), subgroups included 18 patients (15.5%) who received their first treatment for <3 months, 62 (53.4%) treated for 3 to <6 months, and 35 (31.0%) treated for ≥6 months. In patients who received their first drug treatment for a period of 3 to <6 months, the R/T sequence had a significantly longer median OS (13.7 vs. 10.8 months, p = 0.0069) and a longer median PFS (10.8 vs. 8.5 months, p = 0.0003) than the T/R group. There were no statistically significant differences between groups with first drug treatment durations of <3 months and ≥6 months. Conclusions: Our analysis seems to suggest that the administration of R for a period of 3 to <6 months before that of T can prolong both OS and PFS, as compared to the opposite sequence.
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Affiliation(s)
- Carlo Signorelli
- Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, 01100 Viterbo, Italy
| | | | - Diana Giannarelli
- Biostatistics Unit, Scientific Directorate, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy
| | - Michele Basso
- Unit of Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy
| | - Maria Alessandra Calegari
- Unit of Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy
| | - Annunziato Anghelone
- Unit of Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy
| | - Jessica Lucchetti
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Alessandro Minelli
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Lorenzo Angotti
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | | | - Marta Schirripa
- Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, 01100 Viterbo, Italy
| | - Cristina Morelli
- Medical Oncology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy
| | - Emanuela Dell’Aquila
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Antonella Cosimati
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Donatello Gemma
- Medical Oncology Unit, ASL Frosinone, 03039 Sora (FR), Italy
| | - Marta Ribelli
- Medical Oncology Unit, Isola Tiberina Hospital-Gemelli Isola, 00186 Rome, Italy
| | - Alessandra Emiliani
- Medical Oncology Unit, Isola Tiberina Hospital-Gemelli Isola, 00186 Rome, Italy
| | | | - Giulia Arrivi
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy
| | | | - Maria Grazia Morandi
- Medical Oncology Unit, San Camillo de Lellis Hospital, ASL Rieti, 02100 Rieti, Italy
| | - Fiorenza Santamaria
- UOC Oncology A, Policlinico Umberto I, 00185 Rome, Italy
- Experimental Medicine, Network Oncology and Precision Medicine, Department of Experimental Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Rosa Saltarelli
- UOC Oncology, San Giovanni Evangelista Hospital, ASL RM5, 00019 Tivoli (RM), Italy
| | - Enzo Maria Ruggeri
- Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, 01100 Viterbo, Italy
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6
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Signorelli C, Calegari MA, Basso M, Anghelone A, Lucchetti J, Minelli A, Angotti L, Zurlo IV, Schirripa M, Chilelli MG, Morelli C, Dell'Aquila E, Cosimati A, Gemma D, Ribelli M, Emiliani A, Corsi DC, Arrivi G, Mazzuca F, Zoratto F, Morandi MG, Santamaria F, Saltarelli R, Ruggeri EM. Treatment Settings and Outcomes with Regorafenib and Trifluridine/Tipiracil at Third-Line Treatment and beyond in Metastatic Colorectal Cancer: A Real-World Multicenter Retrospective Study. Curr Oncol 2023; 30:5456-5469. [PMID: 37366896 DOI: 10.3390/curroncol30060413] [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: 04/23/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Patients with refractory mCRC rarely undergo third-line or subsequent treatment. This strategy could negatively impact their survival. In this setting, regorafenib (R) and trifluridine/tipiracil (T) are two key new treatment options with statistically significant improvements in overall survival (OS), progression-free survival (PFS), and disease control with different tolerance profiles. This study aimed to retrospectively evaluate the efficacy and safety profiles of these agents in real-world practice. MATERIALS AND METHODS In 2012-2022, 866 patients diagnosed with mCRC who received sequential R and T (T/R, n = 146; R/T, n = 116]) or T (n = 325]) or R (n = 279) only were retrospectively recruited from 13 Italian cancer institutes. RESULTS The median OS is significantly longer in the R/T group (15.9 months) than in the T/R group (13.9 months) (p = 0.0194). The R/T sequence had a statistically significant advantage in the mPFS, which was 8.8 months with T/R vs. 11.2 months with R/T (p = 0.0005). We did not find significant differences in outcomes between groups receiving T or R only. A total of 582 grade 3/4 toxicities were recorded. The frequency of grade 3/4 hand-foot skin reactions was higher in the R/T sequence compared to the reverse sequence (37.3% vs. 7.4%) (p = 0.01), while grade 3/4 neutropenia was slightly lower in the R/T group than in the T/R group (66.2% vs. 78.2%) (p = 0.13). Toxicities in the non-sequential groups were similar and in line with previous studies. CONCLUSIONS The R/T sequence resulted in a significantly longer OS and PFS and improved disease control compared with the reverse sequence. R and T given not sequentially have similar impacts on survival. More data are needed to define the best sequence and to explore the efficacy of sequential (T/R or R/T) treatment combined with molecular-targeted drugs.
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Affiliation(s)
- Carlo Signorelli
- Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, 01100 Viterbo, Italy
| | - Maria Alessandra Calegari
- Unit of Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy
| | - Michele Basso
- Unit of Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy
| | - Annunziato Anghelone
- Unit of Medical Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy
| | - Jessica Lucchetti
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Alessandro Minelli
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Lorenzo Angotti
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | | | - Marta Schirripa
- Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, 01100 Viterbo, Italy
| | | | - Cristina Morelli
- Medical Oncology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy
| | - Emanuela Dell'Aquila
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Antonella Cosimati
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Donatello Gemma
- Medical Oncology Unit, ASL Frosinone, 03039 Sora (FR), Italy
| | - Marta Ribelli
- Medical Oncology Unit, Ospedale San Giovanni Calibita Fatebenefratelli, Isola Tiberina, Gemelli Isola, 00186 Rome, Italy
| | - Alessandra Emiliani
- Medical Oncology Unit, Ospedale San Giovanni Calibita Fatebenefratelli, Isola Tiberina, Gemelli Isola, 00186 Rome, Italy
| | - Domenico Cristiano Corsi
- Medical Oncology Unit, Ospedale San Giovanni Calibita Fatebenefratelli, Isola Tiberina, Gemelli Isola, 00186 Rome, Italy
| | - Giulia Arrivi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Oncology Unit, Sant' Andrea Hospital, 00189 Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Oncology Unit, Sant' Andrea Hospital, 00189 Rome, Italy
| | | | - Maria Grazia Morandi
- Medical Oncology Unit, San Camillo de Lellis Hospital, ASL Rieti, 02100 Rieti, Italy
| | - Fiorenza Santamaria
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Medical Oncology A, Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Rosa Saltarelli
- UOC Oncology, San Giovanni Evangelista Hospital, ASL RM5, 00019 Tivoli (RM), Italy
| | - Enzo Maria Ruggeri
- Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, 01100 Viterbo, Italy
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7
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Carconi C, Cerreti M, Roberto M, Arrivi G, D'Ambrosio G, De Felice F, Di Civita MA, Iafrate F, Lucatelli P, Magliocca FM, Picchetto A, Picone V, Catalano C, Cortesi E, Tombolini V, Mazzuca F, Tomao S. The Management of Oligometastatic Disease in Colorectal Cancer: Present Strategies and Future Perspectives. Crit Rev Oncol Hematol 2023; 186:103990. [PMID: 37061075 DOI: 10.1016/j.critrevonc.2023.103990] [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: 10/13/2022] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 04/17/2023] Open
Abstract
Oligometastatic disease has been described as an intermediate clinical state between localized cancer and systemically metastasized disease. Recent clinical studies have shown prolonged survival when aggressive locoregional approaches are added to systemic therapies in patients with oligometastases. The aim of this review is to outline the newest options to treat oligometastatic colorectal cancer (CRC), also considering its molecular patterns. We present an overview of the available local treatment strategies, including surgical procedures, stereotactic body radiation therapy (SBRT), thermal ablation, as well as trans-arterial chemoembolization (TACE) and selective internal radiotherapy (SIRT). Moreover, since imaging methods provide crucial information for the early diagnosis and management of oligometastatic CRC, we discuss the role of modern radiologic techniques in selecting patients that are amenable to potentially curative locoregional treatments.
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Affiliation(s)
- Catia Carconi
- Sant'Andrea University Hospital, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Micaela Cerreti
- Sant'Andrea University Hospital, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Michela Roberto
- UOC Oncologia A, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy.
| | - Giulia Arrivi
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giancarlo D'Ambrosio
- Department of General Surgery, Surgical Specialties and Organ Transplantation, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Mattia Alberto Di Civita
- UOC Oncologia A, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Franco Iafrate
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Fabio Massimo Magliocca
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Picchetto
- Emergency Department, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Picone
- UOC Oncologia B, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Enrico Cortesi
- UOC Oncologia B, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Federica Mazzuca
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Silverio Tomao
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
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8
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Botticelli A, Scagnoli S, Conte P, Cremolini C, Ascierto PA, Cappuzzo F, Aglietta M, Mazzuca F, Capoluongo E, Blandino G, Malapelle U, Nuti M, D’Amati G, Cerbelli B, Pruneri G, Biffoni M, Giannini G, Cognetti F, Curigliano G, Marchetti P. Abstract P6-10-09: Mutational landscape of breast cancer patients in ROME trial: preliminary results. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p6-10-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
BACKGROUND: The Rome Trial is a randomized phase II trial (NCT04591431). The aim is to evaluate efficacy and safety of a tailored treatment (TT) compared to standard of care (SoC) in patients with solid tumors. Here we report the preliminary results of the molecular alterations, microsatellite status (MS) and tumor mutational burden (TMB) in metastatic breast cancer (mBC) cohort. METHODS: MBC patients who received at least 1 and no more than 2 systemic treatments were enrolled. Tissue samples were collected within 6 months from the screening. Centralized Next Generation Sequencing (NGS) was performed on both tissue and liquid biopsy. Molecular alterations were evaluated by the Molecular Tumor Board (MTB) using COSMIC, ClinVar, OncoKB and VarSome datasets. Genes with at least 10% frequency of mutation, MS and TMB are reported. RESULTS: From Oct 2020 to June 2022, 980 pts with solid tumors were enrolled. Complete screening mutational data are available for sixty-two pts from the mBC cohort (63% HR+/HER2-, 35% triple negative, 2% HR-/HER2+). NGS was available both on tissue and liquid biopsy in 48 (77%) pts, 14 had only liquid biopsy available due to tissue test failure. 328 genes resulted altered with a median of 7 alteration per pts (0-31). Some pathways were frequently altered: PIK3CA/AKT/MTOR (60%), TP53 (60%), Cell cycle/cycline (35%), FGF/FGFR (26%), BRCA1/2 (17%). The most frequent altered genes were: TP53 (61%), PIK3CA (50%), ESR1 (27%), CCND1 (27%), FGF19 (24%), FGF3 (24%), FGF4 (22%), MYC (22%), FGFR1 (21%), PTEN (21%), EMSY (16%), RB1 (14%), RAD21 (14%), TET2 (13%), BRCA2 (11%), GATA3 (11%), KRAS (10%). No pts with MSI status were reported. Eight (13%) had a high TMB (>10) and the overall median TMB was 5.5 (0-24). Median TMB was similar in tissue and liquid samples (5 and 5.3 mut/mb, p= 0.8). Actionable mutations were detected in 34 pts (54%). Twenty-eight (45%) pts were assigned to a specific TT after the MTB discussion: ipatasertib (16), pemigatinib (5), ipilimumab plus nivolumab (4), lapatinib plus trastuzumab, TDM1 and everolimus (1). MTB requested a germline test for 6 pts: 4 were confirmed (66%; 2 BRCA, 1 PALB2, 1 BRIP1). CONCLUSIONS: The extensive NGS analysis performed in the ROME trial shown that several pathways are commonly mutated in mBC, with target drug potentially available. About 15% of pts had a high TMB but MSI is confirmed as a rare event in breast cancer. Germline mutations have been identified in patients with no prior indication for germline testing.
Citation Format: Andrea Botticelli, Simone Scagnoli, Pierfranco Conte, Chiara Cremolini, Paolo Antonio Ascierto, Federico Cappuzzo, Massimo Aglietta, Federica Mazzuca, Ettore Capoluongo, Giovanni Blandino, Umberto Malapelle, Marianna Nuti, Giulia D’Amati, Bruna Cerbelli, Giancarlo Pruneri, Mauro Biffoni, Giuseppe Giannini, Francesco Cognetti, Giuseppe Curigliano, Paolo Marchetti. Mutational landscape of breast cancer patients in ROME trial: preliminary results [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-10-09.
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9
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van de Haar J, Ma X, Ooft SN, van der Helm PW, Hoes LR, Mainardi S, Pinato DJ, Sun K, Salvatore L, Tortora G, Zurlo IV, Leo S, Giampieri R, Berardi R, Gelsomino F, Merz V, Mazzuca F, Antonuzzo L, Rosati G, Stavraka C, Ross P, Rodriquenz MG, Pavarana M, Messina C, Iveson T, Zoratto F, Thomas A, Fenocchio E, Ratti M, Depetris I, Cergnul M, Morelli C, Libertini M, Parisi A, De Tursi M, Zanaletti N, Garrone O, Graham J, Longarini R, Gobba SM, Petrillo A, Tamburini E, La Verde N, Petrelli F, Ricci V, Wessels LFA, Ghidini M, Cortellini A, Voest EE, Valeri N. Codon-specific KRAS mutations predict survival benefit of trifluridine/tipiracil in metastatic colorectal cancer. Nat Med 2023; 29:605-614. [PMID: 36864254 PMCID: PMC10033412 DOI: 10.1038/s41591-023-02240-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/26/2023] [Indexed: 03/04/2023]
Abstract
Genomics has greatly improved how patients with cancer are being treated; however, clinical-grade genomic biomarkers for chemotherapies are currently lacking. Using whole-genome analysis of 37 patients with metastatic colorectal cancer (mCRC) treated with the chemotherapy trifluridine/tipiracil (FTD/TPI), we identified KRAS codon G12 (KRASG12) mutations as a potential biomarker of resistance. Next, we collected real-world data of 960 patients with mCRC receiving FTD/TPI and validated that KRASG12 mutations were significantly associated with poor survival, also in analyses restricted to the RAS/RAF mutant subgroup. We next analyzed the data of the global, double-blind, placebo-controlled, phase 3 RECOURSE trial (n = 800 patients) and found that KRASG12 mutations (n = 279) were predictive biomarkers for reduced overall survival (OS) benefit of FTD/TPI versus placebo (unadjusted interaction P = 0.0031, adjusted interaction P = 0.015). For patients with KRASG12 mutations in the RECOURSE trial, OS was not prolonged with FTD/TPI versus placebo (n = 279; hazard ratio (HR) = 0.97; 95% confidence interval (CI) = 0.73-1.20; P = 0.85). In contrast, patients with KRASG13 mutant tumors showed significantly improved OS with FTD/TPI versus placebo (n = 60; HR = 0.29; 95% CI = 0.15-0.55; P < 0.001). In isogenic cell lines and patient-derived organoids, KRASG12 mutations were associated with increased resistance to FTD-based genotoxicity. In conclusion, these data show that KRASG12 mutations are biomarkers for reduced OS benefit of FTD/TPI treatment, with potential implications for approximately 28% of patients with mCRC under consideration for treatment with FTD/TPI. Furthermore, our data suggest that genomics-based precision medicine may be possible for a subset of chemotherapies.
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Affiliation(s)
- Joris van de Haar
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Xuhui Ma
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Salo N Ooft
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Pim W van der Helm
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Louisa R Hoes
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Sara Mainardi
- Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - David J Pinato
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Imperial College Healthcare NHS Trust, London, UK
| | - Kristi Sun
- Imperial College Healthcare NHS Trust, London, UK
| | - Lisa Salvatore
- Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italy
- Oncologia Medica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giampaolo Tortora
- Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italy
- Oncologia Medica, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Silvana Leo
- Medical Oncology, 'Vito Fazzi' Hospital, Lecce, Italy
| | - Riccardo Giampieri
- Department of Oncology, Università Politecnica delle Marche, Azienda Ospedialiera Universitaria delle Marche, Ancona, Italy
| | - Rossana Berardi
- Department of Oncology, Università Politecnica delle Marche, Azienda Ospedialiera Universitaria delle Marche, Ancona, Italy
| | | | - Valeria Merz
- Medical Oncology Unit, Santa Chiara Hospital, Trento, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Sapienza University, Oncology Unit, Azienda Ospedialiera Universitaria Sant'Andrea, Rome, Italy
| | - Lorenzo Antonuzzo
- Clinical Oncology Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gerardo Rosati
- Medical Oncology Unit, S. Carlo Hospital, Potenza, Italy
| | - Chara Stavraka
- School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Hospital, London, UK
- Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul Ross
- Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Maria Grazia Rodriquenz
- Istituto di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Michele Pavarana
- Oncology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Carlo Messina
- Oncology Unit, ARNAS Civico Di Cristina Benfratelli Hospital, Palermo, Italy
| | | | - Federica Zoratto
- Unità Operativa Complessa Oncologia, Ospedale Santa Maria Goretti Latina, Latina, Italy
| | - Anne Thomas
- Leicester Cancer Research Centre, University of Leicester, Leicester Royal Infirmary, Leicester, UK
| | - Elisabetta Fenocchio
- Candiolo Cancer Institute FPO Istituto di Ricovero e Cura a Carattere Scientifico Candiolo, Candiolo, Italy
| | | | - Ilaria Depetris
- Division of Medical Oncology, ASL TO4, Ospedale Civile di Ivrea, Ivrea, Italy
| | - Massimiliano Cergnul
- Unità Operativa Oncologia Medica, Ospedale Civile di Legnano, Azienda Socio-Sanitaria Territoriale Ovest Milanese, Legnano, Italy
| | - Cristina Morelli
- Medical Oncology Unit, Department of Systems Medicine, Tor Vergata University Hospital, Rome, Italy
| | | | - Alessandro Parisi
- Department of Oncology, Università Politecnica delle Marche, Azienda Ospedialiera Universitaria delle Marche, Ancona, Italy
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Michele De Tursi
- Dipartimento di Tecnologie Innovative in Medicina & Odontoiatria, Università G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - Nicoletta Zanaletti
- Experimental Clinical Abdominal Oncology Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione G. Pascale, Naples, Italy
| | - Ornella Garrone
- Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Janet Graham
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | | | - Stefania Maria Gobba
- Division of Clinical Oncology, Azienda Socio-Sanitaria Territoriale dei Sette Laghi Varese, Varese, Italy
| | | | | | - Nicla La Verde
- Luigi Sacco Hospital-Polo Universitario, Azienda Socio-Sanitaria Territoriale Fatebenefratelli Sacco, Milan, Italy
| | - Fausto Petrelli
- Oncology Unit, Azienda Socio-Sanitaria Territoriale Bergamo Ovest, Treviglio, Italy
| | - Vincenzo Ricci
- Medical Oncology Unit, Azienda Ospedaliera di Rilievo Nazionale 'San Pio', Benevento, Italy
| | - Lodewyk F A Wessels
- Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, Delft, the Netherlands
| | - Michele Ghidini
- Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Emile E Voest
- Division of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Nicola Valeri
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK.
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK.
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Botticelli A, Scagnoli S, Conte P, Cremolini C, Ascierto P, Aglietta M, Mazzuca F, Capoluongo E, Malapelle U, Nuti M, D'Amati G, Cerbelli B, Pruneri G, Giannini G, Cappuzzo F, Biffoni M, Blandino G, Cognetti F, Curigliano G, Marchetti P. 70MO Genomic profiling to expand precision cancer medicine in the real world: The ROME trial. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100928] [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: 03/10/2023] Open
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11
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Roberto M, Arrivi G, Di Civita MA, Barchiesi G, Pilozzi E, Marchetti P, Santini D, Mazzuca F, Tomao S. The role of CXCL12 axis in pancreatic cancer: New biomarkers and potential targets. Front Oncol 2023; 13:1154581. [PMID: 37035150 PMCID: PMC10076769 DOI: 10.3389/fonc.2023.1154581] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Chemokines are small, secreted peptides involved in the mediation of the immune cell recruitment. Chemokines have been implicated in several diseases including autoimmune diseases, viral infections and also played a critical role in the genesis and development of several malignant tumors. CXCL12 is a homeostatic CXC chemokine involved in the process of proliferation, and tumor spread. Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive tumors, that is still lacking effective therapies and with a dramatically poor prognosis. Method We conducted a scientific literature search on Pubmed and Google Scholar including retrospective, prospective studies and reviews focused on the current research elucidating the emerging role of CXCL12 and its receptors CXCR4 - CXCR7 in the pathogenesis of pancreatic cancer. Results Considering the mechanism of immunomodulation of the CXCL12-CXCR4-CXCR7 axis, as well as the potential interaction with the microenvironment in the PDAC, several combined therapeutic approaches have been studied and developed, to overcome the "cold" immunological setting of PDAC, like combining CXCL12 axis inhibitors with anti PD-1/PDL1 drugs. Conclusion Understanding the role of this chemokine's axis in disease initiation and progression may provide the basis for developing new potential biomarkers as well as therapeutic targets for related pancreatic cancers.
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Affiliation(s)
- Michela Roberto
- Oncology Unit (UOC) Oncologia A, Department of Radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Giulia Arrivi
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Mattia Alberto Di Civita
- Oncology Unit (UOC) Oncologia A, Department of Radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
- *Correspondence: Mattia Alberto Di Civita,
| | - Giacomo Barchiesi
- Oncology Unit (UOC) Oncologia A, Department of Radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Emanuela Pilozzi
- Department of Clinical and Molecular Medicine, Anatomia Patologica Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Scientific Direction, Istituto Dermopatico dell’Immacolata (IDI-IRCCS), Rome, Italy
| | - Daniele Santini
- Oncology Unit (UOC) Oncologia A, Department of Radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Federica Mazzuca
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Silverio Tomao
- Oncology Unit (UOC) Oncologia A, Department of Radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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12
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Arrivi G, Verrico M, Roberto M, Barchiesi G, Faggiano A, Marchetti P, Mazzuca F, Tomao S. Capecitabine and Temozolomide (CAPTEM) in Advanced Neuroendocrine Neoplasms (NENs): A Systematic Review and Pooled Analysis. Cancer Manag Res 2022; 14:3507-3523. [PMID: 36575665 PMCID: PMC9790144 DOI: 10.2147/cmar.s372776] [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: 05/17/2022] [Accepted: 08/09/2022] [Indexed: 12/24/2022] Open
Abstract
Background Retrospective studies and single center experiences suggest a role of capecitabine combined with temozolomide (CAPTEM) in neuroendocrine tumors (NENs). Methods We performed a systematic review to assess the efficacy and safety of CAPTEM in patients affected with NENs, with the aim to better clarify the role of this regimen in the therapeutic algorithm of NENs. Results A total of 42 articles and 1818 patients were included in our review. The overall disease control rate was 77% (range 43.5%-100%). The median progression free survival ranged from 4 to 38.5 months, while the median overall survival ranged from 8 to 103 months. Safety analysis showed an occurrence of G3-G4 toxicities in 16.4% of the entire population. The most common toxicities were hematological (27.2%), gastrointestinal (8.3%,) and cutaneous (3.2%). Conclusion This systematic review demonstrated that CAPTEM was an effective and relatively safe treatment for patients with advanced well-moderate differentiated NENs of gastroenteropancreatic, lung and unknown origin.
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Affiliation(s)
- Giulia Arrivi
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Monica Verrico
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Michela Roberto
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Giacomo Barchiesi
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Antongiulio Faggiano
- Department of Clinical and Molecular Medicine, Endocrinology Unit, Sant ‘Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
- Istituto Dermopatico dell’Immacolata (IDI-IRCCS), Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Silverio Tomao
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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Botticelli A, Scagnoli S, Conte P, Cremolini C, Ascierto PA, Cappuzzo F, Aglietta M, Mazzuca F, Capoluongo E, Blandino G, Malapelle U, Nuti M, D'Amati G, Cerbelli B, Pruneri G, Biffoni M, Giannini G, Cognetti F, Curigliano G, Marchetti P. Molecular landscape and actionable alterations in a genomic-guided cancer clinical trial: First analysis of the ROME trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.3087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3087 Background: The Rome Trial is a randomized, prospective, multicenter, multi-basket, Phase II clinical trial (EudraCT n° 2018-002190-21; NCT04591431). The aim is to evaluate the efficacy of Tailored Therapy (TT) vs Standard of Care (SoC) in patients (pts) with metastatic solid tumors who received at least one and no more than two lines of treatment. Pts with a molecular alteration were discussed in a Molecular Tumor Board (MTB), assigned to one or a combination of the 20 available treatments, and randomized to TT or SoC. Methods: Tissue (collected within 6 months) and blood samples from pts with refractory solid tumors were analyzed centrally with next generation sequencing (NGS, FoundationOneCDx and FoundationOneLiquid). MTB discussed all screened pts with any actionable genomic alterations using common mutational database and ESCAT. Genomic data, MTB reports and treatment outcomes were collected. The 3 outcomes of the MTB were: A) assignment of a TT and randomization, B) screening failure (SF) C) SF for the trial but with relevant information from the genomic test. Outcome C was divided into 3 groups: 1) indication to receive a personalized standard treatment different from the planned one, 2) indication to access to another clinical trial/compassionate use/expanded access, 3) indication to perform a germline test (GT). Results: From Oct 2020 to Dec 2021, 497 pts were enrolled in 38 Italian accrual sites, 303 (61.0%) had relevant genomic alterations and were discussed to the MTB. Molecular profiling was determined both on tissue and liquid biopsy in 262/303 (86.5%) pts, while in 11 (3.5%) and 30 (10.0%) only on tissue or liquid, respectively. After applying clinical and molecular exclusion criteria and considering multiple actionable or resistance-conferring mutations (detected in 95 and 70 out of 303 patients): 135 pts (45%) were randomized (outcome A), 19 (30%) were SF (outcome B), and 78 (25%) SF but with an additional indication (outcome C). Of them, 14 patients (18%) were group 1 and 42 (54%) had indication to a target therapy outside from the trial (group 2). MTB suggested a GT to 60/303 pts (20%, group 3). To date, 8 out of 9 GT performed confirmed a germline mutation (4 BRCA1/2, 2 PALB2, 1 MUTHY, 1 ATM). Finally, 213 pts, 71% of those discussed to MTB and 43% of the entire screened population, were randomized or received at least one specific indication following the extended molecular assessment with NGS. Conclusions: We demonstrated the feasibility of screening a large numbers of pts from numerous accruing sites in a complex trial to test investigational therapies for moderately frequent molecular targets. Co-occurring resistance mutations were common and endorse to investigate combination targeted-therapy regimens. The Rome trial MTB, even when no actionable alterations were detected, provided a therapeutic and diagnostic indication with a potential impact on patient’s outcomes. Clinical trial information: NCT04591431.
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Affiliation(s)
- Andrea Botticelli
- Department of Radiology, Oncology and Pathology, “Sapienza” University of Rome, Rome, Italy
| | - Simone Scagnoli
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | | | | | - Paolo Antonio Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | | | - Massimo Aglietta
- Candiolo Cancer Institute, FPO-IRCCS and University of Turin, Candiolo, Italy
| | | | - Ettore Capoluongo
- Department of Molecular Medicine, Federico II University of Naples, Cannizzaro Hospital of Catania, Naples, Italy
| | | | - Umberto Malapelle
- Department of Public Health, Federico II University of Naples, Neaples, Italy
| | - Marianna Nuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia D'Amati
- Department of Radiological Oncological and Anatomo-Pathological Science, Sapienza University of Rome, Rome, Italy
| | - Bruna Cerbelli
- Department of Radiological, Oncological and Anatomo-Pathological Science, Sapienza University of Rome, Rome, Italy
| | - Giancarlo Pruneri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Mauro Biffoni
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Giuseppe Giannini
- Dipartimento di Medicina Sperimentale, Università La Sapienza, Rome, Italy
| | | | | | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Roberto M, Arrivi G, Pilozzi E, Montori A, Balducci G, Mercantini P, Laghi A, Ierinò D, Panebianco M, Marinelli D, Tomao S, Marchetti P, Mazzuca F. The Potential Role of Genomic Signature in Stage II Relapsed Colorectal Cancer (CRC) Patients: A Mono-Institutional Study. Cancer Manag Res 2022; 14:1353-1369. [PMID: 35418781 PMCID: PMC9000544 DOI: 10.2147/cmar.s342612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/22/2021] [Accepted: 02/21/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose The absolute benefit of adjuvant chemotherapy in stage II CRC is only 3–4%. The identification of biomarkers through molecular profiling could identify patients who will more benefit from adjuvant chemotherapy. Patients and Methods This retrospective analysis examined tissue blocks from 17 patients affected by relapsed stage II CRC, whose comprehensive genomic profiling of tumors was conducted through next-generation sequencing (NGS) via Roche-FoundationOne®. Results Mutations were found in APC (76.5%), TP53 (58.8%) and KRAS (52.9%). Only KRAS wild-type samples showed FBXW7. APC frameshift mutations and MLH1 splice variant were conversely significant correlated (7% v 93%, P = 0.014). The median number of gene mutations reported was 6 (range 2–14). The TP53 mutation was associated most frequently with lung metastasis (P = 0.07) and high tumor budding (P = 0.03). Despite no statistical significance, lung recurrence, LVI/Pni, MSI and more than 6 genetic mutations were correlated to worse DFS and OS. Patients carried co-mutations of TP53-FBXW7 reported the worse DFS (4 v 14 months) and OS (4 v 65 months) compared to the other patients. Conclusion According to the present analysis, the setting of relapsed CRC emerges as one of the fields of greatest utility for NGS, looking at personalized cancer care.
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Affiliation(s)
- Michela Roberto
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy
| | - Giulia Arrivi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Oncology Unit, Sant’ Andrea University Hospital, Rome, Italy
- Correspondence: Giulia Arrivi, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Oncology Unit, Sant’ Andrea University Hospital, Via di Grottarossa 1035-1039, Rome, 00189, Italy, Tel +39 3387231524, Fax +39 0633776629, Email
| | - Emanuela Pilozzi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Anatomia Patologica Unit, Sant’ Andrea University Hospital, Rome, Italy
| | - Andrea Montori
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Anatomia Patologica Unit, Sant’ Andrea University Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical-Surgical Sciences and Translation Medicine, Sapienza University of Rome, Gastro-intestinal Surgery Unit, Sant’ Andrea University Hospital, Rome, Italy
| | - Paolo Mercantini
- Department of Medical-Surgical Sciences and Translation Medicine, Sapienza University of Rome, Gastro-intestinal Surgery Unit, Sant’ Andrea University Hospital, Rome, Italy
| | - Andrea Laghi
- Department of Medical-Surgical Sciences and Translation Medicine, Sapienza University of Rome, Radiology Unit, Sant’ Andrea University Hospital, Rome, Italy
| | - Debora Ierinò
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Oncology Unit, Sant’ Andrea University Hospital, Rome, Italy
| | - Martina Panebianco
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Oncology Unit, Sant’ Andrea University Hospital, Rome, Italy
| | - Daniele Marinelli
- Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Silverio Tomao
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Oncology Unit, Sant’ Andrea University Hospital, Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Oncology Unit, Sant’ Andrea University Hospital, Rome, Italy
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15
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Roberto M, Carconi C, Cerreti M, Schipilliti FM, Botticelli A, Mazzuca F, Marchetti P. The Challenge of ICIs Resistance in Solid Tumours: Could Microbiota and Its Diversity Be Our Secret Weapon? Front Immunol 2021; 12:704942. [PMID: 34489956 PMCID: PMC8417795 DOI: 10.3389/fimmu.2021.704942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/04/2021] [Accepted: 08/03/2021] [Indexed: 12/14/2022] Open
Abstract
The human microbiota and its functional interaction with the human body were recently returned to the spotlight of the scientific community. In light of the extensive implementation of newer and increasingly precise genome sequencing technologies, bioinformatics, and culturomic, we now have an extraordinary ability to study the microorganisms that live within the human body. Most of the recent studies only focused on the interaction between the intestinal microbiota and one other factor. Considering the complexity of gut microbiota and its role in the pathogenesis of numerous cancers, our aim was to investigate how microbiota is affected by intestinal microenvironment and how microenvironment alterations may influence the response to immune checkpoint inhibitors (ICIs). In this context, we show how diet is emerging as a fundamental determinant of microbiota’s community structure and function. Particularly, we describe the role of certain dietary factors, as well as the use of probiotics, prebiotics, postbiotics, and antibiotics in modifying the human microbiota. The modulation of gut microbiota may be a secret weapon to potentiate the efficacy of immunotherapies. In addition, this review sheds new light on the possibility of administering fecal microbiota transplantation to modulate the gut microbiota in cancer treatment. These concepts and how these findings can be translated into the therapeutic response to cancer immunotherapies will be presented.
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Affiliation(s)
- Michela Roberto
- Department of Clinical and Molecular Medicine, Sant' Andrea University Hospital, Sapienza University of Rome, Rome, Italy.,Medical Oncology Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Catia Carconi
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant' Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Micaela Cerreti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant' Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Francesca Matilde Schipilliti
- Department of Clinical and Molecular Medicine, Sant' Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Andrea Botticelli
- Department of Clinical and Molecular Medicine, Sant' Andrea University Hospital, Sapienza University of Rome, Rome, Italy.,Medical Oncology Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Sant' Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Sant' Andrea University Hospital, Sapienza University of Rome, Rome, Italy.,Medical Oncology Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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16
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Tipaldi MA, Ronconi E, Lucertini E, Krokidis M, Zerunian M, Polidori T, Begini P, Marignani M, Mazzuca F, Caruso D, Rossi M, Laghi A. Hepatocellular Carcinoma Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE): Outcome Analysis Using a Model Based On Pre-Treatment CT Texture Features. Diagnostics (Basel) 2021; 11:diagnostics11060956. [PMID: 34073545 PMCID: PMC8226518 DOI: 10.3390/diagnostics11060956] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/30/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 02/08/2023] Open
Abstract
(1) Introduction and Aim: The aim of this study is to investigate the prognostic value, in terms of response and survival, of CT-based radiomics features for patients with HCC undergoing drug-eluting beads transarterial chemoembolization (DEB-TACE). (2) Materials and Methods: Pre-treatment CT examinations of 50 patients with HCC, treated with DEB-TACE were manually segmented to obtain the tumor volumetric region of interest, extracting radiomics features with TexRAD. Response to therapy evaluation was performed basing on post-procedural CT examination compared to pre-procedural CT, using modified RECIST criteria for HCC. The prognostic value of texture analysis was evaluated, investigating the correlation between radiomics features, response to therapy and overall survival. Three models based on texture and clinical variables and a combination of them were finally built; (3) Results: Entropy, skewness, MPP and kurtosis showed a significant correlation with complete response (CR) to TACE (all p < 0.001). A predictive model to identify patients with a high and low probability of CR was evaluated with an ROC curve, with an AUC of 0.733 (p < 0.001). The three models built for survival prediction yielded an HR of 2.19 (95% CI: 2.03-2.35) using texture features, of 1.7 (95% CI: 1.54-1.9) using clinical data and of 4.61 (95% CI: 4.24-5.01) combining both radiomics and clinical data (all p < 0.0001). (4) Conclusion: Texture analysis based on pre-treatment CT examination is associated with response to therapy and survival in patients with HCC undergoing DEB-TACE, especially if combined with clinical data.
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Affiliation(s)
- Marcello Andrea Tipaldi
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza-University of Rome, 00189 Rome, Italy; (M.Z.); (M.R.); (A.L.)
- Department of Radiology, Sant’Andrea University of Hospital La Sapienza, 00189 Rome, Italy; (E.R.); (E.L.); (T.P.)
- Correspondence: ; Tel.: +39-06-33775391 (ext. 5893)
| | - Edoardo Ronconi
- Department of Radiology, Sant’Andrea University of Hospital La Sapienza, 00189 Rome, Italy; (E.R.); (E.L.); (T.P.)
| | - Elena Lucertini
- Department of Radiology, Sant’Andrea University of Hospital La Sapienza, 00189 Rome, Italy; (E.R.); (E.L.); (T.P.)
| | - Miltiadis Krokidis
- Department of Radiology, Areteion Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Marta Zerunian
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza-University of Rome, 00189 Rome, Italy; (M.Z.); (M.R.); (A.L.)
| | - Tiziano Polidori
- Department of Radiology, Sant’Andrea University of Hospital La Sapienza, 00189 Rome, Italy; (E.R.); (E.L.); (T.P.)
| | - Paola Begini
- Department of Liver Diseases Section, AOU Sant’Andrea Hospital, University of Hospital La Sapienza, 00189 Rome, Italy; (P.B.); (M.M.)
| | - Massimo Marignani
- Department of Liver Diseases Section, AOU Sant’Andrea Hospital, University of Hospital La Sapienza, 00189 Rome, Italy; (P.B.); (M.M.)
| | - Federica Mazzuca
- Department of Clinical and Molecular Oncology-Sapienza, University of Rome, Sant’Andrea University Hospital, via di Grottarossa 1035, 00189 Rome, Italy;
| | - Damiano Caruso
- Department of Radiological Sciences, Oncological and Pathological Sciences, University of Rome Sapienza, Sant’Andrea University Hospital, 00189 Rome, Italy;
| | - Michele Rossi
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza-University of Rome, 00189 Rome, Italy; (M.Z.); (M.R.); (A.L.)
- Department of Radiology, Sant’Andrea University of Hospital La Sapienza, 00189 Rome, Italy; (E.R.); (E.L.); (T.P.)
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza-University of Rome, 00189 Rome, Italy; (M.Z.); (M.R.); (A.L.)
- Department of Radiology, Sant’Andrea University of Hospital La Sapienza, 00189 Rome, Italy; (E.R.); (E.L.); (T.P.)
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17
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Rinzivillo M, Prosperi D, Mazzuca F, Magi L, Iannicelli E, Pilozzi E, Franchi G, Laghi A, Annibale B, Signore A, Panzuto F. [ 18F]FDG-PET/CT and long-term responses to everolimus in advanced neuroendocrine neoplasia. J Endocrinol Invest 2021; 44:811-818. [PMID: 32767279 DOI: 10.1007/s40618-020-01378-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/30/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE This study aims to identify in patients with neuroendocrine neoplasia (NEN) the potential correlation between FDG-PET findings and responses to everolimus therapy to identify predictors of long-term efficacy. METHODS Retrospective analysis of patients with sporadic, advanced, progressive NEN treated with everolimus was performed based on the available data on FDG-PET patients obtained before commencing therapy. Data are expressed as the median (25-75th IQR). Risk factor analysis and survival analysis were performed by logistic regression and Cox proportional hazard regression and the determination of Kaplan-Meier curves, as appropriate. RESULTS Sixty-six patients were evaluated (NET G1 19.7%, NET G2 75.7%, and NET G3 4.6%), including 45.4% with positive FDG-PET findings. Overall, disease stabilization and a partial response were achieved for 71.2% and 6% of patients, respectively. A long-term response (> 24 months) was observed in 33% of patients. Ki67 was the only predictor of tumor progression (p = 0.03). No significant difference in clinical outcomes was observed between patients with positive or negative FDG-PET findings (median PFS was 24 months and 18 months, respectively, p = 0.337; the disease control rate was 83.3% and 70%, respectively, p = 0.245). CONCLUSIONS Everolimus is a valid therapeutic option for advanced, progressive, well-differentiated NEN, even in patients with positive FDG-PET findings.
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Affiliation(s)
- M Rinzivillo
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Via di Grottarossa 1035, 00189, Rome, Italy
| | - D Prosperi
- Nuclear Medicine Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - F Mazzuca
- Medical Oncology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - L Magi
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Via di Grottarossa 1035, 00189, Rome, Italy
| | - E Iannicelli
- Radiology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
- Department of Medical-Surgical Sciences and of Translational Medicine, "Sapienza" University of Rome, Rome, Italy
| | - E Pilozzi
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
- Pathology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - G Franchi
- Nuclear Medicine Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - A Laghi
- Radiology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
- Department of Medical-Surgical Sciences and of Translational Medicine, "Sapienza" University of Rome, Rome, Italy
| | - B Annibale
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Via di Grottarossa 1035, 00189, Rome, Italy
- Department of Medical-Surgical Sciences and of Translational Medicine, "Sapienza" University of Rome, Rome, Italy
| | - A Signore
- Nuclear Medicine Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
- Department of Medical-Surgical Sciences and of Translational Medicine, "Sapienza" University of Rome, Rome, Italy
| | - F Panzuto
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Via di Grottarossa 1035, 00189, Rome, Italy.
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18
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Roberto M, Rossi A, Panebianco M, Pomes LM, Arrivi G, Ierinò D, Simmaco M, Marchetti P, Mazzuca F. Drug-Drug Interactions and Pharmacogenomic Evaluation in Colorectal Cancer Patients: The New Drug-PIN ® System Comprehensive Approach. Pharmaceuticals (Basel) 2021; 14:ph14010067. [PMID: 33467633 PMCID: PMC7830292 DOI: 10.3390/ph14010067] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/12/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/17/2022] Open
Abstract
Drug–drug interactions (DDIs) can affect both treatment efficacy and toxicity. We used Drug-PIN® (Personalized Interactions Network) software in colorectal cancer (CRC) patients to evaluate drug–drug–gene interactions (DDGIs), defined as the combination of DDIs and individual genetic polymorphisms. Inclusion criteria were: (i) stage II-IV CRC; (ii) ECOG PS (Performance status sec. Eastern coperative oncology group) ≤2; (iii) ≥5 concomitant drugs; and (iv) adequate renal, hepatic, and bone marrow function. The Drug-PIN® system analyzes interactions between active and/or pro-drug forms by integrating biochemical, demographic, and genomic data from 110 SNPs. We selected DDI, DrugPin1, and DrugPin2 scores, resulting from concomitant medication interactions, concomitant medications, and SNP profiles, and DrugPin1 added to chemotherapy drugs, respectively. Thirty-four patients, taking a median of seven concomitant medications, were included. The median DrugPin1 and DrugPin2 scores were 42.6 and 77.7, respectively. In 13 patients, the DrugPin2 score was two-fold higher than the DrugPin1 score, with 7 (54%) of these patients experiencing severe toxicity that required hospitalization. On chi-squared testing for any toxicity, a doubled DrugPin2 score (p = 0.001) was significantly related to G3–G4 toxicity. Drug-PIN® software may prevent severe adverse events, decrease hospitalizations, and improve survival in cancer patients.
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Affiliation(s)
- Michela Roberto
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00187 Rome, Italy; (M.R.); (A.R.); (G.A.); (D.I.); (P.M.); (F.M.)
- Department of Medical-Surgical Sciences and Translation Medicine, Sapienza University, Sant’Andrea University Hospital, 00187 Rome, Italy
| | - Alessandro Rossi
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00187 Rome, Italy; (M.R.); (A.R.); (G.A.); (D.I.); (P.M.); (F.M.)
| | - Martina Panebianco
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00187 Rome, Italy; (M.R.); (A.R.); (G.A.); (D.I.); (P.M.); (F.M.)
- Correspondence:
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health, 00187 Rome, Italy; (L.M.P.); (M.S.)
- and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Sant’Andrea University Hospital, 00187 Rome, Italy
| | - Giulia Arrivi
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00187 Rome, Italy; (M.R.); (A.R.); (G.A.); (D.I.); (P.M.); (F.M.)
| | - Debora Ierinò
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00187 Rome, Italy; (M.R.); (A.R.); (G.A.); (D.I.); (P.M.); (F.M.)
- Department of Medical-Surgical Sciences and Translation Medicine, Sapienza University, Sant’Andrea University Hospital, 00187 Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, 00187 Rome, Italy; (L.M.P.); (M.S.)
- and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Sant’Andrea University Hospital, 00187 Rome, Italy
- Department of Advanced Molecular Diagnostics, Sant’Andrea Hospital, University “La Sapienza”, 00187 Rome, Italy
| | - Paolo Marchetti
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00187 Rome, Italy; (M.R.); (A.R.); (G.A.); (D.I.); (P.M.); (F.M.)
| | - Federica Mazzuca
- Oncology Unit, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University “La Sapienza”, 00187 Rome, Italy; (M.R.); (A.R.); (G.A.); (D.I.); (P.M.); (F.M.)
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Rinzivillo M, Prosperi D, Mazzuca F, Magi L, Iannicelli E, Pilozzi E, Franchi G, Silveri GG, Laghi A, Annibale B, Signore A, Panzuto F. 1185P [18F]FDG-PET/CT and long-term response to everolimus in advanced neuroendocrine neoplasia. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1398] [Citation(s) in RCA: 1] [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: 11/24/2022] Open
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Botticelli A, Mezi S, Pomati G, Cerbelli B, Di Rocco C, Amirhassankhani S, Sirgiovanni G, Occhipinti M, Napoli V, Emiliani A, Mazzuca F, Tomao S, Nuti M, Marchetti P. The 5-Ws of immunotherapy in head and neck cancer. Crit Rev Oncol Hematol 2020; 153:103041. [DOI: 10.1016/j.critrevonc.2020.103041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/11/2020] [Accepted: 06/29/2020] [Indexed: 02/07/2023] Open
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Roberto M, Arrivi G, Lo Bianco F, Cascinu S, Gelsomino F, Caputo F, Cerma K, Ghidini M, Ratti M, Pizzo C, Ficorella C, Parisi A, Cortellini A, Urbano F, Calandrella ML, Dell’Aquila E, Minelli A, Fulgenzi CAM, Gariazzo L, Montori A, Pilozzi E, Di Girolamo M, Marchetti P, Mazzuca F. Evaluation of Prognostic Factors for Survival in Transverse Colon Cancer. Cancers (Basel) 2020; 12:cancers12092457. [PMID: 32872561 PMCID: PMC7563638 DOI: 10.3390/cancers12092457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/25/2020] [Revised: 08/18/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Transverse colon cancer (TCC) is mostly included among right-sided colon cancer, and sometimes even excluded at all, thus it is not completely clear if they present total similarities with right-sided ones or if they have their own specific features. With a median follow-up of 34 months, we concluded that TCC shares some clinicopathological characteristics with left-sided colon cancer and many others with the right-sided ones, but only poorly/undifferentiated tumor grade and BRAF V600E mutation are independent prognostic factors for survival, regardless of tumor stage. The present study provides more insightful knowledge of clinicopathological characteristics of TCC patients, emphasize the role of BRAF mutation since the early stage of disease and lay the basis for new treatment algorithms in this specific setting of colon cancer. Abstract Background: Although most of the analyses included transverse colon cancers (TCC) among right colon cancer (RCC), it is not completely clear if they present total similarities with RCC or if they have their specific features. Therefore, we present an observational study to evaluate clinicopathological characteristics and survival data of patients with TCC. Methods: We retrospectively reviewed 450 RCC, of whom 97 stages I–IV TCC were included in this multicenter study; clinicopathological and molecular parameters were analyzed to identify prognostic factors for disease-free survival (DFS) and overall survival (OS). Results: Most of TCC cases were male (61%), with ≤70 years old (62%), and good performance status (ECOG PS 0, 68%). According to WHO classification, 41 (49%) and 40 (48%) tumors were classified as well to moderate and poorly/undifferentiated respectively, regardless of mucinous component (30%). About molecular data, 8 (26%), 45 (63%), and 14 (24%) were MSI-H, KRAS wild-type, and BRAF V600E mutant, respectively. With a median follow-up of 34 months, there were 29 and 50 disease recurrences and deaths respectively. Charlson comorbidity index ≥5 was a significant prognostic factor for DFS (HR = 7.67, 95% CI 2.27–25.92). Colon obstruction/perforation (HR = 2.65, 95% CI 1.01–7.01), and BRAF mutant (HR = 3.03, 95% CI 0.97–9.50) cases showed a worst, despite not statistically significant, DFS. Whereas for OS, at the multivariate model, only tumor grade differentiation (HR = 5.26, 95% CI 1.98–14.01) and BRAF mutation status (3.71, 95% CI 1.07–12.89) were independent prognostic factors. Conclusions: Poorly/undifferentiated tumor grade and BRAF V600E mutation are independent prognostic factors for OS in TCC. Further prospective clinical trials are needed to better define TCC treatment in order to improve patient outcome.
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Affiliation(s)
- Michela Roberto
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea Hospital, Sapienza University of Rome, 00187 Rome, Italy; (M.R.); (G.A.); (F.L.B.); (L.G.); (P.M.)
| | - Giulia Arrivi
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea Hospital, Sapienza University of Rome, 00187 Rome, Italy; (M.R.); (G.A.); (F.L.B.); (L.G.); (P.M.)
| | - Francesca Lo Bianco
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea Hospital, Sapienza University of Rome, 00187 Rome, Italy; (M.R.); (G.A.); (F.L.B.); (L.G.); (P.M.)
| | - Stefano Cascinu
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, 41125 Modena, Italy; (S.C.); (F.G.); (F.C.); (K.C.)
| | - Fabio Gelsomino
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, 41125 Modena, Italy; (S.C.); (F.G.); (F.C.); (K.C.)
| | - Francesco Caputo
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, 41125 Modena, Italy; (S.C.); (F.G.); (F.C.); (K.C.)
| | - Krisida Cerma
- Division of Oncology, Department of Oncology and Hematology, University Hospital of Modena, 41125 Modena, Italy; (S.C.); (F.G.); (F.C.); (K.C.)
| | - Michele Ghidini
- Oncology Unit, Oncology Department, ASST of Cremona, 26100 Cremona, Italy; (M.G.); (M.R.); (C.P.)
| | - Margherita Ratti
- Oncology Unit, Oncology Department, ASST of Cremona, 26100 Cremona, Italy; (M.G.); (M.R.); (C.P.)
| | - Claudio Pizzo
- Oncology Unit, Oncology Department, ASST of Cremona, 26100 Cremona, Italy; (M.G.); (M.R.); (C.P.)
| | - Corrado Ficorella
- Medical Oncology, St. Salvatore Hospital, University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (C.F.); (A.P.); (A.C.)
| | - Alessandro Parisi
- Medical Oncology, St. Salvatore Hospital, University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (C.F.); (A.P.); (A.C.)
| | - Alessio Cortellini
- Medical Oncology, St. Salvatore Hospital, University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (C.F.); (A.P.); (A.C.)
| | - Federica Urbano
- Department of Radiology, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy; (F.U.); (M.L.C.)
| | - Maria Letizia Calandrella
- Department of Radiology, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy; (F.U.); (M.L.C.)
| | - Emanuela Dell’Aquila
- Medical Oncology Department, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (E.D.); (A.M.); (C.A.M.F.)
| | - Alessandro Minelli
- Medical Oncology Department, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (E.D.); (A.M.); (C.A.M.F.)
| | | | - Ludovica Gariazzo
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea Hospital, Sapienza University of Rome, 00187 Rome, Italy; (M.R.); (G.A.); (F.L.B.); (L.G.); (P.M.)
| | - Andrea Montori
- Department of Clinical and Molecular Medicine, UOC Anatomia Patologica, Sant’ Andrea Hospital, Sapienza University of Rome, 00187 Rome, Italy; (A.M.); (E.P.)
| | - Emanuela Pilozzi
- Department of Clinical and Molecular Medicine, UOC Anatomia Patologica, Sant’ Andrea Hospital, Sapienza University of Rome, 00187 Rome, Italy; (A.M.); (E.P.)
| | - Marco Di Girolamo
- Department of Radiology, Sant’Andrea University Hospital, 00187 Rome, Italy;
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea Hospital, Sapienza University of Rome, 00187 Rome, Italy; (M.R.); (G.A.); (F.L.B.); (L.G.); (P.M.)
- Department of Radiology, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy; (F.U.); (M.L.C.)
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea Hospital, Sapienza University of Rome, 00187 Rome, Italy; (M.R.); (G.A.); (F.L.B.); (L.G.); (P.M.)
- Correspondence:
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Roberto M, Bianco FL, Arrivi G, Pietro FD, Gariazzo L, Gelsomino F, Ghidini M, Ficorella C, Parisi A, Urbano F, Dell'Aquila E, Mazzuca F. P-348 A multi-institutional retrospective study of stage I-IV transverse colon cancer: Diagnosis, treatment and outcome analyses. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.430] [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: 11/30/2022] Open
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Parisi A, Camarda F, Ribelli M, Rossini D, Germani M, Dell'Aquila E, Natoli C, Pietro D, Corsi D, Zurlo I, Lombardi P, Zanaletti N, Giampieri R, Merloni F, Occhipinti M, Marchetti P, Roberto M, Mazzuca F, Ghidini M, Garajová I, Zoratto F, Ficorella C. P-168 Second-line, anti-VEGF based after first-line, anti-EGFR based treatment in RAS wild-type metastatic colorectal cancer: The multicenter, retrospective, real-life SLAVE study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.250] [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: 10/23/2022] Open
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Roberto M, Ierinò D, Panebianco M, Romiti A, Cerbo AD, Falcone R, Ferri M, Balducci G, Ramacciato G, Pilozzi E, Marchetti P, Mazzuca F. P-124 Tumor budding and CDX2 as additional prognostic factors in stage II colon cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.206] [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] Open
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Roberto M, Basta F, Mazzuca F, Curigliano G, Marchetti P. Risk of coronavirus disease 2019 in patients treated for cancer: An immune response-based hypothesis. Eur J Cancer 2020; 134:6-8. [PMID: 32425367 PMCID: PMC7231735 DOI: 10.1016/j.ejca.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Michela Roberto
- Clinical and Molecular Medicine, Sapienza University, Rome, Italy.
| | - Fabio Basta
- University center of autoimmunity, Johannes Gutenberg University of Mainz, Germany
| | - Federica Mazzuca
- Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giuseppe Curigliano
- Division of Early Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, University of Milan, Department of Oncology and Haemato-Oncology, Milan, Italy
| | - Paolo Marchetti
- Clinical and Molecular Medicine, Sapienza University, Rome, Italy
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DI Girolamo M, Carbonetti F, Bonome P, Grossi A, Mazzuca F, Masoni L. Hydro-MDCT for Gastric Adenocarcinoma Staging. A Comparative Study With Surgical and Histopathological Findings for Selecting Patients for Echo-endoscopy. Anticancer Res 2020; 40:3401-3410. [PMID: 32487637 DOI: 10.21873/anticanres.14324] [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: 03/25/2020] [Revised: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM In local staging of gastric adenocarcinoma CT is the modality of choice. Less frequently used in a few selected patients is echo-endoscopy. Aim of this study was to evaluate the accuracy of hydro-multidetector-computed tomography (hydro-MDCT) in the evaluation of gastric adenocarcinomas with subsequent surgical and histopathological correlation to select cases for echo-endoscopy. PATIENTS AND METHODS A total of 65 patients with gastric adenocarcinomas, diagnosed by endoscopy and biopsy, underwent contrast-enhanced hydro-MDCT with subsequent tumor, nodes, metastases (TNM) classification. The distension of the gastric lumen was obtained after the oral administration of 500 ml of water. RESULTS Hydro-MDCT always detected gastric cancer and in 49/65 patients the assessment of T-parameter was identical to the histopathological results (accuracy: 75%). We found overstaging in 12 and understaging in 4 cases. N-parameter with MDCT was in agreement with histo-pathology in 69%of patients; in metastatic disease hydro-MDCT had an accuracy of 99%. Hydro-MDCT has proven to be a reliable diagnostic technique in evaluating gastric cancer T3-T4 stages in comparison to T1 and T2: in defining T2-stage we found the highest number of errors (37%). CONCLUSION Hydro-MDCT is a reliable technique in the preoperative staging of gastric adenocarcinoma. Echo-endoscopy could be particularly useful in doubtful cases to evaluate the muscularis propria infiltration (T2 vs. T3) and characterize the peri-gastric lymph nodes.
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Affiliation(s)
- Marco DI Girolamo
- Departments of Radiology, Sant' Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Francesco Carbonetti
- Departments of Radiology, Sant' Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Paolo Bonome
- Departments of Radiology, Sant' Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Grossi
- Departments of Radiology, Sant' Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Federica Mazzuca
- Department of Oncology, Sant' Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Luigi Masoni
- Department of Surgery, Sant' Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Mercantini P, Lucarini A, Mazzuca F, Osti MF, Laghi A. How technology can help in oncologic patient management during COVID-19 outbreak. Eur J Surg Oncol 2020; 46:1189-1191. [PMID: 32389524 PMCID: PMC7192092 DOI: 10.1016/j.ejso.2020.04.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 11/02/2022] Open
Affiliation(s)
- Paolo Mercantini
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Rome, Italy.
| | - Alessio Lucarini
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Mattia Falchetto Osti
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Laghi
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Rome, Italy
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Mazzuca F, Roberto M, Arrivi G, Sarfati E, Schipilliti FM, Crimini E, Botticelli A, Di Girolamo M, Muscaritoli M, Marchetti P. Clinical Impact of Highly Purified, Whey Proteins in Patients Affected With Colorectal Cancer Undergoing Chemotherapy: Preliminary Results of a Placebo-Controlled Study. Integr Cancer Ther 2020; 18:1534735419866920. [PMID: 31370717 PMCID: PMC6681246 DOI: 10.1177/1534735419866920] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Indexed: 01/06/2023] Open
Abstract
Background and Aims: Sarcopenia, the loss of both lean body and skeletal muscle mass, may interfere in cancer patients outcome. As investigated, whey proteins could prevent the onset of sarcopenia. We have conducted a study to evaluate the effects of whey protein in colorectal cancer patients, undergoing 5-fluorouracil-based chemotherapy. Methods: After written informed consent, patients were blind randomized 1:1 to whey protein (ProLYOtin; arm A) versus placebo (arm B). The patients were assessed both physically and nutritionally before chemotherapy and after 3 (T2) and 6 months (T3) by body impedance assessment, L3-computed tomography scan, Mini Nutritional Assessment (MNA), and Malnutrition Universal Screening Tool (MUST) tests. Results: Forty-seven patients were included in this preliminary analysis. Baseline characteristics were well balanced between the 2 arms. During chemotherapy, 33 patients were reevaluated: anthropometric parameters (lean body mass from 68.5% to 71.2% vs 68.7% to 66.3%, and sarcopenia from 84% to 54% and 83% to 77% from baseline to T2 evaluation in arms A and B, respectively), nutritional status (MNA >24 = 100% [A] vs 73.7% [B]), and toxicity (no adverse effects in 86% [A] vs 29% [B] and 94% [A] vs 29% [B] for hematological and gastrointestinal toxicities, respectively) resulted to be significantly different. At univariate analysis, a condition of malnutrition risk according to MUST (relative risk [RR] = 7.5, P = .02) or MNA (RR = 1.45, P = .02) and ProLYOtin intake (RR = 0.12, P = .01) were found to be significantly predictive of chemotherapy toxicity. Conclusions: At present, our study shows how whey protein could be an important therapeutic option to improve nutritional status, and particularly to prevent severe toxicity during chemotherapy.
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Affiliation(s)
| | - Michela Roberto
- 1 Sant'Andrea Hospital, University "La Sapienza," Rome, Italy
| | - Giulia Arrivi
- 1 Sant'Andrea Hospital, University "La Sapienza," Rome, Italy
| | - Elena Sarfati
- 1 Sant'Andrea Hospital, University "La Sapienza," Rome, Italy
| | | | - Edoardo Crimini
- 1 Sant'Andrea Hospital, University "La Sapienza," Rome, Italy
| | | | | | | | - Paolo Marchetti
- 1 Sant'Andrea Hospital, University "La Sapienza," Rome, Italy
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Parisi A, Cortellini A, Roberto M, Venditti O, Santini D, Dell'Aquila E, Stellato M, Marchetti P, Occhipinti MA, Zoratto F, Mazzuca F, Tinari N, De Tursi M, Iezzi L, Natoli C, Ratti M, Pizzo C, Ghidini M, Porzio G, Ficorella C, Cannita K. Weight loss and body mass index in advanced gastric cancer patients treated with second-line ramucirumab: a real-life multicentre study. J Cancer Res Clin Oncol 2019; 145:2365-2373. [PMID: 31280347 DOI: 10.1007/s00432-019-02971-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 04/28/2019] [Accepted: 07/02/2019] [Indexed: 12/14/2022]
Abstract
AIMS AND METHODS This multicenter retrospective study aims to evaluate the correlations between Body Weight Loss (BWL), Body Mass Index (BMI) and clinical outcomes (ORR, PFS, and OS) of advanced gastric cancer (aGC) patients treated with second-line ramucirumab-based therapy in a "real-life" setting. RESULTS From December 2014 to October 2018, 101 consecutive aGC patients progressed to a first-line chemotherapy were treated with ramucirumab alone (10.9%) or in combination with paclitaxel (89.1%). Median BMI was 21.2 kg/m2 and mBWL since first-line treatment commencement was 4.5%. Among 53 patients who underwent primary tumor resection (PTR), 73.6% experienced BWL, while 26.4% did not experience BWL (p = 0.0429). Patients who underwent PTR had a significantly higher probability of experiencing BWL (yes vs no) [OR = 2.35 (95% CI 1.02-5.42), p = 0.0439]. Among the 89 evaluable patients, ORR was 26.9% (95% CI 17.2-40.1). At a median follow-up of 17.3 months, mPFS was 5.4 months (95% CI 3.6-6.8) and mOS was 8.7 months (95% CI 7.3-11.9). In the multivariate analysis, only ECOG-PS and BMI were confirmed independent predictors for shorter PFS [HR = 1.69 (95% CI 1.01-2.82), p = 0.04] [HR = 1.97 (95% CI 1.12-3.46), p = 0.01] and OS [HR = 1.69 (95% CI 1.01-2.83), p = 0.04] [HR = 2.08 (95% CI 1.17-3.70), p = 0.01]. CONCLUSION Efficacy of ramucirumab is confirmed in this "real-life" analysis. BWL seems not to have correlations with clinical outcomes in these patients, while BMI and ECOG-PS remain major prognostic factors. A possible explanation for the lack of prognostic effect of BWL might be the proportion of patients subjected to PTR in this series (52.5%).
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Affiliation(s)
- Alessandro Parisi
- Medical Oncology, St. Salvatore Hospital, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessio Cortellini
- Medical Oncology, St. Salvatore Hospital, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy.
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - Olga Venditti
- Medical Oncology, St. Salvatore Hospital, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
| | - Daniele Santini
- Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy
| | | | - Marco Stellato
- Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Paolo Marchetti
- Medical Oncology, Sant'Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
- Medical Oncology, Policlinico Umberto I, Rome, Italy
| | | | | | | | - Nicola Tinari
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Michele De Tursi
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Laura Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Clara Natoli
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Margherita Ratti
- Oncology Unit, Oncology Department, Azienda Socio Sanitaria Territoriale Ospedale di Cremona, Cremona, Italy
| | - Claudio Pizzo
- Oncology Unit, Oncology Department, Azienda Socio Sanitaria Territoriale Ospedale di Cremona, Cremona, Italy
| | - Michele Ghidini
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giampiero Porzio
- Medical Oncology, St. Salvatore Hospital, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Corrado Ficorella
- Medical Oncology, St. Salvatore Hospital, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Katia Cannita
- Medical Oncology, St. Salvatore Hospital, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
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Rossi A, Roberto M, Panebianco M, Botticelli A, Mazzuca F, Marchetti P. Drug resistance of BRAF-mutant melanoma: Review of up-to-date mechanisms of action and promising targeted agents. Eur J Pharmacol 2019; 862:172621. [PMID: 31446019 DOI: 10.1016/j.ejphar.2019.172621] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [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: 03/06/2019] [Revised: 08/09/2019] [Accepted: 08/19/2019] [Indexed: 12/29/2022]
Abstract
Melanoma onset and progression are associated with a high variety of activating mutations in the MAPK-pathway, most frequently involving BRAF (35-45%) and NRAS (15-25%) genes, but also c-KIT and PTEN. Targeted therapies with BRAF and MEK inhibitors showed promising results over the past years, but it is known that most responses are temporary, and almost all of patients develop a tumor relapse within one year. Different drug-resistance mechanisms underlie the progression of disease and activation of both MAPK and PI3K/AKT/mTOR pathways. Therefore, in this article we reviewed the main studies about clinical effects of several target inhibitors, describing properly the most prominent mechanisms of both intrinsic and acquired resistance. Furthermore, suggestive strategies for overcoming drug resistance and the most recent alternative combination therapies to optimize the use of MAPK pathway inhibitors were also discussed.
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Affiliation(s)
- Alessandro Rossi
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy
| | - Michela Roberto
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy; Department of Medical-Surgical Sciences and Translation Medicine, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy.
| | - Martina Panebianco
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy
| | - Andrea Botticelli
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy; Oncology Unit, IDI-IRCCS of Rome, Italy
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31
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Parisi A, Cortellini A, Roberto M, Venditti O, Santini D, Dell’Aquila E, Stellato M, Marchetti P, Occhipinti M, Zoratto F, Mazzuca F, Tinari N, De Tursi M, Iezzi L, Natoli C, Ratti M, Pizzo C, Ghidini M, Ficorella C, Cannita K. A real-life multicenter study on body weight loss and body mass index in advanced Gastric Cancer patients treated with Ramucirumab-based second-line therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.100] [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: 11/14/2022] Open
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32
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Roberto M, Arrivi G, Milano A, D’Antonio C, Romiti A, Falcone R, Mazzuca F, Fais S, Marchetti P. Updated results of a phase II randomized trial with high dose proton pump inhibitors and metronomic capecitabine as salvage treatment for patients with advanced gastrointestinal tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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33
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Magi L, Mazzuca F, Rinzivillo M, Arrivi G, Pilozzi E, Prosperi D, Iannicelli E, Mercantini P, Rossi M, Pizzichini P, Laghi A, Signore A, Marchetti P, Annibale B, Panzuto F. Multidisciplinary Management of Neuroendocrine Neoplasia: A Real-World Experience from a Referral Center. J Clin Med 2019; 8:E910. [PMID: 31242670 PMCID: PMC6616416 DOI: 10.3390/jcm8060910] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 05/27/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Multidisciplinary approach is widely advised for an effective care of patients with neuroendocrine neoplasia (NEN). Since data on efficacy of multidisciplinary management of NENs patients in referral centers are scanty, this study aimed at analyzing the modality of presentation and clinical outcome of patients with NENs managed by a dedicated multidisciplinary team. METHODS In this prospective observational study, we included all consecutive new patients visiting the Sant'Andrea Hospital in Rome (ENETS-Center of Excellence) between January 2014 and June 2018. RESULTS A total of 195 patients were evaluated. The most frequent sites were pancreas (38.5%), small bowel (22%), and lung (9.7%). Median Ki67 was 3%. After the first visit at the center, additional radiological and/or nuclear medicine procedures were requested in 163 patients (83.6%), whereas histological data revision was advised in 84 patients (43.1%) (revision of histological slides: 27.7%, new bioptic sampling: 15.4%). After that, disease imaging staging and grading was modified in 30.7% and 17.9% of patients, respectively. Overall, a change in therapeutic management was proposed in 98 patients (50.3%). CONCLUSIONS Multidisciplinary approach in a dedicated team may lead to change of disease imaging staging and grading in a significant proportion of patients. Enhancing referral routes to dedicated-NEN center should be promoted, since it may improve patients' clinical outcome.
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Affiliation(s)
- Ludovica Magi
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
| | - Federica Mazzuca
- Medical Oncology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
| | - Maria Rinzivillo
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
| | - Giulia Arrivi
- Medical Oncology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
| | - Emanuela Pilozzi
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
- Pathologic Anatomy and Molecular Morphology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
| | - Daniela Prosperi
- Nuclear Medicine Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
| | - Elsa Iannicelli
- Radiology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
| | - Paolo Mercantini
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
- Surgery Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
| | - Michele Rossi
- Radiology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
| | - Patrizia Pizzichini
- Nuclear Medicine Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
| | - Andrea Laghi
- Radiology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
| | - Alberto Signore
- Nuclear Medicine Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
| | - Paolo Marchetti
- Medical Oncology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
| | - Bruno Annibale
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
- Department of Medical-Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, 00189 Rome, Italy.
| | - Francesco Panzuto
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
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Falcone R, Romiti A, Filetti M, Roberto M, Righini R, Botticelli A, Pilozzi E, Ghidini M, Pizzo C, Mazzuca F, Marchetti P. Impact of tumor site on the prognosis of small bowel adenocarcinoma. Tumori Journal 2019; 105:524-528. [DOI: 10.1177/0300891619839297] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: Because of a lack of large-scale prospective studies there is no clear indication about the management of patients with small bowel adenocarcinoma (SBA). This study evaluated clinical outcome of patients diagnosed with SBA at our institution. Methods: Clinicopathologic features, treatments, and clinical outcome of patients diagnosed with SBA between 2006 and 2017 were retrospectively analyzed. Median time of survival was calculated and compared using the log-rank test. Multivariate Cox regression was used to test independence of significant factors in univariate analysis. Results: Forty patients were included in the study; the majority (82.5%) had a tumor in the duodenum (including ampulla of Vater) and an early stage disease at the diagnosis. Median overall survival (OS) in the whole study population was 26.5 months. Patients with a tumor of the lower part of the small intestine (jejunum, ileum, and appendix) showed a better OS compared with that of patients with upper SBA (40 months vs 26 months, respectively; P=0.09). Primary tumor site and stage were independent predictors of OS. Conclusions: Our results suggest a prognostic role for the primary tumor site. This finding deserves to be further investigated to ensure better classification as well as more effective management strategies for SBA.
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Affiliation(s)
- Rosa Falcone
- Department of Molecular and Clinical Medicine, “Sapienza” University of Rome, Italy
| | - Adriana Romiti
- Department of Molecular and Clinical Medicine, “Sapienza” University of Rome, Italy
| | - Marco Filetti
- Department of Molecular and Clinical Medicine, “Sapienza” University of Rome, Italy
| | - Michela Roberto
- Department of Molecular and Clinical Medicine, “Sapienza” University of Rome, Italy
| | | | - Andrea Botticelli
- Department of Molecular and Clinical Medicine, “Sapienza” University of Rome, Italy
| | - Emanuela Pilozzi
- Department of Molecular and Clinical Medicine, “Sapienza” University of Rome, Italy
| | - Michele Ghidini
- Oncology Department, ASST Ospedale di Cremona, Cremona, Italy
| | - Claudio Pizzo
- Oncology Department, ASST Ospedale di Cremona, Cremona, Italy
| | - Federica Mazzuca
- Department of Molecular and Clinical Medicine, “Sapienza” University of Rome, Italy
| | - Paolo Marchetti
- Department of Molecular and Clinical Medicine, “Sapienza” University of Rome, Italy
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35
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Botticelli A, Salati M, Di Pietro FR, Strigari L, Cerbelli B, Zizzari IG, Giusti R, Mazzotta M, Mazzuca F, Roberto M, Vici P, Pizzuti L, Nuti M, Marchetti P. A nomogram to predict survival in non-small cell lung cancer patients treated with nivolumab. J Transl Med 2019; 17:99. [PMID: 30917841 PMCID: PMC6437908 DOI: 10.1186/s12967-019-1847-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 01/02/2019] [Accepted: 03/12/2019] [Indexed: 12/24/2022] Open
Abstract
Background The advent of immune checkpoint inhibitors (ICIs) has considerably expanded the armamentarium against non-small cell lung cancer (NSCLC) contributing to reshaping treatment paradigms in the advanced disease setting. While promising tissue- and plasma-based biomarkers are under investigation, no reliable predictive factor is currently available to aid in treatment selection. Methods Patients with stage IIIB–IV NSCLC receiving nivolumab at Sant’Andrea Hospital and Regina Elena National Cancer Institute from June 2016 to July 2017 were enrolled onto this study. Major clinicopathological parameters were retrieved and correlated with patients’ survival outcomes in order to assess their prognostic value and build a useful tool to assist in the decision making process. Results A total of 102 patients were included in this study. The median age was 69 years (range 44–85 years), 69 (68%) were male and 52% had ECOG PS 0. Loco-regional/distant lymph nodes were the most commonly involved site of metastasis (71%), followed by lung parenchyma (67%) and bone (26%). Overall survival (OS) in the whole patients’ population was 83.6%, 63.2% and 46.9% at 3, 6 and 12 months, respectively; while progression-free survival (PFS) was 66.5%, 44.4% and 26.4% at 3, 6 and 12 months, respectively. At univariate analysis, age ≥ 69 years (P = 0.057), ECOG PS (P < 0.001), the presence of liver (P < 0.001), lung (P = 0.017) metastases, lymph nodes only involvement (P = 0.0145) were significantly associated with OS and ECOG PS (P < 0.001) and liver metastases (P < 0.001), retained statistical significance at multivariate analysis. A prognostic nomogram based on three variables (liver and lung metastases and ECOG PS) was built to assign survival probability at 3, 6, and 12 months after nivolumab treatment commencement. Conclusion We developed a nomogram based on easily available and inexpensive clinical factors showing a good performance in predicting individual OS probability among NSCLC patients treated with nivolumab. This prognostic device could be valuable to clinicians in more accurately driving treatment decision in daily practice as well as enrollment onto clinical trials.
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Affiliation(s)
- Andrea Botticelli
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Salati
- Department of Oncology, University Hospital of Modena and Reggio Emilia, Modena, Italy. .,Division of Molecular Pathology, The Institute of Cancer Research and Gastrointestinal Unit, The Royal Marsden Hospital, London, Sutton, UK.
| | - Francesca Romana Di Pietro
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Lidia Strigari
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome, Italy
| | - Bruna Cerbelli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Raffaele Giusti
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marco Mazzotta
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Michela Roberto
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Patrizia Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marianna Nuti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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36
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Roberto M, Sarfati E, Di Girolamo M, Schipilliti F, Crimini E, Botticelli A, Marchetti L, Muscaritoli M, Marchetti P, Mazzuca F. Clinical impact of whey protein and nutritional counseling in gastrointestinal cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Botticelli A, Cerbelli B, Lionetto L, Zizzari I, Pisano A, Roberto M, Onesti E, Pietro FRDI, Napoletano C, Pizzuti L, Vici P, D'Amati G, Mazzuca F, Simmaco M, Nuti M, Marchetti P. Abstract 5705: The key role of kynurenine in anti-PD-1 failure. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Immune checkpoint inhibitors have revolutionized treatment and outcome of severe and often fatal disease, as metastatic lung cancer, demonstrating long-term tumor control and extended patient survival. Unfortunately, only 25-30% of patients have a long-term benefit from immunotherapy, while the remaining 70-75% demonstrate primary or acquired resistance. Recently, indoleamine 2,3-dioxygenase (IDO) has been proposed as a possible mechanism of resistance to anti-PD1 treatment. Indeed, IDO catalyzes the degradation of tryptophan (Trp) into kynurenine (Kyn), which seems to enhance the activity of Treg, leading to an immunosuppressive microenvironment.
Methods: The serum concentrations of Trp and Kyn were measured by high-performance liquid chromatography tandem mass spectrometry in 26 patients affected by non-small cell lung cancer (NCLSC) before the start of the second-line therapy with nivolumab. The IDO activity was expressed with Kyn/Trp ratio. The associations between Kyn/Trip ratio and early progression, PS, age, sex, brain metastases and pleural effusion were analyzed using Spearman test and Mann Whitney test.
Results: 14 out of 26 patients (54%) presented early progression (defined as progression of the disease within 6 months from the beginning of nivolumab treatment). The median value of Kyn/Trp ratio was 0.073 (0.024-0.18). We found a significant association between Kyn/Trp ratio and early progression (p= 0.009), while no statistical associations were found between Kyn/Trp ratio and PS, age, sex, brain metastases and pleural effusion. Indeed, patients with early progressive disease presented a median value of Kyn/Trp ratio significantly higher than other patients (0.094 vs 0.052; p= 0.01).
Conclusion: The pretreatment evaluation of IDO activity, expressed as Kyn/Trp ratio, seems to be associated with response to immunotherapy. In particular, higher Kyn/Trp ratio could predict resistance to anti-PD-1 treatment. These preliminary results suggest the possibility of using anti-PD-1 plus IDO inhibitor in patients with high level of Kyn/Trp ratio.
Citation Format: Andrea Botticelli, Bruna Cerbelli, Luana Lionetto, Ilaria Zizzari, Annalina Pisano, Michela Roberto, Elisa Onesti, Francesca Romana DI Pietro, Chiara Napoletano, Laura Pizzuti, Patrizia Vici, Giulia D'Amati, Federica Mazzuca, Maurizio Simmaco, Marianna Nuti, Paolo Marchetti. The key role of kynurenine in anti-PD-1 failure [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5705.
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Affiliation(s)
| | | | - Luana Lionetto
- 1Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | | | - Michela Roberto
- 1Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Elisa Onesti
- 1Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | | | - Laura Pizzuti
- 3Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy, Rome, Italy
| | - Patrizia Vici
- 3Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy, Rome, Italy
| | | | | | | | | | - Paolo Marchetti
- 1Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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38
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Roberto M, Botticelli A, Strigari L, Ghidini M, Onesti CE, Ratti M, Benzoni I, Pizzo C, Falcone R, Lomiento D, Donida BM, Totaro L, Mazzuca F, Marchetti P. Prognosis of elderly gastric cancer patients after surgery: a nomogram to predict survival. Med Oncol 2018; 35:111. [DOI: 10.1007/s12032-018-1166-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/13/2018] [Indexed: 12/14/2022]
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39
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Mazzuca F, Onesti CE, Roberto M, Di Girolamo M, Botticelli A, Begini P, Strigari L, Marchetti P, Muscaritoli M. Lean body mass wasting and toxicity in early breast cancer patients receiving anthracyclines. Oncotarget 2018; 9:25714-25722. [PMID: 29876019 PMCID: PMC5986630 DOI: 10.18632/oncotarget.25394] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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: 02/12/2018] [Accepted: 04/28/2018] [Indexed: 12/21/2022] Open
Abstract
Background Sarcopenia refers to the reduction of both volume and number of skeletal muscle fibers. Lean body mass loss is associated with survival, quality of life and tolerance to treatment in cancer patients. The aim of our study is to analyse the association between toxicities and sarcopenia in early breast cancer patients receiving adjuvant treatment. Materials and Methods Breast cancer patients who have received anthracycline-based adjuvant treatment were retrospectively enrolled. CT scan images performed before, during and after adjuvant chemotherapy were used to evaluate lean body mass at third lumbar vertebra level with the software Slice Omatic V 5.0. Results 21 stage I–III breast cancer patients were enrolled. According to the skeletal muscle index at third lumbar vertebra cut-off ≤38.5 cm2/m2, 8 patients (38.1%) were classified as sarcopenic before starting treatment, while 10 patients (47.6%) were sarcopenic at the end of treatment. A lower baseline L3 skeletal muscle index is associated with G3-4 vs G0-2 toxicities (33.4 cm2/m2 (31.1–39.9) vs 40.5 cm2/m2 (33.4–52.0), p = 0.028). Similarly skeletal muscle cross sectional area was significantly lower in patients with G3-4 toxicities (86.7 cm2 (82.6–104.7) vs 109.0 cm2 (83.3–143.9), p = 0.017). L3 skeletal muscle index is an independent predictor of severe toxicity (p = 0.0282) in multivariate analysis. Conclusion Lean body mass loss is associated with higher grade of toxicity in early breast cancer patients receiving adjuvant chemotherapy.
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Affiliation(s)
- Federica Mazzuca
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy.,Department of Medical Oncology, Sant'Andrea Hospital, Rome, Italy
| | - Concetta Elisa Onesti
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy.,Department of Medical Oncology, University Hospital (CHU) and University of Liège, Liège, Belgium
| | - Michela Roberto
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy.,Department of Medical Oncology, Sant'Andrea Hospital, Rome, Italy
| | | | - Andrea Botticelli
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Paola Begini
- Department of Gastroenterology, Sant'Andrea Hospital, Rome, Italy
| | - Lidia Strigari
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy.,Department of Medical Oncology, Sant'Andrea Hospital, Rome, Italy
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40
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Botticelli A, Putignani L, Zizzari I, Del Chierico F, Reddel S, DI Pietro F, Quagliarello A, Onesti CE, Raffaele G, Mazzuca F, Nuti M, Marchetti P. Changes of microbiome profile during nivolumab treatment in NSCLC patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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)
- Andrea Botticelli
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | - Lorenza Putignani
- Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ilaria Zizzari
- Department of Experimental Medicine, Sapienza University Policlinico Umberto 1, Rome, Italy
| | | | - Sofia Reddel
- Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca DI Pietro
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | - Andrea Quagliarello
- Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Concetta Elisa Onesti
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | | | | | - Marianna Nuti
- Department of Experimental Medicine, Sapienza University Policlinico Umberto 1, Rome, Italy
| | - Paolo Marchetti
- S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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41
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Mazzuca F, Roberto M, Botticelli A, Marchetti L, Sarfati E, Crimini E, Schipilliti F, Di Girolamo M, Muscaritoli M, Marchetti P. Effect of nutritional support with highly purified, whey proteins for malnutrition and sarcopenia in patients affected with stage II-III colorectal or breast cancer: A blind, placebo controlled, randomized clinical trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps10129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
| | - Michela Roberto
- S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | | | - Elena Sarfati
- S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | | | | | | | - Paolo Marchetti
- S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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42
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Botticelli A, Cerbelli B, Sciattella P, Salati M, Zizzari I, Roberto M, Poti G, De Galitiis F, Picone V, D'Amati G, Mazzuca F, Nuti M, Marchetti P. Anatomic site of metastases can influence response to nivolumab in NSCLC patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15021] [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)
- Andrea Botticelli
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | | | | | - Massimiliano Salati
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Ilaria Zizzari
- Department of Experimental Medicine, Sapienza University Policlinico Umberto 1, Rome, Italy
| | - Michela Roberto
- S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Giulia Poti
- Sapienza University of Rome - Ospedale Sant'Andrea, Rome, Italy
| | | | - Vincenzo Picone
- Medical Oncology, Istituto Dermopatico Dell'immacolata, Rome, Italy
| | | | | | - Marianna Nuti
- Department of Experimental Medicine, Sapienza University Policlinico Umberto 1, Rome, Italy
| | - Paolo Marchetti
- S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Milano A, Borro M, Pilozzi E, Montori A, Mazzotta M, Lorenzon L, Caivano D, Chiloiro G, Botticelli A, Mazzuca F, Osti MF, Simmaco M, Ruco L, Valentini V, Marchetti P. Next-generation expression analysis (NanoString) to develop prognostic and predictive gene signatures for patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
700 Background: The standard of care for locally advanced rectal cancer (RC) is neoadjuvant chemoradiotherapy (CRT) with 5FU aimed to tumor downstaging prior to radical resection but there is a wide spectrum of responses to it, from none to complete. The aim of this project is to validate top candidate genes previously identified by microarray studies as prognostic and predictive classifiers of locally advanced RC, using the NanoString nCounter Platform. Methods: Two cohorts of RC patients were identified according to tumor regression grade (TRG) of AJCC Staging Manual (7th) system: 1) good prognosis: patients that after neoadjuvant CRT obtained TRG0 (complete response); 2) poor prognosis: patients with TRG1 (moderate response), patients with TRG2 (minimum response rate) and patients with TRG3 (poor response). Pre-treatment biopsies tissues from ten TRG0 patients (ID TRG0bio) and thirteen TRG1-3 patients (ID TRG1-3bio) were macro-dissected from FFPE sections, RNA isolated and used for expression profiling of a 305 genes custom code set consisting of 12 normalizer genes, 101 prognostic genes (markers of stemness, invasiveness, proliferation, drug-resistance), 192 predictive genes (involved in response to 5-FU, to radiation therapy and in the response to CRT). All samples were normalized using the geometric mean of the housekeeper genes. P-values were calculated by student’s t-test and was consider significance if was less than 0.05. Gene-specific RNA expression profiles were compared using Spearman's correlation. The heat map was generated using MeV 4.9.0. Results: When we compared TRG0bio to TRG1-3bio tissues, among the 305 genes assayed, changes in expression levels of 18 genes (SSB, GAPDH, TXNDC9, DUT, PKM, STAT1,SLC28A3, DAG1, TYMS, FERMT1, ARNT,SLC6A6, SMAD3, SCRN1, POU5F1, GNG4, PDRG1, ATP5E) were statistically significant. Conclusions: Results suggest that TRG0 RC is characterized by distinct molecular events compared TRG1-3 disease. Next steps will be: to amplify sample size, to understand signaling pathways of top differentially expressed genes and to validate prospectively our gene signature.
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Affiliation(s)
| | | | | | | | | | - Laura Lorenzon
- Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Donatella Caivano
- Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Mattia Falchetto Osti
- Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Maurizio Simmaco
- Advanced Molecular Diagnostics, Saint Andrea Hospital, Rome, Italy
| | - Luigi Ruco
- Azienda Ospedaliera Sant'Andrea, Rome, Italy
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Mazzuca F, Borro M, Botticelli A, Mazzotti E, Marchetti L, Gentile G, La Torre M, Lionetto L, Simmaco M, Marchetti P. Pre-treatment evaluation of 5-fluorouracil degradation rate: association of poor and ultra-rapid metabolism with severe toxicity in a colorectal cancer patients cohort. Oncotarget 2018; 7:20612-20. [PMID: 26967565 PMCID: PMC4991479 DOI: 10.18632/oncotarget.7991] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 12/08/2015] [Accepted: 02/15/2016] [Indexed: 12/22/2022] Open
Abstract
Despite the wide use of 5-fluorouracil-based chemotherapy, development of severe toxicity that follow the treatment is not a rare event. The efforts to establish pretreatment tools for toxicity prediction, led to the development of various pharmacogenetic and biochemical assays, mainly targeted to assess the activity level of dihydropyrimidine dehydrogenase (DPD), the main metabolizing enzyme for 5-fluorouracil. Using peripheral blood mononuclear cells, we developed a biochemical assay, that is not limited to the evaluation of DPD activity, but determines the net result of all the enzymatic transformation of 5FU, in terms of the amount of drug consumed by the cells in a time unit. This parameter, named 5-fluorauracil degradation rate, presents a normal distribution inside the population and highlight the presence of an ultra-rapid metabolizers class of subjects, besides the expected poor metabolizers class. Here we will show that, in a colorectal cancer patient cohort, both poor and ultra-rapid metabolizers have significantly increased the risk of developing severe toxicity (grade3–4). Patient stratification depending on the individual 5-fluorouracil degradation rate allows to identify a 10% of the overall population at high risk of developing severe toxicity, compared to the 1.3% (as assessed in the Italian population) identified by the most commonly employed pharmacogenetic test, including the DPD polymorphism IVS14+1G>A.
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Affiliation(s)
- Federica Mazzuca
- Oncology Unit, Sant'Andrea Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Marina Borro
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Andrea Botticelli
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Eva Mazzotti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Luca Marchetti
- Department of Clinical Oncology, Policlinico Umberto I, Rome, Italy
| | | | - Marco La Torre
- Department of Clinical Oncology, Policlinico Umberto I, Rome, Italy
| | | | - Maurizio Simmaco
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Oncology Unit, Sant'Andrea Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
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45
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Occhipinti M, Falcone R, Onesti CE, Botticelli A, Mazzuca F, Marchetti P, Lauro S. Crizotinib plus radiotherapy in brain oligoprogressive NSCLC ROS1 rearranged and PD-L1 strong. J Thorac Dis 2017; 9:E985-E989. [PMID: 29268554 DOI: 10.21037/jtd.2017.09.74] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 11/06/2022]
Abstract
ROS1+ patients represent a unique molecular subset of non-small cell lung cancer (NSCLC). Early phase clinical trials have shown a high response rate to crizotinib in these patients. We describe a case of an 18 years old woman, never smoker, with NSCLC ROS1+ and miliary brain metastases treated with crizotinib and radiotherapy. From October 2014 to June 2015 the Patient was treated with crizotinib. The first intracranial time to progression (IT-TTP) occurred after 7 months; the patient underwent stereotactic radiosurgery (SRS) and continued TKI treatment. The second IT-TTP appeared after 16 months. A continued response in the chest was observed for all the 23 months of crizotinib treatment. At the progression, we assessed programmed death ligand 1 (PD-L1) expression by immunohistochemistry, that resulted highly expressed. Our report indicates that the integration of crizotinib with local treatments should be considered in ROS1 NSCLC patients experiencing oligometastatic progression. Moreover, this case is an example of PD-L1 strong in oncogene addicted patients.
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Affiliation(s)
| | - Rosa Falcone
- Medical Oncology Unit, Sant' Andrea Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Concetta Elisa Onesti
- Medical Oncology Unit, Sant' Andrea Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Botticelli
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Federica Mazzuca
- Medical Oncology Unit, Sant' Andrea Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Paolo Marchetti
- Medical Oncology Unit, Sant' Andrea Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy.,Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Salvatore Lauro
- Medical Oncology Unit, Sant' Andrea Hospital, Rome, Italy.,Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
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Roberto M, Falcone R, Mazzuca F, Archibugi L, Castaldi N, Botticelli A, Osti MF, Marchetti P. The role of stereotactic body radiation therapy in oligometastatic colorectal cancer: Clinical case report of a long-responder patient treated with regorafenib beyond progression. Medicine (Baltimore) 2017; 96:e9023. [PMID: 29310420 PMCID: PMC5728821 DOI: 10.1097/md.0000000000009023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
RATIONALE Regorafenib is the new standard third-line therapy in metastatic colorectal cancer (mCRC). However, the reported 1-year overall survival rate does not exceed 25%. PATIENT CONCERNS A 55-year-old man affected by mCRC, treated with regorafenib combined with stereotactic body radiotherapy (SBRT), showing a durable response. INTERVENTIONS After 6 months of regorafenib, a PET/CT scan revealed a focal uptake in a solid lung nodule which was treated with SBRT, whereas continuing regorafenib administration. Fourteen months later, the patient had further progression in a parasternal lymph node, but treatment with regorafenib was continued. The regorafenib-associated side effects, such us the hand-foot syndrome, were favorable managed by reducing the dose from 160 to 120 mg/day. OUTCOMES Patient-reported outcome was characterized by a progression-free survival of approximately 3 years. LESSONS in presence of oligometastatic progression, a local SBRT while retaining the same systemic therapy may be a better multidisciplinary approach. Moreover, disease progression is no longer an absolute contraindication for continuing the regorafenib treatment.
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Affiliation(s)
- Michela Roberto
- Clinical and Molecular Medicine Department, Medical Oncology Unit, Sant’Andrea Hospital
| | - Rosa Falcone
- Clinical and Molecular Medicine Department, Medical Oncology Unit, Sant’Andrea Hospital
| | - Federica Mazzuca
- Clinical and Molecular Medicine Department, Medical Oncology Unit, Sant’Andrea Hospital
| | - Livia Archibugi
- Medical-Surgical Department of Clinical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant’Andrea Hospital, School of Medicine
| | - Nadia Castaldi
- Clinical and Molecular Medicine Department, Medical Oncology Unit, Sant’Andrea Hospital
| | - Andrea Botticelli
- Clinical and Molecular Medicine Department, Medical Oncology Unit, Sant’Andrea Hospital
| | - Mattia Falchetto Osti
- Medicine-Surgery and Translational Medicine Department, Radiotherapy Unit, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Clinical and Molecular Medicine Department, Medical Oncology Unit, Sant’Andrea Hospital
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47
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Botticelli A, Onesti CE, Zizzari I, Cerbelli B, Sciattella P, Occhipinti M, Roberto M, Di Pietro F, Bonifacino A, Ghidini M, Vici P, Pizzuti L, Napoletano C, Strigari L, D’Amati G, Mazzuca F, Nuti M, Marchetti P. The sexist behaviour of immune checkpoint inhibitors in cancer therapy? Oncotarget 2017; 8:99336-99346. [PMID: 29245905 PMCID: PMC5725096 DOI: 10.18632/oncotarget.22242] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [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: 07/28/2017] [Accepted: 10/10/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors, targeting the molecules CTLA-4, PD-1 and PD-L1, showed efficacy against several type of cancers and are currently used in clinical practice. An important biological variable that influences innate and adaptive immunity is the sex, acting through genetic, hormonal and environmental factors. The overall differences between sexes could be crucial to evaluate the response to ICIs. MATERIALS AND METHODS We performed a meta-analysis of Phase II-III Clinical Trials published up to June 2017 in which anti-CTLA-4, anti-PD-1 and anti-PD-L1 were studied. We extracted the OS and PFS HR differentiated by sex from subgroups analysis of each trial. We analyzed the three classes of drugs separately. RESULTS We selected 36 Phase II-III Clinical Trials, 9 of which reported results for OS and 6 for PFS. We analyzed 2 Clinical Trials for OS with anti-CTLA-4, including 1178 patients, observing a benefit for males vs females (HR 0.65, 95% CI 0.55-0.77 vs HR 0.79, 95% CI 0.65-0.96, p 0.078).Not statistically significant results were observed with anti-PD-1 neither for OS (males vs females: HR 0.72, 95% CI 0.64-0.83 vs HR 0.81, 95% CI 0.70-0.94, p 0.285) neither for PFS (males vs females: HR 0.66, 95% CI 0.52-0.82 vs HR 0.85, 95% CI 0.66-1.09, p 0.158). We cannot perform a meta-analysis for anti-PD-L1 due to the lack of data. CONCLUSIONS Different mechanisms could be involved in sex differences with regard to immunotherapy. These differences could be relevant to identify immunological targets in order to draw studies exploring novel combinations of immunotherapy agents.
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Affiliation(s)
- Andrea Botticelli
- Medical Oncology Department, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Concetta Elisa Onesti
- Medical Oncology Department, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Ilaria Zizzari
- Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Bruna Cerbelli
- Department of Radiological Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Paolo Sciattella
- Statistical Department, “Sapienza” University of Rome, Rome, Italy
| | | | - Michela Roberto
- Medical Oncology Department, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Francesca Di Pietro
- Medical Oncology Department, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Adriana Bonifacino
- Breast Diagnosis and Treatment Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | | | - Patrizia Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Napoletano
- Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Lidia Strigari
- Laboratory of Medical Physics and Expert Systems, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giulia D’Amati
- Department of Radiological Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Federica Mazzuca
- Medical Oncology Department, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Marianna Nuti
- Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Paolo Marchetti
- Medical Oncology Department, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
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Occhipinti M, Botticelli A, Onesti C, Ghidini M, Righini R, Pizzo C, Milano A, Tomasello G, Di Pietro F, Toppo L, Ratti M, Passalacqua R, Marchetti P, Mazzuca F. Treatment and outcome for small bowel adenocarcinoma (SBA): a real life experience of two Italian centres. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx425.022] [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: 11/14/2022] Open
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Botticelli A, Cerbelli B, Pernazza A, Onesti C, Sciattella P, Costarelli L, Monti M, Campagna D, Mazzuca F, Fortunato L, Marchetti P, D'Amati G. PD-L1 expression in TNBC: A predictive biomarker of response to neoadjuvant chemotherapy? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.027] [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: 11/14/2022] Open
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50
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Ghidini M, Botticelli A, Donida BM, Strigari L, Onesti CE, Ratti M, Pizzo C, Aldighieri F, Toppo L, Ranieri V, Occhipinti M, Senti C, Tanzi G, Mazzuca F, Marchetti P, Martinotti M, Passalacqua R, Tomasello G, Rovatti M. Prognostic factors associated with survival and recurrence in resectable gastroesophageal adenocarcinoma: retrospective analysis of 497 patients operated at two Italian centers. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e15588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15588 Background: Chemotherapy (CT) and chemoradiotherapy (CTRT) both in neoadjuvant (neoadj) or adjuvant (adj) setting are associated with better overall survival (OS) over surgery alone in patients (pts) with resectable gastroesophageal (GE) adenocarcinoma (ADK). The best sequence and timing of treatments have still not been defined. A large cohort of GE ADKs derived from 2 high-volume Italian centers was analyzed to describe clinical outcomes and prognostic factors. Methods: 497 patients (pts) diagnosed with GE ADK who underwent surgery with curative intent from 2007 to 2016 were considered. Variables analyzed were: age, sex, tumor location, histology, T, N, M, R, G, HER-2, Helicobacter Pylori (HP) infection, (neo)adj CT, and adj CTRT. Analysis was performed according to ITT principle. Results: Median age at diagnosis was 71 years (range 35-92). At 26.7 months (mo) median follow-up, median OS was 27.6 mo (range 1-127) and median time to recurrence (TTR) 10.8 mo (range 7.8-13.1). Adj CT was administered in 203 cases (41%); 116 pts (23%) had adj CTRT and 47 (9%) neoadj CT. Statistically significant variables for OS and/or TTR at 12 months at univariate analysis were: age, T, N, M, R, G, adj CTRT, neoadj CT and adj CT. Results of multivariate analysis (MVA) are shown in Table 1. Conclusions: Despite a short follow-up, our analysis performed on a very large cohort of consecutive pts confirms the prognostic value of T and N for both OS and TTR. Adj CT and CTRT had a significant impact on 1 year OS, while neoadj CT gave only a 12 months TTR significant benefit. Based on these results, perioperative treatment strategies should always be considered in the management of resectable GE cancer. [Table: see text]
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Affiliation(s)
- Michele Ghidini
- Oncology Unit, Oncology Department, ASST of Cremona, Cremona, Italy
| | - Andrea Botticelli
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | | | - Lidia Strigari
- Laboratory of Medical Physics and Expert System, Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy
| | - Concetta Elisa Onesti
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | - Margherita Ratti
- Oncology Unit, Oncology Department, ASST of Cremona, Cremona, Italy
| | - Claudio Pizzo
- Oncology Unit, Oncology Department, ASST of Cremona, Cremona, Italy
| | - Federico Aldighieri
- General Surgery Unit, Surgical Department, Assistant of Cremona, Cremona, Italy
| | - Laura Toppo
- Oncology Unit, Oncology Department, ASST of Cremona, Cremona, Italy
| | - Valerio Ranieri
- General Surgery Unit, Surgical Department, Assistant of Cremona, Cremona, Italy
| | - Mario Occhipinti
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | - Chiara Senti
- Division of Oncology, ASST Cremona, Cremona, Italy
| | - Giulia Tanzi
- Pathology Unit, Laboratory department, ASST of Cremona, Cremona, Italy
| | - Federica Mazzuca
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Sapienza University Sant' Andrea Hospital, Rome, Italy
| | - Mario Martinotti
- General Surgery Unit, Surgical Department, Assistant of Cremona, Cremona, Italy
| | | | | | - Massimo Rovatti
- General Surgery Unit, Surgical Department, Assistant of Cremona, Cremona, Italy
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