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Ringborg U, von Braun J, Celis J, Baumann M, Berns A, Eggermont A, Heard E, Heitor M, Chandy M, Chen C, Costa A, De Lorenzo F, De Robertis EM, Dubee FC, Ernberg I, Gabriel M, Helland Å, Henrique R, Jönsson B, Kallioniemi O, Korbel J, Krause M, Lowy DR, Michielin O, Nagy P, Oberst S, Paglia V, Parker MI, Ryan K, Sawyers CL, Schüz J, Silkaitis K, Solary E, Thomas D, Turkson P, Weiderpass E, Yang H. Strategies to decrease inequalities in cancer therapeutics, care and prevention: Proceedings on a conference organized by the Pontifical Academy of Sciences and the European Academy of Cancer Sciences, Vatican City, February 23-24, 2023. Mol Oncol 2024; 18:245-279. [PMID: 38135904 PMCID: PMC10850793 DOI: 10.1002/1878-0261.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 12/24/2023] Open
Abstract
Analyses of inequalities related to prevention and cancer therapeutics/care show disparities between countries with different economic standing, and within countries with high Gross Domestic Product. The development of basic technological and biological research provides clinical and prevention opportunities that make their implementation into healthcare systems more complex, mainly due to the growth of Personalized/Precision Cancer Medicine (PCM). Initiatives like the USA-Cancer Moonshot and the EU-Mission on Cancer and Europe's Beating Cancer Plan are initiated to boost cancer prevention and therapeutics/care innovation and to mitigate present inequalities. The conference organized by the Pontifical Academy of Sciences in collaboration with the European Academy of Cancer Sciences discussed the inequality problem, dependent on the economic status of a country, the increasing demands for infrastructure supportive of innovative research and its implementation in healthcare and prevention programs. Establishing translational research defined as a coherent cancer research continuum is still a challenge. Research has to cover the entire continuum from basic to outcomes research for clinical and prevention modalities. Comprehensive Cancer Centres (CCCs) are of critical importance for integrating research innovations to preclinical and clinical research, as for ensuring state-of-the-art patient care within healthcare systems. International collaborative networks between CCCs are necessary to reach the critical mass of infrastructures and patients for PCM research, and for introducing prevention modalities and new treatments effectively. Outcomes and health economics research are required to assess the cost-effectiveness of new interventions, currently a missing element in the research portfolio. Data sharing and critical mass are essential for innovative research to develop PCM. Despite advances in cancer research, cancer incidence and prevalence is growing. Making cancer research infrastructures accessible for all patients, considering the increasing inequalities, requires science policy actions incentivizing research aimed at prevention and cancer therapeutics/care with an increased focus on patients' needs and cost-effective healthcare.
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2
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Lillini R, De Lorenzo F, Baili P, Iannelli E, Del Campo LM, Pero D, Traclò G, Sproviero A, Sant M, Perrone F. Out-of-pocket costs sustained in the last 12 months by cancer patients: an Italian survey-based study on individual expenses between 2017 and 2018. Eur J Health Econ 2023; 24:1309-1319. [PMID: 36414809 DOI: 10.1007/s10198-022-01544-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Out of Pocket costs (OOP) sustained by cancer patients also in public NHS contribute to disease-related financial toxicity. Aim of the study was to investigate the amount and the types of OOP sustained by Italian cancer patients for care services. METHODS A sample survey was conducted by FAVO in December 2017-June 2018, in 39 adhering hospitals and 1289 patients diagnosed from 1985 to 2018, by standardized questionnaire inquiring on: yearly expenditure by cancer service, age, year of diagnosis, disease phase, cancer site, sex, marital status, education, residence. Univariate and multivariable regression analyses were performed between OOP and each variable. Multilevel mixed-effects negative binomial regression was used to assess the combined effects of patients characteristics on the differences in acquiring health services. RESULTS The yearly average OOP was 1841.81€, with the highest values for transports (359.34€) and for diagnostic examinations (259.82€). Significantly higher OOP were found in North and Centre than South and Islands (167.51 vs. 138.39). In the fully adjusted multivariable analysis, the variables significantly associated with higher than reference expenditure were: medium/high education (OR 1.22 [1.05-1.42], upper gastrointestinal tract cancer (OR 1.37 [1.06-1.77]), disease phase of treatments for cancer progression or pain therapy (OR 1.59 [1.30-1.93]). CONCLUSION Italian cancer patients in 2018 sustained OOP quite similar to those measured in 2012 to supplement NHS services. The main component of the OOP costs were diagnostic examination and transportation. The NHS should pay attention to potentiate its ability to answer unmet needs of patients with advanced cancer who are the most fragile ones. IMPLICATIONS FOR CANCER SURVIVORS Reinforcing the services where the main OOP expenses are located can help in promoting public health actions and reduce socio-economic needs that could compromise the receipt of optimal care along the whole disease course, from diagnosis to rehabilitation.
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Affiliation(s)
- Roberto Lillini
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy.
| | - Francesco De Lorenzo
- Italian Federation of Cancer Patients Organization, FAVO, Via Barberini 11, 00187, Rome, Italy
| | - Paolo Baili
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Elisabetta Iannelli
- Italian Federation of Cancer Patients Organization, FAVO, Via Barberini 11, 00187, Rome, Italy
| | - Laura M Del Campo
- Italian Federation of Cancer Patients Organization, FAVO, Via Barberini 11, 00187, Rome, Italy
| | - Dina Pero
- Italian Association of Cancer Patients, Relatives and Friends, Aimac, Via Barberini, 11, 00187, Rome, Italy
| | - Gianfranca Traclò
- Italian Association of Cancer Patients, Relatives and Friends, Aimac, Via Barberini, 11, 00187, Rome, Italy
| | | | - Milena Sant
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Francesco Perrone
- Clinical Trials Unit, National Cancer Institute of Naples, IRCCS Fondazione Pascale, Via Mariano Semmola, 80131, Naples, Italy
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3
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Bosetti C, Casirati A, Da Prat V, Masi S, Crotti S, Ferrari A, Perrone L, Serra F, Santucci C, Cereda E, Iannelli E, De Lorenzo F, Pedrazzoli P, Caccialanza R. Multicentric, observational, longitudinal study for the evaluation of nutritional management implications in newly diagnosed Italian cancer patients: the Italian Registry of Malnutrition in Oncology (IRMO). BMJ Open 2023; 13:e071858. [PMID: 37604631 PMCID: PMC10445343 DOI: 10.1136/bmjopen-2023-071858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/17/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Malnutrition is a frequent problem in oncology and is associated with reduced response to cancer treatments, increased drug-related toxicity, higher rates of clinical complications, reduced quality of life (QoL) and worse prognosis. Guidelines on clinical nutrition in oncology emphasise the usefulness of early assessment of nutritional status for a prompt identification of malnutrition and the implementation of effective interventions, but no real-world clinical data are available on the adequate management of nutritional support in patients with cancer in Italy. METHODS AND ANALYSIS This is an observational, longitudinal, multicentre registry of patients with a new diagnosis of cancer or metastatic disease, candidates for active treatment. They will be identified in at least 15 Italian oncological centres, members of the Alliance Against Cancer Working Group 'Survivorship Care and Nutritional Support'. At least 1500 patients with cancer are expected to be enrolled each year. Detailed clinical and nutritional data will be collected by oncologists and clinical nutritionists during the visits foreseen in the clinical practice, through an ad hoc developed digital platform (e-Nutracare). The effects of malnutrition and nutritional support-at diagnosis and during follow-up-on overall survival and progression-free survival, as well as on patients' symptoms and QoL, will be investigated. ETHICS AND DISSEMINATION The study protocol was approved by the Ethics Committee of the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy and from the Ethics Committees of all other participating centres. An informed consent will be obtained from each patient enrolled in the study. Study findings will be disseminated through peer-reviewed journals, conferences and patients with cancer or professional associations. The registry will allow a better monitoring of the nutritional status of patients with cancer, promoting adequate and sustainable nutritional support, with the ultimate goal of improving the care and prognosis of these patients.
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Affiliation(s)
- Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Amanda Casirati
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Da Prat
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Masi
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Crotti
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandra Ferrari
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lorenzo Perrone
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Serra
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Claudia Santucci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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4
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Baumann M, Celis J, Ringborg U, Heitor M, Berns A, Albreht T, Arabadjiev J, Boutros M, Brandenburg M, Canhao H, Carneiro F, Chomienne C, De Lorenzo F, Eggermont AMM, Font A, Garralda E, Goulart M, Henrique R, Lawler M, Maier‐Hein L, Meunier F, Oberst S, Oliveira P, Papatriantafyllou M, Schüz J, Solary E, Valencia A, Vargas R, Weiderpass E, Wilking N. Engaging European society at the forefront of cancer research and care: How discussions at the 5 th Gago Conference on European Science policy led to the Heidelberg Manifesto. Mol Oncol 2023; 17:925-945. [PMID: 36938773 PMCID: PMC10257409 DOI: 10.1002/1878-0261.13423] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/26/2023] [Accepted: 03/17/2023] [Indexed: 03/21/2023] Open
Abstract
European cancer research stakeholders met in October 2022 in Heidelberg, Germany, at the 5th Gago conference on European Cancer Policy, to discuss the current cancer research and cancer care policy landscape in Europe. Meeting participants highlighted gaps in the existing European programmes focusing on cancer research, including Europe's Beating Cancer Plan (EBCP), the Mission on Cancer (MoC), Understanding Cancer (UNCAN.eu), and the joint action CRANE, and put forward the next priorities, in the form of the Heidelberg Manifesto for cancer research. This meeting report presents all discussions that shed light on how infrastructures can be effectively shaped for translational, prevention, clinical and outcomes cancer research, with a focus on implementation and sustainability and while engaging patients and the public. In addition, we summarize recommendations on how to introduce frameworks for the digitalization of European cancer research. Finally, we discuss what structures, commitment, and resources are needed to establish a collaborative cancer research environment in Europe to achieve the scale required for innovation.
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Affiliation(s)
- Michael Baumann
- German Cancer Research Center (DKFZ)HeidelbergGermany
- European Academy of Cancer SciencesStockholmSweden
| | - Julio Celis
- European Academy of Cancer SciencesStockholmSweden
- Danish Cancer Society Research CenterCopenhagenDenmark
| | - Ulrik Ringborg
- European Academy of Cancer SciencesStockholmSweden
- Cancer Center KarolinskaKarolinska University HospitalStockholmSweden
| | - Manuel Heitor
- European Academy of Cancer SciencesStockholmSweden
- Center for Innovation, Technology and Policy Research, IN+ @ IS TécnicoUniversity of LisbonPortugal
| | - Anton Berns
- European Academy of Cancer SciencesStockholmSweden
- The Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Tit Albreht
- National Institute of Public Health of SloveniaLjubljanaSlovenia
- Faculty of MedicineUniversity of LjubljanaSlovenia
| | - Jeliazko Arabadjiev
- Clinic of Medical OncologyUniversity Hospital Acibadem City Clinic TokudaSofiaBulgaria
- Bulgarian Scientific Society of Immuno‐oncology, and MoC BoardSofiaBulgaria
| | - Michael Boutros
- European Academy of Cancer SciencesStockholmSweden
- Division Signaling and Functional GenomicsGerman Cancer Research Center (DKFZ) and Heidelberg UniversityGermany
- DKFZ‐Hector Cancer Institute at the University Medical Center MannheimGermany
| | | | - Helena Canhao
- Comprehensive Health Research Center (CHRC), NOVA Medical SchoolUniversidade Nova de LisboaPortugal
| | - Fatima Carneiro
- European Academy of Cancer SciencesStockholmSweden
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto (Ipatimup)Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), Faculdade de Medicina da Universidade do Porto (FMUP)Portugal
- Centro Hospitalar Universitário de São João (CHUSJ)PortoPortugal
| | | | - Francesco De Lorenzo
- European Academy of Cancer SciencesStockholmSweden
- European Cancer Patient CoalitionBrusselsBelgium
| | - Alexander M. M. Eggermont
- European Academy of Cancer SciencesStockholmSweden
- Department Cancer MedicineCSO Princess Máxima Centre Pediatric Oncology, University Medical Center UtrechtThe Netherlands
- Board of the Comprehensive Cancer Center MunichTechnical University MunichGermany
- Ludwig Maximiliaan UniversityMunichGermany
| | | | - Elena Garralda
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO)BarcelonaSpain
- Cancer Core EuropeAmsterdamThe Netherlands
| | | | - Rui Henrique
- Department of Pathology & Cancer Biology & Epigenetics Group – Research Center of IPO Porto (CI‐IPOP)/RISE@CI‐IPOP (Health Research Network)Portuguese Oncology Institute of Porto (IPO‐Porto)/Porto Comprehensive Cancer Centre Raquel Seruca (P.CCC Raquel Seruca)Portugal
- Department of Pathology and Molecular Immunology, School of Medicine & Biomedical SciencesUniversity of Porto (ICBAS‐UP)Portugal
| | - Mark Lawler
- European Academy of Cancer SciencesStockholmSweden
- FRCPath Patrick G Johnston Centre for Cancer Research, Faculty of Medicine, Health and Life SciencesQueen's University BelfastUK
| | - Lena Maier‐Hein
- Intelligent Medical Systems (IMSY)German Cancer Research Center (DKFZ)HeidelbergGermany
| | - Francoise Meunier
- European Academy of Cancer SciencesStockholmSweden
- Belgian Royal Academy of MedicineBrusselsBelgium
| | - Simon Oberst
- Quality and AccreditationOrganisation of European Cancer InstitutesBrusselsBelgium
| | - Pedro Oliveira
- Nova School of Business and EconomicsCopenhagen Business School & Patient InnovationFrederiksbergDenmark
| | | | - Joachim Schüz
- European Academy of Cancer SciencesStockholmSweden
- International Agency for Research on Cancer (IARC/WHO)LyonFrance
| | - Eric Solary
- European Academy of Cancer SciencesStockholmSweden
- INSERM, U1287 and Department of HematologyGustave Roussy Cancer CenterVillejuifFrance
- Faculté de MédecineUniversité Paris‐SaclayLe Kremlin‐BicêtreFrance
| | - Alfonso Valencia
- Barcelona Supercomputing Center (BSC)BarcelonaSpain
- ICREABarcelonaSpain
| | | | - Elisabete Weiderpass
- European Academy of Cancer SciencesStockholmSweden
- International Agency for Research on Cancer (IARC/WHO)LyonFrance
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5
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Casolino R, Johns AL, Courtot M, Lawlor RT, De Lorenzo F, Horgan D, Mateo J, Normanno N, Rubin M, Stein L, Subbiah V, Westphalen BC, Lawler M, Park K, Perdomo S, Yoshino T, Wu J, Biankin AV. Accelerating cancer omics and precision oncology in health care and research: a Lancet Oncology Commission. Lancet Oncol 2023; 24:123-125. [PMID: 36725142 DOI: 10.1016/s1470-2045(23)00007-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023]
Affiliation(s)
- Raffaella Casolino
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1BD, UK.
| | - Amber L Johns
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Cancer Division, Sydney, NSW, Australia
| | | | - Rita T Lawlor
- ARC-NET Research Centre, University and Hospital Trust of Verona, Verona, Italy
| | | | - Denis Horgan
- European Alliance for Personalised Medicine, Brussels, Belgium
| | - Joaquin Mateo
- ESMO Translational Research and Precision Medicine Working Group, Lugano, Switzerland; Medical Oncology, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Nicola Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, Naples, Italy
| | - Mark Rubin
- Department for BioMedical Research, University of Bern, Bern, Switzerland; Bern Center for Precision Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Lincoln Stein
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Vivek Subbiah
- ESMO Translational Research and Precision Medicine Working Group, Lugano, Switzerland; Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Benedikt C Westphalen
- ESMO Translational Research and Precision Medicine Working Group, Lugano, Switzerland; Department of Medicine III and Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany
| | - Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK
| | - Keunchil Park
- Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sandra Perdomo
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Takayuki Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology and Division for the Promotion of Drug and Diagnostic Development, National Cancer Center Hospital East, Kashiwa, Japan
| | - Jianmin Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Center for Cancer Bioinformatics, Peking University Cancer Hospital & Institute, Beijing, China
| | - Andrew V Biankin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1BD, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK; South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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6
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Cavaletti G, D’Acunti A, Porcu A, Masiello G, Del Campo L, Traclò G, De Lorenzo F, Bernasconi DP. Self-Reported Assessment of the Socio-Economic Impact of Anticancer Chemotherapy-Related Neurotoxicity. Toxics 2023; 11:104. [PMID: 36850979 PMCID: PMC9966709 DOI: 10.3390/toxics11020104] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Chemotherapy-induced neurotoxicity is a well-known complication of several very effective systemic anticancer treatments, mainly presenting as cognitive impairment ("chemo-brain") and peripheral neuropathy. The social and economic effects of long-lasting chemotherapy-induced neurotoxicity on patients' lifestyles and their relationships are under-investigated, and their impact is, therefore, largely unknown. In this study, we used a web-based questionnaire to record the self-reported perception of chemotherapy-induced neurotoxicity on cancer patients' health status, but also on several different aspects of their daily life. From the study results, it emerged that the impact of chemotherapy-induced neurotoxicity on personal, social, and working activities is very high. A similar effect was also observed when the psychological impact is assessed. Moreover, there is evidence suggesting that the management of CIPN is suboptimal; this is partially due to a lack of effective drugs, but also of appropriate advice from healthcare providers. In conclusion, this study provides evidence for the relevance of the impact on the explored aspects of the daily life of cancer patients and spotlights the need for a larger and more structured investigation on these long-term side effects of anticancer chemotherapy.
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Affiliation(s)
- Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | | | | | | | - Laura Del Campo
- Aimac—Italian Association of Cancer Patient, 00187 Roma, Italy
| | | | | | - Davide Paolo Bernasconi
- Bicocca Bioinformatics Biostatistics and Bioimaging Center—B4, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Functional Department for Higher Education, Research, and Development, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
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7
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Ciani O, Meregaglia M, De Lorenzo F, Perrone F, Pinto C. Patient-Reported Outcome Measures in Oncology Drugs Approved by the European Medicines Agency, 2017-2021. JAMA Netw Open 2023; 6:e2251564. [PMID: 36656587 PMCID: PMC9857398 DOI: 10.1001/jamanetworkopen.2022.51564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
This cross-sectional study investigates the use of patient-reported outcome measures in new marketing authorizations for oncology drugs approved by the European Medicines Agency (EMA) between 2017 and 2021.
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Affiliation(s)
- Oriana Ciani
- Center for Research on Health and Social Care Management, SDA Bocconi, Milan, Italy
| | - Michela Meregaglia
- Center for Research on Health and Social Care Management, SDA Bocconi, Milan, Italy
| | | | - Francesco Perrone
- Clinical Trials Unit, National Cancer Institute, Naples, Italy
- Italian Association of Medical Oncology, Milan, Italy
| | - Carmine Pinto
- Comprehensive Cancer Centre, Istituto di Ricovero e Cura a Carattere Scientifico–Azienda Unità Sanitaria Locale Reggio Emilia, Italy
- Federation of Italian Cooperative Oncology Groups, Florence, Italy
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8
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Casirati A, Da Prat V, Cereda E, Serra F, Perrone L, Corallo S, De Lorenzo F, Pedrazzoli P, Caccialanza R. The Key Role of Patient Empowerment in the Future Management of Cancer-Related Malnutrition. Nutrients 2023; 15:nu15010235. [PMID: 36615892 PMCID: PMC9824368 DOI: 10.3390/nu15010235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
Malnutrition is a common condition in cancer patients [...].
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Affiliation(s)
- Amanda Casirati
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Valentina Da Prat
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Francesco Serra
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Lorenzo Perrone
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Salvatore Corallo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | | | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Correspondence:
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9
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Fabozzi F, Trovato CM, Diamanti A, Mastronuzzi A, Zecca M, Tripodi SI, Masetti R, Leardini D, Muratore E, Barat V, Lezo A, De Lorenzo F, Caccialanza R, Pedrazzoli P. Management of Nutritional Needs in Pediatric Oncology: A Consensus Statement. Cancers (Basel) 2022; 14:cancers14143378. [PMID: 35884438 PMCID: PMC9319266 DOI: 10.3390/cancers14143378] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Nutritional management is an underestimated issue in treating pediatric cancer, since a systematic approach is currently lacking. In this consensus statement, a cohort of 12 experts selected from four different tertiary pediatric oncology centers formulated 21 clinical questions regarding the identification and treatment of nutritional issues in children with cancer. These questions were discussed, and practical recommendations were provided. With this paper, we aimed to give consensus-based guidance for addressing the nutritional needs of children with cancer, filling a gap in the field. Abstract Malnutrition, intended as both overnutrition and undernutrition, is a common problem in children with cancer, impacting quality of life as well as survival. In addition, nutritional imbalances during childhood can significantly affect proper growth. Nevertheless, there is currently a lack of a systematic approach to this issue in the pediatric oncology population. To fill this gap, we aimed to provide practice recommendations for the uniform management of nutritional needs in children with cancer. Twenty-one clinical questions addressing evaluation and treatment of nutritional problems in children with cancer were formulated by selected members from four Italian Association of Pediatric Hematology and Oncology (AIEOP) centers and from the Survivorship Care and Nutritional Support Working Group of Alliance Against Cancer. A literature search in PubMed was performed; during two consensus meetings, all recommendations were discussed and finalized using the nominal group technique. Members representing every institution voted on each recommendation. Finally, recommendations were approved by all authors.
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Affiliation(s)
- Francesco Fabozzi
- Department of Hematology/Oncology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (F.F.); (A.M.)
- Department of Pediatrics, University of Rome Tor Vergata, 00165 Rome, Italy
| | - Chiara Maria Trovato
- Hepatology Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, 00165 Rome, Italy;
| | - Antonella Diamanti
- Hepatology Gastroenterology and Nutrition Unit, Bambino Gesù Children Hospital, 00165 Rome, Italy;
- Correspondence:
| | - Angela Mastronuzzi
- Department of Hematology/Oncology, Cell Therapy, Gene Therapies and Hemopoietic Transplant, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (F.F.); (A.M.)
| | - Marco Zecca
- Pediatric Hematology-Oncology, Fondazione IRCCS, Policlinico San Matteo, 27100 Pavia, Italy; (M.Z.); (S.I.T.)
| | - Serena Ilaria Tripodi
- Pediatric Hematology-Oncology, Fondazione IRCCS, Policlinico San Matteo, 27100 Pavia, Italy; (M.Z.); (S.I.T.)
| | - Riccardo Masetti
- Pediatric Oncology and Hematology “Lalla Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (R.M.); (D.L.); (E.M.)
| | - Davide Leardini
- Pediatric Oncology and Hematology “Lalla Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (R.M.); (D.L.); (E.M.)
| | - Edoardo Muratore
- Pediatric Oncology and Hematology “Lalla Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (R.M.); (D.L.); (E.M.)
| | - Veronica Barat
- SC Onco-Ematologia Pediatrica, AOU Città della Salute e della Scienza, 10126 Torino, Italy;
| | - Antonella Lezo
- Dietetic and Clinical Nutrition Unit, Children’s Hospital Regina Margherita, AOU Città della Salute e della Scienza, 10126 Turin, Italy;
| | | | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy;
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10
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Caccialanza R, Laviano A, Bosetti C, Nardi M, Casalone V, Titta L, Mele R, De Pergola G, De Lorenzo F, Pedrazzoli P. Clinical and economic value of oral nutrition supplements in patients with cancer: a position paper from the Survivorship Care and Nutritional Support Working Group of Alliance Against Cancer. Support Care Cancer 2022; 30:9667-9679. [PMID: 35792925 DOI: 10.1007/s00520-022-07269-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
Malnutrition is a common clinical and public health problem that can frequently affect patients in hospital and community settings. In particular, cancer-related malnutrition results from a combination of metabolic dysregulation and anorexia, caused both by the tumor itself and by its treatment. Patients with head-neck cancer, or with gastroesophageal, pancreatic, lung, and colorectal cancer, are particularly at risk of developing malnutrition, with a prevalence varying between 30 and 50% depending on tumor location and anti-cancer treatment complications. Prevention and adequate management of malnutrition is now considered an essential key point of therapeutic pathways of patients with cancer, with the aim to enhance their quality of life, reduce complications, and improve clinical outcomes. Oral nutritional supplements (ONS) are part of the nutritional therapy and represent an effective tool to address cancer-related malnutrition, as supported by growing literature data. However, patients' access to ONS - which is regulated by different national and regional policies in terms of reimbursement - is quite heterogeneous. This narrative review aims to summarize the current knowledge about the role of ONS in terms of cost-effectiveness in the management of actively treated patients with cancer, following surgery and/or radiotherapy/chemotherapy treatment and to present the position on this issue of the Alliance Against Cancer, the Italian National Oncology Network, coming up from a focused virtual roundtable of the Survivorship Care and Nutritional Support Working Group.
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Affiliation(s)
- Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy.
| | - Alessandro Laviano
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Cristina Bosetti
- Unit of Cancer Epidemiology, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Mariateresa Nardi
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Valentina Casalone
- Clinical Nutrition and Dietetics Unit, Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy
| | - Lucilla Titta
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy
| | - Roberto Mele
- Hospital Health Direction, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | | | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine, University of Pavia, Pavia, Italy
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11
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Dal Maso L, Santoro A, Iannelli E, De Paoli P, Minoia C, Pinto M, Bertuzzi AF, Serraino D, De Angelis R, Trama A, Haupt R, Pravettoni G, Perrone M, De Lorenzo F, Tralongo P. Cancer Cure and Consequences on Survivorship Care: Position Paper from the Italian Alliance Against Cancer (ACC) Survivorship Care Working Group. Cancer Manag Res 2022; 14:3105-3118. [PMID: 36340999 PMCID: PMC9635309 DOI: 10.2147/cmar.s380390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/08/2022] [Indexed: 02/05/2023] Open
Abstract
A multidisciplinary panel of experts and cancer patients developed a position paper to highlight recent evidence on "cancer cure" (ie, the possibility of achieving the same life expectancy as the general population) and discuss the consequences of this concept on follow-up and rehabilitation strategies. The aim is to inform clinicians, patients, and health-care policy makers about strategies of survivorship care for cured cancer patients and consequences impacting patient lives, spurring public health authorities and research organizations to implement resources to the purpose. Two identifiable, measurable, and reproducible indicators of cancer cure are presented. Cure fraction (CF) is >60% for breast and prostate cancer patients, >50% for colorectal cancer patients, and >70% for patients with melanoma, Hodgkin lymphoma, and cancers of corpus uteri, testis (>90%), and thyroid. CF was >65% for patients diagnosed at ages 15-44 years and 30% for those aged 65-74 years. Time-to-cure was consistently <1 year for thyroid and testicular cancer patients and <10 years for patients with colorectal and cervical cancers, melanoma, and Hodgkin lymphoma. The working group agrees that the evidence allows risk stratification of cancer patients and implementation of personalized care models for timely diagnosis, as well as treatment of possible cancer relapses or related long-term complications, and preventive measures aimed at maintaining health status of cured patients. These aspects should be integrated to produce an appropriate follow-up program and survivorship care plan(s), avoiding stigma and supporting return to work, to a reproductive life, and full rehabilitation. The "right to be forgotten" law, adopted to date only in a few European countries, may contribute to these efforts for cured patients.
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Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
- Correspondence: Luigino Dal Maso, Epidemiologia Oncologica, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, Aviano (PN), 33081, Italy, Tel +39 0434 659354, Email
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
| | - Elisabetta Iannelli
- Italian Federation of Cancer Patients Organisations (FAVO), Rome, Italy
- Italian Association of Cancer Patients (Aimac), Rome, Italy
| | | | - Carla Minoia
- SC Haematology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, Italian National Institute of Health (ISS), Rome, Italy
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Riccardo Haupt
- DOPO Clinic, Department of Pediatric Haematology/Oncology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Perrone
- Psychology Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy
| | - Francesco De Lorenzo
- Italian Federation of Cancer Patients Organisations (FAVO), Rome, Italy
- Italian Association of Cancer Patients (Aimac), Rome, Italy
| | - Paolo Tralongo
- Medical Oncology Unit, Umberto I Hospital, Department of Oncology, RAO, Siracusa, Italy
- Paolo Tralongo, Medical Oncology Unit, Umberto I Hospital, Department of Oncology, RAO, Via Giuseppe Testaferrata 1, Siracusa, 96100, Italy, Tel +39 0931 724 464, Email
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12
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Caccialanza R, Cotogni P, Cereda E, Bossi P, Aprile G, Delrio P, Gnagnarella P, Mascheroni A, Monge T, Corradi E, Grieco M, Riso S, De Lorenzo F, Traclò F, Iannelli E, Beretta GD, Zanetti M, Cinieri S, Zagonel V, Pedrazzoli P. Nutritional Support in Cancer patients: update of the Italian Intersociety Working Group practical recommendations. J Cancer 2022; 13:2705-2716. [PMID: 35812181 PMCID: PMC9254882 DOI: 10.7150/jca.73130] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/15/2022] [Indexed: 12/03/2022] Open
Abstract
Malnutrition is a frequent problem in cancer patients, which leads to prolonged and repeated hospitalizations, increased treatment-related toxicity, reduced response to cancer treatment, impaired quality of life, a worse overall prognosis and the avoidable waste of health care resources. Despite being perceived as a limiting factor in oncologic treatments by both oncologists and patients, there is still a considerable gap between need and actual delivery of nutrition care, and attitudes still vary considerably among health care professionals. In the last 5 years, the Italian Intersociety Working Group for Nutritional Support in Cancer Patients (WG), has repeatedly revisited this issue and has concluded that some improvement in nutritional care in Italy has occurred, at least with regard to awareness and institutional activities. In the same period, new international guidelines for the management of malnutrition and cachexia have been released. Despite these valuable initiatives, effective structural strategies and concrete actions aimed at facing the challenging issues of nutritional care in oncology are still needed, requiring the active participation of scientific societies and health authorities. As a continuation of the WG's work, we have reviewed available data present in the literature from January 2016 to September 2021, together with the most recent guidelines issued by scientific societies and health authorities, thus providing an update of the 2016 WG practical recommendations, with suggestions for new areas/issues for possible improvement and implementation.
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13
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Riva S, Arenare L, Di Maio M, Efficace F, Montesarchio V, Frontini L, Giannarelli D, Bryce J, Del Campo L, De Lorenzo F, Iannelli E, Traclò F, Gitto L, Jommi C, Vaccaro CM, Barberio D, Cinieri S, Porta C, Del Mastro L, Zagonel V, Cogoni AA, Bordonaro R, Gimigliano A, Piccirillo MC, Guizzaro L, Gallo C, Perrone F. Cross-sectional study to develop and describe psychometric characteristics of a patient-reported instrument (PROFFIT) for measuring financial toxicity of cancer within a public healthcare system. BMJ Open 2021; 11:e049128. [PMID: 34670762 PMCID: PMC8529986 DOI: 10.1136/bmjopen-2021-049128] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/20/2022] Open
Abstract
OBJECTIVES To measure and explain financial toxicity (FT) of cancer in Italy, where a public healthcare system exists and patients with cancer are not expected (or only marginally) to pay out-of-pocket for healthcare. SETTING Ten clinical oncological centres, distributed across Italian macroregions (North, Centre, South and Islands), including hospitals, university hospitals and national research institutes. PARTICIPANTS From 8 October 2019 to 11 December 2019, 184 patients, aged 18 or more, who were receiving or had received within the previous 3 months active anticancer treatment were enrolled, 108 (59%) females and 76 (41%) males. INTERVENTION A 30-item prefinal questionnaire, previously developed within the qualitative tasks of the project, was administered, either electronically (n=115) or by paper sheet (n=69). PRIMARY AND SECONDARY OUTCOME MEASURES According to the protocol and the International Society for Pharmacoeconomics and Outcomes Research methodology, the final questionnaire was developed by mean of explanatory factor analysis and tested for reliability, internal consistency (Cronbach's α test and item-total correlation) and stability of measurements over time (test-retest reliability by intraclass correlation coefficient and weighted Cohen's kappa coefficient). RESULTS After exploratory factor analysis, a score measuring FT (FT score) was identified, made by seven items dealing with outcomes of FT. The Cronbach's alpha coefficient for the FT score was 0.87 and the item-total correlation coefficients ranged from 0.53 to 0.74. Further, nine single items representing possible determinants of FT were also retained in the final instrument. Test-retest analysis revealed a good internal validity of the FT score and of the 16 items retained in the final questionnaire. CONCLUSIONS The Patient-Reported Outcome for Fighting FInancial Toxicity (PROFFIT) instrument consists of 16 items and is the first reported instrument to assess FT of cancer developed in a country with a fully public healthcare system. TRIAL REGISTRATION NUMBER NCT03473379.
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Affiliation(s)
- Silvia Riva
- Psychology and Pedagogic Science, St Mary's University, Twickenham, London, UK
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University Hospital of Milan, Milano, Italy
| | - Laura Arenare
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Massimo Di Maio
- Dipartimento di Oncologia, AO Ordine Mauriziano, Università degli Studi di Torino, Torino, Italy
| | - Fabio Efficace
- Health Outcomes Research Unit, Gruppo Italiano per le Malattie Ematologiche dell'Adulto (GIMEMA), Roma, Italy
| | | | - Luciano Frontini
- Federation of Italian Cooperative Oncology Groups (FICOG), Milano, Italy
| | - Diana Giannarelli
- Unità di Biostatistica, Istituto Nazionale per lo Studio e la Cura dei Tumori Regina Elena, IRCCS, Roma, Italy
| | - Jane Bryce
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
- Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma "Tor Vergata", Roma, Italy
- Clinical Research Institute, Ascension St. John Clinical Research Institute, Tulsa, Oklahoma, USA
| | - Laura Del Campo
- Federazione Italiana delle Associazioni di Volontariato in Oncologia (FAVO), Roma, Italy
| | - Francesco De Lorenzo
- Associazione Italiana Malati di Cancro (AIMAC), Roma, Italy
- European Cancer Patient Coalition (ECPC), Brussels, Belgium
| | - Elisabetta Iannelli
- Federazione Italiana delle Associazioni di Volontariato in Oncologia (FAVO), Roma, Italy
| | | | - Lara Gitto
- Dipartimento di Economia, Università degli Studi di Messina, Messina, Italy
| | - Claudio Jommi
- CERGAS (Centre for Health and Social Care Management), Università Bocconi, Milano, Italy
| | | | - Daniela Barberio
- Psiconcologia Clinica, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | | | - Camillo Porta
- Oncologia Medica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Dipartimento di Scienze Biomediche ed Oncologia Umana, Università degli Studi di Bari, Bari, Italy
| | - Lucia Del Mastro
- Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dipartimento di Medicina Interna e Medicina Specialistica (DIMI), Università di Genova, Genova, Italy
| | | | | | | | - Anna Gimigliano
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Maria Carmela Piccirillo
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Lorenzo Guizzaro
- Statistica Medica, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
| | - Ciro Gallo
- Statistica Medica, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
| | - Francesco Perrone
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
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14
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Vetrugno L, Cherchi V, Lorenzin D, De Lorenzo F, Ventin M, Zanini V, Terrosu G, Risaliti A, Baccarani U, Bove T. The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review. Transplant Direct 2021; 7:e746. [PMID: 34476291 PMCID: PMC8405129 DOI: 10.1097/txd.0000000000001200] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 11/25/2022] Open
Abstract
The exact origin of intracardiac thrombi formation during orthotopic liver transplant remains unknown. The altered balance between hypercoagulability, hypocoagulation, and endothelial dysfunction associated with end-stage liver disease is thought to play a pivotal role. Venous stasis, vascular clamping, and reperfusion could also contribute to clot formation. The incidence of intracardiac thrombi formation stands at 4.2%, associated with a mortality rate of 45.5%, and to date, no consensus exists regarding the best way to treat this complication. Intraoperative transesophageal echocardiography is the only effective method for diagnosing intracardiac thrombi formation early, while point-of-care coagulation testing could guide the coagulation management potentially improving patient outcomes.
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Affiliation(s)
- Luigi Vetrugno
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.,Department of Medicine, University of Udine, Italy, Udine, Italy
| | - Vittorio Cherchi
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy
| | - Dario Lorenzin
- General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy
| | - Francesco De Lorenzo
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy
| | - Marco Ventin
- Department of Medicine, University of Udine, Italy, Udine, Italy
| | - Victor Zanini
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.,Department of Medicine, University of Udine, Italy, Udine, Italy
| | - Giovanni Terrosu
- Department of Medicine, University of Udine, Italy, Udine, Italy.,General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy
| | - Andrea Risaliti
- Department of Medicine, University of Udine, Italy, Udine, Italy
| | - Umberto Baccarani
- Department of Medicine, University of Udine, Italy, Udine, Italy.,General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy
| | - Tiziana Bove
- Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.,Department of Medicine, University of Udine, Italy, Udine, Italy
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15
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Lawler M, De Lorenzo F, Lagergren P, Mennini FS, Narbutas S, Scocca G, Meunier F. Challenges and solutions to embed cancer survivorship research and innovation within the EU Cancer Mission. Mol Oncol 2021; 15:1750-1758. [PMID: 34053182 PMCID: PMC8253087 DOI: 10.1002/1878-0261.13022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/14/2021] [Accepted: 05/27/2021] [Indexed: 02/06/2023] Open
Abstract
We have reached a watershed moment in Europe in our efforts to ensure increased survival and better outcomes for cancer patients. The EU Cancer Mission and the European Beating Cancer Plan together provide an unrivalled opportunity to make significant inroads into a disease that kills over 1.7 million European citizens annually. Harnessing these twin pillars of cancer research and cancer control can be transformative for the European cancer community and in particular for the European cancer patient. However, from a research perspective, in order to fully realise these benefits, we need to ensure that all aspects of the cancer continuum are addressed. Previous research efforts have focussed more on the diagnosis and treatment of cancer, whereas cancer survivorship, to date, has been overlooked. Here, we aim to redress this balance, by identifying the key challenges in cancer survivorship research that need to be addressed and proposing a series of recommended solutions, which, if acted upon, would deliver significant benefits for the nearly 20 million cancer survivors in Europe. To achieve this, we propose the development of a clearly articulated and sustainably funded European Cancer Survivorship Research and Innovation Plan. Embedding this plan within the framework of the EU Cancer Mission would be transformative for cancer survivors and society.
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Affiliation(s)
- Mark Lawler
- Patrick G Johnston Centre for Cancer ResearchQueen's University BelfastUK
- European Cancer OrganisationBrusselsBelgium
| | - Francesco De Lorenzo
- European Cancer Patient CoalitionBrusselsBelgium
- Italian Federation of Cancer Patients OrganisationsRomeItaly
| | - Pernilla Lagergren
- Surgical Care ScienceDepartment of Molecular Medicine and SurgeryKarolinska InstitutetKarolinska University HospitalStockholmSweden
- Department of Surgery and CancerImperial College LondonUK
| | - Francesco S. Mennini
- EEHTA CEIS, DEF DepartmentFaculty of EconomicsUniversity “Tor Vergata” RomeItaly
- Institute of Leadership and Management in HealthKingston UniversityLondonUK
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16
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Caccialanza R, De Lorenzo F, Lobascio F, Gnagnarella P, Iannelli E, Traclò F, Delrio P, Tancredi R, Pedrazzoli P. Nutritional care in cancer patients: Initiatives and perspectives of the Italian Intersociety Working Group for Nutritional Support in Cancer Patients. Nutrition 2021; 91-92:111358. [PMID: 34303958 DOI: 10.1016/j.nut.2021.111358] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/07/2021] [Accepted: 05/18/2021] [Indexed: 01/07/2023]
Abstract
Malnutrition is a frequent comorbidity in people with cancer, associated with poor tolerance of anticancer treatments, prognosis, and quality of life. Despite the abundance of scientific literature supporting this evidence and the availability of international guidelines for managing nutritional care in people with cancer, attitudes about this issue still vary considerably among oncologists, to the point that many patients who are malnourished do not receive adequate nutritional support. In view of this, the Italian Association of Medical Oncology, the Italian Society of Artificial Nutrition and Metabolism, and the Italian Federation of Volunteer-based Cancer Organizations implemented in 2016 a collaborative working group and initiated a structured project called Integrating Nutritional Therapy in Oncology, with the aim of increasing oncologists' awareness of nutritional issues and consequently improving the nutritional care of cancer patients in Italy. In 2019, the Italian Society of Oncological Surgery and the Technical Scientific Association of Food, Nutrition and Dietetics joined the working group. In this article, we present the updated initiatives and the perspectives of this intersociety project.
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Affiliation(s)
- Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | | | - Federica Lobascio
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology IRCSS, Milan, Italy
| | | | - Francesca Traclò
- Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy
| | - Paolo Delrio
- Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Giovanni Pascale IRCCS, Naples, Italy
| | - Richard Tancredi
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine, University of Pavia, Pavia, Italy
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17
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Caccialanza R, Lobascio F, Aprile G, De Lorenzo F, Pedrazzoli P. Reply to: The challenge for nutritional care in a cancer center: The need for integration between clinical nutritionist, oncologist and palliative care physician. Curr Probl Cancer 2020; 44:100648. [PMID: 32921437 DOI: 10.1016/j.currproblcancer.2020.100648] [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: 11/26/2022]
Affiliation(s)
- Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Federica Lobascio
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giuseppe Aprile
- Department of Oncology, San Bortolo General Hospital, Vicenza, Italy
| | | | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
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18
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Mauri D, Tzachanis D, Valachis A, Kamposioras K, Tolia M, Dambrosio M, Zarkavelis G, Gkoura S, Gazouli I, De Lorenzo F, Apostolidis K. Behind the numbers and the panic of a viral pandemic: fixed restrictive oncology guidance may jeopardize patients' survival. J BUON 2020; 25:1277-1280. [PMID: 32862566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To protect cancer patients from COVID-19 exposure, prioritization strategies are being implemented at global level. Measures include use of tele-health services, deferring elective surgeries, delaying non life-saving therapies, interrupting maintenance and supportive care regimens and suspending screening and regular follow-up visits. Nonetheless, the risk of infection may not always outweigh oncology treatment benefit. Lives of most oncology patients depend on their ability to receive medical, surgical and radiotherapy care. Postponing screening, follow-up and radical surgeries increase patients' risk of developing metastatic disease. A viral pandemic lasts long time and exhibits seasonal and geographical variations. Though vaccines will be available only in the 2021, a global, aggressive, all-embracing and protracted slowdown of oncologic activities will severely jeopardize patients' outcomes. A present international oncologists' panel, ECPC and FAVO, strongly suggest that Hospital measures in a specific geographical area/Nation should be in line with the local epidemic, and restrictions adopted should be adapted and stratified over time.
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Affiliation(s)
- Davide Mauri
- Dept of Medical Oncology, University of Ιoannina, Greece
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19
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Philip T, Karjalainen S, De Lorenzo F, Apostolidis K, Lombardo C, Nilbert M, Lacombe D, Poortmans P, Albreht T, Kearns P, Vassal G. What could be a cancer mission objective if we join our forces in the fight against cancer? Tumori 2019; 105:447-455. [PMID: 31718477 PMCID: PMC6952939 DOI: 10.1177/0300891619886351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 12/29/2022]
Abstract
The European cancer burden is growing rapidly, with an estimated 2 million deaths a year according to the latest research. As almost half of cancers are diagnosed after the age of 65, and considering the aging European population, a tidal wave of cancer cases will sweep across Europe within the coming decades. Without major action, the additional number of annual cancer cases is expected to rise from 4.2 million to 5.2 million by 2040. If we are to reach plateauing numbers by 2040 (as a minimum goal), this would require 0.75% annual reduction in risk and 1% reduction in risk of death. These challenges call for attack from various angles, coordinated efforts, rational strategies, initiatives throughout the cancer trajectory, activities to reduce inequities, and implementation of evidence-based measures. In order to defeat the societal challenges of cancer through innovation, Europe will need to join forces and connect the European Commission and the member states, politicians and citizens, industries and patient associations. A cancer mission should thus unite the public and patient viewpoint to the perspective of cancer professionals. The authors describe a plan that has been agreed upon among some of the major European Cancer organizations and associations. This plan uses a cancer mission as a tool and must deliver robust medical evidence to patients and doctors through high-quality research delivering sustainable and affordable strategies for prevention, treatment, and follow-up.
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Affiliation(s)
- Thierry Philip
- Organisation of European Cancer
Institutes, Brussels, Belgium
| | | | | | | | | | | | - Denis Lacombe
- European Organisation for Research and
Treatment of Cancer, Brussels, Belgium
| | - Philip Poortmans
- European Cancer Organisation, Brussels,
Belgium
- European Society for Radiotherapy &
Oncology, Brussels, Belgium
| | - Tit Albreht
- Innovative Partnership for Action
Against Cancer, Ljubljana, Slovenia
| | - Pamela Kearns
- European Society for Paediatric
Oncology, Birmingham, UK
| | - Gilles Vassal
- European Society for Paediatric
Oncology, Birmingham, UK
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20
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Bryce J, Riva S, Di Maio M, Efficace F, Frontini L, Gallo C, Giannarelli D, Montesarchio V, De Lorenzo F, Del Campo L, Iannelli E, Traclò F, Gitto L, Jommi C, Vaccaro CM, Gimigliano A, Sparavigna L, Perrone F. Measuring financial toxicity of cancer in the Italian health care system: Initial results of the patient reported outcome for fighting financial toxicity of cancer project (proFFiT). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.27_suppl.91] [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
91 Background: Financial toxicity in cancer patients has been initially reported in the United States and subsequently in other countries, including Italy, despite its health care system is grounded on universal coverage. Considering that the way healthcare and welfare systems are shaped does impact on financial problems faced by cancer patients, we are developing an instrument for evaluating occurrence, gravity, and consequences of financial toxicity in Italy, and hopefully for fighting it. Methods: Concept elicitation, item generation and qualitative analyses represented the initial tasks of the project. Literature review, focus groups with 34 cancer patients or caregivers in three regions located in nothern, central, and southern Italy, and semi-structured interviews with 97 oncologists were conducted for concept elicitation. A recursive process was used to identify themes in the data to inform instrument until saturation was reached. Importance analysis questionnaires were administered to further 44 cancer patients to evaluate and revise the draft item pool. A multi-disciplinary committee (including oncologists, psychologists, statisticians, patient association’s representatives, nurses, social science researchers and economists) oversights the project. Results: Overall, 156 concepts were distributed among 10 themes (bureaucracy, medical care, domestic economy, emotion, family, job, health workers, welfare state, free time, transportation). After controlling for redundancy, 55 candidate items were generated and 30 items, with at least one per each theme, remained after importance analysis. Out of the 30 items, 23 (77%) refer to material conditions, 4 (13%) to psychological response and 3 (10%) to coping behaviors. Conclusions: The first results of the proFFiT project show that most of the items selected by patients are related to material conditions that cause, or derive from, financial hardship. The final questionnaire will be ready by the end of 2019. Supported by Fondazione AIRC IG grant 2017-20402. Clinical trial information: NCT03473379 .
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Affiliation(s)
- Jane Bryce
- Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS Fondazione Pascale, Naples, Italy
| | - Silvia Riva
- University of Wolverhampton, Wolverhampton, United Kingdom
| | - Massimo Di Maio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | | | - Luciano Frontini
- Federation of Italian Cooperative Oncology Groups (FICOG), Milan, Italy
| | - Ciro Gallo
- Università Della Campania "Luigi Vanvitelli", Naples, Italy
| | | | | | | | | | | | | | | | | | | | - Anna Gimigliano
- Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS Fondazione Pascale, Naples, Italy
| | - Lucia Sparavigna
- Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS Fondazione Pascale, Naples, Italy
| | - Francesco Perrone
- Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS Fondazione Pascale, Naples, Italy
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21
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Riva S, Bryce J, De Lorenzo F, Del Campo L, Di Maio M, Efficace F, Frontini L, Giannarelli D, Gitto L, Iannelli E, Jommi C, Montesarchio V, Traclò F, Vaccaro CM, Gallo C, Perrone F. Development and validation of a patient-reported outcome tool to assess cancer-related financial toxicity in Italy: a protocol. BMJ Open 2019; 9:e031485. [PMID: 31501130 PMCID: PMC6738930 DOI: 10.1136/bmjopen-2019-031485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Financial toxicity (FT) is a well-recognised problem in oncology. US-based studies have shown that: (a) cancer patients have a 2.7 times risk of bankruptcy; (b) patients who declare bankruptcy have a 79% greater hazard of death; (c) financial burden significantly impairs quality of life (QoL) and (d) reduces compliance and adherence to treatment prescriptions. The aim of the project is to develop and validate a patient-reported-outcome (PRO) measure to assess FT of cancer patients in Italy, where, despite the universal health coverage provided by the National Health Service, FT is an emerging issue. METHODS AND ANALYSIS Our hypothesis is that a specific FT measure, which considers the relevant sociocultural context and healthcare system, would allow us to understand the main determinants of cancer-related FT in Italy, in order to address and reduce these factors. According to the International Society for Pharmaco-economics and Outcomes Research guidelines on PROs, the project will include the following steps: (1) concept elicitation (from focus groups with patients and caregivers; literature; oncologists; nurses) and analysis, creating a coding library; (2) item generation (using a format that includes a question and a response on a 4-point Likert scale) and analysis through patients' cognitive interviews of item importance within different coding categories to produce the draft instrument; (3) factor analysis and internal validation (with Cronbach's alpha and test-retest for reliability) to produce the final instrument; (4) external validation with QoL anchors and depression scales. The use of the FT measure in prospective trials is also planned. ETHICS AND DISSEMINATION The protocol is approved by the ethical committees of all the participating centres. The project will tentatively produce a validated tool by the spring 2021. The project might also represent a model and the basis for future cooperation with other European countries, with different healthcare systems and socioeconomic conditions. TRIAL REGISTRATION NUMBER NCT03473379.
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Affiliation(s)
- Silvia Riva
- Department of Psychology and Pedagogical Science, Faculty of Sport, Health and Applied Science, St.Mary's University, Twickenham, London, UK
- Dipartimento di Medicina Interna, IRCCS Ca' Granda Foundation, Università di Milano, Milano, Italy
| | - Jane Bryce
- Unità Sperimentazioni Cliniche, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS Fondazione Pascale, Napoli, Italy
- St. John Clinical Research Institute, St. John Medical Center, Tulsa, Oklahoma, USA
- Departmento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata, Roma, Italy
| | - Francesco De Lorenzo
- Associazione Italiana Malati di Cancro (AIMAC), Roma, Italy
- European Cancer Patient Coalition (ECPC), Brussels, Belgium
| | - Laura Del Campo
- Federazione italiana delle Associazioni di Volontariato in Oncologia (FAVO), Roma, Italy
| | - Massimo Di Maio
- Dipartimento di Oncologia, AO Ordine Mauriziano, Università degli Studi di Torino, Torino, Italy
| | - Fabio Efficace
- Health Outcomes Research Unit, Fondazione GIMEMA, Roma, Italy
| | - Luciano Frontini
- Federation of Italian Cooperative Oncology Groups (FICOG), Milano, Italy
| | - Diana Giannarelli
- Unità di Biostatistica, Istituto Nazionale per lo Studio e la Cura dei Tumori Regina Elena, IRCCS, Roma, Italy
| | - Lara Gitto
- Dipartimento di Economia, Università degli Studi di Messina, Messina, Italy
| | - Elisabetta Iannelli
- Federazione italiana delle Associazioni di Volontariato in Oncologia (FAVO), Roma, Italy
| | - Claudio Jommi
- Practice, Government, Health and Not for Profit Division, SDA Bocconi School of Management, Milano, Italy
| | | | | | | | - Ciro Gallo
- Statistica Medica, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
| | - Francesco Perrone
- Unità Sperimentazioni Cliniche, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS Fondazione Pascale, Napoli, Italy
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22
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Cotogni P, Pedrazzoli P, De Waele E, Aprile G, Farina G, Stragliotto S, De Lorenzo F, Caccialanza R. Nutritional Therapy in Cancer Patients Receiving Chemoradiotherapy: Should We Need Stronger Recommendations to Act for Improving Outcomes? J Cancer 2019; 10:4318-4325. [PMID: 31413751 PMCID: PMC6691712 DOI: 10.7150/jca.31611] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 04/26/2019] [Indexed: 01/06/2023] Open
Abstract
One of the challenges during chemotherapy and radiotherapy is to complete the planned cycles and doses without dose-limiting toxicity. Growing evidence clearly demonstrates the relationship between dose-limiting toxicity and low muscle mass. Moreover, malnutrition leads to low performance status, impaired quality of life, unplanned hospital admissions, and reduced survival. In the past, the lack of clear and authoritative recommendations and guidelines has meant that oncologists have not always fully appreciated the importance of nutritional therapy in patients receiving anticancer treatments. Therefore, collaboration between oncologists and clinical nutrition specialists needs to be urgently improved. Recent guidelines from scientific societies and practical recommendations by inter-society consensus documents can be summarized as follows: 1) timely nutritional therapy should be carefully considered if patients undergoing anticancer treatments are malnourished or at risk of malnutrition due to inadequate oral intake; 2) if oral intake is inadequate despite counseling and oral nutritional supplements, supplemental enteral nutrition or, if this is not sufficient or feasible, parenteral nutrition should be considered; 3) home artificial nutrition should be prescribed and regularly monitored using defined protocols developed between oncologists and clinical nutrition specialists; 4) appropriate nutritional management in the context of simultaneous care should become a guaranteed right for all patients with cancer. The purpose of this review is to provide oncologists with an overview of the aims and current evidence about nutrition in oncology, together with updated practical and concise recommendations on the application of nutritional therapy in cancer patients receiving chemoradiotherapy.
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Affiliation(s)
- Paolo Cotogni
- Pain Management and Palliative Care, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, Turin, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Elisabeth De Waele
- Intensive Care Unit and Department of Nutrition, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Giuseppe Aprile
- Department of Oncology, San Bortolo General Hospital, Vicenza, Italy
| | - Gabriella Farina
- Department of Oncology, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | | | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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23
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Muscaritoli M, Molfino A, Scala F, Christoforidi K, Manneh-Vangramberen I, De Lorenzo F. Nutritional and metabolic derangements in Mediterranean cancer patients and survivors: the ECPC 2016 survey. J Cachexia Sarcopenia Muscle 2019; 10:517-525. [PMID: 30953399 PMCID: PMC6596398 DOI: 10.1002/jcsm.12420] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 02/04/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The prevalence of nutritional derangements in patients with cancer is high. This survey assessed patients' awareness of cancer-related nutritional issues and evaluated how important they perceive the impact of nutrition on cancer and treatment to be. METHODS A structured questionnaire was developed to determine: presence of feeding problems, perception of nutrition importance, and perception of physicians' approach to nutrition. The European Cancer Patient Coalition disseminated the questionnaire to its members in 10 countries. The Mediterranean cluster (Italy, Spain, and Greece) was analysed separately to further determine specific patterns in answers. RESULTS In total, 907 respondents completed the questionnaire (68.8% female participants; 51.7% with cancer; 48.3% cancer survivors; 59.3% diagnosed with cancer ≤3 years ago; 46.2% receiving treatment for <1 year). Feeding problems during illness/therapy were experienced by 72.5% (628/867) of all respondents (Italian: 90.0%, 117/130), although up to 53.9% (467/867) reported that physicians did not check their feeding status. Overall, 69.6% (586/842) of respondents reported weight loss after cancer diagnosis (moderate to severe: 36.7%, 309/842). For Italian respondents, the percentages of overall weight loss and moderate-to-severe weight loss were 85.1% (109/128) and 70.3% (90/128), respectively. Only 35.0% (295/842) of all respondents reported having their weight measured regularly during treatment; 45.7% (385/842) believed their physician considered cancer-related weight loss unimportant. Respondents [all: 56.9% (472/830); Italian: 73.0% (92/126); Spanish: 68.9% (42/61); Greek: 79.7% (47/59)] were unaware of supplements' negative effects during therapy or the need to inform their physician about these supplements [all: 43.6% (362/830); Italian: 55.6% (70/126); Spanish: 47.5% (29/61); Greek: 49.2% (29/59)]. The term 'cachexia' was generally unknown to respondents [all: 72.9% (603/827); Italian: 64.3% (81/126); Spanish: 68.9% (42/61); Greek: 47.5% (28/59)] and most respondents [all: 92.4% (764/827); Italian: 91.3% (115/126); Spanish: 91.8% (56/61); Greek: 86.4% (51/59)] received no cachexia-related information. CONCLUSIONS Patients reported differences in perspective between them and physicians on cancer-related nutritional issues and the specific nutritional approaches available for cancer treatment. Increasing physician focus on nutrition during treatment, particularly among Italian physicians, and providing information on optimizing nutrition to patients are essential factors to improving patients' quality of life.
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Affiliation(s)
- Maurizio Muscaritoli
- Department of Translational and Precision Medicine (formerly Department of Clinical Medicine), Sapienza University of Rome, Rome, Italy
| | - Alessio Molfino
- Department of Translational and Precision Medicine (formerly Department of Clinical Medicine), Sapienza University of Rome, Rome, Italy
| | - Ferdinando Scala
- Healthware International c/o Palazzo Innovazione, Salerno, Italy
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24
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Apolone G, Ardizzoni A, Buzzetti G, Clerico MA, Conte P, de Braud F, De Lorenzo F, Ferrandina MG, Genazzani A, Gori S, Maio M, Patroncini M, Perrone F, Scambia G, Scroccaro G. Early Access in Oncology: Why Is It Needed? Global & Regional Health Technology Assessment 2019. [DOI: 10.1177/2284240319857072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | - Giuliano Buzzetti
- Consulta Prevenzione Rischio Cardiovascolare, Dephaforum S.r.l., Milano, Italia
| | | | | | | | | | | | | | - Stefania Gori
- Presidente AIOM, Ospedale Sacro Cuore Don Calabria, Negrar (Verona), Italia
| | - Michele Maio
- Azienda Ospedaliera Universitaria Senese, Siena, Italia
| | | | - Francesco Perrone
- Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, Napoli, Italia
| | | | - Giovanna Scroccaro
- Direzione Farmaci, Dispositivi medici e Protesica, Area Sanità e Sociale, Regione Veneto, Venezia, Italia
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25
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Vetrugno L, Bignami E, Barbariol F, Langiano N, De Lorenzo F, Matellon C, Menegoz G, Della Rocca G. Cardiac output measurement in liver transplantation patients using pulmonary and transpulmonary thermodilution: a comparative study. J Clin Monit Comput 2018; 33:223-231. [PMID: 29725794 DOI: 10.1007/s10877-018-0149-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/26/2018] [Indexed: 11/24/2022]
Abstract
During liver transplantation surgery, the pulmonary artery catheter-despite its invasiveness-remains the gold standard for measuring cardiac output. However, the new EV1000 transpulmonary thermodilution calibration technique was recently introduced into the market by Edwards LifeSciences. We designed a single-center prospective observational study to determine if these two techniques for measuring cardiac output are interchangeable in this group of patients. Patients were monitored with both pulmonary artery catheter and the EV1000 system. Simultaneous intermittent cardiac output measurements were collected at predefined steps: after induction of anesthesia (T1), during the anhepatic phase (T2), after liver reperfusion (T3), and at the end of the surgery (T4). The 4-quadrant and polar plot techniques were used to assess trending ability between the two methods. We enrolled 49 patients who underwent orthotopic liver transplantation surgery. We analyzed a total of 588 paired measurements. The mean bias between pulmonary artery catheter and the EV1000 system was 0.35 L/min with 95% limits of agreement of - 2.30 to 3.01 L/min, and an overall percentage error of 35%. The concordance rate between the two techniques in 4-quadrant plot analysis was 65% overall. The concordance rate of the polar plot showed an overall value of 83% for all pairs. In the present study, in liver transplantation patients we found that intermittent cardiac output monitoring with EV1000 system showed a percentage error compared with pulmonary artery catheter in the acceptable threshold of 45%. On the others hand, our results showed a questionable trending ability between the two techniques.
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Affiliation(s)
- Luigi Vetrugno
- Anesthesiology and Intensive Care Clinic, Department of Medicine, University of Udine, P.le S. Maria della Misericordia n.15, 33100, Udine, Italy.
| | - Elena Bignami
- Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126, Parma, Italy
| | - Federico Barbariol
- Anesthesiology and Intensive Care 1, University-Hospital of Udine, P.le S. Maria della Misericordia n.15, 33100, Udine, Italy
| | - Nicola Langiano
- Anesthesiology and Intensive Care Clinic, Department of Medicine, University of Udine, P.le S. Maria della Misericordia n.15, 33100, Udine, Italy
| | - Francesco De Lorenzo
- Anesthesiology and Intensive Care Clinic, Department of Medicine, University of Udine, P.le S. Maria della Misericordia n.15, 33100, Udine, Italy
| | - Carola Matellon
- Anesthesiology and Intensive Care 1, University-Hospital of Udine, P.le S. Maria della Misericordia n.15, 33100, Udine, Italy
| | - Giuseppe Menegoz
- Statistical Physics, SISSA, University of Trieste, via Bonomea 265, 34136, Trieste, Italy
| | - Giorgio Della Rocca
- Anesthesiology and Intensive Care Clinic, Department of Medicine, University of Udine, P.le S. Maria della Misericordia n.15, 33100, Udine, Italy
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26
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Di Salvo F, Baili P, Vicentini M, Tumino R, Vercelli M, Pirino D, Contiero P, Foschi R, Minicozzi P, Rossi PG, de Lorenzo F, Micheli A, Marani E, Orengo MA, Rossi PG, Mangone L, Pellegri C, Di Felice E, Cascone G, Cilia S, Morana G, Nicita C, Rollo C, Sigona A, Spata E, Spata G, Budroni M, Cesaraccio R, Contiero P, Maghini A, Tagliabue G, De Lorenzo F, Del Campo L, Polacchi F, Aurora F, Vittone D, Compagni A, Fattore G, Casella I, Cifalà A, Sant M, Gatta G, Trama A, Anselmi V, Casoli C. Cancer Rehabilitation Services: An Italian Population-based Cohort Study. Tumori Journal 2018. [DOI: 10.1177/1578.17224] [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: 11/16/2022]
Affiliation(s)
- Francesca Di Salvo
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Paolo Baili
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | | | - Marina Vercelli
- Liguria Region Cancer Registry, IRCCS AOU S Martino - Istituto Nazionale per la Ricerca sul Cancro, Genoa
- Department of Health Sciences, University of Genoa, Genoa
| | | | | | - Roberto Foschi
- Evaluation Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Paolo Giorgi Rossi
- Servizio Interaziendale di Epidemiologia, AUSL Reggio Emilia, Reggio Emilia
| | | | - Andrea Micheli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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27
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Caccialanza R, Cereda E, De Lorenzo F, Farina G, Pedrazzoli P. To fast, or not to fast before chemotherapy, that is the question. BMC Cancer 2018; 18:337. [PMID: 29587670 PMCID: PMC5870384 DOI: 10.1186/s12885-018-4245-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/19/2018] [Indexed: 12/28/2022] Open
Abstract
Fasting in disease prevention and treatment has recently become a popular topic, particularly in the context of oncology. Unfortunately, the growing attention paid by the media has created a background of speculations and ambiguous messages. The attitude towards the role of fasting in cancer patients should be very cautious, as the risk of malnutrition/sarcopenia and disinformation may be associated with this approach. Whether the results obtained by fasting in the cellular and animal models can be transferred to cancer patients is still to be ascertained. At the moment, more preclinical studies are required to determine in which cancers, at which stage, and in what combinations fasting, fasting-mimicking diets or caloric restriction mimetics may prove effective. So, despite the “rumors” of marketing and media, nowadays fasting and calorie restriction around CT represent only a promising intuition, which requires proper efforts and time to be validated by evidence-based clinical data.
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Affiliation(s)
- Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy.
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy
| | | | - Gabriella Farina
- Department of Oncology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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28
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Micheli A, Sanz N, Mwangi-Powell F, Coleman MP, Neal C, Ullrich A, Travado L, Santini LA, Grassi L, De Lorenzo F, Costa A, Dangou JM, Bisanti L, Costantini AS, Abu-Rmeileh N, Kamal M, Federico M, Saracci R, Rennert G, Stefanini A, Cavalli F, Cazap E, Redmond K, O?Reilly S, Muti P, Casali P, Gatta G, Ferrari A, Koifman S, Bah E, Pastore G, Barr R, Lombardo C, Frazzingaro C, Ciampichini R, Baili P. International collaborations in cancer control and the Third International Cancer Control Congress. Tumori 2018; 95:579-96. [DOI: 10.1177/030089160909500502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over the past few decades, there has been growing support for the idea that cancer needs an interdisciplinary approach. Therefore, the international cancer community has developed several strategies as outlined in the WHO non-communicable diseases Action Plan (which includes cancer control) as the World Health Assembly and the UICC World Cancer Declaration, which both include primary prevention, early diagnosis, treatment, and palliative care. This paper highlights experiences/ideas in cancer control for international collaborations between low, middle, and high income countries, including collaborations between the European Union (EU) and African Union (AU) Member States, the Latin-American and Caribbean countries, and the Eastern Mediterranean countries. These proposals are presented within the context of the global vision on cancer control set forth by WHO in partnership with the International Union Against Cancer (UICC), in addition to issues that should be considered for collaborations at the global level: cancer survival (similar to the project CONCORD), cancer control for youth and adaptation of Clinical Practice Guidelines. Since cancer control is given lower priority on the health agenda of low and middle income countries and is less represented in global health efforts in those countries, EU and AU cancer stakeholders are working to put cancer control on the agenda of the EU-AU treaty for collaborations, and are proposing to consider palliative care, population-based cancer registration, and training and education focusing on primary prevention as core tools. A Community of Practice, such as the Third International Cancer Control Congress (ICCC-3), is an ideal place to share new proposals, learn from other experiences, and formulate new ideas. The aim of the ICCC-3 is to foster new international collaborations to promote cancer control actions in low and middle income countries. The development of supranational collaborations has been hindered by the fact that cancer control is not part of the objectives of the Millennium Development Goals (MGGs). As a consequence, less resources of development aids are allocated to control NCDs including cancer.
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Affiliation(s)
- Andrea Micheli
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Natalia Sanz
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | | | - Michel P Coleman
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Andreas Ullrich
- Diseases and Health Promotion, World Health Organization (WHO), Geneva, Switzerland
| | - Luzia Travado
- National Coordination for Oncology Diseases, High Commission for Health, Lisbon, Portugal
| | | | - Luigi Grassi
- Section of Psychiatry, University of Ferrara, Italy
| | | | | | | | - Luigi Bisanti
- Epidemiology Unit, Local Health Authority of Milan, Milan, Italy
| | - Adele Seniori Costantini
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University West Bank, Palestinian Authority
| | - Mostafa Kamal
- Egyptian Smoking Prevention Research Institute, Cairo, Egypt
| | | | | | - Gad Rennert
- National Israeli Breast and Colorectal Cancer Detection Programs Ministry of Health and Israel Cancer Association, Department of Community Medicine and Epidemiology Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion, Israel
| | - Angelo Stefanini
- Office of Development Cooperation, Consulate General of Italy, Jerusalem (on leave from the University of Bologna, Italy), Jerusalem, Israel
| | - Franco Cavalli
- International Union Against Cancer (UICC), Geneva, Switzerland
| | - Eduardo Cazap
- Latino American and Caribbean Society of Medical Oncology (SLACOM), Buenos Aires, Argentina
| | - Kathy Redmond
- Cancer World Magazine and Media Program, European School of Oncology, Milan, Italy
| | - Susan O?Reilly
- British Columbia Cancer Agency, Division of Medical Oncology Department of Medicine at the University of British Columbia, Vancouver, Canada
| | - Paola Muti
- Italian National Cancer Institute “Regina Elena”, Rome, Italy
| | - Paolo Casali
- Oncology Medicine Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Gemma Gatta
- Evaluation Epidemiology Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Andrea Ferrari
- Paedriatic Oncology Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | | | - Ebrima Bah
- International Agency for Cancer Research (IARC), Banjul, Gambia
| | | | | | - Claudio Lombardo
- National Institute for Cancer Research of Genoa, Genoa, and Alleanza Contro il Cancro, Rome
| | - Cristina Frazzingaro
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Roberta Ciampichini
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Paolo Baili
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
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Truccolo I, Bufalino R, Annunziata MA, Caruso A, Costantini A, Cognetti G, Florita A, Pero D, Pugliese P, Tancredi R, De Lorenzo F. National Cancer Information Service in Italy: An information points network as a new model for providing information for cancer patients. Tumori 2018; 97:510-6. [DOI: 10.1177/030089161109700416] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The international literature data report that good information and communication are fundamental components of a therapeutic process. They contribute to improve the patient-health care professional relationship, to facilitate doctor-patient relationships, therapeutic compliance and adherence, and to the informed consent in innovative clinical trials. We report the results of a multicentric national initiative that developed a 17-information-structure network: 16 Information Points located in the major state-funded certified cancer centers and general hospitals across Italy and a national Help-line at the nonprofit organization AIMaC (the Italian oncologic patients, families and friends association), and updated the already existing services with the aim to create the National Cancer Information Service (SION). The project is the result of a series of pilot and research projects funded by the Italian Ministry of Health. The Information Service model proposed is based on some fundamental elements: 1) human interaction with experienced operators, adequately trained in communication and information, complemented with 2) virtual interaction (Help line, Internet, blog, forum and social network); 3) informative material adequate for both scientific accuracy and communicative style; 4) adequate locations for appropriate positioning and privacy (adequate visibility); 5) appropriate advertising. First results coming from these initiatives contributed to introduce issues related to “Communication and Information to patients” as a “Public Health Instrument” to the National Cancer Plan approved by the Ministry of Health for the years 2010–2012.
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Affiliation(s)
- Ivana Truccolo
- Biblioteca Scientifica e per i Pazienti, Centro di Riferimento Oncologico IRCCS, Aviano
| | - Rosaria Bufalino
- Direzione Scientifica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Maria Antonietta Annunziata
- Struttura Operativa Semplice Dipartimentale di Psicologia Oncologica, Centro di Riferimento Oncologico IRCCS, Aviano
| | - Anita Caruso
- Struttura Formazione IFO, Istituti Fisioterapici Ospitalieri, Rome
| | - Anna Costantini
- Unità Operativa Dipartimentale di Psiconcologia, Azienda Ospedaliera Sant'Andrea, Rome
| | - Gaetana Cognetti
- Biblioteca Digitale, Centro di Conoscenza “Riccardo Maceratini”, IRCCS Istituto Nazionale Tumori Regina Elena, Rome
| | - Antonio Florita
- Direzione Scientifica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - Dina Pero
- “Associazione Italiana Malati di Cancro, parenti e amici” (AIMaC), Rome
| | - Patrizia Pugliese
- Unità Operativa Semplice Dipartimentale Psicologia, Istituti Fisioterapici Ospitalieri, Rome, Italy
| | - Roberta Tancredi
- “Associazione Italiana Malati di Cancro, parenti e amici” (AIMaC), Rome
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Truccolo I, Bogliolo A, Ricci R, Giacomini M, Pivetti S, Russell-Edu W, De Lorenzo F, Della Seta M, Colombo C, Bufalino R, Bocchini G, Pierotti M, Lombardo C, De Paoli P. CIGNOweb.it. Tumori 2018; 97:133-5. [DOI: 10.1177/030089161109700125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We introduce CIGNOweb.it, a database of oncology resources for patients, the general public and healthcare professionals. It builds on the previous Italian cancer resource Azaleaweb and offers quality-evaluated content. It meets international bibliographic and technical standards such as the Open Archives Initiative (OAI) for web content interoperability and the Functional Requirements for Bibliographic Records (FRBR) for bibliographic description with respect to the different media, applications, and user needs. Database content is supplied in collaboration with non-profit associations, libraries and the network of Cancer Information Points that is currently being established all over Italy. Expert and customer evaluation and feedback are provided for in the system. The graphic layout has been painstakingly designed to be user-friendly for a non-expert public. CIGNOweb.it is multicentric and will in time offer health information outside the field of oncology. It is designed to become a multilingual tool to organize, optimize and access patient information produced in the languages of the “newer” European countries. It is hoped that CIGNOweb.it will support other European nations in enhancing the structure and organization of their own-language patient health information and will contribute towards making a common health information portal of the European Union a reality. Free full text available at www.tumorionline.it
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Affiliation(s)
- Ivana Truccolo
- Centro di Riferimento Oncologico, National Cancer Institute (CRO), Aviano
| | | | - Roberto Ricci
- Centro di Riferimento Oncologico, National Cancer Institute (CRO), Aviano
| | - Mauro Giacomini
- MEDINFO Laboratory – Department of Communication, Computer and System Science (University of Genoa), Genoa
| | - Susanna Pivetti
- MEDINFO Laboratory – Department of Communication, Computer and System Science (University of Genoa), Genoa
| | | | | | | | - Cinzia Colombo
- Mario Negri Institute for Pharmacological Research, Milan
| | | | | | | | | | - Paolo De Paoli
- Centro di Riferimento Oncologico, National Cancer Institute (CRO), Aviano
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Caccialanza R, De Lorenzo F, Pedrazzoli P. The integrating nutritional therapy in oncology (INTO) project: rationale, structure and preliminary results. ESMO Open 2017; 2:e000221. [PMID: 29209526 PMCID: PMC5703379 DOI: 10.1136/esmoopen-2017-000221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 06/09/2017] [Indexed: 11/08/2022] Open
Affiliation(s)
- Riccardo Caccialanza
- Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy - Italian Society of Artificial Nutrition and Metabolism
| | | | - Paolo Pedrazzoli
- Division of Medical Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy - Italian Society of Medical Oncology
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Caccialanza R, De Lorenzo F, Gianotti L, Zagonel V, Gavazzi C, Farina G, Cotogni P, Cinieri S, Cereda E, Marchetti P, Nardi M, Iannelli E, Santangelo C, Traclò F, Pinto C, Pedrazzoli P. Nutritional support for cancer patients: still a neglected right? Support Care Cancer 2017; 25:3001-3004. [DOI: 10.1007/s00520-017-3826-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/04/2017] [Indexed: 12/25/2022]
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Florindi F, De Lorenzo F, Apostolidis K, Pelouchova J, Winterbottom A, Chrostowski S, Cimpoeru D, Bolanos N, Rek A, Manneh-Vangramberen I, Bolhuis J, Makaroff L. Value of innovation in oncology: The position of European cancer patients on access to innovative treatments. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e18021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
e18021 Background: The paper presents the position of the European Cancer Patient Coalition (ECPC), in partnership with Interel, on the value of innovation in oncology today, focusing on issues that would benefit most from the direct involvement of patients.The objective of the paper is to present key factors affecting access to innovation in oncology in Europe and to propose key recommendations on how to improve equity in access and to actively involve patients in decision-making. Methods: The document was produced under the supervision of the ECPC Board of Directors, and the contribution of the ECPC General Assembly, which was consulted in June 2016 during the Annual General Meeting.The paper is based also on a systemic literature review. Results: The paper analyses the main systems barriers to access to innovation, which affect all European cancer patients: low level fo health expenditure on cancer; high cost of innovative treatments; complex regulatory and reimbursement pathways; lack of enabling environments; limited patient involvement in decision making. The paper goes on identifying 40 key policy recommendations in 10 pivotal areas (see Table). Conclusions: Innovative healthcare technologies, strategies, and services offer the potential to improve the lives of many people living with cancer. Ensuring that effective innovations are accessible and affordable to all patients is a challenge facing all cancer stakeholders. The successful development and implementation of new cancer care modalities stems from putting the needs of patients at the centre of the innovation process. Patients are the ultimate beneficiaries and users of cancer diagnosis, treatment, and care. They have unique knowledge, perspectives, and experiences that improves and encourages innovation in oncology. Optimal innovation can only be obtained by understand the diverse needs and preferences of cancer patients, and integrating patient-centred approaches into the regulatory and healthcare system. [Table: see text]
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Affiliation(s)
| | | | | | | | | | | | - Dan Cimpoeru
- European Cancer Patient Coalition, Brussels, Belgium
| | | | - Anna Rek
- European Cancer Patient Coalition, Brussels, Belgium
| | | | - Jiska Bolhuis
- European Cancer Patient Coalition, Brussels, Belgium
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Lawler M, Banks I, Law K, Albreht T, Armand JP, Barbacid M, Barzach M, Bergh J, Cameron D, Conte P, de Braud F, de Gramont A, De Lorenzo F, Diehl V, Diler S, Erdem S, Geissler J, Gore-Booth J, Henning G, Højgaard L, Horgan D, Jassem J, Johnson P, Kaasa S, Kapitein P, Karjalainen S, Kelly J, Kienesberger A, La Vecchia C, Lacombe D, Lindahl T, Löwenberg B, Luzzatto L, Malby R, Mastris K, Meunier F, Murphy M, Naredi P, Nurse P, Oliver K, Pearce J, Pelouchov J, Piccart M, Pinedo B, Spurrier-Bernard G, Sullivan R, Tabernero J, Van de Velde C, van Herk B, Vedsted P, Waldmann A, Weller D, Wilking N, Wilson R, Yared W, Zielinski C, Zur Hausen H, Le Chevalier T, Johnston P, Selby P. The European Cancer Patient's Bill of Rights, update and implementation 2016. ESMO Open 2017; 1:e000127. [PMID: 28848664 PMCID: PMC5548978 DOI: 10.1136/esmoopen-2016-000127] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/24/2016] [Indexed: 11/04/2022] Open
Abstract
In this implementation phase of the European Cancer Patient's Bill of Rights (BoR), we confirm the following three patient-centred principles that underpin this initiative:The right of every European citizen to receive the most accurate information and to be proactively involved in his/her care.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control and the associated progress in ensuring good patient experience and quality of life.Establish the major mechanisms to underpin its delivery. (1) The systematic and rigorous sharing of best practice between and across European cancer healthcare systems and (2) the active promotion of Research and Innovation focused on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically identify, evaluate and validate and disseminate best practice in cancer management for the different countries and regions and (2) promote Research and Innovation and its translation to maximise its impact to improve outcomes.
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Affiliation(s)
- Mark Lawler
- Queen's University Belfast,; European Cancer Concord
| | - Ian Banks
- European Cancer Concord,; European Men's Health Forum,; University of Leeds
| | | | - Tit Albreht
- Institut za varovanje zdravja Republike Slovenija
| | | | - Mariano Barbacid
- Experimental Oncology, Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO)
| | | | - Jonas Bergh
- Department of Oncology-Pathology, Karolinska Institutet
| | | | | | | | | | - Francesco De Lorenzo
- Italian Federation of Volunteer-based Cancer Organizations,; European Cancer Patient Coalition
| | | | | | | | - Jan Geissler
- Leukemia Patient Advocates Foundation,; European Patients Academy on Therapeutic Innovation
| | | | | | - Liselotte Højgaard
- Danmarks Grundforskningsfond,; Faculty of Health and Medical Sciences, Kobenhavns Universitet
| | | | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk
| | - Peter Johnson
- Department of Medical Oncology, University of Southampton,; Cancer Research UK
| | - Stein Kaasa
- Institute of Cancer Research and Molecular Medicine, Norges teknisk-naturvitenskapelige universitet
| | | | | | - Joan Kelly
- Association of European Cancer Leagues,; Irish Cancer Society
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Universita degli Studi di Milano
| | - Denis Lacombe
- European Organisation for Research and Treatment of Cancer
| | | | - Bob Löwenberg
- Department of Hematology, Erasmus University Medical Center
| | - Lucio Luzzatto
- Muhimbili University of Health and Allied Sciences,; Universita degli Studi di Firenze
| | - Rebecca Malby
- School of Health and Social Care, London South Bank University
| | | | | | - Martin Murphy
- European Cancer Concord, Society for Translational Oncology
| | - Peter Naredi
- Goteborgs Universitet,; European Cancer Organisation
| | | | | | | | | | | | | | | | - Richard Sullivan
- Institute of Cancer Policy, Kings Health Partners Integrated Cancer Centre
| | - Josep Tabernero
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona
| | | | | | - Peter Vedsted
- Institute for Public Health and Department of Clinical Medicine, Aarhus Universitet
| | | | - David Weller
- Centre for Population Health Sciences, University of Edinburgh
| | - Nils Wilking
- Department of Oncology, Karolinska Institutet,; Skåne University Hospital
| | | | | | - Christoph Zielinski
- Comprehensive Cancer Center and Department of Medicine I, Medical University of Vienna,; European Society for Medical Oncology
| | | | | | | | - Peter Selby
- European Cancer Concord,; University of Leeds,.
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Gnagnarella P, Misotti AM, Santoro L, Akoumianakis D, Del Campo L, De Lorenzo F, Lombardo C, Milolidakis G, Sullivan R, McVie JG. Nutritional Online Information for Cancer Patients: a Randomized Trial of an Internet Communication Plus Social Media Intervention. J Cancer Educ 2016; 31:472-480. [PMID: 25820605 DOI: 10.1007/s13187-015-0820-5] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We hypothesized that cancer patients using an Internet website would show an improvement in the knowledge about healthy eating habits, and this might be enhanced by social media interaction. A 6-month randomized intervention was set up. Eligible subjects were allocated in intervention (IG) and control groups (CG). IG had access to the website, and CG was provided with printed versions. All enrolled participants filled in Nutrition Questionnaire (NQ), Quality of Life Questionnaire (QoL) and Psychological Distress Inventory (PDI), at baseline and after 6 months. The difference between post- vs pre-questionnaires was calculated. Seventy-four subjects (CG 39; IG 35) completed the study. There was an increase in the score after the intervention in both groups for the NQ, even if not statistically significant. Dividing the IG into three categories, no (NI), low (LI) and high interactions (HI), we found a decreased score (improvement) in the CG (-0.2) and in the HI (-1.7), and an increased score (worsening) in the NI (+3.3) (p = NS) analysing the PDI. We found an increased score in the QoL both in CG and IG (adjusted LSMeans +3.5 and +2.8 points, respectively; p = NS). This study represents an example for support cancer patients. Despite the lack of significant effects, critical points and problems encountered may be of interest to researchers and organization working in the cancer setting. Intervention strategies to support patients during the care process are needed in order to attain the full potential of patient-centred care on cancer outcomes.
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Affiliation(s)
- Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ramusio 1, 20141, Milan, Italy
| | - Alessandro Maria Misotti
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ramusio 1, 20141, Milan, Italy.
| | - Luigi Santoro
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ramusio 1, 20141, Milan, Italy
| | - Demosthenes Akoumianakis
- Centre for Technological Research of Crete, Technological Education Institution of Crete, Crete, Greece
| | - Laura Del Campo
- Federazione Italiana Delle Associazioni di Volontariato in Oncologia, Rome, Italy
| | - Francesco De Lorenzo
- Federazione Italiana Delle Associazioni di Volontariato in Oncologia, Rome, Italy
| | - Claudio Lombardo
- Organisation of the European Cancer Institute, Brussels, Belgium
- SOS Europe Srl, Genoa, Italy
| | - Giannis Milolidakis
- Centre for Technological Research of Crete, Technological Education Institution of Crete, Crete, Greece
| | | | - John Gordon McVie
- Scientific Directorate, European Institute of Oncology, Milan, Italy
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De Paoli P, Ciliberto G, Ferrarini M, Pelicci P, Dellabona P, De Lorenzo F, Mantovani A, Musto P, Opocher G, Picci P, Ricciardi W, De Maria R. Alliance Against Cancer, the network of Italian cancer centers bridging research and care. J Transl Med 2015; 13:360. [PMID: 26578263 PMCID: PMC4650281 DOI: 10.1186/s12967-015-0711-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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: 09/30/2015] [Accepted: 10/23/2015] [Indexed: 11/10/2022] Open
Abstract
Alliance Against Cancer (ACC) was established in Rome in 2002 as a consortium of six Italian comprehensive cancer centers (Founders). The aims of ACC were to promote a network among Italian oncologic institutions in order to develop specific, advanced projects in clinical and translational research. During the following years, many additional full and associate members joined ACC, that presently includes the National Institute of Health, 17 research-oriented hospitals, scientific and patient organizations. Furthermore, in the last three years ACC underwent a reorganization process that redesigned the structure, governance and major activities. The present goal of ACC is to achieve high standards of care across Italy, to implement and harmonize principles of modern personalized and precision medicine, by developing cost effective processes and to provide tailored information to cancer patients. We herein summarize some of the major initiatives that ACC is currently developing to reach its goal, including tumor genetic screening programs, establishment of clinical trial programs for cancer patients treated in Italian cancer centers, facilitate their access to innovative drugs under development, improve quality through an European accreditation process (European Organization of Cancer Institutes), and develop international partnerships. In conclusion, ACC is a growing organization, trying to respond to the need of networking in Italy and may contribute significantly to improve the way we face cancer in Europe.
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Affiliation(s)
- Paolo De Paoli
- Centro di Riferimento Oncologico (CRO), IRCCS, Istituto Nazionale Tumori, Via Franco Gallini 2, 33081, Aviano, PN, Italy.
| | - Gennaro Ciliberto
- Istituto Nazionale Tumori, Fondazione Pascale, IRCCS, Naples, Italy.
| | - Manlio Ferrarini
- Azienda Ospedaliera-Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
| | | | | | | | - Alberto Mantovani
- Humanitas University, Istituto Clinico Humanitas, Rozzano, MI, Italy.
| | - Pellegrino Musto
- Centro di Riferimento Oncologico della Basilicata (CROB) IRCCS, Rionero in Vulture, PZ, Italy.
| | | | - Piero Picci
- Istituto Ortopedico Rizzoli, IRCCS, Bologna, Italy.
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De Lorenzo F. The point of view of patients' organisations. Epidemiol Prev 2014; 38:130-132. [PMID: 25759298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Francesco De Lorenzo
- Presidente Federazione italiana delle associazioni di volontariato in oncologia (FAVO). Presidente European cancer patient coalition (ECPC)
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Di Salvo F, Baili P, Vicentini M, Tumino R, Vercelli M, Pirino D, Contiero P, Foschi R, Minicozzi P, Giorgi Rossi P, De Lorenzo F, Micheli A. Cancer rehabilitation services: an Italian population-based cohort study. Tumori 2014; 100:346-51. [PMID: 25076249 DOI: 10.1700/1578.17224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND In Italy more than 55% of cancer patients live for more than 5 years after diagnosis, sometimes with several cancer-related sequelae. For this reason rehabilitation must offer not only physical interventions but also psychological, clinical, social and nutritional support. The CAREMORE pilot study was designed to assess whether cancer registries could serve to collect information on rehabilitation services, to describe and quantify the services provided by the National Health Service, and to examine the allocation of rehabilitation services to cancer patients. METHODS AND STUDY DESIGN This was a pilot population-based cohort study. A sample of 1200 patients was identified from the databases of the Varese, Genoa, Reggio Emilia, Sassari and Ragusa cancer registries, all diagnosed in 2002 and followed for 5 years. For 4 cancer sites a list of rehabilitation items to be collected was drafted by a joint community of researchers and voluntary associations, with variables regarding rehabilitation data and follow-up. Data were analyzed by groups of patients, vital status, sex, and age. RESULTS This pilot study suggested it is useful to collect information on several rehabilitation services: disability benefits, home care, aids and other support; it was not possible to collect reliable information on nutritional and psychological rehabilitation. In all, 36% of the sample applied for disability benefits, but with important differences between cancer sites. Eleven percent of the sample obtained home care, with no substantial differences between cancer sites, and 16% received at least one aid, with percentages varying from 27% for rectal cancer to 8% for lymphoma patients. CONCLUSIONS The pilot study indicated that cancer registries could collect information on rehabilitation services. In the future it would be interesting to expand the roles of these registries to factors that influence quality of life, taking into account the possibility of collecting more information by actually interviewing patients.
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Numico G, Pinto C, Gori S, Ucci G, Di Maio M, Cancian M, De Lorenzo F, Silvestris N. Clinical and organizational issues in the management of surviving breast and colorectal cancer patients: attitudes and feelings of medical oncologists. PLoS One 2014; 9:e101170. [PMID: 24983237 PMCID: PMC4077745 DOI: 10.1371/journal.pone.0101170] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 06/03/2014] [Indexed: 12/17/2022] Open
Abstract
Background The fast growing demand and the shortage of resources are pushing toward more efficient models of survivorship care delivery. The Associazione Italiana di Oncologia Medica (AIOM) established an interdisciplinary working group with the purpose of promoting organizational improvements at the national level. A survey aimed at assessing attitudes and feelings of oncologists was considered preliminary to further initiatives. Methods A 25-item questionnaire, sent to the mailing list of the Society, explored the following issues on the practice of breast and colorectal cancer patients' follow up: 1) organization; 2) clinical features; 3) feelings about the different meanings of follow-up. Results Ninety-one oncologists of 160 institutions (57%) answered to the questionnaire. Although follow up is considered a distinct oncological activity in 68%, a fully shared organization between specialists is not common and communications with Primary Care Physicians are not structured in the majority of the cases. Fifty-five and 30% of the oncologists follow breast and colorectal cancer patients indefinitely. In case of discharge a survivorship care plan is delivered in only 9%. The majority of respondents do not hold a role of follow up in mortality reduction. Conclusions Although survivorship care represents a significant part of the oncologists' workload, an “oncology-centered” model is largely adopted and established care pathways are still incomplete. Survivorship care needs to be put at the center of an educational policy and of a widespread organizational effort, directed at improving appropriateness and quality.
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Affiliation(s)
- Gianmauro Numico
- Medical Oncology Unit, Azienda USL della Valle d′Aosta, Aosta, Italy
- * E-mail:
| | - Carmine Pinto
- Medical Oncology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Stefania Gori
- Medical Oncology, Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Giovanni Ucci
- Oncology Department, Azienda Ospedaliera di Lodi, Lodi, Italy
| | - Massimo Di Maio
- Clinical Trial Unit, National Cancer Institute “G. Pascale” Foundation, Napoli, Italy
| | | | | | - Nicola Silvestris
- Medical Oncology Unit, National Cancer Research Centre “Giovanni Paolo II”, Bari, Italy
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Lawler M, Le Chevalier T, Banks I, Conte P, De Lorenzo F, Meunier F, Pinedo HM, Selby P, Murphy MJ, Johnston PG. A Bill of Rights for patients with cancer in Europe. Lancet Oncol 2014; 15:258-60. [PMID: 24503530 DOI: 10.1016/s1470-2045(13)70552-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Mark Lawler
- Centre for Cancer Research and Cell Biology and Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast BT9 7BL, UK.
| | | | - Ian Banks
- European Men's Health Forum, Brussels, Belgium
| | - Pierfranco Conte
- University of Padua and Istituto Oncologico Veneto, Padua, Italy; Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy
| | - Francesco De Lorenzo
- Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy; European Cancer Patient Coalition, Brussels, Belgium
| | - Françoise Meunier
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - H M Pinedo
- VuMC Cancer Center, Amsterdam, Netherlands
| | - Peter Selby
- Leeds' Institute of Cancer and Pathology, University of Leeds, UK
| | | | - Patrick G Johnston
- Centre for Cancer Research and Cell Biology and Institute of Health Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast BT9 7BL, UK
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Lawler M, Le Chevalier T, Murphy MJ, Banks I, Conte P, De Lorenzo F, Meunier F, Pinedo H, Selby P, Armand JP, Barbacid M, Barzach M, Bergh J, Bode G, Cameron DA, de Braud F, de Gramont A, Diehl V, Diler S, Erdem S, Fitzpatrick JM, Geissler J, Hollywood D, Højgaard L, Horgan D, Jassem J, Johnson PW, Kapitein P, Kelly J, Kloezen S, La Vecchia C, Löwenberg B, Oliver K, Sullivan R, Tabernero J, Van de Velde CJ, Wilking N, Wilson R, Zielinski C, zur Hausen H, Johnston PG. A catalyst for change: the European cancer Patient's Bill of Rights. Oncologist 2014; 19:217-24. [PMID: 24493667 PMCID: PMC3958470 DOI: 10.1634/theoncologist.2013-0452] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 01/06/2014] [Indexed: 11/17/2022] Open
Abstract
The European Cancer Concord is a unique patient-centered partnership that will act as a catalyst to achieve improved access to an optimal standard of cancer care and research for European citizens. In order to provide tangible benefits for European cancer patients, the partnership proposes the creation of a “European Cancer Patient’s Bill of Rights,” a patient charter that will underpin equitable access to an optimal standard of care for Europe’s citizens.
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Affiliation(s)
- Mark Lawler
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | | | - Martin J. Murphy
- European Cancer Concord, Society for Translational Oncology, Durham, North Carolina, USA
| | - Ian Banks
- European Men’s Health Forum, Brussels, Belgium
| | | | - Francesco De Lorenzo
- Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy
- European Cancer Patient Coalition, Brussels, Belgium
| | - Françoise Meunier
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - H.M. Pinedo
- VuMC Cancer Center, Amsterdam, The Netherlands
| | - Peter Selby
- Department of Medical Oncology, University of Leeds, Leeds, United Kingdom
| | | | | | | | - Jonas Bergh
- Department of Oncology-Pathology, Karolinska Institut, Stockholm, Sweden
| | - Gerlind Bode
- International Confederation of Childhood Cancer Parent Organizations, Nieuwegein, The Netherlands
| | - David A. Cameron
- Edinburgh Cancer Centre, NHS Lothian & Edinburgh Cancer Research Centre, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom
| | - Filippo de Braud
- Medical Oncology Division, National Cancer Institute, Milan, Italy
| | | | - Volker Diehl
- Internal Medicine, University of Cologne, Köln, Germany
| | | | - Sema Erdem
- Europa Donna, Piazza Amendola, Milan, Italy
| | - John M. Fitzpatrick
- Irish Cancer Society, Dublin, Ireland
- Department of Surgery, University College Dublin, Dublin, Ireland
| | - Jan Geissler
- Leukemia Patient Advocates Foundation, Berne, Switzerland
- European Patients Academy on Therapeutic Innovation, Riemerling, Germany
| | - Donal Hollywood
- >† Deceased
- Academic Unit of Clinical and Molecular Oncology, St James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - Liselotte Højgaard
- Danish National Research Foundation, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Denis Horgan
- European Alliance for Personalised Medicine, Brussels, Belgium
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - Peter W. Johnson
- Department of Medical Oncology, University of Southampton, Southampton, United Kingdom
- Cancer Research UK, London, United Kingdom
| | | | - Joan Kelly
- Irish Cancer Society, Dublin, Ireland
- European Cancer Leagues, Brussels, Belgium
| | | | - Carlo La Vecchia
- Dipartimento di Epidemiologia, Istituto di Ricerche Farmacologiche “Mario Negri” Milan, Italy
| | - Bob Löwenberg
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kathy Oliver
- International Brain Tumor Alliance, Tadworth, Surrey, United Kingdom
| | - Richard Sullivan
- Institute of Cancer Policy, Kings Health Partners Integrated Cancer Centre, London, United Kingdom
| | | | | | - Nils Wilking
- Department of Oncology, Karolinska Institut, Stockholm, Sweden, and Skåne University Hospital, Lund, Sweden
| | | | - Christoph Zielinski
- Comprehensive Cancer Center and Department of Medicine I, Medical University Vienna - General Hospital, Vienna, Austria
| | - Harald zur Hausen
- German Cancer Research Centre, University of Heidelberg, Heidelberg, Germany
| | - Patrick G. Johnston
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
- School of Medicine, Dentistry and Biomedical Sciences, and Institute of Health Sciences, Queens University Belfast, Belfast, United Kingdom
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Numico G, Pinto C, Ucci G, Gori S, Di Maio M, Cancian M, De Lorenzo F, Venturini M. How are cared surviving cancer patients? Results of an Italian national survey to medical oncologists (MO) about clinical and organizational features of follow-up (FU). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e19592] [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
e19592 Background: The growing demand and the resources shortage are pushing toward more efficient models of survivorship care delivery. The interface between the MO, the specialists involved in FU and Primary Care Physicians (PCP) should be optimized. While the “oncology centered” model seems hardly sustainable, a “sequential” model (PCP FU after an arbitrarily defined period of specialist FU) is gaining acceptance. A proposed alternative is a “shared-cares” model that promotes the interaction between MO and PCP throughout the whole clinical history. AIOM established a working group with the aim of promoting improvements at the national level. A survey aimed at assessing attitudes and feelings of MO was considered preliminary to any further initiative. Methods: A 25-item questionnaire was sent to the mailing list of the Society, in a 2-months period during 2011. One MO per institution was asked to answer to the questions. The sections of the survey were the following: 1) organizational features of FU; 2) clinical features involving breast (BC) and colorectal cancer (CRC) FU; 3) feelings of MO about the different meanings of FU. Results: 91 MO of 160 institutions (57%) answered. A shared organization between specialists is reported in 71% for BC and 53% for CRC. However, a shared medical record is used in only 19% and 11% respectively. The ordinary communication between MO and PCP consists in the medical report released to the pt in 87% and in other instruments in 8%. 55% and 30% of the MO follow BC and CRC pts indefinitely. In case of discharge, a conclusive letter is sent to the PCP in 74%, while a survivorship care plan is delivered in only 9%. Only 6% and 14% of the MO feel that FU has an important role in reducing mortality or in improving recurrence detection in BC. These figures grow to 31% and 47% for CRC. The educational role of FU is considered important in 36% and 32% while the psychological role in 44% and 37% for BC and CRC respectively. Conclusions: Although efforts are made to include other specialists and PCP into survivorship care, MO tend to privilege the “oncology centered” model. National efforts are being encouraged to promote the diffusion of a “shared-cares” model.
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Affiliation(s)
| | - Carmine Pinto
- Associazione Italiana di Oncologia Medica (AIOM), Milano, Italy
| | - Giovanni Ucci
- Collegio Italiano dei Primari Oncologi Ospedalieri (CIPOMO), Milano, Italy
| | - Stefania Gori
- Associazione Italiana di Oncologia Medica (AIOM), Milano, Italy
| | - Massimo Di Maio
- Associazione Italiana di Oncologia Medica (AIOM), Milano, Italy
| | | | - Francesco De Lorenzo
- Federazione Italiana delle Associazioni di Volontariato in Oncologia (FAVO), Roma, Italy
| | - Marco Venturini
- Associazione Italiana di Oncologia Medica (AIOM), Milano, Italy
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Truccolo I, Bufalino R, Annunziata MA, Caruso A, Costantini A, Cognetti G, Florita A, Pero D, Pugliese P, Tancredi R, De Lorenzo F. National Cancer Information Service in Italy: an information points network as a new model for providing information for cancer patients. Tumori 2012. [PMID: 21989442 DOI: 10.1700/950.10406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The international literature data report that good information and communication are fundamental components of a therapeutic process. They contribute to improve the patient-health care professional relationship, to facilitate doctor-patient relationships, therapeutic compliance and adherence, and to the informed consent in innovative clinical trials. We report the results of a multicentric national initiative that developed a 17-information-structure network: 16 Information Points located in the major state-funded certified cancer centers and general hospitals across Italy and a national Help-line at the nonprofit organization AIMaC (the Italian oncologic patients, families and friends association), and updated the already existing services with the aim to create the National Cancer Information Service (SION). The project is the result of a series of pilot and research projects funded by the Italian Ministry of Health. The Information Service model proposed is based on some fundamental elements: 1) human interaction with experienced operators, adequately trained in communication and information, complemented with 2) virtual interaction (Help line, Internet, blog, forum and social network); 3) informative material adequate for both scientific accuracy and communicative style; 4) adequate locations for appropriate positioning and privacy (adequate visibility); 5) appropriate advertising. First results coming from these initiatives contributed to introduce issues related to "Communication and Information to patients" as a "Public Health Instrument" to the National Cancer Plan approved by the Ministry of Health for the years 2010-2012.
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Affiliation(s)
- Ivana Truccolo
- Biblioteca Scientifica e per i Pazienti, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
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De Lorenzo F, Fuchs S, Anfinsen CB. Characterization of a Peptide Fragment Containing the Essential Half-Cystine Residue of a Microsomal Disulfide Interchange Enzyme*. Biochemistry 2002. [DOI: 10.1021/bi00876a030] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Williams PD, Lorenzo FD, Borja M. Pediatric chronic illness: effects on siblings and mothers. Matern Child Nurs J 1993; 21:111-21. [PMID: 8127160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study describes mothers' reports of the effects of pediatric chronic illness on sibling and maternal activities. Mothers of children with cardiac (n = 57) and neurologic (n = 43) conditions were interviewed in hospital clinics of Manila, Philippines. Results showed that pediatric chronic illness in the family significantly increased siblings' household activities (which included both housekeeping and well-sibling caretaking) and decreased school and social activities. Maternal participation in four areas--caregiving to well children, housekeeping, job, and social activities also decreased significantly. Girls, more than boys, were delegated chores related to caregiving of well siblings and housekeeping. Spouses and grandparents also helped with caregiving of well children.
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Affiliation(s)
- P D Williams
- University of Kansas School of Nursing, Kansas City
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De Lorenzo F, Di Natale P, Schechter AN. Chemical and Physical Studies on the Structure of the Histidyl Transfer Ribonucleic Acid Synthetase from Salmonella typhimurium. J Biol Chem 1974. [DOI: 10.1016/s0021-9258(19)43017-2] [Citation(s) in RCA: 12] [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: 10/22/2022] Open
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Steiner R, De Lorenzo F, Anfinsen CB. Enzymically Catalyzed Disulfide Interchange in Randomly Cross-linked Soybean Trypsin Inhibitor. J Biol Chem 1965. [DOI: 10.1016/s0021-9258(18)97003-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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