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Buti S, Basso U, Giannarelli D, De Giorgi U, Maruzzo M, Iacovelli R, Galli L, Porta C, Carrozza F, Procopio G, Fonarini G, Lo Re G, Santoni M, Sabbatini R, Cusmai A, Zucali PA, Aschele C, Baldini E, Zafarana E, Favaretto A, Leo S, Hamzaj A, Mirabelli R, Nole’ F, Zai S, Chini C, Masini C, Fatigoni S, Rocchi A, Tamburini E, Cortellini A, Bersanelli M. Concomitant Drugs Prognostic Score in Patients With Metastatic Renal Cell Carcinoma Receiving Ipilimumab and Nivolumab in the Compassionate Use Program in Italy: Brief Communication. J Immunother 2023; 46:22-26. [PMID: 36472582 PMCID: PMC10561686 DOI: 10.1097/cji.0000000000000446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022]
Abstract
A concomitant drug-based score was developed by our group and externally validated for prognostic and predictive purposes in patients with advanced cancer treated with immune checkpoint inhibitors (ICIs). The model considers the use of three classes of drugs within a month before initiating ICI, assigning score 1 for each between proton pump inhibitor and antibiotic administration until a month before immunotherapy initiation and score 2 in case of corticosteroid intake. In the present analysis, the drug score was validated in a prospective population of 305 patients with metastatic renal cell carcinoma treated with ipilimumab plus nivolumab in the first-line setting. The value of the model in predicting overall survival and progression-free survival was statistically significant and clinically meaningful, with an overall survival rate at 12 months of 73% vs. 44% (P<0.0001), and median progression-free survival of 11.6 (95% CI: 9.1-14.1) months versus 4.8 (95% CI: 2.7-7.0) months (P=0.002), respectively, for patients belonging to the favorable group (score 0-1) versus the unfavorable (score 2-4). Further development will be represented by the gut microbiome analysis according to the drug-based model classification and to the outcome of patients to ICI therapy to demonstrate the link between drug exposure and immune sensitivity.
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Affiliation(s)
- Sebastiano Buti
- Department of Medicine and Surgery, University of Parma, Parma
- Medical Oncology Unit, University Hospital of Parma, Parma
| | - Umberto Basso
- Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, Padua
| | - Diana Giannarelli
- Department of Biostatistical, Regina Elena National Cancer Institute, IRCCS, Rome
| | - Ugo De Giorgi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola
| | - Marco Maruzzo
- Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, Padua
| | - Roberto Iacovelli
- Department of Medical and Surgical Sciences, Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma
| | - Luca Galli
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera Universitaria Pisana, Pisa
| | - Camillo Porta
- Department of Biomedical Sciences and Human Oncology, University of Bari ‘A. Moro’ and Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari
| | - Francesco Carrozza
- Oncology Unit" Santa Maria delle Croci Hospital", Department Oncology and Haematology AUSL, Romagna, Ravenna
| | - Giuseppe Procopio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori
| | - Giuseppe Fonarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova
| | - Giovanni Lo Re
- Division of Medical Oncology and Immune-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano
| | | | - Roberto Sabbatini
- Oncological Medicine Unit and Medical Oncology Unit, Department of Oncology and Haematology, University Hospital of Modena, University of Modena and Reggio Emilia, Modena
| | - Antonio Cusmai
- Interventional and Medical Oncology Unit, National Cancer Research Center, Istituto Tumori Giovanni Paolo II, Viale Orazio Flacco, Bari
| | - Paolo Andrea Zucali
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Department of Oncology, IRCCS Humanitas Research Hospital, Rozzano
| | - Carlo Aschele
- Department of Oncology, Ospedale S. Andrea, La Spezia
| | - Editta Baldini
- Department of Medical Oncology, San Luca Hospital, Lucca
| | - Elena Zafarana
- Department of Medical Oncology, Hospital of Prato, Prato
| | - Adolfo Favaretto
- Department of Medical Oncology, AULSS 2 Marca Trevigiana, Ca'Foncello Hospital, Treviso
| | - Silvana Leo
- Medical Oncology Unit, Vito Fazzi Hospital, Lecce
| | | | - Rosanna Mirabelli
- Department of Ematology and Oncology, Pugliese-Ciaccio Hospital, Catanzaro
| | - Franco Nole’
- Medical Oncology Division of Urogenital and Head and Neck Tumours IEO, European Institute of Oncology IRCCS, Milan
| | - Silvia Zai
- Medical Oncology Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria
| | - Claudio Chini
- Department of Medical Oncology, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese
| | - Cristina Masini
- Medical Oncology Unit, Clinical Cancer Centre, AUSL-IRCCS di Reggio Emilia, Reggio Emilia
| | - Sonia Fatigoni
- Medical Oncology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia
| | - Andrea Rocchi
- Hematology and Oncology Unit, San Giovanni Battista Hospital, Foligno
| | - Emiliano Tamburini
- Department of Oncology and Palliative Care, Cardinale G. Panico, Tricase City Hospital, Tricase, Italy
| | | | - Melissa Bersanelli
- Department of Medicine and Surgery, University of Parma, Parma
- Medical Oncology Unit, University Hospital of Parma, Parma
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Sciandivasci A, Munzone E, Aurilio G, Adamoli L, Botteri E, Locatelli M, Esposito A, Minchella I, Cullura’ D, Curigliano G, Goldhirsch A, Nole’ F. Abstract P6-11-14: Long-Term Disease Control with Vinorelbine, Cisplatin and Continuous Infusion of 5-Fluorouracil -ViFuP Regimen-in Metastatic Triple Negative Breast Cancer Patients. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p6-11-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Triple negative breast cancers (TNBCs) are characterized by lack of estrogen, progesterone, HER-2-neu receptors expression and comprise 15% to 20% of all breast cancers. Studies have suggested that
TNBCs may be more sensitive to DNA damaging agents like cisplatin. Our previous experience had identified a combination chemotherapy -the ViFuP regimen-with noteworthy efficacy and safety as a first or subsequent line treatment for metastatic breast cancer (MBC) patients (pts). In this view we retrospectively examined the activity of ViFuP regimen in 2 cohorts (A and B) of metastatic TNBC pts.
Material and Methods: From January 2000 to December 2008, 115 pts with MBC were treated with ViFuP regimen, at the European Institute of Oncology, Milan, Italy. Among these, 35 pts (30%) had TNBC. Pts received continuous infusion 5-fluorouracil 200 mg/m2/day, vinorelbine 20 mg iv on days 1 and 3 and cisplatin 60 mg/m2on day 1. Therapy was given every three weeks. In A 22 pts (63%) were triple negative on primary tumor and in B 13 pts (37%) were triple negative in metastatic site. Median age was 54 years (range 35-73), 11 pts (31%) were pre-treated for MBC and 21 pts (60%) had ≥3 metastatic sites.
Results: Thirty three pts were evaluable for response and 34 pts were assessable for toxicity. Median duration of treatment was 3.57 months (range 1-5.7). Four pts (12%) had complete responses, 14 pts (42%) had partial responses and 11 pts (33%) had stable disease with a clinical benefit (CB) of 73% (95% CI, 55%-87%). Four pts (12%) had progressive disease. Median time to progression was 6 months (95% CI, 5-8 months). Main toxicity was haematological with 62% of the pts showing grade 3/4 leuco-neutropenia. Alopecia was almost absent.
Discussion: Treatment with ViFuP regimen was effective and safe in metastatic TNBC providing long-term disease control in a high proportion of pts. The prolonged CB supports this regimen as an additional therapeutic opportunity in this category of pts.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-11-14.
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Affiliation(s)
| | - E Munzone
- European Institute of Oncology, Italy
| | - G Aurilio
- European Institute of Oncology, Italy
| | - L Adamoli
- European Institute of Oncology, Italy
| | - E Botteri
- European Institute of Oncology, Italy
| | | | | | | | | | | | | | - F. Nole’
- European Institute of Oncology, Italy
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