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Scalera S, Ricciuti B, Mazzotta M, Calonaci N, Alessi JV, Cipriani L, Bon G, Messina B, Lamberti G, Di Federico A, Pecci F, Milite S, Krasniqi E, Barba M, Vici P, Vecchione A, De Nicola F, Ciuffreda L, Goeman F, Fanciulli M, Buglioni S, Pescarmona E, Sharma B, Felt KD, Lindsay J, Rodig SJ, De Maria R, Caravagna G, Cappuzzo F, Ciliberto G, Awad MM, Maugeri-Saccà M. Clonal KEAP1 mutations with loss of heterozygosity share reduced immunotherapy efficacy and low immune cell infiltration in lung adenocarcinoma. Ann Oncol 2023; 34:275-288. [PMID: 36526124 DOI: 10.1016/j.annonc.2022.12.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/26/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND KEAP1 mutations have been associated with reduced survival in lung adenocarcinoma (LUAD) patients treated with immune checkpoint inhibitors (ICIs), particularly in the presence of STK11/KRAS alterations. We hypothesized that, beyond co-occurring genomic events, clonality prediction may help identify deleterious KEAP1 mutations and their counterparts with retained sensitivity to ICIs. PATIENTS AND METHODS Beta-binomial modelling of sequencing read counts was used to infer KEAP1 clonal inactivation by combined somatic mutation and loss of heterozygosity (KEAP1 C-LOH) versus partial inactivation [KEAP1 clonal diploid-subclonal (KEAP1 CD-SC)] in the Memorial Sloan Kettering Cancer Center (MSK) MetTropism cohort (N = 2550). Clonality/LOH prediction was compared to a streamlined clinical classifier that relies on variant allele frequencies (VAFs) and tumor purity (TP) (VAF/TP ratio). The impact of this classification on survival outcomes was tested in two independent cohorts of LUAD patients treated with immunotherapy (MSK/Rome N = 237; DFCI N = 461). Immune-related features were studied by exploiting RNA-sequencing data (TCGA) and multiplexed immunofluorescence (DFCI mIF cohort). RESULTS Clonality/LOH inference in the MSK MetTropism cohort overlapped with a clinical classification model defined by the VAF/TP ratio. In the ICI-treated MSK/Rome discovery cohort, predicted KEAP1 C-LOH mutations were associated with shorter progression-free survival (PFS) and overall survival (OS) compared to KEAP1 wild-type cases (PFS log-rank P = 0.001; OS log-rank P < 0.001). Similar results were obtained in the DFCI validation cohort (PFS log-rank P = 0.006; OS log-rank P = 0.014). In both cohorts, we did not observe any significant difference in survival outcomes when comparing KEAP1 CD-SC and wild-type tumors. Immune deconvolution and multiplexed immunofluorescence revealed that KEAP1 C-LOH and KEAP1 CD-SC differed for immune-related features. CONCLUSIONS KEAP1 C-LOH mutations are associated with an immune-excluded phenotype and worse clinical outcomes among advanced LUAD patients treated with ICIs. By contrast, survival outcomes of patients whose tumors harbored KEAP1 CD-SC mutations were similar to those with KEAP1 wild-type LUADs.
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Affiliation(s)
- S Scalera
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - B Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M Mazzotta
- Medical Oncology Unit, Sandro Pertini Hospital, Rome, Italy
| | - N Calonaci
- Department of Mathematics and Geosciences, University of Trieste, Trieste, Italy
| | - J V Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - L Cipriani
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - G Bon
- Cellular Network and Molecular Therapeutic Target Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - B Messina
- Clinical Trial Center, Biostatistics and Bioinformatics Division, IRCCS Regina Elena National Cancer Institute, Roma, Italy
| | - G Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - A Di Federico
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - F Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Milite
- Department of Mathematics and Geosciences, University of Trieste, Trieste, Italy
| | - E Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - P Vici
- UOSD Phase IV Studies, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - A Vecchione
- Department of Clinical and Molecular Medicine, Pathology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - F De Nicola
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - L Ciuffreda
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - F Goeman
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Fanciulli
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S Buglioni
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - E Pescarmona
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - B Sharma
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA
| | - K D Felt
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA
| | - J Lindsay
- Knowledge Systems Group, Dana-Farber Cancer Institute, Boston, USA
| | - S J Rodig
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA; Department of Pathology, Brigham and Women's Hospital, Boston, USA
| | - R De Maria
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Caravagna
- Department of Mathematics and Geosciences, University of Trieste, Trieste, Italy
| | - F Cappuzzo
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - G Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M Maugeri-Saccà
- Clinical Trial Center, Biostatistics and Bioinformatics Division, IRCCS Regina Elena National Cancer Institute, Roma, Italy; Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
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Lamberti G, Sadeghi H, Fernandes M, Filho S, Marchizeli J, Knychala R, Lucy M, Moraes J. 14 Effect of breed on oocyte recovery and embryo production following ovum pickup and fertility outcomes after transferring fresh. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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Ricciuti B, Alessi JV, Elkrief A, Wang X, Cortellini A, Li YY, Vaz VR, Gupta H, Pecci F, Barrichello A, Lamberti G, Nguyen T, Lindsay J, Sharma B, Felt K, Rodig SJ, Nishino M, Sholl LM, Barbie DA, Negrao MV, Zhang J, Cherniack AD, Heymach JV, Meyerson M, Ambrogio C, Jänne PA, Arbour KC, Pinato DJ, Skoulidis F, Schoenfeld AJ, Awad MM, Luo J. Dissecting the clinicopathologic, genomic, and immunophenotypic correlates of KRAS G12D-mutated non-small-cell lung cancer. Ann Oncol 2022; 33:1029-1040. [PMID: 35872166 PMCID: PMC11006449 DOI: 10.1016/j.annonc.2022.07.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [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: 04/17/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Allele-specific KRAS inhibitors are an emerging class of cancer therapies. KRAS-mutant (KRASMUT) non-small-cell lung cancers (NSCLCs) exhibit heterogeneous outcomes, driven by differences in underlying biology shaped by co-mutations. In contrast to KRASG12C NSCLC, KRASG12D NSCLC is associated with low/never-smoking status and is largely uncharacterized. PATIENTS AND METHODS Clinicopathologic and genomic information were collected from patients with NSCLCs harboring a KRAS mutation at the Dana-Farber Cancer Institute (DFCI), Memorial Sloan Kettering Cancer Center, MD Anderson Cancer Center, and Imperial College of London. Multiplexed immunofluorescence for CK7, programmed cell death protein 1 (PD-1), programmed death-ligand 1 (PD-L1), Foxp3, and CD8 was carried out on a subset of samples with available tissue at the DFCI. Clinical outcomes to PD-(L)1 inhibition ± chemotherapy were analyzed according to KRAS mutation subtype. RESULTS Of 2327 patients with KRAS-mutated (KRASMUT) NSCLC, 15% (n = 354) harbored KRASG12D. Compared to KRASnon-G12D NSCLC, KRASG12D NSCLC had a lower pack-year (py) smoking history (median 22.5 py versus 30.0 py, P < 0.0001) and was enriched in never smokers (22% versus 5%, P < 0.0001). KRASG12D had lower PD-L1 tumor proportion score (TPS) (median 1% versus 5%, P < 0.01) and lower tumor mutation burden (TMB) compared to KRASnon-G12D (median 8.4 versus 9.9 mt/Mb, P < 0.0001). Of the samples which underwent multiplexed immunofluorescence, KRASG12D had lower intratumoral and total CD8+PD1+ T cells (P < 0.05). Among 850 patients with advanced KRASMUT NSCLC who received PD-(L)1-based therapies, KRASG12D was associated with a worse objective response rate (ORR) (15.8% versus 28.4%, P = 0.03), progression-free survival (PFS) [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.45-2.00, P = 0.003], and overall survival (OS; HR 1.45, 1.05-1.99, P = 0.02) to PD-(L)1 inhibition alone but not to chemo-immunotherapy combinations [ORR 30.6% versus 35.7%, P = 0.51; PFS HR 1.28 (95%CI 0.92-1.77), P = 0.13; OS HR 1.36 (95%CI 0.95-1.96), P = 0.09] compared to KRASnon-G12D. CONCLUSIONS KRASG12D lung cancers harbor distinct clinical, genomic, and immunologic features compared to other KRAS-mutated lung cancers and worse outcomes to PD-(L)1 blockade. Drug development for KRASG12D lung cancers will have to take these differences into account.
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Affiliation(s)
- B Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J V Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - A Elkrief
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - X Wang
- Harvard School of Public Health, Boston, USA
| | - A Cortellini
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - Y Y Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Cancer Program, Broad Institute of Harvard and Massachusetts Institute of Technology (MIT), Cambridge, USA
| | - V R Vaz
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - H Gupta
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - F Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - A Barrichello
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - G Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - T Nguyen
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J Lindsay
- Knowledge Systems Group, Dana-Farber Cancer Institute, Boston, USA
| | - B Sharma
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA
| | - K Felt
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA
| | - S J Rodig
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA; Department of Pathology, Brigham and Women's Hospital, Boston, USA
| | - M Nishino
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, Boston, USA
| | - L M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, USA
| | - D A Barbie
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - M V Negrao
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Zhang
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - A D Cherniack
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - M Meyerson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - C Ambrogio
- Molecular Biotechnology and Health Science, University of Turin, Turin, Italy
| | - P A Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - K C Arbour
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D J Pinato
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - F Skoulidis
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - A J Schoenfeld
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J Luo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA.
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Alessi J, Elkrief A, Ricciuti B, Cortellini A, Wang X, Vaz V, Barrichello A, Lamberti G, Fulgenzi C, Pecci F, Pinato D, Schoenfeld A, Awad M. EP08.01-043 Clinicopathologic and Genomic Factors Impacting Efficacy of First-Line Chemoimmunotherapy in Advanced Non-small Cell Lung Cancer (NSCLC). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pecci F, Ricciuti B, Alden S, Alessi J, Vaz V, Barrichiello A, Lamberti G, Awad M. P1.15-03 Clinical Outcomes Among Patients with Non-small Cell Lung Cancer Who Discontinued Immune Checkpoint Inhibitors Due to Toxicity. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Andrini E, Lamberti G, Mazzoni F, Riccardi F, Bonetti A, Follador A, Giardina D, Genova C, Guaitoli G, Frassoldati A, Brighenti M, Colantonio I, Pasello G, Ficorella C, Cinieri S, Tiseo M, Gelsomino F, Tognetto M, Rihawi K, Ardizzoni A. EP14.01-006 CeLEBrATE: Phase II trial of CarbopLatin, Etoposide, Bevacizumab and Atezolizumab in Patients with exTEnsive-Stage SCLC-GOIRC-01-2019. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Andrini E, Lamberti G, Argalia G, Fortunati E, Ambrosini V, Fanti S, Campana D, Ardizzoni A. MA01.08 Impact of [18F]FDG PET/CT-derived Metabolic Parameters on Outcomes in Extensive-stage SCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Andrini E, Lamberti G, Argalia G, Fortunati E, Ambrosini V, Fanti S, Ardizzoni A, Campana D. 149P Total metabolic tumor volume: A new potential prognostic factor in SCLC. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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9
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Rossi RE, Milanetto AC, Andreasi V, Campana D, Coppa J, Nappo G, Rinzivillo M, Invernizzi P, Modica R, David A, Partelli S, Lamberti G, Mazzaferro V, Zerbi A, Panzuto F, Pasquali C, Falconi M, Massironi S. Risk of preoperative understaging of duodenal neuroendocrine neoplasms: a plea for caution in the treatment strategy. J Endocrinol Invest 2021; 44:2227-2234. [PMID: 33651317 DOI: 10.1007/s40618-021-01528-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/04/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Pretreatment staging is the milestone for planning either surgical or endoscopic treatment in duodenal neuroendocrine neoplasms (dNENs). Herein, a series of surgically treated dNEN patients was evaluated to assess the concordance between the pre- and postsurgical staging. METHODS Retrospective analysis of patients with a histologically confirmed diagnosis of dNENs, who underwent surgical resection observed at eight Italian tertiary referral centers. The presurgical TNM stage, based on the radiological and functional imaging, was compared with the pathological TNM stage, after surgery. RESULTS From 2000 to 2019, 109 patients were included. Sixty-six patients had G1, 26 a G2, 7 a G3 dNEN (Ki-67 not available in 10 patients). In 46/109 patients (42%) there was disagreement between the pre- and postsurgical staging, being it understaged in 42 patients (38%), overstaged in 4 (3%). As regards understaging, in 25 patients (22.9%), metastatic loco-regional nodes (N) resulted undetected at both radiological and functional imaging. Understaging due to the presence of distal micrometastases (M) was observed in 2 cases (1.8%). Underestimation of tumor extent (T) was observed in 12 patients (11%); in three cases the tumor was understaged both in T and N extent. CONCLUSIONS Conventional imaging has a poor detection rate for loco-regional nodes and micrometastases in the presurgical setting of the dNENs. These results represent important advice when local conservative approaches, such as endoscopy or local surgical excision are considered and it represents a strong recommendation to include endoscopic ultrasound in the preoperative tools for a more accurate local staging.
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Affiliation(s)
- R E Rossi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
- HBP Surgery, Hepatology and Liver Transplantation Unit, ENETS Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori (INT, National Cancer Institute), Milan, Italy.
| | - A C Milanetto
- Pancreatic and Endocrine Digestive Surgical Unit, Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padua, Italy
| | - V Andreasi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, ENETS Center of Excellence, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
| | - D Campana
- Department of Experimental, Diagnostic and Specialty Medicine, ENETS Center of Excellence, Bologna University, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - J Coppa
- HBP Surgery, Hepatology and Liver Transplantation Unit, ENETS Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori (INT, National Cancer Institute), Milan, Italy
| | - G Nappo
- Pancreatic Surgery, Humanitas Clinical, and Research Center-IRCCS, ENETS Center of Excellence, Humanitas University, Milan, Rozzano, Italy
| | - M Rinzivillo
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - P Invernizzi
- Division of Gastroenterology, San Gerardo Hospital, Bicocca School of Medicine, University of Milano, Monza, Italy
| | - R Modica
- Division of Endocrinology, Department of Clinical Medicine and Surgery, ENETS Center of Excellence, University "Federico II" of Naples, Naples, Italy
| | - A David
- Pancreatic and Endocrine Digestive Surgical Unit, Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padua, Italy
| | - S Partelli
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, ENETS Center of Excellence, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
| | - G Lamberti
- Department of Experimental, Diagnostic and Specialty Medicine, ENETS Center of Excellence, Bologna University, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V Mazzaferro
- HBP Surgery, Hepatology and Liver Transplantation Unit, ENETS Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori (INT, National Cancer Institute), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A Zerbi
- Pancreatic Surgery, Humanitas Clinical, and Research Center-IRCCS, ENETS Center of Excellence, Humanitas University, Milan, Rozzano, Italy
| | - F Panzuto
- Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - C Pasquali
- Pancreatic and Endocrine Digestive Surgical Unit, Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padua, Italy
| | - M Falconi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, ENETS Center of Excellence, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
| | - S Massironi
- Division of Gastroenterology, San Gerardo Hospital, Bicocca School of Medicine, University of Milano, Monza, Italy
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Cortellini A, Ricciuti B, Facchinetti F, Alessi JVM, Venkatraman D, Dall'Olio FG, Cravero P, Vaz VR, Ottaviani D, Majem M, Piedra A, Sullivan I, Lee KA, Lamberti G, Hussain N, Clark J, Bolina A, Barba A, Benitez JC, Gorría T, Mezquita L, Hoton D, Aboubakar Nana F, Besse B, Awad MM, Pinato DJ. Antibiotic-exposed patients with non-small-cell lung cancer preserve efficacy outcomes following first-line chemo-immunotherapy. Ann Oncol 2021; 32:1391-1399. [PMID: 34400292 DOI: 10.1016/j.annonc.2021.08.1744] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 03/23/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Prior antibiotic therapy (pATB) is known to impair efficacy of single-agent immune checkpoint inhibitors (ICIs), potentially through the induction of gut dysbiosis. Whether ATB also affects outcomes to chemo-immunotherapy combinations is still unknown. PATIENTS AND METHODS In this international multicentre study, we evaluated the association between pATB, concurrent ATB (cATB) and overall survival (OS), progression-free survival (PFS) and objective response rate (ORR) in patients with non-small-cell lung cancer (NSCLC) treated with first-line chemo-immunotherapy at eight referral institutions. RESULTS Among 302 patients with stage IV NSCLC, 216 (71.5%) and 61 (20.2%) patients were former and current smokers, respectively. Programmed death-ligand 1 tumour expression in assessable patients (274, 90.7%) was ≥50% in 76 (25.2%), 1%-49% in 84 (27.9%) and <1% in 113 (37.5%). Multivariable analysis showed pATB-exposed patients to have similar OS {hazard ratio (HR) = 1.42 [95% confidence interval (CI): 0.91-2.22]; P = 0.1207} and PFS [HR = 1.12 (95% CI: 0.76-1.63); P = 0.5552], compared to unexposed patients, regardless of performance status. Similarly, no difference with respect to ORR was found across pATB exposure groups (42.6% versus 57.4%, P = 0.1794). No differential effect was found depending on pATB exposure duration (≥7 versus <7 days) and route of administration (intravenous versus oral). Similarly, cATB was not associated with OS [HR = 1.29 (95% CI: 0.91-1.84); P = 0.149] and PFS [HR = 1.20 (95% CI: 0.89-1.63); P = 0.222] when evaluated as time-varying covariate in multivariable analysis. CONCLUSIONS In contrast to what has been reported in patients receiving single-agent ICIs, pATB does not impair clinical outcomes to first-line chemo-immunotherapy of patients with NSCLC. pATB status should integrate currently available clinico-pathologic factors for guiding first-line treatment decisions, whilst there should be no concern in offering cATB during chemo-immunotherapy when needed.
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Affiliation(s)
- A Cortellini
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy; Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK.
| | - B Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - F Facchinetti
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France
| | - J V M Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - D Venkatraman
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - F G Dall'Olio
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - P Cravero
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - V R Vaz
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - D Ottaviani
- Cancer Division, University College London Hospitals, London, UK
| | - M Majem
- Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - A Piedra
- Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - I Sullivan
- Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - K A Lee
- Department of Medical Oncology, Royal Marsden Hospital, London, UK; Department of Twin Research and Genetic Epidemiology, St Thomas's Hospital, King's College London, London, UK
| | - G Lamberti
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - N Hussain
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - J Clark
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - A Bolina
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - A Barba
- Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - J C Benitez
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - T Gorría
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - L Mezquita
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - D Hoton
- Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - F Aboubakar Nana
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL et Dermatologie (PNEU), Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - B Besse
- Cancer Medicine Department, Gustave Roussy, Villejuif, France; University Paris-Saclay, School of Medicine, Villejuif, France
| | - M M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - D J Pinato
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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Ricciuti B, Arbour K, Lin J, Vajdi A, Tolstorukov M, Hong L, Zhang J, Vokes N, Li Y, Spurr L, Cherniack A, Recondo G, Lamberti G, Rizvi H, Egger J, Plodkowski A, Khosrowjerdi S, Digumarthy S, Vaz N, Park H, Nishino M, Sholl L, Barbie D, Altan M, Heymach J, Skoulidis F, Gainor J, Hellmann M, Awad M. P14.26 Diminished Efficacy of PD-(L)1 Inhibition in STK11- and KEAP1-Mutant Lung Adenocarcinoma is Impacted by KRAS Mutation Status. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.532] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Massironi S, Campana D, Pusceddu S, Albertelli M, Faggiano A, Panzuto F, Smiroldo V, Andreasi V, Rossi RE, Maggio I, Torchio M, Dotto A, Modica R, Rinzivillo M, Carnaghi C, Partelli S, Fanetti I, Lamberti G, Corti F, Ferone D, Colao A, Annibale B, Invernizzi P, Falconi M. Second primary neoplasms in patients with lung and gastroenteropancreatic neuroendocrine neoplasms: Data from a retrospective multi-centric study. Dig Liver Dis 2021; 53:367-374. [PMID: 33645508 DOI: 10.1016/j.dld.2020.09.031] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients with sporadic neuroendocrine neoplasms may exhibit a higher risk of a second primary tumor than the general population. AIM This study aimed to analyze the occurrence of second primary malignancies. METHODS A retrospective cohort of 2757 patients with sporadic lung and gastro-entero-pancreatic neuroendocrine neoplasms, managed at eight Italian tertiary referral Centers, was included. RESULTS Between 2000 and 2019, a second primary malignancy was observed in 271 (9.8%) neuroendocrine neoplasms patients with 32 developing a third tumor. There were 135 (49.8%) females and the median age was 64 years. The most frequent locations of the second tumors were breast (18.8%), prostate (12.5%), colon (9.6%), blood tumors (8.5%), and lung (7.7%). The second primary tumor was synchronous in 19.2% of cases, metachronous in 43.2%, and previous in 37.6%. As concerned the neuroendocrine neoplasms, the 5- and 10-year survival rates were 87.8% and 74.4%, respectively. PFS for patients with a second primary malignancy was shorter than for patients without a second primary malignancy. Death was mainly related to neuroendocrine neoplasms. CONCLUSION In NEN patients the prevalence of second primary malignancies was not negligible, suggesting a possible neoplastic susceptibility. Overall survival was not affected by the occurrence of a second primary malignancy.
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Affiliation(s)
- S Massironi
- Division Gastroenterology, San Gerardo Hospital, University of Milano - Bicocca School of Medicine, Via Pergolesi 33, 20900 Monza (MB), Italy.
| | - D Campana
- NET Team Bologna, ENETS Center of Excellence, "S. Orsola-Malpighi" University Hospital, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - S Pusceddu
- Department of Medical Oncology, ENETS Center of Excellence, Fondazione IRCCS Istituto Tumori Milano, Milan, Italy
| | - M Albertelli
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, and Department of Internal Medicine and Medical Specialties (DiMI), Center of Excellence for Biomedical Research, University of Genova, Genoa, Italy
| | - A Faggiano
- Department of Experimental Medicine, "Sapienza University of Rome" Rome, Italy
| | - F Panzuto
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy
| | - V Smiroldo
- UO Oncologia Medica ed Ematologia, Humanitas Cancer Center, ENETS Center of Excellence, Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - V Andreasi
- Pancreatic Surgery Unit, ENETS Center of Excellence, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
| | - R E Rossi
- Gastrointestinal and Hepato-Pancreatic Surgery and Liver Transplantation Unit, ENETS Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori (INT, National Cancer Institute) and Department of Pathophysiology and Organ Transplant, Università degli Studi di Milano, Milan, Italy
| | - I Maggio
- NET Team Bologna, ENETS Center of Excellence, "S. Orsola-Malpighi" University Hospital, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - M Torchio
- Department of Medical Oncology, ENETS Center of Excellence, Fondazione IRCCS Istituto Tumori Milano, Milan, Italy
| | - A Dotto
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, and Department of Internal Medicine and Medical Specialties (DiMI), Center of Excellence for Biomedical Research, University of Genova, Genoa, Italy
| | - R Modica
- Department of Clinical Medicine and Surgery, ENETS Center of Excellence, Federico II University of Naples, Naples, Italy
| | - M Rinzivillo
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy
| | - C Carnaghi
- UO Oncologia Medica, Comprensorio Sanitario Bolzano, Bozen, Italy
| | - S Partelli
- Pancreatic Surgery Unit, ENETS Center of Excellence, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
| | - I Fanetti
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - G Lamberti
- NET Team Bologna, ENETS Center of Excellence, "S. Orsola-Malpighi" University Hospital, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - F Corti
- Department of Medical Oncology, ENETS Center of Excellence, Fondazione IRCCS Istituto Tumori Milano, Milan, Italy
| | - D Ferone
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, and Department of Internal Medicine and Medical Specialties (DiMI), Center of Excellence for Biomedical Research, University of Genova, Genoa, Italy
| | - A Colao
- Department of Clinical Medicine and Surgery, ENETS Center of Excellence, Federico II University of Naples, Naples, Italy
| | - B Annibale
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy; Department of Medical-Surgical Sciences and Translational Medicine, "La Sapienza" University of Rome, Rome, Italy
| | - P Invernizzi
- Division Gastroenterology, San Gerardo Hospital, University of Milano - Bicocca School of Medicine, Via Pergolesi 33, 20900 Monza (MB), Italy
| | - M Falconi
- Pancreatic Surgery Unit, ENETS Center of Excellence, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy
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13
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Lamberti G, Maggio I, Manuzzi L, Siepe G, Campana D. 1088P Efficacy of post-operative radiation therapy in non-metastatic Merkel cell carcinoma: A registry-based analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Maggio I, Panzuto F, Manuzzi L, Dall'Olio V, Rinzivillo M, Campana D, Lamberti G. 1179P Therapeutic sequences in advanced grade 1-2 pancreatic neuroendocriene tumours (pNET). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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15
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Maggio I, Mollica V, Brighi N, Lamberti G, Manuzzi L, Ricci AD, Campana D. The functioning side of the pancreas: a review on insulinomas. J Endocrinol Invest 2020; 43:139-148. [PMID: 31368049 DOI: 10.1007/s40618-019-01091-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/24/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Insulinomas are a rare type of neuroendocrine tumors, originating in the pancreas, difficult to diagnose and to treat. Due to its rarity, insulinomas are a not well-known pathological entity; thus, the diagnostic process is frequently a medical challenge with many possible differential diagnoses. The diagnostic process varies between non-invasive procedures, such as the fasting test or imaging techniques, and invasive ones. Insulinomas are rarely malignant, but the glycemic imbalance correlated with this tumor can frequently alter the quality of life of the patients and the consequent hypoglycemia can be extremely dangerous. Moreover, insulinomas can be associated with different genetic syndromes, such as Multiple Endocrine Neoplasia 1, accompanied by other specific symptoms. There are many different treatment strategies, depending on the need to control symptoms or control diseases progression, the only curative one being surgery. METHODS AND RESULTS We reviewed the evidences present in the literature on insulinomas and reported its main clinical characteristics and management strategies. CONCLUSION The aim of this review of the literature is to present the current knowledge on insulinomas, exploring the main clinical characteristics, the diagnostic tools, and the therapeutic strategies.
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Affiliation(s)
- I Maggio
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - V Mollica
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - N Brighi
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
- NET Team Bologna ENETS Center of Excellence, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - G Lamberti
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - L Manuzzi
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - A D Ricci
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - D Campana
- NET Team Bologna ENETS Center of Excellence, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
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16
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Cani M, Incorvaia L, Fanale D, De Luca I, Gelsomino F, Ibrahim T, Pusceddu S, Riccardi F, Tafuto S, Lamberti G, Faggiano A, La salvia A, Albertelli M, Massironi S, Rinzivillo M, butturini G, Bazan V, Campana D, Russo A, Badalamenti G. Safety of high doses of somatostatin analogs in well differentiated NENs in elderly. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz245.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Recondo G, Bahcall M, Sholl L, Leonardi G, Ricciuti B, Nguyen T, Venkatraman D, Lamberti G, Umeton R, Jänne P, Awad M. MA09.11 Mechanisms of Resistance to MET Tyrosine Kinase Inhibitors in Patients with MET Exon 14 Mutant Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Dall’Olio F, Lamberti G, Capizzi E, Gruppioni E, Sperandi F, Altimari A, Giunchi F, Fiorentino M, Ardizzoni A. Clinical significance of ROS1 5’ deletions detected by FISH and response to crizotinib. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Baricich A, de Sire A, Antoniono E, Gozzerino F, Lamberti G, Cisari C, Invernizzi M. Recovery from vegetative state of patients with a severe brain injury: a 4-year real-practice prospective cohort study. Funct Neurol 2018; 32:131-136. [PMID: 29042001 DOI: 10.11138/fneur/2017.32.3.131] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Patients who have suffered severe traumatic or nontraumatic brain injuries can show a progressive recovery, transitioning through a range of clinical conditions. They may progress from coma to a vegetative state (VS) and/or a minimally conscious state (MCS). A longer duration of the VS is known to be related to a lower probability of emergence from it; furthermore, the literature seems to lack evidence of late improvements in these patients. This real-practice prospective cohort study was conducted in inpatients in a VS following a severe brain injury, consecutively admitted to a vegetative state unit (VSU). The aim of the study was to assess their recovery in order to identify variables that might increase the probability of a VS patient transitioning to MCS. Rehabilitation treatment included passive joint mobilisation and helping/placing patients into an upright sitting position on a tilt table. All the patients underwent a specific assessment protocol every month to identify any emergence, however late, from the VS. Over a 4-year period, 194 patients suffering sequelae of a severe brain injury, consecutively seen, had an initial Glasgow Coma Scale score ≤ 8. Of these, 63 (32.5%) were in a VS, 84 (43.3%) in a MCS, and 47 (24.2%) in a coma; of the 63 patients admitted in a VS, 49 (57.1% males and 42.9% females, mean age 25.34 ± 19.12 years) were transferred to a specialist VSU and put on a slow-to-recover brain injury programme. Ten of these 49 patients were still in a VS after 36 months; of these 10, 3 recovered consciousness, transitioning to a MCS, 2 died, and 5 remained in a VS during the last 12 months of the observation. Univariate analysis identified male sex, youth, a shorter time from onset of the VS, diffuse brain injury, and the presence of status epilepticus as variables increasing the likelihood of transition to a MCS. Long-term monitoring of patients with chronic disorders of consciousness should be adequately implemented in order to optimise their access to rehabilitation services.
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20
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Caccavo D, Cascone S, Lamberti G, Barba AA. Hydrogels: experimental characterization and mathematical modelling of their mechanical and diffusive behaviour. Chem Soc Rev 2018; 47:2357-2373. [DOI: 10.1039/c7cs00638a] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Hydrogels are materials widely used in biomedical, pharmaceutical, and nutraceutical applications. Knowledge of their mechanical and diffusive behaviour is desired to design new hydrogels-based-systems.
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Affiliation(s)
- D. Caccavo
- Dept. Industrial Engineering
- University of Salerno
- Fisciano
- Italy
| | - S. Cascone
- Dept. Industrial Engineering
- University of Salerno
- Fisciano
- Italy
| | - G. Lamberti
- Dept. Industrial Engineering
- University of Salerno
- Fisciano
- Italy
| | - A. A. Barba
- Dept. Pharmacy
- University of Salerno
- Fisciano
- Italy
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21
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Caccavo D, Barba A, d'Amore M, De Piano R, Lamberti G, Rossi A, Colombo P. Modeling the modified drug release from curved shape drug delivery systems – Dome Matrix®. Eur J Pharm Biopharm 2017; 121:24-31. [DOI: 10.1016/j.ejpb.2017.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/23/2017] [Accepted: 08/25/2017] [Indexed: 01/01/2023]
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Affiliation(s)
- D. Caccavo
- Department of Industrial Engineering, University of Salerno, Fisciano (SA), Italy
| | - S. Cascone
- Department of Industrial Engineering, University of Salerno, Fisciano (SA), Italy
| | - P. Apicella
- Department of Industrial Engineering, University of Salerno, Fisciano (SA), Italy
| | - G. Lamberti
- Department of Industrial Engineering, University of Salerno, Fisciano (SA), Italy
| | - A. A. Barba
- Department of Pharmacy, University of Salerno, Fisciano (SA), Italy
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23
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Caccavo D, Lamberti G. PoroViscoElastic model to describe hydrogels' behavior. Mater Sci Eng C Mater Biol Appl 2017; 76:102-113. [PMID: 28482465 DOI: 10.1016/j.msec.2017.02.155] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 02/24/2017] [Accepted: 02/26/2017] [Indexed: 11/25/2022]
Abstract
Hydrogels are three-dimensional, cross-linked hydrophilic polymeric network able of absorb large amount of water. The mechanics of these systems is strictly coupled with the water transport resulting in the peculiar behavior known as poroviscoelasticy. This can be considered as sum of the viscoelastic behavior of the polymeric network and the poroelastic behavior caused by the water movement within the hydrogel. In this work a 3D monophasic model able to depict the poroviscoelastic behavior of these systems, within the field of nonlinear solid mechanics, is developed. The mass and momentum balances equations, supported by constitutive equations from non-equilibrium thermodynamics and by initial and boundary conditions, is implemented through the weak formulation in a commercial FEM-based software. A parametric study is performed in order to assess the relative importance of the model parameters on hydrogels' behavior.
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Affiliation(s)
- D Caccavo
- Department of Industrial Engineering, Università degli Studi di Salerno, 84084 Fisciano (SA), Italy.
| | - G Lamberti
- Department of Industrial Engineering, Università degli Studi di Salerno, 84084 Fisciano (SA), Italy
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24
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Bochicchio S, Sala M, Spensiero A, Scala MC, Gomez-Monterrey IM, Lamberti G, Barba AA. On the design of tailored liposomes for KRX29 peptide delivery. NEW J CHEM 2017. [DOI: 10.1039/c7nj03115g] [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: 11/21/2022]
Abstract
The high interest in therapeutic peptides, due to the specificity of their mechanisms of action, has stimulated the research of new delivery strategies to overcome bioavailability problems concerning the use of peptides in their naked form. In this study liposomal suitable delivery system was designed and produced.
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Affiliation(s)
- S. Bochicchio
- Dipartimento di Farmacia
- University of Salerno
- Fisciano (SA)
- Italy
| | - M. Sala
- Dipartimento di Farmacia
- University of Salerno
- Fisciano (SA)
- Italy
| | - A. Spensiero
- Dipartimento di Farmacia
- University of Salerno
- Fisciano (SA)
- Italy
| | - M. C. Scala
- Dipartimento di Farmacia
- University of Salerno
- Fisciano (SA)
- Italy
| | | | - G. Lamberti
- Dipartimento di Ingegneria Industriale
- University of Salerno
- Italy
| | - A. A. Barba
- Dipartimento di Farmacia
- University of Salerno
- Fisciano (SA)
- Italy
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25
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Lamberti G, Rossi G, Grillo F, Spada F, Pusceddu S, Rinzivillo M, Massironi S, Tafuto S, Faggiano A, Antonuzzo L, Luppi G, Albertelli M, Fazio N, Vernieri C, Delle Fave G, Brighi N, Ferone D, Campana D. Appendiceal neuroendocrine tumors: a large multicentre Italian series. Preliminary result. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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26
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Barba AA, Bochicchio S, Lamberti G, Dalmoro A. Ultrasonic energy in liposome production: process modelling and size calculation. Soft Matter 2014; 10:2574-2581. [PMID: 24647821 DOI: 10.1039/c3sm52879k] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The use of liposomes in several fields of biotechnology, as well as in pharmaceutical and food sciences is continuously increasing. Liposomes can be used as carriers for drugs and other active molecules. Among other characteristics, one of the main features relevant to their target applications is the liposome size. The size of liposomes, which is determined during the production process, decreases due to the addition of energy. The energy is used to break the lipid bilayer into smaller pieces, then these pieces close themselves in spherical structures. In this work, the mechanisms of rupture of the lipid bilayer and the formation of spheres were modelled, accounting for how the energy, supplied by ultrasonic radiation, is stored within the layers, as the elastic energy due to the curvature and as the tension energy due to the edge, and to account for the kinetics of the bending phenomenon. An algorithm to solve the model equations was designed and the relative calculation code was written. A dedicated preparation protocol, which involves active periods during which the energy is supplied and passive periods during which the energy supply is set to zero, was defined and applied. The model predictions compare well with the experimental results, by using the energy supply rate and the time constant as fitting parameters. Working with liposomes of different sizes as the starting point of the experiments, the key parameter is the ratio between the energy supply rate and the initial surface area.
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Affiliation(s)
- A A Barba
- Dipartimento di Farmacia, Università di Salerno, 84084 Fisciano, SA, Italy
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Zampolini M, Corea F, Avesani R, Boldrini P, De Tanti A, Di Stefano MG, Formisano R, Lamberti G, Lombardi F, Mazzucchi A, Pistarini C, Taricco M, Citterio A. Rehabilitation of acquired brain injuries: a multicentric prospective survey. Eur J Phys Rehabil Med 2013; 49:365-372. [PMID: 23389644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The rehabilitation of the persons with Severe Acquired Brain Injury (ABI) is an important concern to be approached with a comprehensive program aimed to improve the recovery of patients.The efficacy of an early and intensive rehabilitation program has been shown in large number of studies. Few studies focused on the prevalence of TBI and the data are often extrapolated in indirect ways. AIM An analysis of the demographic characteristics of the population included in the GISCAR (Gruppo Italiano per lo Studio delle Gravi Cerebrolesioni Acquisite e Riabilitazione- Italian Group for the Study of the severe ABI) database, type and conditions associated to the index event; the treatment administered during hospitalization; and the prognosis according to outcome measures. DESIGN The study was an observational prospective survey looking at management of ABI (both traumatic and non-traumatic). SETTING In hospital rehabilitation. POPULATION Patients consecutively admitted in each of the 52 GISCAR centres. METHODS Every centre included a consecutive cohort and recorded demographic data and index event characteristics. RESULTS In the study population were included 2626 subjects suffering of a severe ABI. The difference of length of stay (LOS) was significantly different with 67.5 days for traumatic patients compared to the 80 days of non traumatic ones. In the study population the probability of discharge at home is significantly greater for the traumatic condition (odds ratio 0,4587; CI 0.3671-0.5731). The overall benefit of the rehabilitative treatment was encountered in a net gain in all disability scores taken into account: LCF classes; DRS as well as GOS scores. At discharge the main destination for severe ABI patients was home (67.2%). CONCLUSIONS A large number of patients admitted in Italian rehabilitative facilities for a severe ABI suffered from a TBI, more often these subjects were young male victims of road accident. The majority of subjects during the rehabilitative hospitalization demonstrated a significant recovery. CLINICAL REHABILITATION IMPACT Considering the evidence of an early treatment benefit the delay ofthe rehabilitation program start is far from being satisfactory. The high frequency of the home discharge indicate a good compliance of national family network.
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Affiliation(s)
- M Zampolini
- Operative Unit of Severe Acquired Brain Lesions, Asl 3 Umbria, Foligno, Perugia, Italy -
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Abstract
Abstract
The crystallization of a polymer melt, taking place during transformation processes, has a great impact on the process itself, mainly because it causes a large increase in the viscosity (hardening). Knowledge of the hardening kinetics is important for modeling and controlling the transformation processes. In this work, first an overview is given of the experimental and modeling work on the hardening of crystallizing polymers. Next, we present isothermal crystallization experiments using differential scanning calorimetry (DSC) and rotational rheometry to measure the dynamic viscosity. The evolution of the relative crystallinity and normalized complex viscosity are correlated by a novel technique which allows simultaneous analysis of several runs, even if they are not carried out at same temperatures; the main requirement with the traditional technique. The technique, described in detail in this paper, provides an experimental relationship between the crystallinity and the hardening, i.e. the increase in the viscosity. Moreover, by measuring the dynamic viscosity at different frequencies, surprisingly, a master curve is obtained which combines the effects of shear rate, temperature and the level of crystallinity.
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Affiliation(s)
- G. Lamberti
- Department of Chemical and Food Engineering, University of Salerno, Fisciano (SA), Italy
| | - G. W. M. Peters
- Department of Mechanical Engineering, Technical University of Eindhoven, Eindhoven, The Netherlands
| | - G. Titomanlio
- Department of Chemical and Food Engineering, University of Salerno, Fisciano (SA), Italy
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Grassi G, Scaggiante B, Dapas B, Farra R, Tonon F, Lamberti G, Barba A, Fiorentino S, Fiotti N, Zanconati F, Abrami M, Grassi M. Therapeutic potential of nucleic acid-based drugs in coronary hyper- proliferative vascular diseases. Curr Med Chem 2013; 20:3515-38. [PMID: 23745553 DOI: 10.2174/09298673113209990031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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: 03/01/2013] [Accepted: 03/15/2013] [Indexed: 02/06/2023]
Abstract
The thickening of the vessel wall (intimal hyperplasia) is a pathological process which often follows revascularization approaches such as transluminal angioplasty and artery bypass graft, procedures used to re-vascularize stenotic artery. Despite the significant improvements in the treatment of intimal hyperplasia obtained in the last years, the problem has not completely solved. Nucleic acid based-drugs (NABDs) represent an emergent class of molecules with potential therapeutic value for the treatment of intimal hyperplasia. NABDs of interest in the field of intimal hyperplasia are: ribozymes, DNAzymes, antisense oligonucleotides, decoy oligonucleotides, small interfering RNAs and micro interfering RNAs. These molecules can recognize, in a sequencespecific fashion, a target which, depending on the different NABDs, can be represented by a nucleic acid or a protein. Upon binding, NABDs can down-modulate the functions of the target (mRNA/proteins) and thus they are used to impair the functions of disease-causing biological molecules.In spite of the great therapeutic potential demonstrated by NABDs in many experimental model of intima hyperplasia, their practical use is hindered by the necessity to identify optimal delivery systems to the vasculature. In the first part of this review a brief description of the clinical problem related to intima hyperplasia formation after revascularization procedures is reported. In the second part, the attention is focused on the experimental evidences of NABD therapeutic potential in the prevention of intimal hyperplasia. Finally, in the third part, we will describe the strategies developed to optimize NABD delivery to the diseased vessel.
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Affiliation(s)
- G Grassi
- Department of Life Sciences, University of Trieste, Trieste, Italy.
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Perri P, Fiorica F, D'Angelo S, Lamberti G, Parmeggiani F, Martini A, Carpenteri F, Colosimo C, Micucci M, Perazzini L, De Gugliemo E, Berretta M, Sebastiani A, Cartei F. Ruthenium-106 eye plaque brachytherapy in the conservative treatment of uveal melanoma: a mono-institutional experience. Eur Rev Med Pharmacol Sci 2012; 16:1919-1924. [PMID: 23242717] [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: 06/01/2023]
Abstract
BACKGROUND Traditional treatment for uveal melanoma is the enucleation of the eye with outcomes cosmetically unacceptable and loss of useful vision. Plaque brachytherapy, compared to enucleation, had the advantage to preserve the eye with outcomes cosmetically acceptable and preservation of vision. PATIENTS AND METHODS From July 1990 to December 2009 one hundred forty-two (142) patients (51 males and 91 females) with small to medium uveal melanoma were treated with 106Ru plaque brachytherapy. The patients underwent a complete staging before brachytherapy with indirect ophthalmoscopy and ultrasounds. Mean tumour thickness was 3.26 mm (1.6-6 mm). The dose scheduled was 80-100 Gy to the apex with a maximum dose of 800 Gy to the sclera. RESULTS One hundred forty-two have been treated, nine patients had lost the follow-up and drop out; 133 patients were assessed. Mean follow-up was 7.7 years (6 months-18 years). The overall survival at 5, 10 and 15 years was 92%, 85% and 78% respectively. Cancer fee survival was 95%, 90% and 83%, respectively at 5, 10 and 15 year. Radiation-induced toxicity was represented in 47 patients with a 5 year actuarial survival rate free from complications of 54%. CONCLUSIONS 106Ru plaque brachytherapy is a valid approach for treatment of uveal melanoma. This technique is efficacy and safe, with a low toxicity profile.
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Affiliation(s)
- P Perri
- Department of Ophthalmology, University Hospital Ferrara, Italy.
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Secchiero P, Perri P, Melloni E, Martini A, Lamberti G, Sebastiani A, Zauli G. Decreased levels of soluble TNF-related apoptosis-inducing ligand (TRAIL) in the conjunctival sac fluid of patients with diabetes affected by proliferative retinopathy. Diabet Med 2011; 28:1277-8. [PMID: 21923698 DOI: 10.1111/j.1464-5491.2010.03202.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Etzrodt A, Jung H, Schweissfurth C, Tolxdorff T, Lamberti G. Die Beziehung der Steroid-Hormon-Rezeptoren zum axillären Lymphknotenbefall beim Mammakarzinom. Geburtshilfe Frauenheilkd 2008; 43:726-31. [PMID: 6559147 DOI: 10.1055/s-2008-1036742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
In 337 patients with primary cancer of the breast, the oestrogen and progesterone receptor concentration was correlated to the metastasis of axillary lymph nodes taking into account the age of the patients and the size of the primary tumour. The frequency of axillary lymph node involvement increases significantly with size, although not quite steadily but rather stepwise within the T classification. Whereas the tumour diameter influences the receptor status only slightly, the age of the patients plays a major rôle in the oestrogen receptor concentration. In the age group up to 50 years the oestrogen receptor concentration is significantly lower than in the age group over 50 years. There is no comparable influence of age on progesterone receptor concentration. With all 337 breast cancers, no difference in axillary lymph node metastasis is found either between oestrogen receptor positive and oestrogen receptor negative cancers, or between progesterone receptor positive and progesterone receptor negative cancers. In the age group up to 50 years, if looked upon separately, the oestrogen receptor positive cancers do show significantly more often an axillary lymph node involvement, than do oestrogen receptor negative cancers. As this difference exists in the age group up to 50 years only, it is assumed that endogenous oestradiol favours the axillary spread in oestrogen receptor positive cancers. With oestrogen receptor negative cancers the axillary lymph node involvement increases from the younger to the older age group, explaining why in unselected series the oestrogen receptor negative cancers show a more unfavourable course.
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Del Popolo G, Mosiello G, Pilati C, Lamartina M, Battaglino F, Buffa P, Redaelli T, Lamberti G, Menarini M, Di Benedetto P, De Gennaro M. Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study. Spinal Cord 2008; 46:517-22. [PMID: 18317488 DOI: 10.1038/sj.sc.3102167] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
STUDY DESIGN Thirty-six patients with unsatisfactory treatment of neurogenic bowel dysfunctions (NBD) were enrolled from Spinal Units and Rehabilitation Centers in Italy. Treatment was for 3 weeks using a newly developed integrated system with an enema continence catheter for transanal irrigation (Peristeen, Coloplast A/S Kokkedal Denmark). OBJECTIVES To evaluate the effects of Peristeen Anal Irrigation on NBD and patient quality of life (QoL). SETTING Italy. METHODS Lesion level, ambulatory status and hand functionality were determined in all patients. NBD symptoms and QoL were evaluated before and after treatment, using a specific questionnaire. Statistical analysis was performed using McNemar Test and Sign Test. RESULTS Thirty-six patients were enrolled, and 32 patients completed the study. At the end of the treatment, 28.6% of patients reduced or eliminated their use of pharmaceuticals. Twenty-four patients became less dependent on their caregiver. There was a significant increase in patients' opinion of their intestinal functionality (P=0.001), QoL score (P=0.001) and their answers regarding their degree of satisfaction (P=0.001). A successful outcome was recorded for 68% of patients with fecal incontinence, and for 63% of patients with constipation. CONCLUSION Peristeen Anal Irrigation is a simple therapeutic method for managing NBD and improving QoL. It should be considered as the treatment of choice for NBD, playing a role in the neurogenic bowel analogous to that of intermittent clean catheterization in bladder treatment.
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Affiliation(s)
- G Del Popolo
- Neuro-Urology Spinal Unit, University of Florence, Florence, Italy
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Perri P, Incorvaia C, Costagliola C, Parmeggiani F, Lamberti G, Paduano B, Sebastiani A, Ciro C. Bilateral circumscribed haemangioma of the choroid not associated with systemic vascular syndrome. Br J Ophthalmol 2001; 85:1260-1. [PMID: 11596577 PMCID: PMC1723744 DOI: 10.1136/bjo.85.10.1260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
PURPOSE To evaluate the effect of a hinged lamellar keratotomy on refraction, vision, and corneal topography of postkeratoplasty eyes with high-degree astigmatism. DESIGN Noncomparative, interventional case series. PARTICIPANTS A hinged lamellar keratotomy was performed on nine eyes of nine patients at least 9 months after penetrating keratoplasty and with high-degree astigmatism. All patients were spectacle and contact lens intolerant. INTERVENTION A superiorly hinged lamellar keratotomy (corneal flap), 160 microm in thickness and 9 mm in diameter, was created on all eyes included in this study. Each patient was examined 1 day, 1 month, and 3 months after surgery. MAIN OUTCOME MEASURES Uncorrected visual acuity, best spectacle-corrected visual acuity, refraction, computerized analysis of corneal topography. RESULTS At each postoperative examination time, there was a significant reduction in both average spherical equivalent (P < 0.05) and average absolute value of astigmatism (P < 0.01) over mean preoperative values. The major changes were seen as early as 1 day after surgery, but both progression and regression of the effect were documented at later postoperative examinations. In all patients best spectacle-corrected acuity was maintained or improved after the procedure. Postoperatively, four patients could be successfully corrected either with spectacles (n = 2) or with gas-permeable contact lenses (n = 2). There were no surgical flap or corneal graft complications. CONCLUSIONS Hinged lamellar keratotomy improves vision and refraction of postkeratoplasty eyes with high-degree astigmatism. In some cases it may be so effective as to make planned excimer laser treatment unnecessary.
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Affiliation(s)
- M Busin
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Incorvaia C, Parmeggiani F, Costagliola C, Lamberti G, Ferraresi P, Bernardi F, Sebastiani A. The heterozygous 20210 G/A genotype prevalence in patients affected by central and branch retinal vein occlusion: a pilot study. Graefes Arch Clin Exp Ophthalmol 2001; 239:251-6. [PMID: 11450488 DOI: 10.1007/s004170100266] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Several inherited conditions have been associated with an increased or decreased incidence of retinal vein occlusion (RVO). The A allele in the 20210 G/A prothrombin gene has been found to be associated with systemic venous thrombosis. The aim of this study has been to verify the prevalence of this mutation in patients affected by central RVO (CRVO) or branch RVO (BRVO). METHODS A retrospective study was carried out on 100 consecutive patients suffering from RVO, more than 50 years old, unaffected by systemic diseases known to be associated with markedly increased RVO occurrence. We determined the frequency of this mutation by performing mutagenised amplification of exon 14 followed by restriction analysis of the amplified DNA fragment. RESULTS The overall frequency of prothrombin 20210A allele in RVO patients was 6.0%. All heterozygous patients had suffered from CRVO. In this study subgroup, the frequency of the 20210 G/A prothrombin heterozygosis was 12.0%. The difference in the frequency of this the genetic variant between the CRVO and BRVO groups was statistically significant. None of the conventional RVO risk factors were statistically related to the occurrence of the disease in either the CRVO or the BRVO subgroup. CONCLUSION The prevalence of the prothrombin 20210A mutation observed in CRVO patients is significantly higher than in the normal Italian population. Moreover, the prevalence is significantly greater in CRVO than in BRVO patients. These results raise the possibility that the prothrombin 20210A variant may be considered as a risk factor for CRVO.
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Affiliation(s)
- C Incorvaia
- Department of Ophthalmology, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.
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41
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Incorvaia C, Lamberti G, Parmeggiani F, Ferraresi P, Calzolari E, Bernardi F, Sebastiani A. Idiopathic central retinal vein occlusion in a thrombophilic patient with the heterozygous 20210 G/A prothrombin genotype. Am J Ophthalmol 1999; 128:247-8. [PMID: 10458191 DOI: 10.1016/s0002-9394(99)00069-0] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To report the occurrence of monolateral central retinal vein occlusion in a patient with heterozygous 20210 G/A prothrombin genotype, known to be associated with high thrombophilic risk. METHODS A monolateral central retinal vein occlusion was diagnosed in a 71-year-old woman, who had suffered from a deep vein thrombosis in her left leg at the age of 36 years. Mutations of the genes involved in the coagulation process were investigated by DNA polymerase chain reaction. RESULT DNA analysis showed the patient to be heterozygous for the prothrombin 20210 G/A genetic variation. CONCLUSION The 20210 G/A prothrombin gene mutation may be associated with central retinal vein occlusion.
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Affiliation(s)
- C Incorvaia
- Department of Ophthalmology, University of Ferrara, Italy
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Busin M, Zambianchi L, Franceschelli F, Lamberti G, al-Naweiseh I. Intraoperative cauterization of the cornea can reduce postkeratoplasty refractive error in patients with keratoconus. Ophthalmology 1998; 105:1524-9; discussion 1529-30. [PMID: 9709768 DOI: 10.1016/s0161-6420(98)98040-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of intraoperative corneal cauterization on the postkeratoplasty refraction of patients with keratoconus. DESIGN A randomized clinical trial. PARTICIPANTS Thirty eyes of 29 patients with keratoconus undergoing standard penetrating keratoplasty by the same surgeon were evaluated (MB). INTERVENTION Standard penetrating keratoplasty included the use of an 8.0-mm donor button sutured into a 7.5-mm recipient bed by means of two running 10-0 nylon sutures with 16 bites each. Before trephination of the recipient bed, superficial cauterization causing tissue shrinkage was applied to a 6-mm central area of the cornea of only 15 eyes (group A). The remaining 15 eyes (group B) did not undergo intraoperative cauterization. Before surgery, 6 months, and 13 months after surgery, a complete ophthalmologic examination was performed on each patient, including uncorrected and best-corrected visual acuity, refraction, keratometry, computerized corneal topography, as well as A-scan contact ultrasonography. MAIN OUTCOME MEASURES Postkeratoplasty refractive error was measured. RESULTS Both 6 months (sutures still in place) and 13 months (suture removal performed in all patients) after surgery, the average spherical equivalent was significantly less myopic in the patients undergoing cauterization. At 6 months, it was +1.72 diopters (D) +/- 1.13 D in group A and -3.16 D +/- 2.84 D in group B; at 13 months, it was +0.09 D 1.52 D in group A and -3.89 D +/- 3.01 D in group B. The average keratometric astigmatism also was significantly lower in group A than in group B both at 6 (2.5 D +/- 1.6 D vs. 4.1 D +/- 2.3 D) and 13 months (2.7 D +/- 1.5 D vs. 4.4 D +/- 2.4 D) after surgery. CONCLUSION Cauterization of the central cornea improves the postkeratoplasty refractive results of patients with keratoconus.
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Lamberti G, Pignalosa B, Fusco R, Pignalosa G, Di Govanni A, Sebastiani A. Short-term clinical trial evaluating the efficacy of the combination of apraclonidine 0.5% solution and betaxolol 0.25% suspension. Acta Ophthalmol Scand Suppl 1998:20-1. [PMID: 9589713 DOI: 10.1111/j.1600-0420.1997.tb00454.x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zölzer F, Alberti W, Pelzer T, Lamberti G, Hülskamp FH, Streffer C. Changes in S-phase fraction and micronucleus frequency as prognostic factors in radiotherapy of cervical carcinoma. Radiother Oncol 1995; 36:128-32. [PMID: 7501810 DOI: 10.1016/0167-8140(95)01601-c] [Citation(s) in RCA: 17] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Twenty-five patients with cervical carcinoma were treated with combined external beam and high dose rate afterloading radiotherapy. Biopsies obtained at different time points in the course of therapy were analysed with respect to cell proliferation and cytogenetic damage. The fraction of cells with an S-phase DNA-content as well as the frequency of micronuclei were determined. These two parameters were then related to treatment outcome, in particular patient survival. Neither S-phase fraction nor the micronucleus frequency before radiotherapy were predictive of treatment outcome in this small group of patients. However, when changes in response to therapy were considered, patients whose S-phase fraction decreased and patients whose micronucleus frequency increased tended to have a better prognosis. Although statistical significance was not achieved with either criterion alone, when applied together the combination predicted patient survival quite reliably; the 5-year survival rate of those patients who showed a decrease in S-phase fraction as well as an increase in micronucleus frequency was about 90% in contrast to less than 30% for the non-responders (p < 0.03).
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Affiliation(s)
- F Zölzer
- Institut für Medizinische Strahlenbiologie, Universitätsklinikum Essen, Germany
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Gebauer W, Lamberti G. [Neuropsychological analysis of schizophrenia-induced attention deficits--attempt at an overview]. Rehabilitation (Stuttg) 1995; 34:128-38. [PMID: 7481061] [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: 01/25/2023]
Abstract
In this review schizophrenic attention disorders are described from a neuropsychological perspective. After a historical excursion to Wundt, James and Kraepelin, the experimental psychology attention research of the last decades is presented, with special regard to Joseph Zubin's model of attention. After describing the symptomatology and course of schizophrenic psychosis, the concept of positive and negative symptoms according to Crow and Andreasen is set out as well. In describing the cognitive disorders it is on the one hand tried to elucidate the concept of "Basisstörung", and, on the other, to deal with attention disorders as potential vulnerability markers. After setting out various models re. the origin of attention disorders in both acute and chronic psychoses, implications for diagnosis and treatment are offered for the clinical psychologist in conclusion.
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Held T, Lamberti G, Kubitzki J. [Psychoses and driving fitness--development of criteria for clinical assessment]. Rehabilitation (Stuttg) 1993; 32:155-61. [PMID: 8210664] [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: 01/29/2023]
Abstract
The legal foundations for driver fitness evaluation in psychiatric conditions are enumerated in the 1985 "Illness and road traffic" expert opinion of the advisory medical council with the Federal Ministry of Transport. In case of the endogenous psychoses, in-patient episodes will invariably give rise to a call for expert psychiatric appraisement, notwithstanding the fact that reliable and valid criteria, with the exception of a standardized driving sample, continue to be almost non-existent. Carried out between 1989 and 1991 with support from the Federal Employment Institute in the framework of an employment creation project as well as from Bundesanstalt für Strassenwesen, the present study hence had been aimed at correlation-statistical identification of as valid driving ability predictors as possible in post-acute patients with a diagnosis of schizophrenic psychosis (ICD 295.3). The patients' pre-discharge fitness for driving, for one, was assessed using a number of psychological procedures and, for the other, was examined during a 60 minute practical driving sample, involving both city and autobahn driving. Driving behaviour during the practical trial was taken down according to pertinent categories, with subsequent judgment of overall driving performance both by self-ratings and by driving instructor ratings by means of a school grades scale of 1 to 6. With reference to pertinent studies elsewhere, our test battery had consisted of procedures for testing visual perception, reaction, selective and split attention, personality structure, anxiety, and risk-taking.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- T Held
- Rheinische Landesklinik Bonn
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Linke DB, Lamberti G. [Which method establishes general practice? Comment on the responses by Kinzel, Laros and Lehrl on "The Diamed Test System (System House König & Partner, 1984)--a critical comment, volume 4 (1989)]. Rehabilitation (Stuttg) 1989; 28:207-8. [PMID: 2616883] [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: 01/01/2023]
Affiliation(s)
- D B Linke
- Klinische Neurophysiologie, Neurochirurgische Universitätsklinik, Bonn
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Lamberti G, Linke D. [The Diamed Test System (König & Partner System House, 1984)--a review]. Rehabilitation (Stuttg) 1989; 28:27-9. [PMID: 2928595] [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: 01/03/2023]
Affiliation(s)
- G Lamberti
- Rheinische Landesklinik Bonn, Psychologisches Labor
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Lamberti G, Wieneke KH, Franke N. [The computer as an aid in attention training--a clinico-experimental study]. Rehabilitation (Stuttg) 1988; 27:190-8. [PMID: 2467337] [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: 01/01/2023]
Abstract
Reported is the evaluation of a computer-directed training programme for visual attention, that is based on the results of experimental studies by Zubin (1975) and Shakow (1979). With reference to Zubin's model, this training programme addresses active maintenance of selective visual attention (in terms of "sustained attention"), applying Shakow's diagnostic research paradigm (with a preparatory stimulus, an RT stimulus, and a variable preparatory interval) in a behavioural setting (learning of strategies for attention) for clinical purposes. In a pre-post-study carried out for a three-week programme, the results of single case experiments showed a significant decrease of reaction time variability, which partly persisted in follow-up studies. It was found that attentional performance increased in both psychotic patients and patients with cerebral dysfunction. In the second phase of statistical validation on patients with psychotic attention deviations, both attention performance and transfer effects were verified. The behavioural training methods, which were implemented to foster attention, proved helpful in the majority of cases. For greater practicability, a programme version for use on the home computer has been developed. The study on the whole illustrates the growing utilization of computer technology in neuropsychological rehabilitation.
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Affiliation(s)
- G Lamberti
- Psychologisches Labor, Rheinischen Landesklinik Bonn
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