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Quagliariello V, Passariello M, Rea D, Barbieri A, Buccolo S, Iovine M, Bonelli A, Caronna A, Botti G, De Lorenzo C, Maurea N. Ipilimumab and Nivolumab exertes cardiotoxic and pro-fibrotic effects in mice through the overexpression of NLRP3 inflammasome, chemokines and leukotrienes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2838] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Several strategies based on immune checkpoint inhibitors (ICIs) have been developed for cancer therapy, opening to advantages in cancer outcomes. However, several ICIs-induced side effects emerged in these patients, especially a rare but clinically significant cardiotoxicity with high rate of mortality.
Purpose
We studied cytotoxic and pro-inflammatory properties of Ipilimumab and Nivolumab in cellular and preclinical models
Methods
Co-cultures of human cardiomyocytes and hPBMCs were exposed to Ipilimumab or Nivolumab at 100 nM; cell viability and expression of leukotrienes, NLRP3 inflammasome, MyD88 (myddosome) and p65/NF-kB were performed. C57 mice were untreated (Sham; n=6) or treated with Ipilimumab (IPI, n=6) (15 mg/kg); analysis of fractional shortening, ejection fraction, radial and longitudinal strain were made before and after treatments through 2D-echocardiography (Vevo 2100). Expression of NLRP3, MyD88, p65/NF-kB, leukotrienes and 12 cytokines (IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-12, IL17-α, IFN-γ, TNF-α, G-CSF, and GM-CSF) have been analyzed in murine myocardium.
Results
Nivolumab and Ipilimumab induced cell death and apoptosis in cardiomyocutes. Both ICIs increased NLRP3, MyD88 and p65/NF-kB expression compared to untreated cells, however the most pro-inflammatory and cardiotoxic effects were seen after exposure to Ipilimumab. Mice treated with Ipilimumab showed a significant decrease of fractional shortening and radial strain compared to untreated mice. Metabolic studies clearly indicates that ipilimumab increases leukotrienes production and NLRP3 expression in heart tissues, probably due to increased iROS content (iROS are key inductors of leukotrienes expression). High expression of IL-6, IL-1 and IL-17 were also seein in mice treated with ipilimumab (p<0,001).
Conclusions
Nivolumab and Ipilimumab exert cytotoxic effects mediated by NLRP3 inflammasome, leukotrienes and pro-inflammatory cytokines in heart tissues.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministero della Salute, Ricerca Corrente Project
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Affiliation(s)
- V Quagliariello
- National Cancer Institute G.Pascale Foundation IRCCS, Naples, Italy
| | | | - D Rea
- National Cancer Institute G.Pascale Foundation IRCCS, Naples, Italy
| | - A Barbieri
- National Cancer Institute G.Pascale Foundation IRCCS, Naples, Italy
| | - S Buccolo
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - M Iovine
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - A Bonelli
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - A Caronna
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - G Botti
- National Cancer Institute G.Pascale Foundation IRCCS, Scientific Direction, Naples, Italy
| | | | - N Maurea
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
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Quagliariello V, Bonelli A, Paccone A, Buccolo S, Iovine M, Conforti G, Botti G, Maurea N. Evolocumab, a PCSK9 inhibitor, co-incubated with doxorubicin and trastuzumab reduces death of cardiomyocytes through reduction of MyD88-NLRP3-NF-kB-mTORC1. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2839] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) is a novel treatment for hypercholesterolaemia; recent studies evidenced that PCSK9i reduces cardiovascular diseases and risk of atherosclerosis. Evolocumab, a PCSK9i, reduced the risk of cardiovascular events in patients with atherosclerotic cardiovascular diseases when added to maximally tolerated statin therapy (± ezetimibe), and recent data from the ODYSSEY OUTCOMES trial indicate that alirocumab added to maximally tolerated statin therapy (± other lipid-lowering drugs) reduces the risk of cardiovascular events in patients with a recent acute coronary syndrome.
Purpose
Considering the expression of PCSK9 in heart tissues and cardiomyocytes, we aimed to study for the first time the putative cellular effects of evolocumab in human cardiomyocytes incubated with doxorubicin, trastuzumab, their sequential treatments
Methods
Human fetal cardiomyocytes (HFC cell line) were exposed to subclinical concentration of doxorubicin, trastuzumab, sequential treatment of both (all 100 nM), alone or in combination with evolocumab (50 nM) for 48h. After the incubation period, we performed the following tests: determination of cell viability, through analysis of mitochondrial dehydrogenase activity, study of lipid peroxidation (quantifying cellular Malondialdehyde and 4-hydroxynonenal), intracellular Ca2+ homeostasis. Moreover, pro-inflammatory studied were also performed (activation of NLRP3 inflammasome; expression of TLR4/MyD88; mTORC1 Fox01/3a; transcriptional activation of p65/NF-κB and secretion of cytokines involved in cardiotoxicity (Interleukins 1β, 8, 6).
Results
Evolocumab co-incubated with doxorubicin alone or in sequence with trastuzumab exerts cardioprotective effects, enhancing cell viability of 35–43% compared to untreated cells (p<0,05 for all); Evolocumab reduced significantly the cardiotoxicity through MyD88/NF-KB/cytokines axis and mTORC1 Fox01/3α mediated mechanisms.
Conclusion
PCSK9 inhibitor evolocumab exerts direct cellular effects in cardiomyocytes during doxorubicin and trastuzumab exposure with anti-inflammatory effects. These results indicated that evolocumab should be studied in cancer-bearing mice treated with anthracyclines and HER2-blocking agents in order to reduces cardiovascular events.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministero della Salute, Ricerca Corrente Project
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Affiliation(s)
- V Quagliariello
- National Cancer Institute G.Pascale Foundation IRCCS, Naples, Italy
| | - A Bonelli
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - A Paccone
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - S Buccolo
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - M Iovine
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - G Conforti
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - G Botti
- National Cancer Institute G.Pascale Foundation IRCCS, Scientific Direction, Naples, Italy
| | - N Maurea
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
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Quagliariello V, Bonelli A, Paccone A, Buccolo S, Iovine M, Botti G, Maurea N. Oxidized Low-Density Lipoproteins increases nivolumab-induced cardiotoxicity through TLR4/NF-KB and NLRP3 pathways. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atherosclerosis is now recognized as a chronic inflammatory disease. Oxidized low-density lipoprotein (Ox-LDL) is oxidatively modified form of LDL with a key role in induction and progressio of atherosclerosis. Recent findings reported that cardiovascular events (myocarditis and atherosclerosis) were higher after initiation of immune check-point inhibitors (ICIs), potentially mediated by accelerated progression of atherosclerosis.
Purpose
We evaluated whether ox-LDL-induced apoptosis through toll-like receptor-4 (TLR4)/Nuclear factor κB (NF-κB) signaling pathway and NLRP3 inflammasome during exposure of human cardiomyocytes to nivolumab turning the light on the mechanisms of cell inflammation induced by OxLDL in cardiotoxicity of ICIs.
Methods
Human fetal cardiomyocytes (HFC cell line) in co-culture with hPBMC, were exposed to clinically relevant concentration of nivolumab (100 nM) alone or combined to OxLDL at 1, 10 and 50 μg/mL for 24h. After the incubation period, we performed the following tests: determination of cell viability, through analysis of mitochondrial dehydrogenase activity, study of lipid peroxidation (quantifying cellular Malondialdehyde and 4-hydroxynonenal), intracellular Ca2+ homeostasis and apoptosis. Moreover, pro-inflammatory studied were also performed (activation of NLRP3 inflammasome, expression of TLR4 and NF-kB). In order to evaluate the pathways involved in OxLDL damages, TLR4 and NLRP3 inhibitor (TAK-242 and dapansutrile, respectively) were added during cell viability and apoptosis studies.
Results
Nivolumab exerts cytotoxic and pro-apoptotic effects in co-coltures of cardiomyocytes and hPBMC. OxLDL increases significantly the nivolumab-induced cardiotoxicity in a manner that is sensitive to TLR4 and NLRP3. Incubation of cardiomyocytes with ox-LDL (10 and 50 μg/mL) for 24 hours increased TLR4 and NF-κB expressions. Ox-LDL had pro-apoptotic effects in a concentration-dependent manner with the involvement of lipid peroxidation but not of intracellular calcium.
Conclusion
Ox-LDL exacerbates cardiotoxicity during exposure to nivolumab through pro-inflammatory mechanisms. These results place the first step to preclinical studies aimed to reduce ox-LDL during treatment with ICIs through pharmacological inhibition or by changing diet and lifestyle.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministero della Salute, Ricerca Corrente project
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Affiliation(s)
- V Quagliariello
- National Cancer Institute G.Pascale Foundation IRCCS, Naples, Italy
| | - A Bonelli
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - A Paccone
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - S Buccolo
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - M Iovine
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - G Botti
- National Cancer Institute G.Pascale Foundation IRCCS, Scientific Direction, Naples, Italy
| | - N Maurea
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
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Quagliariello V, Bonelli A, Paccone A, Buccolo S, Iovine M, Rea D, Cerrone F, Botti G, Maurea N. The combination of a neprilysin inhibitor (sacubitril) and angiotensin-II receptor blocker (valsartan) improves ejection fraction and longitudinal strain in mice treated with doxorubicin through NLRP3. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2836] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Doxorubicin-mediated- adverse cardiovascular events are among the leading causes of morbidity and mortality in breast cancer patients. Sacubitril-valsartan (LCZ 696) is a combination drug, made up of neprilysin inhibitor sacubitril and angiotensin II receptor blocker valsartan, used for the treatment of heart failure in patients with a reduced ejection fraction.
Purpose
Here, we aim to assess whether LCZ 696, administered during doxorubicin, reduces in vitro anticancer drugs-related cardiotoxicity compared to Valsartan (V), used as a control drug.
Methods
Human fetal cardiomyocytes (HFC cell line) were exposed to subclinical concentration of doxorubicin (at 200 nM) alone or in combination with LCZ-696 (100 mM) for 72 h. After the incubation period, we performed the following tests: determination of cell viability, through analysis of mitochondrial dehydrogenase activity, study of lipid peroxidation (quantifying cellular Malondialdehyde and 4-hydroxynonenal), intracellular Ca2+ homeostasis. Moreover, pro-inflammatory studied were also performed (activation of NLRP3 inflammasome; expression of TLR4/MyD88; mTORC1 Fox01/3a; transcriptional activation of p65/NF-κB and secretion of cytokines involved in cardiotoxicity (Interleukins 1β, 8, 6). C57Bl/6 mice were untreated (Sham, n=6) or treated for 10 days with doxorubicin (DOXO, n=6), LCZ-696 (LCZ, n=6) or doxorubicin combined to LCZ-696 (DOXO-LCZ, n=6). DOXO was injected intraperitoneally. Ejection fraction, radial and longitudinal strain were analyzed through transthoracic echocardiography (Vevo 2100). Cardiac tissue expression of NLRP3 inflammasome, Myd8, NF-kB and chemokines and cytokines were quantified after treatments through ELISA method.
Results
LCZ 696 co-incubated with doxorubicin exerts cardioprotective effects, enhancing cell viability of 48–54.6% compared to only doxorubicin-treated cells (p<0,001 for all); LCZ 696 reduced significantly the cardiotoxicity through MyD88/NF-KB/cytokines axis and mTORC1 Fox01/3α mediated mechanisms. In preclinical study, LCZ 696 improved significantly the EF and prevented the reduction of radial and longitudinal strain after 10 days of treatment with doxorubicin. A reduced expression of pro-inflammatory cytokines, NLRP3, MyD88 and NF-kB in heart tissues was also seen in DOXO-LCZ group compared to DOXO mice (p<0.001)
Conclusion
We demonstrated, for the first time, that the LCZ696 exerts direct effects in cardiomyocytes and preclinical models during doxorubicin exposure, turning on a new light on its possible use in cancer patients to reduce cardiovascular side effects.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministero della Salute, Ricerca Corrente project
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Affiliation(s)
- V Quagliariello
- National Cancer Institute G.Pascale Foundation IRCCS, Naples, Italy
| | - A Bonelli
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - A Paccone
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - S Buccolo
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - M Iovine
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - D Rea
- National Cancer Institute G.Pascale Foundation IRCCS, Naples, Italy
| | - F Cerrone
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - G Botti
- National Cancer Institute G.Pascale Foundation IRCCS, Scientific Direction, Naples, Italy
| | - N Maurea
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
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Maurea N, Quagliariello V, Bonelli A, Paccone A, Conforti G, Caronna A, Buccolo S, Iovine M, Cerrone F, Botti G. TheSGLT-2 inhibitor dapagliflozin ehnanced the anticancer activities and exerts cardioprotective effects during exposure to ipilimumab through NLRP3 inflammasome and pro-fibrotic cytokines. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2846] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The clinical trial “DECLARE-TIMI 58” (Dapagliflozin Effect on Cardiovascular Events-Thrombolysis in Myocardial Infarction 58), demonstrated that dapagliflozin, a Sodium glucose cotransporter 2 inhibitor, reduces the composite end point of cardiovascular death/hospitalization for heart failure in a broad population of patients with type 2 diabetes mellitus. Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, achieving unprecedented efficacy in multiple malignancies. However, ICIs are associated with immune-related adverse events involving cardiotoxicity.
Purpose
We aimed to study if dapagliflozin could affect ipilimumab-induced anticancer efficacy in human breast cancer cells and reduces its cardiotoxicity.
Methods
Co-culture of hPBMCs and human cardiomyocytes or estrogen-responsive and triple-negative breast cancer cells (MCF-7 and MDA-MB-231 cell lines) were exposed to ipilimumab (200 nM) alone or combined to SGLT-2 inhibitor (dapagliflozin) for 72h. After the incubation period, we performed the following tests: determination of cell viability, through analysis of mitochondrial dehydrogenase activity, study of lipid peroxidation (quantifying cellular Malondialdehyde and 4-hydroxynonenal), intracellular Ca2+ homeostasis. Moreover, pro-inflammatory studied were also performed (activation of NLRP3 inflammasome; expression of TLR4/MyD88; transcriptional activation of p65/NF-κB and secretion of cytokines involved in cardiotoxicity (Interleukins 1β, 8, 6).
Results
Dapagliflozin increases significantly the cardiomyocytes viability during exposure to Ipilimumab. Indeed, in human breast cancer cells, dapagloflozin showed an opposite behavior with a significant increase in cell mortality and apoptosis (p<0.001 vs only ipilimumab). Cardioprotective properties of dapagliflozin are explainable by the reduction of intracellular Ca2+ overload (−56,8% vs only ipilimumab; p<0,001), of the lipid peroxidation (mean reduction of 42,1–48,6% compared to cells exposed only to ipilimumab; p<0,05). Moreover, cells exposed to dapagliflozin during ipilimumab reduced the protein expression of pro-inflammatory cytokines involved in cardiotoxicity and resistance to anticancer effects of ICIs (−47,2% for Interleukin-1β; −48,7 for Interleukin 6; −32,1% for Interleukin 8; p<0,001 for all vs only ipilimumab groups). Notably, dapagliflozin reduces p65-NF-κB activation (−46,3 and −49,3% vs only ipilimumab, p<0.05) and inhibits of 43,2–53,7% the expression of NLRP3 inflammasome, p<0.05 for all). No significant effects were seen on TLR4/MYD88 expression in all groups.
Conclusion
Dapagliflozin demonstrated cardioprotective properties during Ipilimumab exposure in co-culture model of hPBMCs and cardiomyocytes. Dapagliflozin improves Ca2+ homeostasis and inhibits the pro-inflammatory “NLRP3–NF-κB–cytokines” pathways in cardiac cells.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ricerca corrente grant of Italian Ministry of Health
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Affiliation(s)
- N Maurea
- National Cancer Institute G. Pascale, Naples, Italy
| | - V Quagliariello
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - A Bonelli
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - A Paccone
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - G Conforti
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - A Caronna
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - S Buccolo
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - M Iovine
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - F Cerrone
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - G Botti
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
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Quagliariello V, D'Aiuto G, Iaffaioli RV, Berretta M, Buccolo S, Iovine M, Paccone A, Cerrone F, Bonanno S, Nunnari G, Laganà N, Botti G, Maurea N. Reasons why COVID-19 survivors should follow dietary World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations: from hyper-inflammation to cardiac dysfunctions. Eur Rev Med Pharmacol Sci 2021; 25:3898-3907. [PMID: 34109598 DOI: 10.26355/eurrev_202105_25957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) advise cancer survivors to follow their lifestyle recommendations for cancer prevention. Recent research indicates that a proper diet could exerts beneficial metabolic and immune effects in humans through the involvement of several, not yet properly known, metabolic pathways. Here, we argue that following WCRF/AICR recommendations could be a strategy to prevent cardiovascular outcomes [fulminant myocarditis, heart failure, venous thromboembolism (VTE)] and acute respiratory distress syndrome (ARDS) in patients during follow-up post COVID-19 infection. We discuss the metabolic effects of a WCRF/AICR based diet, highlighting on the involved cardio-metabolic pathways related on NLRP3 inflammasome-cytokines axis aimed to improve prognosis of COVID-19, especially in patients with cancer.
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Affiliation(s)
- V Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori - IRCCS- Fondazione G. Pascale, Napoles, Italy.
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Ottaviano M, Giuliano M, Tortora M, La Civita E, Liotti A, Longo M, Bruzzese D, Cennamo M, Riccio V, De Placido P, Picozzi F, Parola S, Daniele B, Botti G, Formisano P, Beguinot F, De Placido S, Terracciano D, Palmieri G. MA06.10 A New Horizon of Liquid Biopsy in Thymic Epithelial Tumors: The Potential Utility of Circulating Cell-Free DNA. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.180] [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: 11/28/2022]
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Quagliariello V, Caronna A, Lombari C, Bonelli A, Conforti G, Botti G, Maurea N. Cardioprotective effects of PCSK9 inhibitor evolocumab against doxorubicin-trastuzumab sequential treatments and ipilimumab-induced cardiotoxicity: the role of MyD88/NF-KB/mTORC1 pathways. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3252] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) has emerged as a novel therapy to treat hypercholesterolaemia and related cardiovascular diseases. Evolocumab, a PCSK9 inhibitor, reduced the risk of cardiovascular events in patients with atherosclerotic cardiovascular diseases when added to maximally tolerated statin therapy (± ezetimibe), and recent data from the ODYSSEY OUTCOMES trial indicate that alirocumab added to maximally tolerated statin therapy (± other lipid-lowering drugs) reduces the risk of cardiovascular events in patients with a recent acute coronary syndrome.
Purpose
Considering the expression of PCSK9 in heart tissue, we aimed to study for the first time the direct biochemical effects of evolocumab in cardiomyocytes during exposure to doxorubicin, trastuzumab, their sequential treatments, and immune checkpoint inhibitor ipilmumab.
Methods
Human fetal cardiomyocytes (HFC cell line) were exposed to subclinical concentration of doxorubicin, trastuzumab, sequential treatment of both ( all 100 nM), alone or in combination with evolocumab (50 nM) for 48h. In another experiment, in co-coltures of human fetal cardiomyocytes and lymphocytes, we incubated ipilimumab (200 nM) alone or in combination with evolocumab for 48h. After the incubation period, we performed the following tests: determination of cell viability, through analysis of mitochondrial dehydrogenase activity, study of lipid peroxidation (quantifying cellular Malondialdehyde and 4-hydroxynonenal), intracellular Ca2+ homeostasis. Moreover, pro-inflammatory studied were also performed (activation of NLRP3 inflammasome; expression of TLR4/MyD88; mTORC1 Fox01/3a; transcriptional activation of p65/NF-κB and secretion of cytokines involved in cardiotoxicity (Interleukins 1β, 8, 6).
Results
Evolocumab co-incubated with doxorubicin alone or in sequence with trastuzumab exerts cardioprotective effects, enhancing cell viability of 35–43% compared to untreated cells (p<0,05 for all); Cardiomyocytes co-incubated withevolocumab and ipilimumab (in co-colture of cardiomyocytes and lymphocytes) reduces significantly the cardiotoxicity phenomena through MyD88/NF-KB/cytokines axis and mTORC1 Fox01/3α mediated mechanisms.
Conclusion
We demonstrated, for the firts time, that PCSK9 inhibitor evolocumab exerts direct effects in cardiomyocytes during doxorubicin, trastuzumab and ipilimumab mediated cardiotoxicity turning on a new light on its possible use in the management of the cardiotoxic effects of antineoplastic drugs in cancer patients
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This work was funded by the “Ricerca Corrente” grant from the Italian Ministry of Health
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Affiliation(s)
- V Quagliariello
- National Cancer Institute G.Pascale Foundation IRCCS, Naples, Italy
| | - A Caronna
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - C Lombari
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - A Bonelli
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - G Conforti
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
| | - G Botti
- National Cancer Institute G.Pascale Foundation IRCCS, Scientific Direction, Naples, Italy
| | - N Maurea
- National Cancer Institute G.Pascale Foundation IRCCS, Division of Cardiology, Naples, Italy
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Quagliariello V, Bonelli A, Caronna A, Lombari MC, Conforti G, Libutti M, Iaffaioli RV, Berretta M, Botti G, Maurea N. SARS-CoV-2 infection: NLRP3 inflammasome as plausible target to prevent cardiopulmonary complications? Eur Rev Med Pharmacol Sci 2020; 24:9169-9171. [PMID: 32965010 DOI: 10.26355/eurrev_202009_22867] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
NLRP3 (NOD-, LRR- and pyrin domain-containing protein 3) inflammasome has recently become an intriguing target of several chronic and viral diseases. Here, we argue that targeting NLRP3 inflammasome could be a strategy to prevent cardiovascular outcomes [fulminant myocarditis, heart failure, venous thromboembolism (VTE)] and acute respiratory distress syndrome (ARDS) in patients with SARS-CoV-2 infection. We discuss the rationale for NLRP3 targeting in clinical trials as an effective therapeutic strategy aimed to improve prognosis of COVID-19, analyzing the potential of two therapeutic options (tranilast and OLT1177) currently available in clinical practice.
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Affiliation(s)
- V Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori - IRCCS- Fondazione G. Pascale, Naples, Italy.
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Quagliariello V, Bonelli A, Caronna A, Lombari C, Grimaldi I, Conforti G, Botti G, Maurea N. 1944P Hyperglycemia increased nivolumab-induced cardiotoxicity, enhanced immunoresistance of ERɑ+, PR+, HER2- breast cancer cells modulating growth factors and NLRP3 expression. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Palmieri G, Giuliano M, Tortora M, Formisano P, Malfitano A, D'Esposito V, Botti G, Marretta A, Margherita V, Di Lauro V, Daniele B, De Placido S, Verde A, Ottaviano M. 1904P Clinical implications of distinct immunoprofiles in patients with thymic epithelial tumours and autoimmunity. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Ottaviano M, Giuliano M, Tortora M, Picozzi F, Mucci B, Parola S, Riccio V, Pietroluongo E, De Placido P, Vaia A, D'Esposito V, Malfitano A, Di Somma S, Campione S, Staibano S, Botti G, Formisano P, Daniele B, De Placido S, Palmieri G. 1901P Immunomodulatory role of multi-agent therapy in thymic epithelial tumours and severe immunological dysregulation. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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13
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Maurea N, Quagliariello V, Bonelli A, Caronna A, Grimaldi I, Lombari C, Conforti G, Botti G. 1969P The SGLT2 inhibitor dapagliflozin enhanced anticancer activities and exerts cardioprotective effects against doxorubicin and trastuzumab toxicity through TLR4, MyD88, NF-kB signaling and NLRP3 inflammasome pathway. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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14
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Fenizia F, Esposito Abate R, Pasquale R, Roma C, Lambiase M, Chicchinelli N, Graziano P, Botti G, Tatangelo F, Scognamiglio G, Pietrantonio F, Normanno N. Tumour mutation burden and microsatellite instability in colorectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.036] [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: 11/13/2022] Open
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15
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Quagliariello V, Coppola C, Rea D, Maurea C, Barbieri A, Botti G, Maurea N. Cardioprotective and anti-inflammatory effects of empagliflozin during treatment with doxorubicin: A cellular and preclinical study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Maurea N, Quagliariello V, Coppola C, Rea D, Barbieri A, Arra C, Botti G. P5716Cardioprotective anti inflammatory effects of empaglifozin in doxorubicin induced cardiotoxicity: the role of leukotriene B4 and interleukin 1. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0657] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Empagliflozin (EMPA), a selective inhibitor of the sodium glucose co-transporter 2 (SGLT2), reduces the risk of hospitalization for heart failure or cardiovascular death in type 2 diabetic patients.
Purpose
We studied the putative cardioprotective and anti-inflammatory effects of EMPA in Doxorubicin (DOXO)-Induced cardiotoxicity.
Methods
For this purpose, we tested the effects of EMPA (at 100 or 500 nM) alone or in combination with DOXO (20 μM) in HL-1 adult cardiomyocytes evaluating: mitochondrial viability, lipid peroxidation (quantifying cellular Malondialdehyde [MDA] and 4-hydroxynonenal [4-HNA]), Leukotriene-B4 expression, p65-NF-κB activation and Interleukin 1β, 8 and 6 secretion. Preclinical studies were also performed in C57BL6 mice, dividing them in 4 groups (n=6): Sham (untreated mice), EMPA (mice treated with EMPA at 10 mg/kg/day, administrated orally for 7 days); DOXO (mice treated with DOXO at 2.25 mg/kg/day, intraperitoneally administered for 7 days); EMPA-DOXO (pre-treatment with EMPA for 3 days and 7 days of co-administration EMPA and DOXO). As predictor of cardiotoxicity, the Global Longitudinal Strain (GLS) was measured using 2D speckle tracking echocardiography. Cardiac lysates were processed for analysis of pro-inflammatory interleukins.
Results
We demonstrated that EMPA, co-incubated with DOXO, increases cardiomyocyte viability of 33,6 and 82% at 100 and 500 nM, respectively (compared to only DOXO treated cells). EMPA inhibits the lipid peroxidation by decreasing MDA and 4-HNA production of around 23,6 and 28,7%, at 100 nM and of 47,8 and 52,1% at 500 nM, respectively, compared to untreated cells (p<0,01 for all). Moreover, EMPA has anti-inflammatory activity reducing the Leukotriene B4 and p65-NFkb expression of 37,4% and 31% at 100 nM and of 58,4 and 64,3% at 500 nM, respectively (all compared to only DOXO treated cells). EMPA also decreased the expression of Interleukin 1β (of 28,5 and 68,8%), Interleukin-8 (of 21,2 and 57,3%) and Interleukin-6 (of 28,1 and 49,8%) at 100 and 500 nM, respectively, compared to only DOXO exposed cells (p<0,05 for all). In our in vivo studies, after 7 days with DOXO, the GLS decreased. Interestingly, in mice treated with EMPA/DOXO, we observed that EMPA prevents the GLS's reduction: GLS was −19.24±1.5 (p<0,01) vs DOXO alone, indicating cardioprotective effects. In DOXO-EMPA groups the cardiac IL-1β, IL-6 and IL-8 were reduced of 48, 54,4 and 58%, compared to only DOXO group (p<0,001 for all).
Conclusion
EMPA has strong anti-inflammatory and cardioprotective effects in DOXO-Induced cardiotoxicity and these effects are mainly mediated by a reduction of the lipid peroxidation, Leukotriene-B4 and NF-κB activation bringing to a strong inhibition of the Interleukin 1β, 8 and 6 production.
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Affiliation(s)
- N Maurea
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - V Quagliariello
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - C Coppola
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - D Rea
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - A Barbieri
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - C Arra
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - G Botti
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
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17
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Maurea N, Quagliariello V, Passariello M, Coppola C, Rea D, Barbieri A, Arra C, Scherillo M, Iaffaioli RV, Botti G, De Lorenzo C. P1537Cardiotoxicity induced by the combinatorial treatment based on the immune checkpoint inhibitor pembrolizumab associated to trastuzumab. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0299] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The immunotherapy has revolutionized the world of oncology in the last decades with considerable advantages in terms of overall survival in cancer patients. A combination therapy based on the co-administration of Pembrolizumab (an antibody against PD-1) and Trastuzumab (the humanized anti-Her2 mAb) was recently proposed in clinical trials for the treatment of Trastuzumab-resistant advanced HER2-positive breast cancer. Although immunotherapies are frequently associated with a wide spectrum of immune-related adverse events, the cardiac toxicity has not been properly studied.
Purpose
We studied, for the first time, the putative cardiotoxic effects of Pembrolizumab associated to Trastuzumab turning the light on the pro-inflammatory effects of this novel combined therapy
Methods
Cell viability, intracellular calcium quantification and pro-inflammatory assays (analyzing the production of Interleukin 1β, 6 and 8 as well as the expression of p65/NFkB and Leukotriene B4) were performed in human fetal cardiomyocytes in vitro. Preclinical studies were also performed in vivo on C57BL6 mice untreated (Sham) or treated with Pembrolizumab and Trastuzumab alone or in combination by analyzing (in cardiac tissue extracts) the same markers of inflammation used in cellular studies.
Results
Combination therapy leads to an increase of the intracellular calcium overload (more than 3 times compared to untreated cells) and to a reduction of the cardiomyocytes viability (of more than 65 and 20–25%, compared to untreated and Pembrolizumab or Trastuzumab treated cells, respectively) thus indicating cardiotoxic effects. Notably, combination therapy increases the inflammation of cardiomyocytes enhancing significantly the production of p65/NFkB and Interleukins. Moreover, in in vivo studies on mice, the association of Pembrolizumab and Trastuzumab shows pro-inflammatory effects in cardiac tissue by stimulating the Interleukin 1β, 8 and 6 expression of 40–50% more than the single treatments; the expression of p65/NFkB and Leukotriene B4 was also increased indicating pro-inflammatory effects.
Conclusion
Combination therapy based on Pembrolizumab associated to Trastuzumab leads to significant cardiac pro-inflammatory effects mediated by overexpression of NFkB/p65 and Leukotriene B4 related pathways
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Affiliation(s)
- N Maurea
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - V Quagliariello
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - M Passariello
- Federico II University of Naples, Department of Molecular Medicine and Medical Biotechnology, Naples, Italy
| | - C Coppola
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - D Rea
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - A Barbieri
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - C Arra
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - M Scherillo
- Azienda Ospedaliera “G. Rummo”, Azienda ospedaliera San Pio, Cardiologia Interventistica, Naples, Italy
| | - R V Iaffaioli
- Association for Multidisciplinary Studies in Oncology and Mediterranean Diet, Naples, Italy
| | - G Botti
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - C De Lorenzo
- Federico II University of Naples, Department of Molecular Medicine and Medical Biotechnology, Naples, Italy
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18
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Maurea N, Quagliariello V, Passariello M, Coppola C, Rea D, Barbieri A, De Lorenzo C, Monti G, De Laurentiis M, Ascierto P, Botti G. Cardiotoxic and pro-inflammatory effects induced by the association of immune checkpoint inhibitor pembrolizumab and trastuzumab in preclinical models. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Quagliariello V, Coppola C, Mita DG, Piscopo G, Iaffaioli RV, Botti G, Maurea N. Low doses of Bisphenol A have pro-inflammatory and pro-oxidant effects, stimulate lipid peroxidation and increase the cardiotoxicity of Doxorubicin in cardiomyoblasts. Environ Toxicol Pharmacol 2019; 69:1-8. [PMID: 30903913 DOI: 10.1016/j.etap.2019.03.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/12/2019] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
Endocrine disrupters are strictly associated to cancer and several cardiovascular risk factors. Bisphenol A (BPA) is an endocrine disrupter commonly used in the manufacturing of plastics based on polycarbonate, polyvinyl chloride and resins. Our study aims to investigate whether BPA may cause pro-oxidative and pro-inflammatory effects on cardiomyoblasts, thus exacerbating the Doxorubicin (DOXO)-induced cardiotoxicity phenomena. We tested the metabolic effects of BPA at low doses analyzing its affections on the intracellular calcium uptake, oxidative stress, lipid peroxidation and production of nitric oxide and interleukins. Co-incubation of BPA and DOXO significantly reduced the cardiomyoblast viability, compared to only DOXO exposure cells. The mechanisms underlying these effects are based on the stimulation of the intracellular calcium accumulation and lipid peroxidation. Notably, BPA increase the production of pro-inflammatory interleukins involved in cardiovascular diseases as well as in DOXO-Induced cardiotoxicity phenomena. This study provides a rationale for translational studies in the field of cardio-oncology.
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Affiliation(s)
- V Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori- IRCCS- Fondazione Pascale, Napoli, Italy.
| | - C Coppola
- Division of Cardiology, Istituto Nazionale Tumori- IRCCS- Fondazione Pascale, Napoli, Italy
| | - D G Mita
- Institute of Genetics and Biophysics of CNR and National Laboratory on Endocrine Disruptors of INBB Naples, Italy
| | - G Piscopo
- Division of Cardiology, Istituto Nazionale Tumori- IRCCS- Fondazione Pascale, Napoli, Italy
| | - R V Iaffaioli
- Association for Multidisciplinary Studies in Oncology and Mediterranean Diet, Piazza Nicola Amore, Naples, Italy
| | - G Botti
- Scientific Direction, Istituto Nazionale Tumori, IRCCS, Fondazione Pascale, Napoli, Italy
| | - N Maurea
- Division of Cardiology, Istituto Nazionale Tumori- IRCCS- Fondazione Pascale, Napoli, Italy
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20
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Giudice A, Montella M, Boccellino M, Crispo A, D'Arena G, Bimonte S, Facchini G, Ciliberto G, Botti G, Quagliuolo L, Caraglia M, Capunzo M. Epigenetic Changes Induced by Green Tea Catechins a re Associated with Prostate Cancer. Curr Mol Med 2019; 17:405-420. [PMID: 29256350 DOI: 10.2174/1566524018666171219101937] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 12/06/2017] [Accepted: 12/15/2017] [Indexed: 11/22/2022]
Abstract
Prostate cancer is one of the most difficult cancers to treat especially when it becomes hormone resistant such as castrate resistant prostate cancer (CRPC) and subsequent metastatic CRPC. Apart from the genetic alterations in prostate cancer, epigenetic modifications also play an important role in the development and neoplastic progression of this disease. These include DNA methylation, histone modifications, and non-coding microRNAs. miRNAs are a novel class of small endogenous single-stranded non-coding RNAs of 19-25 nucleotides in length that typically silence gene expression. Considering the reversibility of epigenetic alterations in early carcinogenesis process, reversion (correction) of these modifications by green tea catechins could be a promising strategy for cancer chemoprevention and therapy. Recent evidence suggests that green tea catechins such as epigallocatechin gallate (EGCG) not only act as epigenetic modulators but can also modify miRNA expression and their target mRNAs, consistently contributing to the inhibition of prostate carcinogenesis. Various studies also indicate that several green tea polyphenols (GTPs) exert synergistic effects with other cancer chemotherapeutic agents. Therefore, the use of appropriate combinations of green tea catechins with the existing chemotherapeutics will lead to a reduction in side effects without decreasing the chemotherapeutic effects. This review will summarize the key results from recent studies detailing the effects of green tea catechins such as EGCG on epigenetic alterations and miRNA expression in prostate cancer.
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Affiliation(s)
- A Giudice
- Epidemiology Unit, National Cancer Institute of Naples "G. Pascale Foundation", IRCCS, 80131 Naples, Italy
| | - M Montella
- Epidemiology Unit, National Cancer Institute of Naples "G. Pascale Foundation", IRCCS, 80131 Naples, Italy
| | - M Boccellino
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli" Naples, Via L. De Crecchio, 7 - 80138 Naples, Italy
| | - A Crispo
- Epidemiology Unit, National Cancer Institute of Naples "G. Pascale Foundation", IRCCS, 80131 Naples, Italy
| | - G D'Arena
- Department of Hematology and Stem Cell Transplantation Unit, IRCCS, Cancer Referral Center of Basilicata, 85028 Rionero in Vulture, Italy
| | - S Bimonte
- Division of Anesthesia and Pain Medicine, National Cancer Institute "G. Pascale Foundation", IRCCS, 80131 Naples, Italy
| | - G Facchini
- Epidemiology Unit, National Cancer Institute of Naples "G. Pascale Foundation", IRCCS, 80131 Naples, Italy
| | - G Ciliberto
- Scientific Directororate, National Cancer Institute "Regina Elena", IRCCS, 80131 Rome, Italy
| | - G Botti
- Pathology Unit, National Cancer Institute "G. Pascale Foundation", IRCCS, 80131 Naples, Italy
| | - L Quagliuolo
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli" Naples, Via L. De Crecchio, 7 - 80138 Naples, Italy
| | - M Caraglia
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli" Naples, Via L. De Crecchio, 7 - 80138 Naples, Italy
| | - M Capunzo
- Department of Medicine Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
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21
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Quagliariello V, Passariello M, Coppola C, Rea D, Barbieri A, Scherillo M, Monti MG, Iaffaioli RV, De Laurentiis M, Ascierto PA, Botti G, De Lorenzo C, Maurea N. Cardiotoxicity and pro-inflammatory effects of the immune checkpoint inhibitor Pembrolizumab associated to Trastuzumab. Int J Cardiol 2019; 292:171-179. [PMID: 31160077 DOI: 10.1016/j.ijcard.2019.05.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/19/2019] [Accepted: 05/13/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The immunotherapy has revolutionized the world of oncology in the last decades with considerable advantages in terms of overall survival in cancer patients. The association of Pembrolizumab and Trastuzumab was recently proposed in clinical trials for the treatment of Trastuzumab-resistant advanced HER2-positive breast cancer. Although immunotherapies are frequently associated with a wide spectrum of immune-related adverse events, the cardiac toxicity has not been properly studied. PURPOSE We studied, for the first time, the putative cardiotoxic and pro-inflammatory effects of Pembrolizumab associated to Trastuzumab. METHODS Cell viability, intracellular calcium quantification and pro-inflammatory studies (analyses of the production of Interleukin 1β, 6 and 8, the expression of NF-kB and Leukotriene B4) were performed in human fetal cardiomyocytes. Preclinical studies were also performed in C57BL6 mice by analyzing fibrosis and inflammation in heart tissues. RESULTS The combination of Pembrolizumab and Trastuzumab leads to an increase of the intracellular calcium overload (of 3 times compared to untreated cells) and to a reduction of the cardiomyocytes viability (of 65 and 20-25%, compared to untreated and Pembrolizumab or Trastuzumab treated cells, respectively) indicating cardiotoxic effects. Notably, combination therapy increases the inflammation of cardiomyocytes by enhancing the expression of NF-kB and Interleukins. Moreover, in preclinical models, the association of Pembrolizumab and Trastuzumab increases the Interleukins expression of 40-50% compared to the single treatments; the expression of NF-kB and Leukotriene B4 was also increased. CONCLUSION Pembrolizumab associated to Trastuzumab leads to strong cardiac pro-inflammatory effects mediated by overexpression of NF-kB and Leukotriene B4 related pathways.
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Affiliation(s)
- V Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, Napoli, Italy
| | - M Passariello
- CEINGE - Biotecnologie Avanzate S.C.a.R.L., Naples, Italy
| | - C Coppola
- Division of Cardiology, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, Napoli, Italy
| | - D Rea
- Animal Facility, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, Napoli, Italy
| | - A Barbieri
- Animal Facility, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, Napoli, Italy
| | - M Scherillo
- Azienda ospedaliera San Pio, Cardiologia Interventistica ed UTIC, Azienda Ospedaliera "G.Rummo" di Benevento, Napoli, Italy
| | - M G Monti
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - R V Iaffaioli
- Association for Multidisciplinary Studies in Oncology and Mediterranean Diet, Piazza Nicola Amore, Naples, Italy
| | - M De Laurentiis
- Breast Unit, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, Napoli, Italy
| | - P A Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, Napoli, Italy
| | - G Botti
- Scientific Direction, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, Napoli, Italy
| | - C De Lorenzo
- CEINGE - Biotecnologie Avanzate S.C.a.R.L., Naples, Italy; Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Napoli, Italy.
| | - N Maurea
- Division of Cardiology, Istituto Nazionale Tumori- IRCCS- Fondazione G. Pascale, Napoli, Italy.
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22
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Budillon A, Delrio P, Pecori B, Tatangelo F, Di Gennaro E, Romano C, D'Angelo V, Marone P, Granata C, Cavalacanti E, De Stefano A, Pace U, Bianco F, Petrillo A, Lastoria S, Botti G, Muto P, Perrone F, Piccirillo M, Avallone A. Phase I/II study of valproic acid (VPA) and short-course radiotherapy (SCRT) plus capecitabine (CAP) as preoperative treatment in low-moderate risk rectal cancer (V-shoRT-R3). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Caracò C, Chiofalo MG, Niro J, Ascierto PA, Botti G, Lastoria S, Mozzillo N. Sentinel Lymph Node Biopsy to Stage Patients with Cutaneous Melanoma at the National Cancer Institute of Naples. Results from 240 Sentinel Node Biopsies. Tumori 2018; 88:S12-3. [PMID: 12365370 DOI: 10.1177/030089160208800324] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aimsand background The presence of lymph node metastases in patients with cutaneous melanoma represents the basis for correct therapy planning and is the most powerful prognostic factor to evaluate overall survival at diagnosis. Methods and Study Design Since 1992, when Dr Morton published his first experience, the sentinel lymph node (SLN) biopsy technique seems to have resolved this matter by correctly staging patients. We analyzed our data from 240 SLN biopsies performed in the last five years at the National Cancer Institute of Naples, evaluating the total identification rate and the nodal recurrence rate, and compared them with the preliminary data of the MSLT (melanoma sentinel lymph node trial). Results Of all SLNs evaluated 18.5% were micrometastatic and 14% were identified by immunohistochemical staining. Forty-one patients had metastatic SLNs and nodal dissection of the positive basins revealed no other tumor-positive lymph nodes in more than 80% of them. All patients with a Breslow thickness of less than 2 mm had micrometastases only in the SLN, while with increasing thickness two, three or more positive nodes were found. Among SLN-negative patients nine (4%) developed lymph node recurrence in the previously treated basin and were therefore considered as false negative SLN biopsies. Conclusions The prognostic value of SLN biopsy needs to be confirmed by the final results of the MSLT evaluating the therapeutic use of this procedure in patients with a Breslow thickness of less than 2 mm and its possible impact on the course of the disease.
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Affiliation(s)
- C Caracò
- Surgical Division B, National Cancer Institute, Naples, Italy.
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24
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Botti G, Chiappetta G, D'Aiuto G, de Angelis E, De Matteis A, Montella M, Picone A, Cascione F. PCNA/Cyclin and P-Glycoprotein as Prognostic Factors in Locally Advanced Breast Cancer. An Immunohistochemical, Retrospective Study. Tumori 2018; 79:214-8. [PMID: 7901927 DOI: 10.1177/030089169307900312] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background The aim of the present study was to determine, retrospectively, whether the immunohistochemical expression of two biologic markers of aggressivity, P-glycoprotein (P-gp) and PCNA/cyclin (PCNA), could be related to response to chemotherapy and prognosis in locally advanced breast cancer. Methods PC 10 Mab was used to determine the proliferation index (PCNA) and C-219 Mab to determine P-gp in 25 locally advanced breast carcinomas subjected to preoperative chemotherapy with MDR-related drugs. Results P-gp and PCNA were expressed in 76 % and 100 % of the tumors, respectively. No case of high P-gp expression was associated with good chemosensitivity, and all P-gp-negative cases showed the best chemotherapeutic response. P-gp and PCNA were both highly expressed in patients who developed local-regional or distant metastases. No recurrence was associated with a negative or low P-gp score. Conclusions Statistical analysis showed that high P-gp expression was related to a poor response to chemotherapy and a short disease-free survival. A high PCNA score was not found to be significant for predicting chemosensitivity or survival.
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Affiliation(s)
- G Botti
- Istituto Nazionale dei Tumori, Fondazione G. Pascale, Napoli, Italy
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25
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D'Aiuto G, Del Vecchio S, Mansi L, D'Aprile M, Botti G, Salvatore M. Malignant Melanoma of the Nipple: A Case Studied with Radiolabeled Monoclonal Antibody. Tumori 2018; 77:449-51. [PMID: 1664156 DOI: 10.1177/030089169107700517] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 11/16/2022]
Abstract
We describe a case of histologically confirmed malignant melanoma of the nipple. The rare occurrence of these lesions accounts for the relative lack of criteria for standard surgical treatment. After a conventional workup including mammography, chest X ray, bone scan, liver ultrasonography and cytologic smear of the lesion, we used specific radiolabeled monoclonal antibody and external photoscanning to differentiate melanoma from Paget's disease. The patient underwent wide local excision of the lesion and axillary node dissection, and tumor control is optimal since she has no evidence of disease after 5 years of follow-up.
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Affiliation(s)
- G D'Aiuto
- Department of Surgery, National Cancer Institute, Naples, Italy
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Cerra M, Cecco L, Montella M, Tuccillo F, Bonelli P, Botti G. Epidermal Growth Factor Receptor in Human Breast Cancer: Comparison with Steroid Receptors and other Prognostic Factors. Int J Biol Markers 2018; 10:136-42. [PMID: 8551055 DOI: 10.1177/172460089501000302] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The relationship between epidermal growth factor receptor (EGFR) status and various prognostic factors was investigated in 70 human breast cancer specimens. Epidermal growth factor receptor was determined by radioligand binding assay, standardized by the EORTC Receptor Study Group, using hydroxyapatite to separate receptor-bound and free ligand. The percentage of EGFR positivity was 80% when the cutoff was set at 5 fmol/mg of membrane protein; this percentage was among the highest hitherto reported. Regression analysis of EGFR versus ER and PR levels confirmed an inverse relationship between EGFR and ER (p = 0.022) as well as between EGFR and PR (p = 0.024). Univariate analysis of the EGFR data stratified according to steroid hormone receptor status showed EGFR to be negatively associated with ER and PR. No association was found between EGFR and menopausal status, axillary lymph node involvement, tumor size, and differentiation grade. A direct association between EGFR status and Ki-67 positive cell rate could be demonstrated.
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Affiliation(s)
- M Cerra
- Biochemistry Department, National Cancer Institute Fondazione G. Pascale, Napoli, Italy
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de Lima TB, Paz AHR, Rados PV, Leonardi R, Bufo P, Pedicillo MC, Santoro A, Cagiano S, Aquino G, Botti G, Pannone G, Visioli F. Autophagy analysis in oral carcinogenesis. Pathol Res Pract 2017; 213:1072-1077. [PMID: 28843750 DOI: 10.1016/j.prp.2017.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/04/2017] [Accepted: 07/28/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the levels of autophagy in oral leukoplakia and squamous cell carcinoma and to correlate with clinical pathological features, as well as, the evolution of these lesions. METHODOLOGY 7 Normal oral mucosa, 51 oral leukoplakias, and 120 oral squamous cell carcinomas (OSCC) were included in the study. Histological sections of the mucosa and leukoplakias were evaluated throughout their length, while the carcinomas were evaluated using Tissue Microarray. After the immunohistochemical technique, LC3-II positive cells were quantified in the different epithelial layers of the mucosa and leukoplakias and in the microarrays of the squamous cell carcinomas. The correlation between positive cells with the different clinical-pathological variables and with the evolution of the lesions was tested using the t test, ANOVA, and Kaplan-Meier survival analysis. RESULTS We observed increased levels of autophagy in the oral squamous cell carcinomas (p<0.001) in relation to the other groups, but without any association with poorer evolution or survival of these patients. Among the leukoplakias, we observed a higher percentage of positive cells in the intermediate layer of the dysplastic leukoplakias (p=0.0319) and in the basal layer of lesions with poorer evolution (p=0.0133). CONCLUSION The levels of autophagy increased during the process of oral carcinogenesis and are correlated with poorer behavior of the leukoplakias.
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Affiliation(s)
- T B de Lima
- Department of Oral Pathology - Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - A H R Paz
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil
| | - P V Rados
- Department of Oral Pathology - Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - R Leonardi
- Department of Medical and Surgical Science, II Dental Unit - University of Catania, Catania, Italy
| | - P Bufo
- Department of Clinical and Experimental Medicine, Pathological Anatomy Unit - University of Foggia, Foggia, Italy
| | - M C Pedicillo
- Department of Clinical and Experimental Medicine, Pathological Anatomy Unit - University of Foggia, Foggia, Italy
| | - A Santoro
- Department of Clinical and Experimental Medicine, Pathological Anatomy Unit - University of Foggia, Foggia, Italy
| | - S Cagiano
- Department of Clinical and Experimental Medicine, Pathological Anatomy Unit - University of Foggia, Foggia, Italy
| | - G Aquino
- Pathology Unit, Instituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - G Botti
- Pathology Unit, Instituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - G Pannone
- Department of Clinical and Experimental Medicine, Pathological Anatomy Unit - University of Foggia, Foggia, Italy; Pathology Unit, Instituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale", IRCCS, Naples, Italy
| | - F Visioli
- Department of Oral Pathology - Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil.
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Normanno N, Rachiglio A, Lambiase M, Fenizia F, Iannaccone A, Chicchinelli N, Morabito A, Montanino A, Rocco G, Galetta D, Montagna E, Crinò L, Ludovini V, Vincenzi B, Barletta E, Pinto C, Ferraù F, Botti G, Piccirillo M, Perrone F. Tumor heterogeneity affects the activity of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in EGFR mutant non-small cell lung cancer (NSCLC) patients (pts). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.35] [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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29
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Martini G, Belli V, Vitiello P, Troiani T, Cardone C, Napolitano S, Desiderio V, Sforza V, Ferrara M, Papaccio G, Mele L, Liguori G, Botti G, Franco R, Morgillo F, Ciardiello F, Martinelli E. blockade overcomes primary and acquired resistance to anti-epidermal growth factor receptor (EGFR) therapy in metastatic colorectal cancer (mCRC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw362.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Crispo A, Augustin LSA, Grimaldi M, Nocerino F, Giudice A, Cavalcanti E, Di Bonito M, Botti G, De Laurentiis M, Rinaldo M, Esposito E, Riccardi G, Amore A, Libra M, Ciliberto G, Jenkins DJA, Montella M. Risk Differences Between Prediabetes And Diabetes According To Breast Cancer Molecular Subtypes. J Cell Physiol 2016; 232:1144-1150. [PMID: 27579809 DOI: 10.1002/jcp.25579] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 08/29/2016] [Indexed: 02/03/2023]
Abstract
Hyperglycemia and hyperinsulinemia may play a role in breast carcinogenesis and prediabetes and diabetes have been associated with increased breast cancer (BC) risk. However, whether BC molecular subtypes may modify these associations is less clear. We therefore investigated these associations in all cases and by BC molecular subtypes among women living in Southern Italy. Cases were 557 patients with non-metastatic incident BC and controls were 592 outpatients enrolled during the same period as cases and in the same hospital for skin-related non-malignant conditions. Adjusted multivariate logistic regression models were built to assess the risks of developing BC in the presence of prediabetes or diabetes. The analyses were repeated by strata of BC molecular subtypes: Luminal A, Luminal B, HER2+, and Triple Negative (TN). Prediabetes and diabetes were significantly associated with higher BC incidence after controlling for known risk factors (OR = 1.94, 95% CI 1.32-2.87 and OR = 2.46, 95% CI 1.38-4.37, respectively). Similar results were seen in Luminal A and B while in the TN subtype only prediabetes was associated with BC (OR = 2.43, 95% CI 1.11-5.32). Among HER2+ patients, only diabetes was significantly associated with BC risk (OR = 3.04, 95% CI 1.24-7.47). Furthermore, when postmenopausal HER2+ was split into hormone receptor positive versus negative, the association with diabetes remained significant only in the former (OR = 5.13, 95% CI 1.53-17.22). These results suggest that prediabetes and diabetes are strongly associated with BC incidence and that these metabolic conditions may be more relevant in the presence of breast cancer molecular subtypes with positive hormone receptors. J. Cell. Physiol. 232: 1144-1150, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- A Crispo
- Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - L S A Augustin
- Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Naples, Italy.,Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
| | - M Grimaldi
- Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - F Nocerino
- Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - A Giudice
- Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - E Cavalcanti
- Department of Diagnostic Pathology and Laboratory, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - M Di Bonito
- Department of Diagnostic Pathology and Laboratory, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - G Botti
- Department of Diagnostic Pathology and Laboratory, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - M De Laurentiis
- Department of Breast Surgery, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - M Rinaldo
- Department of Breast Surgery, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - E Esposito
- Department of Breast Surgery, National Cancer Institute, G. Pascale Foundation, Naples, Italy.,Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - G Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - A Amore
- Department of Surgery, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - M Libra
- Section of Clinical and General Pathology and Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - G Ciliberto
- Scientific Direction, National Cancer Institute, G. Pascale Foundation, Naples, Italy
| | - D J A Jenkins
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
| | - M Montella
- Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Naples, Italy
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Galon J, Fox BA, Bifulco CB, Masucci G, Rau T, Botti G, Marincola FM, Ciliberto G, Pages F, Ascierto PA, Capone M. Immunoscore and Immunoprofiling in cancer: an update from the melanoma and immunotherapy bridge 2015. J Transl Med 2016; 14:273. [PMID: 27650038 PMCID: PMC5029056 DOI: 10.1186/s12967-016-1029-z] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/06/2016] [Indexed: 12/15/2022] Open
Abstract
The fifth "Melanoma Bridge Meeting" took place in Naples, December 1-5th, 2015. The main topics discussed at this meeting were: Molecular and Immuno advances, Immunotherapies and Combination Therapies, Tumor Microenvironment and Biomarkers and Immunoscore. The natural history of cancer involves interactions between the tumor and the immune system of the host. The immune infiltration at the tumor site may be indicative of host response. Significant correlations were shown between the levels of immune cell infiltration in tumors and patient's clinical outcome. Moreover, incredible progress comes from the discovery of mutation-encoded tumor neoantigens. In fact, as tumors grow, they acquire mutations that are able to influence the response of patients to immune checkpoint inhibitors. It has been demonstrated that sensitivity to PD-1 and CTLA-4 blockade in patients with advanced NSCLC and melanoma was enhanced in tumors enriched for clonal neoantigens. The road ahead is still very long, but the knowledge of the mechanisms of immune escape, the study of tumor neo-antigens as well as of tumor microenvironment and the development of new immunotherapy strategies, will make cancer a more and more treatable disease.
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Affiliation(s)
- J Galon
- Laboratory of Integrative Cancer Immunology, INSERM UMRS1138 Cordeliers Research Center, University Pierre et Marie Curie, Paris 6, 15 Rue de l'Ecole de Medecine, 75006, Paris, France.,University Paris Descartes, 45 Rue Saints Pères, 75006, Paris, France
| | - B A Fox
- Robert W. Franz Cancer Research Center, Earle A. Chiles Research Institute, Providence Cancer Center, Providence Portland Medical Center, Portland, OR, 97213, USA.,Department of Molecular Microbiology & Immunology, Oregon Health & Science University, Portland, OR, 97239, USA
| | - C B Bifulco
- Department of Pathology, Providence Portland Medical Center, Portland, OR, 97213, USA
| | - G Masucci
- Department of Oncology-Pathology, The Karolinska Hospital, Stockholm, Sweden
| | - T Rau
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - G Botti
- Unit of Pathology, IRCCS, Istituto Nazionale Tumori, Fondazione "G. Pascale", Naples, Italy
| | | | - G Ciliberto
- IRCCS, Istituto Nazionale Tumori, Fondazione "G. Pascale",Scentific Directorate, Naples, Italy
| | - F Pages
- University Paris Descartes, 45 Rue Saints Pères, 75006, Paris, France.,Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Cordeliers Research Center, 15 Rue de l'Ecole de Medecine, 75006, Paris, France.,Centre de Recherche des Cordeliers, University Pierre et Marie Curie, Paris 6, 15 Rue de l'Ecole de Medecine, 75006, Paris, France.,Immunomonitoring Platform, Laboratory of Immunology, Georges Pompidou European Hospital, 20-40 Rue Leblanc, 75015, Paris, France
| | - P A Ascierto
- Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy, Istituto Nazionale Tumori, Fondazione "G. Pascale", Naples, Italy
| | - M Capone
- Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy, Istituto Nazionale Tumori, Fondazione "G. Pascale", Naples, Italy.
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Normanno N, Rachiglio A, Lambiase M, Fenizia F, Iannaccone A, Chicchinelli N, Morabito A, Rocco G, Galetta D, Montagna E, Crinò L, Ludovini V, Vincenzi B, Barletta E, Pinto C, Ferraù F, Botti G, Piccirillo M, Perrone F. Tumor heterogeneity affects the activity of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in EGFR mutant non-small cell lung cancer (NSCLC) patients (pts). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw332.03] [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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Franco R, Scognamiglio G, Valentino E, Vitiello M, Panico L, Pinto A, Botti G, De Chiara A, Cerchia L, Fedele M. PATZ1 is a new prognostic marker of diffuse large B cell lymphomas. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61657-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Stilli D, Musso E, Macchi E, Taccardi B, Rolli A, Aurier E, Favaro L, Botti G. Diagnostic value of body surface maps in left bundle-branch block. Adv Cardiol 2015; 28:36-41. [PMID: 7234594 DOI: 10.1159/000391931] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Normanno N, Rachiglio AM, Lambiase M, Martinelli E, Fenizia F, Esposito C, Roma C, Troiani T, Rizzi D, Tatangelo F, Botti G, Maiello E, Colucci G, Ciardiello F. Heterogeneity of KRAS, NRAS, BRAF and PIK3CA mutations in metastatic colorectal cancer and potential effects on therapy in the CAPRI GOIM trial. Ann Oncol 2015; 26:1710-4. [PMID: 25851630 DOI: 10.1093/annonc/mdv176] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [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: 01/21/2015] [Accepted: 03/13/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Evidence suggests that metastatic colorectal carcinoma (mCRC) has a high level of intratumor heterogeneity. We carried out a quantitative assessment of tumor heterogeneity for KRAS, NRAS, BRAF and PIK3CA mutations, in order to assess potential clinical implications. PATIENTS AND METHODS Tumor samples (n = 182) from the CAPRI-GOIM trial of first-line cetuximab + FOLFIRI in KRAS exon-2 wild-type mCRC patients were assessed by next-generation sequencing that allows quantitative assessment of mutant genes. Mutant allelic frequency was normalized for the neoplastic cell content and, assuming that somatic mutations usually affect one allele, the Heterogeneity Score (HS) was calculated by multiplying by 2 the frequency of mutant alleles in neoplastic cells. Therefore, HS virtually corresponds to the fraction of neoplastic cells carrying a specific mutation. RESULTS The KRAS HS ranged between 12 and 260 with mean value of 87.1 and median value of 84.4, suggesting that in most CRC, the majority of neoplastic cells carry mutant KRAS. Similar findings were observed for NRAS (HS range 35.5-146.7; mean 102.8; median 117.1). In contrast, in BRAF (HS range 17.1-120; mean 54.8; median 54.3) and PIK3CA (HS range 14.3-120; mean 59.5; median 47.3) mutant cases, only a fraction of neoplastic cells seem to carry the mutant allele. The response rate was 70% in KRAS mutant patients with an HS <33 (low KRAS; n = 10) and 45.7% in KRAS HS >33 patients (high KRAS; n = 35); median progression-free survival were 7.97 and 8.37 months, respectively. Low-KRAS tumors had a higher frequency of additional mutations in PIK3CA when compared with high-KRAS (6/10 versus 8/35). CONCLUSIONS KRAS and NRAS mutations are usually present in the majority of neoplastic cells, whereas BRAF and PIK3CA mutations often affect a limited fraction of transformed cells. Resistance to cetuximab in low-KRAS patients might be driven by the complex mutational profile rather than KRAS mutation load.
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Affiliation(s)
- N Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - A M Rachiglio
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - M Lambiase
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - E Martinelli
- Department of Clinical and Experimental Medicine 'F. Magrassi'-Medical Oncology, Seconda Università degli Studi di Napoli, Napoli
| | - F Fenizia
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - C Esposito
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - C Roma
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - T Troiani
- Department of Clinical and Experimental Medicine 'F. Magrassi'-Medical Oncology, Seconda Università degli Studi di Napoli, Napoli
| | - D Rizzi
- GOIM, Gruppo Oncologico dell'Italia Meridionale, Bari
| | - F Tatangelo
- Surgical Pathology Unit, Istituto Nazionale Tumori 'Fondazione Giovanni Pascale', IRCCS, Napoli
| | - G Botti
- Surgical Pathology Unit, Istituto Nazionale Tumori 'Fondazione Giovanni Pascale', IRCCS, Napoli
| | - E Maiello
- Medical Oncology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - G Colucci
- GOIM, Gruppo Oncologico dell'Italia Meridionale, Bari
| | - F Ciardiello
- Department of Clinical and Experimental Medicine 'F. Magrassi'-Medical Oncology, Seconda Università degli Studi di Napoli, Napoli
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Normanno N, Rachiglio AM, Lambiase M, Martinelli E, Fenizia F, Esposito C, Roma C, Troiani T, Rizzi D, Tatangelo F, Botti G, Maiello E, Colucci G, Ciardiello F. Heterogeneity of KRAS, NRAS, BRAF and PIK3CA mutations in metastatic colorectal cancer and potential effects on therapy in the CAPRI GOIM trial. Ann Oncol 2015. [PMID: 25851630 DOI: 10.1093/annaoc/mdv176] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Evidence suggests that metastatic colorectal carcinoma (mCRC) has a high level of intratumor heterogeneity. We carried out a quantitative assessment of tumor heterogeneity for KRAS, NRAS, BRAF and PIK3CA mutations, in order to assess potential clinical implications. PATIENTS AND METHODS Tumor samples (n = 182) from the CAPRI-GOIM trial of first-line cetuximab + FOLFIRI in KRAS exon-2 wild-type mCRC patients were assessed by next-generation sequencing that allows quantitative assessment of mutant genes. Mutant allelic frequency was normalized for the neoplastic cell content and, assuming that somatic mutations usually affect one allele, the Heterogeneity Score (HS) was calculated by multiplying by 2 the frequency of mutant alleles in neoplastic cells. Therefore, HS virtually corresponds to the fraction of neoplastic cells carrying a specific mutation. RESULTS The KRAS HS ranged between 12 and 260 with mean value of 87.1 and median value of 84.4, suggesting that in most CRC, the majority of neoplastic cells carry mutant KRAS. Similar findings were observed for NRAS (HS range 35.5-146.7; mean 102.8; median 117.1). In contrast, in BRAF (HS range 17.1-120; mean 54.8; median 54.3) and PIK3CA (HS range 14.3-120; mean 59.5; median 47.3) mutant cases, only a fraction of neoplastic cells seem to carry the mutant allele. The response rate was 70% in KRAS mutant patients with an HS <33 (low KRAS; n = 10) and 45.7% in KRAS HS >33 patients (high KRAS; n = 35); median progression-free survival were 7.97 and 8.37 months, respectively. Low-KRAS tumors had a higher frequency of additional mutations in PIK3CA when compared with high-KRAS (6/10 versus 8/35). CONCLUSIONS KRAS and NRAS mutations are usually present in the majority of neoplastic cells, whereas BRAF and PIK3CA mutations often affect a limited fraction of transformed cells. Resistance to cetuximab in low-KRAS patients might be driven by the complex mutational profile rather than KRAS mutation load.
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Affiliation(s)
- N Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - A M Rachiglio
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - M Lambiase
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - E Martinelli
- Department of Clinical and Experimental Medicine 'F. Magrassi'-Medical Oncology, Seconda Università degli Studi di Napoli, Napoli
| | - F Fenizia
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - C Esposito
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - C Roma
- Laboratory of Pharmacogenomics, Centro di Ricerche Oncologiche di Mercogliano (CROM)-Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS, Napoli
| | - T Troiani
- Department of Clinical and Experimental Medicine 'F. Magrassi'-Medical Oncology, Seconda Università degli Studi di Napoli, Napoli
| | - D Rizzi
- GOIM, Gruppo Oncologico dell'Italia Meridionale, Bari
| | - F Tatangelo
- Surgical Pathology Unit, Istituto Nazionale Tumori 'Fondazione Giovanni Pascale', IRCCS, Napoli
| | - G Botti
- Surgical Pathology Unit, Istituto Nazionale Tumori 'Fondazione Giovanni Pascale', IRCCS, Napoli
| | - E Maiello
- Medical Oncology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - G Colucci
- GOIM, Gruppo Oncologico dell'Italia Meridionale, Bari
| | - F Ciardiello
- Department of Clinical and Experimental Medicine 'F. Magrassi'-Medical Oncology, Seconda Università degli Studi di Napoli, Napoli
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Perrone F, Nuzzo F, Di Rella F, Gravina A, Iodice G, Labonia V, Landi G, Pacilio C, Rossi E, De Laurentiis M, D'Aiuto M, Botti G, Forestieri V, Lauria R, De Placido S, Tinessa V, Daniele B, Gori S, Colantuoni G, Barni S, Riccardi F, De Maio E, Montanino A, Morabito A, Daniele G, Di Maio M, Piccirillo M, Signoriello S, Gallo C, de Matteis A. Weekly docetaxel versus CMF as adjuvant chemotherapy for older women with early breast cancer: final results of the randomized phase III ELDA trial. Ann Oncol 2015; 26:675-682. [DOI: 10.1093/annonc/mdu564] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Montella M, Crispo A, Grimaldi M, Botti G, Di Bonito M, Arpino G, Buono G, De Placido S, D'Aiuto M, D'Aiuto G. PR24 Difference of clinical features and molecular subtypes between under-forty and post-menopausal breast cancer patients in southern Italy. Breast 2014. [DOI: 10.1016/s0960-9776(14)70034-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Normanno N, Rachiglio A, Lambiase M, Martinelli E, Fenizia F, Esposito C, Roma C, Troiani T, Tatangelo F, Botti G, Rizzi D, Maiello E, Colucci G, Ciardiello F. Tumor Heterogeneity and Efficacy of First-Line Cetuximab + Folfiri in Kras Mutant Metastatic Colorectal Cancer (Mcrc) Patients (Pts) of the Capri Goim Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.42] [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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Ciardiello F, Normanno N, Maiello E, Martinelli E, Troiani T, Pisconti S, Giuliani F, Barone C, Cartenì G, Rachiglio AM, Montesarchio V, Tonini G, Rizzi D, Cinieri S, Bordonaro R, Febbraro A, De Vita F, Orditura M, Fenizia F, Lambiase M, Rinaldi A, Tatangelo F, Botti G, Colucci G. Clinical activity of FOLFIRI plus cetuximab according to extended gene mutation status by next-generation sequencing: findings from the CAPRI-GOIM trial. Ann Oncol 2014; 25:1756-1761. [PMID: 24942275 DOI: 10.1093/annonc/mdu230] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Treatment with antiepidermal growth factor receptor (anti-EGFR) monoclonal antibodies has been restricted to metastatic colorectal cancer (mCRC) patients with RAS wild-type tumors. Next-generation sequencing (NGS) allows the assessment in a single analysis of a large number of gene alterations and might provide important predictive and prognostic information. PATIENTS AND METHODS In the CAPRI-GOIM trial, 340 KRAS exon 2 wild-type mCRC patients received first-line FOLFIRI plus cetuximab. Tumor samples (182/340, 53.5%) were assessed by NGS to search for mutations in 22 genes involved in colon cancer. RESULTS Objective responses in the NGS cohort were observed in 104/182 patients [overall response rate (ORR) 57.1%; 95% confidence interval (95% CI) 52% to 66.4%] with a median progression-free survival (mPFS) of 9.8 (95% CI 8.7-11.5) months. NGS analysis was successfully completed in all 182 samples. One or more gene mutations (up to five) were detected in 124/182 (68.1%) tumors within 14/22 genes for a total of 206 mutations. KRAS exon 2 mutations were identified in 29/182 (15.9%) samples, defined as wild type by local laboratory assessment. Frequently mutated genes were: TP53 (39.6%), KRAS exons 3/4 (8.8%), NRAS exons 2/3 (7.1%), PIK3CA exons 9/20 (13.2%), BRAF (8.2%). FOLFIRI plus cetuximab treatment determined ORR of 62.0% (95% CI 55.5% to 74.6%) with mPFS of 11.1 (95% CI 9.2-12.8) months in patients with KRAS and NRAS wild-type tumors. Conversely, ORR was 46.6% (95% CI 39.9-57.5%) with mPFS of 8.9 (95% CI 7.4-9.6) months in patients with KRAS or NRAS mutations. Similarly, the subgroup of patients carrying KRAS, NRAS, BRAF, or PIK3CA mutations showed a worse outcome, although this might be due to a prognostic effect. CONCLUSIONS This study demonstrates that NGS analysis in mCRC is feasible, reveals high level of intra and intertumor heterogeneity, and identifies patients that might benefit of FOLFIRI plus cetuximab treatment.
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Affiliation(s)
- F Ciardiello
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples.
| | - N Normanno
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - E Maiello
- Medical Oncology, Hospital Casa Sollievo Della Sofferenza-San Giovanni Rotondo (Foggia), San Giovanni Rotondo
| | - E Martinelli
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples
| | - T Troiani
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples
| | - S Pisconti
- Department of Medical Oncology, Hospital SS. Annunziata, Taranto
| | - F Giuliani
- Department of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari
| | - C Barone
- Department of Medical Oncology, University Hospital A. Gemelli, Rome
| | - G Cartenì
- Department of Medical Oncology, Hospital 'A. Cardarelli', Naples
| | - A M Rachiglio
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - V Montesarchio
- Department of Medical Oncology, Hospital Monaldi- Azienda Ospedaliera dei Colli, Napoles
| | - G Tonini
- Department of Medical Oncology, Univeristy Hospital Campus Bio-Medico di Rome, Rome
| | - D Rizzi
- Department of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari
| | - S Cinieri
- Department of Medical Oncology, Hospital A. Perrino, Brindisi
| | - R Bordonaro
- Department of Medical Oncology, Hospital Garibaldi, Nesima, Catania
| | - A Febbraro
- Department of Medical Oncology, Hospital Sacro Cuore di Gesù, Fatebenefratelli, Benevento
| | - F De Vita
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples
| | - M Orditura
- Department of Clinical and Experimental Medicine 'F. Magrassi', Medical Oncology, Second University of Naples, Naples
| | - F Fenizia
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - M Lambiase
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - A Rinaldi
- Department of Medical Oncology, Hospital Polo Occidentale, Castellaneta, Bari
| | - F Tatangelo
- Cell Biology and Biotherapy Unit, National Cancer Institute 'Fondazione Giovanni Pascale', Naples
| | - G Botti
- Department of Pathology, National Cancer Institute 'Fondazione Giovanni Pascale', Naples, Italy
| | - G Colucci
- Department of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari
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41
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Cardone C, Liguori G, Troiani T, Nappi A, Amoroso N, Iaffaioli V, Romano C, Botti G, Vitagliano D, Martini G, Napolitano S, Morgillo F, Sforza V, Giunta E, Di Maio M, De Vita F, Ciardiello F, Martinelli E. Expression of Axl Receptor and Its Ligand Gas6 in Colorectal Cancer (Crc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Abstract
In the last few years, surgery of the ageing face seems to have shifted from tissue uplifting and tightening to mere filling. We do not agree with this trend. We are positive that ageing brings about 2 basic phenomena: on one hand bone and fat volume reduction, whilst on the other a deterioration of the skin lining (elastosis) leading to an increase in its compliance and extension. We therefore deem of the utmost importance to couple soft tissue filling with indispensable tightening and repositioning together with resection of overabundant skin. For what concerns the mid-face area in particular, we suggest to resort to 3 different lifting techniques, according to the kind of defect to be treated. It is important to take the right pulling vector into consideration as well as the need of skin excess removal. The procedures can be tailored to suit any peculiar need such as malar bag, lower lid border malposition, tear trough deformity, etc. Different cases will be taken into consideration as examples of the various indications and techniques.
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Affiliation(s)
- G Botti
- Plastic Surgery, Villa Bella Clinic, Saló, Italy
| | - C Botti
- Plastic Surgery, Villa Bella Clinic, Saló, Italy
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43
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Ieranò C, Santagata S, Napolitano M, Guardia F, Grimaldi A, Antignani E, Botti G, Consales C, Riccio A, Nanayakkara M, Barone MV, Caraglia M, Scala S. CXCR4 and CXCR7 transduce through mTOR in human renal cancer cells. Cell Death Dis 2014; 5:e1310. [PMID: 24991762 PMCID: PMC4123065 DOI: 10.1038/cddis.2014.269] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 05/20/2014] [Accepted: 05/22/2014] [Indexed: 01/09/2023]
Abstract
Treatment of metastatic renal cell carcinoma (mRCC) has improved significantly with the advent of agents targeting the mTOR pathway, such as temsirolimus and everolimus. However, their efficacy is thought to be limited by feedback loops and crosstalk with other pathways leading to the development of drug resistance. As CXCR4-CXCL12-CXCR7 axis has been described to have a crucial role in renal cancer; the crosstalk between the mTOR pathway and the CXCR4-CXCL12-CXCR7 chemokine receptor axis has been investigated in human renal cancer cells. In SN12C and A498, the common CXCR4-CXCR7 ligand, CXCL12, and the exclusive CXCR7 ligand, CXCL11, activated mTOR through P70S6K and 4EBP1 targets. The mTOR activation was specifically inhibited by CXCR4 antagonists (AMD3100, anti-CXCR4-12G5 and Peptide R, a newly developed CXCR4 antagonist) and CXCR7 antagonists (anti-CXCR7-12G8 and CCX771, CXCR7 inhibitor). To investigate the functional role of CXCR4, CXCR7 and mTOR in human renal cancer cells, both migration and wound healing were evaluated. SN12C and A498 cells migrated toward CXCL12 and CXCL11; CXCR4 and CXCR7 inhibitors impaired migration and treatment with mTOR inhibitor, RAD001, further inhibited it. Moreover, CXCL12 and CXCL11 induced wound healing while was impaired by AMD3100, the anti CXCR7 and RAD001. In SN12C and A498 cells, CXCL12 and CXCL11 promoted actin reorganization characterized by thin spikes at the cell periphery, whereas AMD3100 and anti-CXCR7 impaired CXCL12/CXCL11-induced actin polymerization, and RAD001 treatment further reduced it. In addition, when cell growth was evaluated in the presence of CXCL12, CXCL11 and mTOR inhibitors, an additive effect was demonstrated with the CXCR4, CXCR7 antagonists and RAD001. RAD001-resistant SN12C and A498 cells recovered RAD001 sensitivity in the presence of CXCR4 and CXCR7 antagonists. In conclusion, the entire axis CXCR4-CXCL12-CXCR7 regulates mTOR signaling in renal cancer cells offering new therapeutic opportunities and targets to overcome resistance to mTOR inhibitors.
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Affiliation(s)
- C Ieranò
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
| | - S Santagata
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
| | - M Napolitano
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
| | - F Guardia
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
| | - A Grimaldi
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy
| | - E Antignani
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
| | - G Botti
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
| | - C Consales
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
| | - A Riccio
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
| | - M Nanayakkara
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Disease (ELFID), University of Naples, Federico II, Italy
| | - M V Barone
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Disease (ELFID), University of Naples, Federico II, Italy
| | - M Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples, Italy
| | - S Scala
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "Giovanni Pascale"-IRCCS-ITALY, Naples, Italy
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44
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Marra L, Cantile M, Scognamiglio G, Marra L, Perdona S, La Mantia E, Cerrone M, Gigantino V, Cillo C, Caraglia M, Pignata S, Facchini G, Botti G, Chieffi S, Chieffi P, Franco R. Deregulation of HOX B13 Expression in Urinary Bladder Cancer Progression. Curr Med Chem 2013. [DOI: 10.2174/0929867311320060008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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45
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Marra L, Cantile M, Scognamiglio G, Marra L, Perdona S, La Mantia E, Cerrone M, Gigantino V, Cillo C, Caraglia M, Pignata S, Facchini G, Botti G, Chieffi S, Chieffi P, Franco R. Deregulation of HOX B13 Expression in Urinary Bladder Cancer Progression. Curr Med Chem 2013. [DOI: 10.2174/092986713805076658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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46
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Marra L, Cantile M, Scognamiglio G, Perdonà S, La Mantia E, Cerrone M, Gigantino V, Cillo C, Caraglia M, Pignata S, Facchini G, Botti G, Chieffi S, Chieffi P, Franco R. Deregulation of HOX B13 expression in urinary bladder cancer progression. Curr Med Chem 2013; 20:833-839. [PMID: 23276138] [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] [Received: 09/14/2012] [Revised: 12/21/2012] [Accepted: 12/21/2012] [Indexed: 06/01/2023]
Abstract
Urinary bladder cancer is a common malignancy in industrialized countries. More than 90% of bladder cancer originates in the transitional cells. Bladder transitional cancer prognosis is, according to the most recent definition related to the level of tumor infiltration, characterized by two main phenotypes, Non Muscle Invasive Bladder Transitional Cancer (NMIBC) and Muscle Invasive Bladder Transitional Cancer (MIBC). The genetic profile and the clinical course of the two subtypes are completely different, however among NMIBC the prognosis is not completely predictable, since 20% of the cases experience a relapse, even in the form of MIBC. It has recently been reported that the chromosomal region 12q13-15, containing crucial cancer genes such as MDM2, CDK4, GLI and an entire cluster of HOX genes, is amplified in bladder cancer. HOX genes codify for transcriptionl factor, involved in embryonal development and cancer progression, with main nuclear expression. Particularly it was also described the strong involvement of HOX B13 in several tumors of urogenital system. In this study we have been investigated, by immunohistochemisty and quantitative Real Time PCR, the HOX B13 expression in bladder cancer evolution and progression, evaluating its ability to discriminate between NMIBC and MBCI phenotypes. Cytoplasmic HOX B13 delocalization significantly relates with muscle invasion (p 0.004). In addition in the series of NMIBC nuclear HOX B13 expression loss is significantly associated to shorter disease free survival (p-value=0.038) defining a potential prognostic role. Overexpression of HOX B13 in more aggressive phenotype is also demonstrate at gene level by quantitative RT-PCR. The de-regulation and delocalization of HOX B13 in urinary bladder cancer supports again the important role of HOX genes in tumor evolution and represents a starting point to establish an integrated analysis, in which HOX genes represent important prognostic and predictive markers for bladder cancer.
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Affiliation(s)
- L Marra
- Pathology Unit, National Cancer Institute ‘G. Pascale’, Naples, Italy
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47
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Marone U, Catalano O, Caracò C, Anniciello AM, Sandomenico F, Di Monta G, Di Cecilia ML, Mori S, Botti G, Petrillo A, Mozzillo N. Can high-resolution ultrasound avoid the sentinel lymph-node biopsy procedure in the staging process of patients with stage I-II cutaneous melanoma? Ultraschall Med 2012; 33:E179-E185. [PMID: 22923259 DOI: 10.1055/s-0032-1312827] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE The objective of our study was to define the diagnostic accuracy of high-resolution ultrasound (US) in detecting nodal involvement before sentinel lymph node biopsy (SLNB) in patients with cutaneous melanoma, to define the sonographic criteria used to assess nodal metastases, and to establish if high-resolution US can directly select patients to radical lymphadenectomy, sparing selective lymphadenectomy. MATERIALS AND METHODS 623 patients underwent high-resolution US of the regional lymph nodes, 24 hours prior being submitted to the sentinel lymph node biopsy procedure. The US findings were compared with histological findings. RESULTS In 14.7 % out of 122 excised lymph nodes, high-resolution US showed sonographic features consistent with malignant involvement before the surgical step. US scan sensitivity and specificity were 15 and 100 %, respectively, since positive and negative predictive values were 100 and 87 % respectively. CONCLUSION US is an effective modality in the presurgical detection of subclinical deposits within sentinel lymph nodes. However, preoperative staging work-up with high-resolution US cannot substitute the SLNB, mainly because of low sensitivity due to missing many micrometastases.
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Affiliation(s)
- U Marone
- Melanoma - Soft Tissues - Head & Neck - Skin Cancers, INT Pascale
| | | | - C Caracò
- Melanoma - Soft Tissues - Head & Neck - Skin Cancers, INT Pascale
| | | | | | - G Di Monta
- Melanoma - Soft Tissues - Head & Neck - Skin Cancers, INT Pascale
| | - M L Di Cecilia
- Melanoma - Soft Tissues - Head & Neck - Skin Cancers, INT Pascale
| | - S Mori
- Melanoma - Soft Tissues - Head & Neck - Skin Cancers, INT Pascale
| | - G Botti
- Department of Pathology, INT Pascale
| | | | - N Mozzillo
- Melanoma - Soft Tissues - Head & Neck - Skin Cancers, INT Pascale
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48
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Mozzillo N, Caracò C, Mori S, Di Monta G, Botti G, Ascierto P, Caracò C, Aloj L. Feasibility of neoadjuvant electrochemotherapy for a large metastatic lesion of the cheek in a patient with melanoma. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.07.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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49
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Caracò C, Mozzillo N, Di Monta G, Botti G, Anniciello A, Marone U, Di Cecilia M, Staibano S, De Rosa G. Sentinel lymph node biopsy in atypical Spitz nevi: Is it useful? Eur J Surg Oncol 2012; 38:932-5. [DOI: 10.1016/j.ejso.2012.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 05/21/2012] [Accepted: 05/24/2012] [Indexed: 11/28/2022] Open
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50
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Nuzzo F, Gallo C, Lastoria S, Di Maio M, Piccirillo MC, Gravina A, Landi G, Rossi E, Pacilio C, Labonia V, Di Rella F, Bartiromo A, Buonfanti G, De Feo G, Esposito G, D'Aniello R, Maiolino P, Signoriello S, De Maio E, Tinessa V, Colantuoni G, De Laurentiis M, D'Aiuto M, Di Bonito M, Botti G, Giordano P, Daniele G, Morabito A, Normanno N, de Matteis A, Perrone F. Bone effect of adjuvant tamoxifen, letrozole or letrozole plus zoledronic acid in early-stage breast cancer: the randomized phase 3 HOBOE study. Ann Oncol 2012; 23:2027-2033. [PMID: 22412041 DOI: 10.1093/annonc/mdr600] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [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: 12/30/2022] Open
Abstract
BACKGROUND To measure bone mineral density (BMD) reduction produced by letrozole as compared with tamoxifen and the benefit of the addition of zoledronic acid. PATIENTS AND METHODS A phase 3 trial comparing tamoxifen, letrozole or letrozole+zoledronic acid in patients with hormone receptor-positive early breast cancer was conducted; triptorelin was given to premenopausal patients. Two comparisons were planned: letrozole versus tamoxifen and letrozole+zoledronic acid versus letrozole. Primary end point was the difference in 1-year change of T-score at lumbar spine (LTS) measured by dual energy X-ray absorptiometry scan. RESULTS Out of 483 patients enrolled, 459 were available for primary analyses. Median age was 50 (range 28-80). The estimated mean difference (95% confidence interval [CI]) in 1-year change of LTS was equal to -0.30 (95% CI -0.44 to -0.17) in the letrozole versus tamoxifen comparison (P<0.0001) and to +0.60 (95% CI +0.46 to +0.77) in the letrozole+zoledronic acid versus letrozole comparison (P<0.0001). Bone damage by letrozole decreased with increasing baseline body mass index in premenopausal, but not postmenopausal, patients (interaction test P=0.004 and 0.47, respectively). CONCLUSIONS In the HOBOE (HOrmonal BOne Effects) trial, the positive effect of zoledronic acid on BMD largely counteracts damage produced by letrozole as compared with tamoxifen. Letrozole effect is lower among overweight/obese premenopausal patients.
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Affiliation(s)
- F Nuzzo
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - C Gallo
- Medical Statistics, Department of Medicine and Public Health, Second University, Napoli
| | - S Lastoria
- Nuclear Medicine and Metabolic Therapy, Department of Imaging, National Cancer Institute, Napoli
| | - M Di Maio
- Clinical Trials Unit, Department of Research, National Cancer Institute, Napoli
| | - M C Piccirillo
- Clinical Trials Unit, Department of Research, National Cancer Institute, Napoli
| | - A Gravina
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - G Landi
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - E Rossi
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli; Division of Medical Oncology, Department of Oncohematology, S. Giuseppe Moscati Hospital, Avellino
| | - C Pacilio
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - V Labonia
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - F Di Rella
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - A Bartiromo
- Nuclear Medicine and Metabolic Therapy, Department of Imaging, National Cancer Institute, Napoli
| | - G Buonfanti
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - G De Feo
- Clinical Trials Unit, Department of Research, National Cancer Institute, Napoli
| | - G Esposito
- Laboratory Medicine, Department of Pathology and Laboratory Diagnostics, National Cancer Institute, Napoli
| | - R D'Aniello
- Department of Pharmacy, National Cancer Institute, Napoli
| | - P Maiolino
- Department of Pharmacy, National Cancer Institute, Napoli
| | - S Signoriello
- Medical Statistics, Department of Medicine and Public Health, Second University, Napoli
| | - E De Maio
- Clinical Trials Unit, Department of Research, National Cancer Institute, Napoli
| | - V Tinessa
- Division of Medical Oncology, Department of Oncology, Rummo Hospital, Benevento
| | - G Colantuoni
- Division of Medical Oncology, Department of Oncohematology, S. Giuseppe Moscati Hospital, Avellino
| | - M De Laurentiis
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - M D'Aiuto
- Division of Surgical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - M Di Bonito
- Pathology, Department of Pathology and Laboratory Diagnostics, National Cancer Institute, Napoli
| | - G Botti
- Pathology, Department of Pathology and Laboratory Diagnostics, National Cancer Institute, Napoli
| | - P Giordano
- Clinical Trials Unit, Department of Research, National Cancer Institute, Napoli
| | - G Daniele
- Clinical Trials Unit, Department of Research, National Cancer Institute, Napoli
| | - A Morabito
- Clinical Trials Unit, Department of Research, National Cancer Institute, Napoli
| | - N Normanno
- Cellular Biology and Biotherapy, Department of Research, National Cancer Institute, Napoli, Italy
| | - A de Matteis
- Medical Oncology, Department of Senology, National Cancer Institute, Napoli
| | - F Perrone
- Clinical Trials Unit, Department of Research, National Cancer Institute, Napoli.
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