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Vallome G, Cafaro I, Bottini A, Dellepiane C, Rossi G, Bennicelli E, Parisi F, Zullo L, Tagliamento M, Ballestrero A, Barisione E, Grazia Piroddi IM, Montecucco F, Carbone F, Pronzato P, Lambertini M, Spagnolo F, Barletta G, Barcellini L, Ferrante M, Nardin S, Coco S, Marconi S, Zinoli L, Moscatelli P, Arboscello E, Del Mastro L, Bellodi A, Genova C. Diagnosis of lung cancer following emergency admission: Examining care pathways, clinical outcomes, and advanced NSCLC treatment in an Italian cancer Center. Heliyon 2023; 9:e21177. [PMID: 37928020 PMCID: PMC10623281 DOI: 10.1016/j.heliyon.2023.e21177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Abstract
Background Lung cancer patients diagnosed following emergency admission often present with advanced disease and poor performance status, leading to suboptimal treatment options and outcomes. This study aimed to investigate the clinical and molecular characteristics, treatment initiation, and survival outcomes of these patients. Methods We retrospectively analyzed data from 124 patients diagnosed with lung cancer following emergency admission at a single institution. Clinical characteristics, results of molecular analyses for therapeutic purpose, systemic treatment initiation, and survival outcomes were assessed. Correlations between patients' characteristics and treatment initiation were analyzed. Results Median age at admission was 73 years, and 79.0 % had at least one comorbidity. Most patients (87.1 %) were admitted due to cancer-related symptoms. Molecular analyses were performed in 89.5 % of advanced non-small cell lung cancer (NSCLC) cases. In this subgroup, two-thirds (66.2 %) received first-line therapy. Median overall survival (OS) was 3.9 months for the entire cohort, and 2.9 months for patients with metastatic lung cancer. Among patients with advanced NSCLC, OS was significantly longer for those with actionable oncogenic drivers and those who received first-line therapy. Improvement of performance status during hospitalization resulted in increased probability of receiving first-line systemic therapy. Discussion Patients diagnosed with lung cancer following emergency admission demonstrated poor survival outcomes. Treatment initiation, particularly for patients with actionable oncogenic drivers, was associated with longer OS. These findings highlight the need for proactive medical approaches, including improving access to molecular diagnostics and targeted treatments, to optimize outcomes in this patient population.
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Affiliation(s)
- Giacomo Vallome
- U.O. Oncologia Medica, Ospedale Padre Antero Micone, ASL3, Genoa, Italy
| | - Iacopo Cafaro
- U.O. Clinica di Medicina Interna a Indirizzo Oncologico, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Annarita Bottini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Chiara Dellepiane
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni Rossi
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elisa Bennicelli
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesca Parisi
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lodovica Zullo
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marco Tagliamento
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Alberto Ballestrero
- U.O. Clinica di Medicina Interna a Indirizzo Oncologico, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Emanuela Barisione
- U.O. Pneumologia a Indirizzo Interventistico, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italian Cardiovascular Network, Genoa, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italian Cardiovascular Network, Genoa, Italy
| | - Paolo Pronzato
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Spagnolo
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), Plastic Surgery Division, University of Genoa, Genoa, Italy
| | - Giulia Barletta
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucrezia Barcellini
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Michele Ferrante
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simone Nardin
- U.O. Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simona Coco
- UO Tumori Polmonari, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Marconi
- UO Tumori Polmonari, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Linda Zinoli
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Paolo Moscatelli
- UO Medicina Interna, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Eleonora Arboscello
- Dipartimento di Emergenza Urgenza e Accettazione (DEA), IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucia Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Bellodi
- U.O. Clinica di Medicina Interna a Indirizzo Oncologico, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Genova
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Vallome G, Cafaro I, Bottini A, Del Mastro L, Pronzato P, Sobrero A, Ballestrero A, Bellodi A, Moscatelli P, Barisione E, Genova C. EP04.01-005 Lung Cancer Diagnosis Following Emergency Admission: Diagnostic and Therapeutic Pathways and Outcomes Within an Italian Cancer Center. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.417] [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]
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Cerbone L, Cattrini C, Vallome G, Latocca MM, Boccardo F, Zanardi E. Combination therapy in metastatic renal cell carcinoma: Back to the future? Semin Oncol 2020; 47:361-366. [PMID: 33168323 DOI: 10.1053/j.seminoncol.2020.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/20/2019] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 01/12/2023]
Abstract
The treatment landscape of metastatic renal cell carcinoma (mRCC), a chemotherapy-resistant disease, has dramatically changed in the last decade after the introduction of small molecule inhibitors targeting the vascular endothelial growth factor receptor and mammalian target of rapamycin kinases. The CheckMate 025 phase III trial in second line mRCC also introduced immunotherapy with immune-checkpoint inhibitors as an option in the management of mRCC. Both small molecules and immunotherapy are used as single agents and they are associated with different toxicities. Recent data demonstrated that the combination of 2 immunotherapies, nivolumab and ipilimumab, is more effective than tyrosine kinase inhibitors (TKI) monotherapy as first line treatment in intermediate and poor risk mRCC. Furthermore, combination of immunotherapies and TKI has been tested in several trials to evaluate if the combo with agents presenting a different mechanism of action is more effective than monotherapy with TKI. During the past several years, combined therapy of cytokines doublets or cytokines and bevacizumab doublets demonstrated little improvement in clinical outcomes and a relevant toxicity profile. Conversely, the combination of new agents has been recently shown to improve survival in patients with metastatic disease, thus changing the treatment landscape of mRCC. This comprehensive review aims at summarizing the recent advances in the treatment of mRCC.
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Affiliation(s)
- Luigi Cerbone
- Dipartimento di Medicina Interna e Specialità Mediche, DIMI, Università degli Studi di Genova, Genoa, Italy; Academic Unit of Medical Oncology, Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Cattrini
- Dipartimento di Medicina Interna e Specialità Mediche, DIMI, Università degli Studi di Genova, Genoa, Italy; Academic Unit of Medical Oncology, Ospedale Policlinico San Martino, Genoa, Italy
| | - Giacomo Vallome
- Dipartimento di Medicina Interna e Specialità Mediche, DIMI, Università degli Studi di Genova, Genoa, Italy; Academic Unit of Medical Oncology, Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Maddalena Latocca
- Dipartimento di Medicina Interna e Specialità Mediche, DIMI, Università degli Studi di Genova, Genoa, Italy; Academic Unit of Medical Oncology, Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Boccardo
- Dipartimento di Medicina Interna e Specialità Mediche, DIMI, Università degli Studi di Genova, Genoa, Italy; Academic Unit of Medical Oncology, Ospedale Policlinico San Martino, Genoa, Italy
| | - Elisa Zanardi
- Dipartimento di Medicina Interna e Specialità Mediche, DIMI, Università degli Studi di Genova, Genoa, Italy; Academic Unit of Medical Oncology, Ospedale Policlinico San Martino, Genoa, Italy.
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Arecco L, Perachino M, Damassi A, Latocca MM, Soldato D, Vallome G, Parisi F, Razeti MG, Solinas C, Tagliamento M, Spinaci S, Massarotti C, Lambertini M. Burning Questions in the Oncofertility Counseling of Young Breast Cancer Patients. Breast Cancer (Auckl) 2020; 14:1178223420954179. [PMID: 32952399 PMCID: PMC7476336 DOI: 10.1177/1178223420954179] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/10/2020] [Indexed: 12/28/2022]
Abstract
The improved prognosis of breast cancer patients makes survivorship issues an area of crucial importance. In this regard, an increased attention is needed toward the development of potential anticancer treatment-related long-term side-effects, including gonadal failure and infertility in young women. Therefore, fertility preservation and family planning are crucial issues to be addressed in all young women of reproductive age with newly diagnosed cancer. Despite a growing availability of data on the efficacy and safety of fertility preservation options and the fact that conceiving after prior history of breast cancer has become more accepted over time, there are still several gray zones in this field so that many physicians remain uncomfortable to deal with these topics. The purpose of this review is to answer some of the most controversial questions frequently asked by patients during their oncofertility counseling, in order to provide a detailed and up-to-date overview on the evidence available in this field to physicians involved in the care of young women with breast cancer.
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Affiliation(s)
- Luca Arecco
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Marta Perachino
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Alessandra Damassi
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Maria Maddalena Latocca
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Davide Soldato
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Giacomo Vallome
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Francesca Parisi
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Maria Grazia Razeti
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Cinzia Solinas
- Department of Medical Oncology, Azienda Tutela della Salute Sardegna, Hospital A.Segni Ozieri, Sassari, Italy
| | - Marco Tagliamento
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Stefano Spinaci
- Division of Breast Surgery, Ospedale Villa Scassi e ASL3, Genova, Italy
| | - Claudia Massarotti
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy.,Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy
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Cattrini C, Bersanelli M, Latocca MM, Conte B, Vallome G, Boccardo F. Sex Hormones and Hormone Therapy during COVID-19 Pandemic: Implications for Patients with Cancer. Cancers (Basel) 2020; 12:E2325. [PMID: 32824674 PMCID: PMC7464909 DOI: 10.3390/cancers12082325] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 01/08/2023] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) shows a wide spectrum of clinical presentations, severity, and fatality rates. The reason older patients and males show increased risk of severe disease and death remains uncertain. Sex hormones, such as estradiol, progesterone, and testosterone, might be implicated in the age-dependent and sex-specific severity of COVID-19. High testosterone levels could upregulate transmembrane serine protease 2 (TMPRSS2), facilitating the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into host cells via angiotensin-converting enzyme 2 (ACE2). Data from patients with prostate cancer treated with androgen-deprivation therapy seem to confirm this hypothesis. Clinical studies on TMPRSS2 inhibitors, such as camostat, nafamostat, and bromhexine, are ongoing. Antiandrogens, such as bicalutamide and enzalutamide, are also under investigation. Conversely, other studies suggest that the immune modulating properties of androgens could protect from the unfavorable cytokine storm, and that low testosterone levels might be associated with a worse prognosis in patients with COVID-19. Some evidence also supports the notion that estrogens and progesterone might exert a protective effect on females, through direct antiviral activity or immune-mediated mechanisms, thus explaining the higher COVID-19 severity in post-menopausal women. In this perspective, we discuss the available evidence on sex hormones and hormone therapy in patients infected with SARS-CoV-2, and we highlight the possible implications for cancer patients, who can receive hormonal therapies during their treatment plans.
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Affiliation(s)
- Carlo Cattrini
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, 16132 Genoa, Italy; (C.C.); (M.M.L.); (B.C.); (G.V.)
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain
| | - Melissa Bersanelli
- Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy;
| | - Maria Maddalena Latocca
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, 16132 Genoa, Italy; (C.C.); (M.M.L.); (B.C.); (G.V.)
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Benedetta Conte
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, 16132 Genoa, Italy; (C.C.); (M.M.L.); (B.C.); (G.V.)
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Giacomo Vallome
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, 16132 Genoa, Italy; (C.C.); (M.M.L.); (B.C.); (G.V.)
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Francesco Boccardo
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, 16132 Genoa, Italy; (C.C.); (M.M.L.); (B.C.); (G.V.)
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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Rossi G, Russo A, Tagliamento M, Tuzi A, Nigro O, Vallome G, Sini C, Grassi M, Dal Bello MG, Coco S, Longo L, Zullo L, Tanda ET, Dellepiane C, Pronzato P, Genova C. Precision Medicine for NSCLC in the Era of Immunotherapy: New Biomarkers to Select the Most Suitable Treatment or the Most Suitable Patient. Cancers (Basel) 2020; 12:E1125. [PMID: 32365882 PMCID: PMC7281184 DOI: 10.3390/cancers12051125] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 03/31/2020] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 12/13/2022] Open
Abstract
In recent years, the evolution of treatments has made it possible to significantly improve the outcomes of patients with non-small cell lung cancer (NSCLC). In particular, while molecular targeted therapies are effective in specific patient sub-groups, immune checkpoint inhibitors (ICIs) have greatly influenced the outcomes of a large proportion of NSCLC patients. While nivolumab activity was initially assessed irrespective of predictive biomarkers, subsequent pivotal studies involving other PD-1/PD-L1 inhibitors in pre-treated advanced NSCLC (atezolizumab within the OAK study and pembrolizumab in the Keynote 010 study) reported the first correlations between clinical outcomes and PD-L1 expression. However, PD-L1 could not be sufficient on its own to select patients who may benefit from immunotherapy. Many studies have tried to discover more precise markers that are derived from tumor tissue or from peripheral blood. This review aims to analyze any characteristics of the immunogram that could be used as a predictive biomarker for response to ICIs. Furthermore, we describe the most important genetic alteration that might predict the activity of immunotherapy.
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Affiliation(s)
- Giovanni Rossi
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | | | - Marco Tagliamento
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Alessandro Tuzi
- UO Oncologia, ASST Sette Laghi, 21100 Varese, Italy; (A.T.); (O.N.)
| | - Olga Nigro
- UO Oncologia, ASST Sette Laghi, 21100 Varese, Italy; (A.T.); (O.N.)
| | - Giacomo Vallome
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Claudio Sini
- Oncologia Medica e CPDO, ASSL di Olbia-ATS Sardegna, 07026 Olbia, Italy;
| | - Massimiliano Grassi
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Maria Giovanna Dal Bello
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Simona Coco
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Luca Longo
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Lodovica Zullo
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Enrica Teresa Tanda
- Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
| | - Chiara Dellepiane
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Paolo Pronzato
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
| | - Carlo Genova
- Lung Cancer Unit, Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.T.); (G.V.); (M.G.); (M.G.D.B.); (S.C.); (L.L.); (L.Z.); (C.D.); (P.P.); (C.G.)
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Cattrini C, Rubagotti A, Nuzzo PV, Zinoli L, Salvi S, Boccardo S, Perachino M, Cerbone L, Vallome G, Latocca MM, Zanardi E, Boccardo F. Overexpression of Periostin in Tumor Biopsy Samples Is Associated With Prostate Cancer Phenotype and Clinical Outcome. Clin Genitourin Cancer 2018; 16:e1257-e1265. [PMID: 30170989 DOI: 10.1016/j.clgc.2018.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Overexpression of periostin (POSTN) is associated with prostate cancer (PCa) aggressiveness. We investigated the prognostic significance of POSTN expression in tumor biopsy samples of patients with PCa. METHODS We scored POSTN expression by immunohistochemistry analysis on 215 PCa biopsy samples using an anti-POSTN-specific antibody. A total immunoreactive score (T-IRS) was calculated by adding the POSTN staining scores of stromal and epithelial tumor cells. Prostate-specific antigen (PSA) progression/recurrence-free survival (PFS), radiographic progression/recurrence-free survival (rPFS), and overall survival (OS) were the study end points. RESULTS A total of 143 patients received therapy with radical attempt, whereas 72 had locally advanced or metastatic disease and received hormone therapy alone. Median T-IRS was 9 and 12 (range, 0-20), respectively (P = .001). Overall, we found a weak positive correlation of T-IRS with prebiopsy PSA levels (r = 0.166, P = .016) and Gleason score (r = 0.266, P < .000). T-IRS ≥ 8 independently predicted for shorter PSA-PFS and OS (hazard ratio [HR] [95% confidence interval (CI)] ≥ 8 versus < 8: 1.50 [1.06-2.14], P = .024 and 1.92 [1.20-3.07], P = .007, respectively). In the subgroup analysis, the association between T-IRS and patient outcome was retained in patients who received therapy with radical attempt (HR [95% CI] ≥ 8 vs. < 8: rPFS: 2.06 [1.18-3.58], P = .01; OS: 2.36 [1.24-4.50], P = .009) and in those with low to intermediate Gleason scores (HR [95% CI] ≥ 8 vs. < 8: PSA-PFS: 1.65 [1.06-2.59], P = .028; rPFS: 2.09 [1.14-3.87], P = .018; OS: 2.57 [1.31-5.04], P = .006). CONCLUSION POSTN T-IRS on PCa biopsy samples independently predicted the risk of recurrence, progression, and death in patients with localized disease and in those with low to intermediate Gleason scores.
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Affiliation(s)
- Carlo Cattrini
- Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Alessandra Rubagotti
- Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Pier Vitale Nuzzo
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Linda Zinoli
- Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - Sandra Salvi
- Pathology Unit, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - Simona Boccardo
- Pathology Unit, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - Marta Perachino
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Luigi Cerbone
- Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Giacomo Vallome
- Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Maria Maddalena Latocca
- Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa, Italy
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, Genoa, Italy.
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Messina C, Messina M, Buzzatti G, Cattrini C, Cerbone L, Latocca MM, Vallome G, Zanardi E, Boccardo F. CDK inhibitors in advanced HR+ Her 2- breast cancer: A systematic review and meta-analysis of randomized trials. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Carlo Messina
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Marco Messina
- Unit of Medical Oncology, Istituto Fondazione G. Giglio, Palermo, Italy
| | - Giulia Buzzatti
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Carlo Cattrini
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Luigi Cerbone
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Maria Maddalena Latocca
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Giacomo Vallome
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
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Cattrini C, Cerbone L, Rubagotti A, Zinoli L, Latocca MM, Buzzatti G, Vallome G, Rizzo F, Cavo A, Beshiri K, Soldato D, Messina C, Zanardi E, Boccardo F. Prognostic variables in localized small cell neuroendocrine carcinoma of the bladder: A population-based study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e16506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Carlo Cattrini
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Luigi Cerbone
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Alessandra Rubagotti
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Linda Zinoli
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Maria Maddalena Latocca
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Giulia Buzzatti
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Giacomo Vallome
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Fabio Rizzo
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Alessia Cavo
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Kristi Beshiri
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Davide Soldato
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Carlo Messina
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, San Martino Polyclinic Hospital – Institute for Cancer Research and Treatment, Genoa, Italy
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Cattrini C, Zanardi E, Vallome G, Cavo A, Cerbone L, Di Meglio A, Fabbroni C, Latocca MM, Rizzo F, Messina C, Rubagotti A, Barboro P, Boccardo F. Targeting androgen-independent pathways: new chances for patients with prostate cancer? Crit Rev Oncol Hematol 2017; 118:42-53. [PMID: 28917268 DOI: 10.1016/j.critrevonc.2017.08.009] [Citation(s) in RCA: 25] [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: 03/31/2017] [Revised: 08/21/2017] [Accepted: 08/21/2017] [Indexed: 02/08/2023] Open
Abstract
Androgen deprivation therapy (ADT) is the mainstay treatment for advanced prostate cancer (PC). Most patients eventually progress to a condition known as castration-resistant prostate cancer (CRPC), characterized by lack of response to ADT. Although new androgen receptor signaling (ARS) inhibitors and chemotherapeutic agents have been introduced to overcome resistance to ADT, many patients progress because of primary or acquired resistance to these agents. This comprehensive review aims at exploring the mechanisms of resistance and progression of PC, with specific focus on alterations which lead to the activation of androgen receptor (AR)-independent pathways of survival. Our work integrates available clinical and preclinical data on agents which target these pathways, assessing their potential clinical implication in specific settings of patients. Given the rising interest of the scientific community in cancer immunotherapy strategies, further attention is dedicated to the role of immune evasion in PC.
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Affiliation(s)
- C Cattrini
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy.
| | - E Zanardi
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - G Vallome
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - A Cavo
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - L Cerbone
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - A Di Meglio
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - C Fabbroni
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - M M Latocca
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - F Rizzo
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - C Messina
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - A Rubagotti
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy
| | - P Barboro
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy
| | - F Boccardo
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, L.go R. Benzi 10, 16132, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
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