1
|
De Vitis LA, Fumagalli D, Schivardi G, Capasso I, Grcevich L, Multinu F, Cucinella G, Occhiali T, Betella I, Guillot BE, Pappalettera G, Shahi M, Fought AJ, McGree M, Reynolds E, Colombo N, Zanagnolo V, Aletti G, Langstraat C, Mariani A, Glaser G. Incidence of sentinel lymph node metastases in apparent early-stage endometrial cancer: a multicenter observational study. Int J Gynecol Cancer 2024:ijgc-2023-005173. [PMID: 38514100 DOI: 10.1136/ijgc-2023-005173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE Ultrastaging is accurate in detecting nodal metastases, but increases costs and may not be necessary in certain low-risk subgroups. In this study we examined the risk of nodal involvement detected by sentinel lymph node (SLN) biopsy in a large population of apparent early-stage endometrial cancer and stratified by histopathologic characteristics. Furthermore, we aimed to identify a subgroup in which ultrastaging may be omitted. METHODS We retrospectively included patients who underwent SLN (with bilateral mapping and no empty nodal packets on final pathology) ± systematic lymphadenectomy for apparent early-stage endometrial cancer at two referral cancer centers. Lymph node status was determined by SLN only, regardless of non-SLN findings. The incidence of macrometastasis, micrometastasis, and isolated tumor cells (ITC) was measured in the overall population and after stratification by histotype (endometrioid vs serous), myometrial invasion (none, <50%, ≥50%), and grade (G1, G2, G3). RESULTS Bilateral SLN mapping was accomplished in 1570 patients: 1359 endometrioid and 211 non-endometrioid, of which 117 were serous. The incidence of macrometastasis, micrometastasis, and ITC was 3.8%, 3.4%, and 4.8%, respectively. In patients with endometrioid histology (n=1359) there were 2.9% macrometastases, 3.2% micrometastases, and 5.3% ITC. No macro/micrometastases and only one ITC were found in a subset of 274 patients with low-grade (G1-G2) endometrioid endometrial cancer without myometrial invasion (all <1%). The incidence of micro/macrometastasis was higher, 2.8%, in 708 patients with low-grade endometrioid endometrial cancer invading <50% of the myometrium. In patients with serous histology (n=117), the incidence of macrometastases, micrometastasis, and ITC was 11.1%, 6.0%, and 1.7%, respectively. For serous carcinoma without myometrial invasion (n=36), two patients had micrometastases for an incidence of 5.6%. CONCLUSIONS Ultrastaging may be safely omitted in patients with low-grade endometrioid endometrial cancer without myometrial invasion. No other subgroups with a risk of nodal metastasis of less than 1% have been identified.
Collapse
Affiliation(s)
- Luigi Antonio De Vitis
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Diletta Fumagalli
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Obstetrics and Gynecology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Gabriella Schivardi
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ilaria Capasso
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Leah Grcevich
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Francesco Multinu
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giuseppe Cucinella
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Palermo, Italy
| | - Tommaso Occhiali
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Clinic of Obstetrics and Gynecology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Ilaria Betella
- Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Benedetto E Guillot
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giulia Pappalettera
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
- Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Maryam Shahi
- Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Angela J Fought
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Michaela McGree
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Evelyn Reynolds
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicoletta Colombo
- Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Faculty of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Vanna Zanagnolo
- Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giovanni Aletti
- Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Carrie Langstraat
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Andrea Mariani
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gretchen Glaser
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
2
|
Dinoi G, Tarantino V, Bizzarri N, Perrone E, Capasso I, Giannarelli D, Querleu D, Giuliano MC, Fagotti A, Scambia G, Fanfani F. Robotic-assisted versus conventional laparoscopic surgery in the management of obese patients with early endometrial cancer in the sentinel lymph node era: a randomized controlled study (RObese). Int J Gynecol Cancer 2024:ijgc-2023-005197. [PMID: 38326228 DOI: 10.1136/ijgc-2023-005197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Nearly 65% of patients with endometrial cancer who undergo primary hysterectomy have concurrent obesity. Retrospective data show advantages in using robotic surgery in these patients compared with conventional laparoscopy, namely lower conversion rate, increased rate of same-day discharge, and reduced blood loss. Nevertheless, to date no prospective randomized controlled trials have compared laparoscopic surgery versus robotic-assisted surgery in morbidly obese patients. PRIMARY OBJECTIVE The robotic-assisted versus conventional laparoscopic surgery in the management of obese patients with early endometrial cancer in the sentinel lymph node era: a randomized controlled study (RObese) trial aims to find the most appropriate minimally invasive surgical approach in morbidly obese patients with endometrial carcinoma. STUDY HYPOTHESIS Robotic surgery will reduce conversions to laparotomy in endometrial cancer patients with obesity compared with those who undergo surgery with conventional laparoscopy. TRIAL DESIGN This phase III multi-institutional study will randomize consecutive obese women with apparent early-stage endometrial cancer to either laparoscopic or robot-assisted surgery. MAJOR INCLUSION/EXCLUSION RITERIA The RObese trial will include obese (BMI≥30 kg/m2) patients aged over 18 years with apparent 2009 Federation of Gynecology and Obstetrics (FIGO) stage IA-IB endometriod endometrial cancer. PRIMARY ENDPOINT Conversion rate to laparotomy between laparoscopic surgery versus robot-assisted surgery. SAMPLE SIZE RObese is a superiority trial. The clinical superiority margin for this study is defined as a difference in conversion rate of -6%. Assuming a significance level of 0.05 and a power of 80%, the study plans to randomize 566 patients. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS Patient recruitment will be completed by 2026, and follow-up will be completed by 2029 with presentation of data shortly thereafter. Two interim analyses are planned: one after the first 188 and the second after 376 randomized patients. TRIAL REGISTRATION NCT05974995.
Collapse
Affiliation(s)
- Giorgia Dinoi
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Vincenzo Tarantino
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Nicolò Bizzarri
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Emanuele Perrone
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Ilaria Capasso
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Diana Giannarelli
- Facility of Epidemiology and Biostatistics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Denis Querleu
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Consiglia Giuliano
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Anna Fagotti
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Fanfani
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
3
|
Bruchim I, Capasso I, Polonsky A, Meisel S, Salutari V, Werner H, Lorusso D, Scambia G, Fanfani F. New therapeutic targets for endometrial cancer: a glimpse into the preclinical sphere. Expert Opin Ther Targets 2024; 28:29-43. [PMID: 38327111 DOI: 10.1080/14728222.2024.2316739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/06/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Endometrial cancer (EC) is the only gynecologic malignancy showing increasing trends in incidence and mortality. While standard treatment has been effective primarily for early-stage EC, precision medicine with tailored therapy has revolutionized the management of this disease. Genome sequencing analyses have identified four sub-types of EC. Treatments for primary and metastatic disease can now be tailored more accurately to achieve better oncologic results. AREAS COVERED This review provides an overview of the most relevant and updated evidence in the literature regarding EC molecular analysis and its role in risk classification, prognostication, and guidance for tailored and target therapies in early and advanced/metastatic stages. In addition, it provides updated information on optimal surgical management based on molecular classification and highlights key advances and future strategies. EXPERT OPINION EC molecular analysis yields the potential of tailoring adjuvant treatment by escalating or deescalating therapy, as shown for POLE-mutated and p53-mutated tumors. Moreover, the expression of specific molecular signatures offers the possibility to employ novel target therapies, such as immune-checkpoint inhibitors that have demonstrated a significant benefit on prognosis. New treatment guidelines are still being established, and ongoing studies are exploring the potential prognostic role of further sub-stratifications of the four molecular classes and treatment options.
Collapse
Affiliation(s)
- Ilan Bruchim
- Gynecology and Gynecologic Oncology Department, Hillel Yaffe Medical Center, Hadera, Israel
- Gynecology Laboratory, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
- The Technion, Institute of Technology, Haifa, Israel
| | - Ilaria Capasso
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ariel Polonsky
- Gynecology and Gynecologic Oncology Department, Hillel Yaffe Medical Center, Hadera, Israel
- Gynecology Laboratory, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Shilhav Meisel
- Gynecology Laboratory, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel
- The Technion, Institute of Technology, Haifa, Israel
| | - Vanda Salutari
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Haim Werner
- The Technion, Institute of Technology, Haifa, Israel
- Department of Human Molecular Genetics and Biochemistry, School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Domenica Lorusso
- Università Cattolica del Sacro Cuore, Rome, Italy
- Scientific Directorate, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Fanfani
- Gynecologic Oncology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
4
|
Schwameis R, Fanfani F, Ebner C, Zimmermann N, Peters I, Nero C, Marth C, Ristl R, Leitner K, Grimm C, Oberndorfer F, Capasso I, Zeimet AG, Polterauer S, Scambia G, Fagotti A, Concin N. Verification of the prognostic precision of the new 2023 FIGO staging system in endometrial cancer patients - An international pooled analysis of three ESGO accredited centres. Eur J Cancer 2023; 193:113317. [PMID: 37748967 DOI: 10.1016/j.ejca.2023.113317] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Recently, the new 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer (EC) critically integrating new pathological and molecular features was published. The present study evaluated the clinical impact of the new 2023 FIGO staging system by comparing it to the previous 2009 system. METHODS This is an international, pooled retrospective study of 519 EC patients who underwent primary treatment (and molecular characterisation) at three European Society of Gynaecological Oncology (ESGO) accredited centres in Austria/Italy. Patients were categorised according to the 2009 and the 2023 FIGO staging systems. Stage shifts were analysed and (sub)stage specific 5-year progression-free (PFS) and overall survival (OS) rates were calculated and compared. Different statistical tests were applied to evaluate the prognostic precision of the two FIGO staging systems and to compare them to each other. RESULTS (Sub)stage shifts occurred in 143/519 (27.6%) patients: 123 upshifts (23.7%) and 20 (3.9%) downshifts. 2023 FIGO staging system identified a stage I cohort with a notably higher 5-year PFS rate compared to 2009 (93.0% versus 87.4%, respectively). For stage II disease, the 5-year PFS rate was similar in the 2023 and the 2009 FIGO staging systems (70.2% versus 71.2%, respectively). The two new molecularly defined 2023 FIGO substages IAmPOLEmut and IICmp53abn displayed distinct, particularly favourable and adverse oncologic outcomes within early stage disease, respectively. A remarkably lower 5-year PFS rate for stage III patients was revealed in the 2023 FIGO staging system compared to 2009 (44.4% versus 54.1%, respectively). All applied statistical tests confirmed a more accurate prediction of PFS and OS by the 2023 FIGO staging system compared to 2009. CONCLUSION The new 2023 FIGO stating system led to a substantial stage shift in about one quarter of patients leading to a higher prognostic precision. In early stage disease, the new substages added further prognostic granularity and identified treatment relevant subgroups.
Collapse
Affiliation(s)
- Richard Schwameis
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Francesco Fanfani
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Christoph Ebner
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Naomi Zimmermann
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Inge Peters
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Camilla Nero
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Robin Ristl
- Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Austria.
| | - Katharina Leitner
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Christoph Grimm
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Felicitas Oberndorfer
- Department of Pathology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Ilaria Capasso
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Stephan Polterauer
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Giovanni Scambia
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Anna Fagotti
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Nicole Concin
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| |
Collapse
|
5
|
Capasso I, D’Angelo G, Fumo M, del Rio Merino M, Caputo D, Liguori B. Valorisation of Tuff and Brick Wastes by Alkali Activation for Historical Building Remediation. Materials (Basel) 2023; 16:6619. [PMID: 37895601 PMCID: PMC10608714 DOI: 10.3390/ma16206619] [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] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023]
Abstract
Nowadays, the preservation and restoration of a historical building needs to be faced in accordance with a novel sensibility regarding the environment in order to preserve the building for future generations. In this context, the scientific community is focusing on novel and sustainable materials and techniques that allow for durability and mechanical performance as well as compatibility with the existing heritage. Alkali-activated materials represent a great challenge to the production of new materials, starting from the existing ones, with the goal of reducing consumption, emission of greenhouse gases and environmental impact. This study deals with the valorisation of waste materials coming from demolition and construction activities in the manufacture of geocomposites suitable for the restoration and conservation of historical heritage. In particular, waste from tuff sawing and brick grinding were used as raw materials, and then the geopolymeric samples produced were characterized based on a physical-chemical and mechanical point of view in order to investigate their performance and evaluate their suitability as materials for a historical building's recovery. The results showed that brick waste-based geocomposites were more compact than the tuff-based ones, as shown by the higher-density values and the lower values of open porosity and water absorption and as further confirmed by the trend of the mechanical performance. Moreover, experimental data showed that the physical and mechanical properties of both bricks and tuff waste-based geocomposites, even with different waste content, are compatible with existing building materials as well as traditional repairing products.
Collapse
Affiliation(s)
- Ilaria Capasso
- Department of Engineering and Geology, University of Chieti-Pescara “G d’Annunzio”, Viale Pindaro 42, 65122 Pescara, Italy
| | - Gigliola D’Angelo
- Department of Civil, Building and Environmental Engineering (DICEA), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy
| | - Marina Fumo
- Department of Civil, Building and Environmental Engineering (DICEA), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy
| | - Mercedes del Rio Merino
- Grupo de Investigación TEMA, Escuela Técnica Superior de Edificación, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Domenico Caputo
- ACLabs—Applied Chemistry Labs, Department of Chemical, Materials and Industrial Production Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy
| | - Barbara Liguori
- ACLabs—Applied Chemistry Labs, Department of Chemical, Materials and Industrial Production Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy
| |
Collapse
|
6
|
Capasso I, Garzon S, Kumar S, Weaver AL, Mc Gree M, De Vitis LA, Uccella S, Petersen I, Glaser G, Langstraat C, Scambia G, Fanfani F, Mariani A. Prognostic factors in patients with endometrial cancer with isolated lymphatic recurrence. Int J Gynecol Cancer 2023; 33:1169-1178. [PMID: 37321674 DOI: 10.1136/ijgc-2023-004435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE To analyze the clinicopathological features and outcomes in patients with endometrial cancer with isolated lymphatic recurrence after lymphadenectomy, stratified by different isolated lymphatic recurrence sites and treatment approaches. METHODS We retrospectively reviewed all surgically treated patients with endometrial cancer, identifying those with recurrence. We defined primary isolated lymphatic recurrence as the first and unique evidence of recurrence in lymph node-bearing areas, without concomitant vaginal, hematogenous, or peritoneal recurrence. Isolated lymphatic recurrences were classified as pelvic, para-aortic, distant, or multiple sites. Our primary outcome was cause-specific survival after diagnosis of the recurrence. RESULTS Among 4216 patients with surgically staged endometrial cancer, we identified 66 (1.6%) women with isolated lymphatic recurrence. The overall median cause-specific survival for patients with isolated lymphatic recurrence was 24 months. Although cause-specific survival was not significantly different between the four isolated lymphatic recurrence groups (p=0.21), 7 of 15 (47%) patients with isolated lymphatic recurrence in the para-aortic area were long-term survivors. At multivariate Cox regression, the absence of lymphovascular space invasion and grade 1 histology in the primary tumor were significantly associated with improved cause-specific survival. In addition, patients with isolated lymphatic recurrence who underwent surgery for recurrence (with/without other associated therapies) had improved cause-specific survival compared with patients who did not undergo surgery, also after adjusting for age. CONCLUSIONS Low-grade histology and absence of lymphovascular space invasion in the primary tumor were predictors of improved prognosis in patients with endometrial cancer with isolated lymphatic recurrence. In addition, in this retrospective cohort, patients with isolated lymphatic recurrence who were selected for eradicative surgical treatment had improved cause-specific survival.
Collapse
Affiliation(s)
- Ilaria Capasso
- Department of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Sanjeev Kumar
- Department of Gynecologic Oncology, Baptist Memorial Hospital for Women, Memphis, Tennessee, USA
| | - Amy L Weaver
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Michaela Mc Gree
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Ivy Petersen
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gretchen Glaser
- Department of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Carrie Langstraat
- Department of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Giovanni Scambia
- Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
| | - Francesco Fanfani
- Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
| | - Andrea Mariani
- Department of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
7
|
Andreacola FR, Capasso I, Langella A, Brando G. 3D-printed metals: Process parameters effects on mechanical properties of 17-4 P H stainless steel. Heliyon 2023; 9:e17698. [PMID: 37483809 PMCID: PMC10362090 DOI: 10.1016/j.heliyon.2023.e17698] [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: 04/17/2023] [Revised: 05/26/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Additive Manufacturing (AM) has spread significantly in recent years, with relevant applications in many fields of research and engineering. Thanks to its distinctive production methods, AM enables the creation of parts with complex shapes that cannot be fabricated easily by employing traditional subtractive processes. 3D printing, which involves overlapping material layer by layer until the designed part is completed, shows several advantages in terms of limiting material waste, reducing production phases and postprocessing/heat treatments needs, leading to an additional benefit in terms of environmental sustainability. However, there are still limited available data on the influence of the 3D printing process on the mechanical properties of the materials that are commonly used and additional investigations are strongly demanded. So, the purpose of the present paper is to provide a useful contribution in the field of metal additive manufacturing, reporting the results of an experimental campaign carried out on 17-4 P H stainless steel, produced using selective laser melting technology. The effects of different printing orientations and scanning times on the tensile behaviour, impact strength and microhardness features of the 3D-printed products are investigated. Furthermore, the influence of an annealing heat treatment on the material mechanical performance is evaluated.
Collapse
Affiliation(s)
- Francesca Romana Andreacola
- Department of Engineering and Geology, University “G. D’Annunzio” of Chieti-Pescara, Viale Pindaro 42, 65127, Pescara, Italy
| | - Ilaria Capasso
- Department of Engineering and Geology, University “G. D’Annunzio” of Chieti-Pescara, Viale Pindaro 42, 65127, Pescara, Italy
| | - Antonio Langella
- Department of Chemical, Materials and Production Engineering, University of Naples Federico II, Piazzale Tecchio 80, 80125, Naples, Italy
| | - Giuseppe Brando
- Department of Engineering and Geology, University “G. D’Annunzio” of Chieti-Pescara, Viale Pindaro 42, 65127, Pescara, Italy
| |
Collapse
|
8
|
Perrone E, Capasso I, De Felice F, Giannarelli D, Dinoi G, Petrecca A, Palmieri L, Foresta A, Nero C, Arciuolo D, Lorusso D, Zannoni GF, Scambia G, Fanfani F. Back to the future: The impact of oestrogen receptor profile in the era of molecular endometrial cancer classification. Eur J Cancer 2023; 186:98-112. [PMID: 37062213 DOI: 10.1016/j.ejca.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE The aim of this study is to evaluate the impact of the oestrogen receptor (ER) profile on oncologic outcomes in the new endometrial cancer (EC) risk classification. METHODS Immunohistochemistry (IHC) analyses were performed in a retrospectively reviewed large series of ECs to assess the presence/absence of oestrogen receptors (ER0\1+ or ER2+\3+) and other molecular factors (i.e. p53 mutation, p53mut; and mismatch repair mutational status, MMRd (mismatch repair deficient) versus MMRp (mismatch repair proficient)), histopathologic and clinical outcomes. ER status was correlated with molecular, histologic, clinical and prognostic data. RESULTS 891 EC patients were included in the study (211 ER0\1+ and 680 ER2+\3+). The ER0\1+ phenotype was associated with an unfavourable clinicopathological profile (i.e. grading, histotype, lymphovascular space invasion (LVSI), stages, etc.). Simple regression showed that risk class, p53mut, and ER0/1+ impacted on both disease-free survival (DFS) and overall survival (OS) (p < 0.05). In the ER0/1+ population, p53mut no longer influenced DFS and OS (p > 0.05). In multiple regression, age, high and advanced/metastatic risk classes influenced survival outcomes (p < 0.05), but lost significance in the ER0/1+ population (p > 0.05). ER-positivity retained a remarkable prognostic impact even after stratification of the population according to the European Society of Gynaecological Oncology, the European Society for Radiotherapy and Oncology, and the European Society of Pathology (ESGO/ESTRO/ESP) 2021 risk classes and molecular classification. ER0/1+ intermediate, high-intermediate, high and advanced risk versus ER2+/3+ intermediate, high-intermediate, high and advanced risk classes showed statistically different OS and DFS (p< 0.001). ER0/1+ status was associated with a worse prognosis when associated with MMRp, MMRd and p53mut compared to the same molecular classes associated with ER2+/3 (p < 0.001). CONCLUSIONS We demonstrated that ER status has a significant impact on oncologic outcomes, regardless of risk class and p53/MMR status. Based on our results, we recommend the inclusion of ER assessment in featured EC risk classification system.
Collapse
Affiliation(s)
- Emanuele Perrone
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy
| | - Ilaria Capasso
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Diana Giannarelli
- Facility of Epidemiology and Biostatistics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Giorgia Dinoi
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy
| | - Alessandro Petrecca
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luca Palmieri
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
| | - Aniello Foresta
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
| | - Camilla Nero
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy
| | - Damiano Arciuolo
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Gyneco-pathology and Breast Pathology Unit, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Rome, Italy
| | - Domenica Lorusso
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Gian Franco Zannoni
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Gyneco-pathology and Breast Pathology Unit, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Rome, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Fanfani
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
| |
Collapse
|
9
|
Perrone E, De Felice F, Capasso I, Distefano E, Lorusso D, Nero C, Arciuolo D, Zannoni GF, Scambia G, Fanfani F. The immunohistochemical molecular risk classification in endometrial cancer: A pragmatic and high-reproducibility method. Gynecol Oncol 2022; 165:585-593. [PMID: 35341588 DOI: 10.1016/j.ygyno.2022.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/27/2022] [Accepted: 03/13/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The aim of this study is to assess the clinical reproducibility and the potential oncological validity of the molecular information provided by the immunohistochemistry (IHC) to properly stratify the endometrial cancer patients. METHODS Retrospective IHC analyses were conducted in a large series of 778 pre-operative uterine-confined ECs, studying the presence/absence of MLH1, MSH2, MSH6 and PMS2 to define the mismatch repair (MMR) stable or instable phenotype; the presence of p53 mutations and other molecular features. The molecular profile was correlated with histological, clinical and prognostic data. RESULTS Based on IHC assessment, we defined 3 EC populations: stable MMR patients (MMRs), instable patients (MMRi) and p53 mutated patients (p53+). Our result demonstrated that the IHC stratification statistically correlated with the most relevant pathologic-clinical features: FIGO stage (p < 0.001), grading (p < 0.001), histotype (p < 0.001), presence of LVSI (p < 0.001), myometrial invasion and tumor dimension (p = 0.003 for both). These 3 IHC populations statistically reflected the EC risk class ESGO-ESMO-ESP classification 2021 (p < 0.001). These results were also confirmed in the Kaplan-Meier curves in terms of overall survival (OS) and disease-free survival (DFS) (p < 0.0001). The multivariate analyses demonstrated that absence of estrogen receptor (ER) impacted the OS (p = 0.011) and, the Age > 60 years and the ER-status the DFS (p = 0.041 and p = 0.004). CONCLUSION In this large series, we demonstrated that the pragmatic and systematic use of IHC may have an important role to properly stratify, in terms of histological features and clinical outcomes, the EC patients.
Collapse
Affiliation(s)
- Emanuele Perrone
- Agostino Gemelli IRCCS University Hospital Foundation, Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Rome, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | | | | | - Domenica Lorusso
- Agostino Gemelli IRCCS University Hospital Foundation, Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy.
| | - Camilla Nero
- Agostino Gemelli IRCCS University Hospital Foundation, Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| | - Damiano Arciuolo
- Agostino Gemelli IRCCS University Hospital Foundation, Department of Women, Children and Public Health Sciences, Gyneco-Pathology and Breast Pathology Unit, Rome, Italy
| | - Gian Franco Zannoni
- Catholic University of the Sacred Heart, Rome, Italy; Agostino Gemelli IRCCS University Hospital Foundation, Department of Women, Children and Public Health Sciences, Gyneco-Pathology and Breast Pathology Unit, Rome, Italy
| | - Giovanni Scambia
- Agostino Gemelli IRCCS University Hospital Foundation, Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| | - Francesco Fanfani
- Agostino Gemelli IRCCS University Hospital Foundation, Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
10
|
Colella A, Capasso I, Iucolano F. Comparison of Latest and Innovative Silica-Based Consolidants for Volcanic Stones. Materials (Basel) 2021; 14:ma14102513. [PMID: 34066248 PMCID: PMC8151927 DOI: 10.3390/ma14102513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/17/2022]
Abstract
This research explores the new perspectives in conservation and protection of two macroporous tuff stones, widely employed in the architectural heritage of Campania region, characterized by highly heterogeneous rock fabric and texture and a variable mineralogical composition that represent crucial factors responsible for their weak durability. The consolidation treatments were performed with a recently and widely used suspension of nano-silica crystals in water and with a lithium silicate solution that has received up to now scarce attention as a consolidant agent. Physical investigations (open porosity, Hg porosimetry, water absorption), morphological observations (SEM analyses) and visual appearance test (colorimetric measurements), along with assessments of performance indicators such as ultrasonic pulse velocity, surface cohesion test (peeling test) and durability test (salt crystallization), were carried out to investigate the consolidation effectiveness. Overall, lithium silicate consolidant showed a better behavior in terms of superficial cohesion, a most successful strengthening action and a considerable enhancement of salt resistance.
Collapse
Affiliation(s)
- Abner Colella
- Dipartimento di Scienze della Terra, dell’Ambiente e delle Risorse(DiSTAR), University of Naples Federico II, Via Vicinale Cupa Cintia 21, 80126 Naples, Italy;
| | - Ilaria Capasso
- Department of Engineering and Geology, University of Chieti-Pescara “G d’Annunzio”, Viale Pindaro 42, 65122 Pescara, Italy
- Correspondence:
| | - Fabio Iucolano
- ACLabs-Applied Chemistry Labs, Department of Chemical, Materials and Industrial Production Engineering, University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy;
| |
Collapse
|
11
|
Perrone E, Capasso I, Pasciuto T, Gioè A, Gueli Alletti S, Restaino S, Scambia G, Fanfani F. Laparoscopic vs. robotic-assisted laparoscopy in endometrial cancer staging: large retrospective single-institution study. J Gynecol Oncol 2021; 32:e45. [PMID: 33825360 PMCID: PMC8039171 DOI: 10.3802/jgo.2021.32.e45] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 11/06/2020] [Revised: 01/09/2021] [Accepted: 01/29/2021] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of this study is to analyze and draw the potential differences between the robotic-assisted surgery (RS) and the laparoscopy (LPS) in endometrial cancer staging. Methods In this single-institution retrospective study we enrolled 1,221 consecutive clinical stage I–III endometrial cancer patients undergone minimally invasive surgical staging. We compared patients treated by LPS and by RS, on the basis of perioperative and oncological outcomes (disease-free survival [DFS] and overall survival [OS]). A sub-analysis of the high-risk endometrial cancer population was performed in the 2 cohorts. Results The 2 cohorts (766 treated by LPS and 455 by RS) were homogeneous in terms of perioperative and pathological data. We recorded differences in number of relapse/progression (11.7% in LPS vs. 7% in RS, p=0.008) and in number of deaths (9.8% in LPS vs. 4.8% in RS, p=0.002). Whereas, univariate and multivariate analyses according to DFS and OS confirmed that the surgical approach did not influence the DFS or the OS. In the multivariable analysis the association of the age and grading was significant for DFS and OS. In the sub-analysis of the 426 high risk EC patients (280 in LPS and 146 in RS) the univariate and the multivariate confirmed the influence of the age in DFS and OS, independently of the minimally invasive approach. Conclusions In our large retrospective analysis, we confirmed that the RS and LPS have similar efficacy and safety for endometrial cancer staging also for the high-risk endometrial cancer patients.
Collapse
Affiliation(s)
- Emanuele Perrone
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy
| | - Ilaria Capasso
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | - Tina Pasciuto
- Statistics Technology Archiving Research (STAR) Center, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome, Italy
| | - Alessandro Gioè
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | - Salvatore Gueli Alletti
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy
| | - Stefano Restaino
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Fanfani
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy.
| |
Collapse
|
12
|
Restaino S, Tortorella L, Dinoi G, Zannoni GF, Baroni A, Capasso I, Distefano E, Sozzi G, Chiantera V, Scambia G, Fanfani F. Semiquantitative evaluation of lymph-vascular space invasion in patients affected by endometrial cancer: Prognostic and clinical implications. Eur J Cancer 2020; 142:29-37. [PMID: 33217679 DOI: 10.1016/j.ejca.2020.10.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 07/21/2020] [Revised: 10/11/2020] [Accepted: 10/15/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The interpretation of lymph-vascular space invasion (LVSI) is usually qualitative, as presence or absence. The aim of this study is to investigate the prognostic role of LVSI in patients affected by endometrial cancer, when evaluated with a semiquantitative analysis. METHODS This retrospective multicentre study enrolled patients who received a histologically confirmed diagnosis of endometrial cancer. The assessment of LVSI was semiquantitative in accordance with the three-tiered scoring system (absent, focal and diffuse). RESULTS Among 1258 patients with surgical-stage endometrial cancer, LVSI has been found in 32.8% of cases (n = 412), whose 12.7% (n = 160) were focal, and 20% (n = 252) diffuse. The rate of lymph node metastasis increased from the 5% in patients with no LVSI to 15% in patients with focal LVSI and 33% in those with diffuse LVSI (p < 0.001). Distant recurrences were more frequent in patients with diffuse LVSI than in focal or no LVSI (24.9% versus 14.7% and 6.6%, respectively, p < 0.001). Diffuse LVSI was found to significantly increase the risk of distant metastasis (adjusted odds ratio (A OR) 2.57, p < 0.001). Adjuvant radiation were associated with improved overall survival (OS) and disease-free survival (DFS) in patients with diffuse LVSI. CONCLUSION The presence of diffuse LVSI is an independent risk factor for both lymph node metastasis and distant recurrence in endometrial cancer patients, and it is associated with a significantly decreased OS and DFS. Adjuvant radiation improved survival regardless of grading, histotype and lymph nodal metastasis in women with diffuse LVSI.
Collapse
Affiliation(s)
- Stefano Restaino
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Ginecologia Oncologica, Dipartimento per La Tutela Della Salute Della Donna e Della Vita Nascente, L.go A. Gemelli, 00167, Roma, Italy
| | - Lucia Tortorella
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Ginecologia Oncologica, Dipartimento per La Tutela Della Salute Della Donna e Della Vita Nascente, L.go A. Gemelli, 00167, Roma, Italy
| | | | - Gian-Franco Zannoni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Area Anatomia Patologica, Dipartimento per La Tutela Della Salute Della Donna e Della Vita Nascente, L.go A. Gemelli, 00167, Roma, Italy
| | | | | | | | - Giulio Sozzi
- Dipartimento di Ginecologia Oncologica, Università di Palermo, Italy
| | - Vito Chiantera
- Dipartimento di Ginecologia Oncologica, Università di Palermo, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Ginecologia Oncologica, Dipartimento per La Tutela Della Salute Della Donna e Della Vita Nascente, L.go A. Gemelli, 00167, Roma, Italy; Università Cattolica Del Sacro Cuore, Roma, Italy.
| | - Francesco Fanfani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Ginecologia Oncologica, Dipartimento per La Tutela Della Salute Della Donna e Della Vita Nascente, L.go A. Gemelli, 00167, Roma, Italy; Università Cattolica Del Sacro Cuore, Roma, Italy
| |
Collapse
|
13
|
Sozzi G, Fanfani F, Berretta R, Capozzi VA, Uccella S, Buono N, Giallombardo V, Di Donna MC, Monterossi G, Restaino S, Capasso I, Dinoi G, Scambia G, Chiantera V. Laparoscopic sentinel node mapping with intracervical indocyanine green injection for endometrial cancer: the SENTIFAIL study – a multicentric analysis of predictors of failed mapping. Int J Gynecol Cancer 2020; 30:1713-1718. [DOI: 10.1136/ijgc-2020-001724] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 11/03/2022] Open
Abstract
ObjectivesLaparoscopy is commonly used for endometrial cancer treatment, and sentinel lymph node (SLN) mapping has become the standard procedure for nodal assessment. Despite the standardization of the technique, there is no definitive data regarding its failure rate. The objective of this study is to identify factors associated with unsuccessful SLN mapping in endometrial cancer patients undergoing laparoscopic SLN mapping after intracervical indocyanine green (ICG) injection.MethodsWe retrospectively evaluated a consecutive series of endometrial cancer patients who underwent laparoscopic SLN mapping with intracervical ICG injection, in four oncological referral centers from January 2016 to July 2019. Inclusion criteria were biopsy-proven endometrial cancer, total laparoscopic approach, and intracervical ICG injection. Exclusion criteria were evidence of lymph node involvement or extrauterine disease at pre-operative imaging, synchronous invasive cancer, the use of tracers different from ICG, and the use of neoadjuvant treatment. Bilateral and failed bilateral SLN mapping groups were compared for clinical and pathological features. In patients with an unsuccessful procedure, side-specific lymphadenectomy was performed. Logistic regression was used to identify predictors of failure.ResultsA total of 376 patients were included in the study. The overall bilateral and unilateral SLN detection rates were 96.3%, 76.3%, and 20.0% respectively. The failed bilateral mapping detection rate was 23.7%. The median number of sentinel nodes removed was 2.2 (range, 0–5). After multivariate analysis, lymph vascular space involvement [OR 2.4 (1.04–1.12), P=0.003], non-endometrioid histology [OR 3.0 (1.43–6.29), P=0.004], and intraoperative finding of enlarged lymph node [OR 2.3 (1.01–5.31), P=0.045] were identified as independent predictors of failure of SLN mapping.ConclusionLymph vascular space involvement, non-endometrioid histology, and intra-operative finding of enlarged lymph nodes were identified as independent risk factors for unsuccessful mapping in patients undergoing laparoscopic SLN mapping.
Collapse
|
14
|
Lirer S, Liguori B, Capasso I, Flora A, Caputo D. Mechanical and chemical properties of composite materials made of dredged sediments in a fly-ash based geopolymer. J Environ Manage 2017; 191:1-7. [PMID: 28082249 DOI: 10.1016/j.jenvman.2017.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 04/29/2016] [Revised: 12/20/2016] [Accepted: 01/02/2017] [Indexed: 06/06/2023]
Abstract
Dredging activity in harbours and channels produces huge quantities of sediments, generally considered as waste soil (WS) to be disposed: the management of such sediments is a great environmental problem for many countries worldwide. Among the recycling possibilities, the use of dredged sediments for the manufacture of geopolymer-based materials seems to be an interesting alternative to disposal, due to their low cost and easy availability. In order to analyse the possibility to use these geopolymer materials as building materials - for instance as precast construction elements in maritime projects - a multi-disciplinary research activity has been developed at the Federico II University of Napoli (Italy). Some experimental tests have been carried out on different geopolymeric specimens made by mixing sediments from Napoli 'harbour and industrial fly ashes produced by a power plant in the South of Italy. A siliceous sand was used for comparison as an inert reference material. Chemical, morphological and mechanical properties of different specimens have been studied by X-ray diffraction, Scanning Electron Microscopy (SEM), Fourier transformed infrared spectroscopy (FTIR) and finally unconfined compression tests. The experimental results highlight that the use of dredged sediments in combination with fly ash can lead to geopolymeric matrices with interesting mechanical performances. Some differences in the microstructure of the geocomposite built with the siliceous sand or the dredged materials were found. In terms of environmental impacts, on the basis of standard leaching tests and according to Italian thresholds, the adopted dredged mixtures satisfy the prescribed limit for inert or non hazardous waste.
Collapse
Affiliation(s)
- S Lirer
- Faculty of Science and Applied Technology - University Guglielmo Marconi, Rome, Italy
| | - B Liguori
- ACLabs- Applied Chemistry Labs, Department of Chemical, Materials and Industrial Production Engineering, University of Naples Federico II, Naples, Italy; Institute of Polymers, Composite and Biomaterials, National Research Council, Naples, Italy.
| | - I Capasso
- ACLabs- Applied Chemistry Labs, Department of Chemical, Materials and Industrial Production Engineering, University of Naples Federico II, Naples, Italy
| | - A Flora
- Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Naples, Italy
| | - D Caputo
- ACLabs- Applied Chemistry Labs, Department of Chemical, Materials and Industrial Production Engineering, University of Naples Federico II, Naples, Italy
| |
Collapse
|
15
|
Liguori B, Capasso I, Romeo V, D’Auria M, Lavorgna M, Caputo D, Iannace S, Verdolotti L. Hybrid geopolymeric foams with diatomite addition: Effect on chemico-physical properties. J CELL PLAST 2017. [DOI: 10.1177/0021955x17695092] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Organic–inorganic hybrid foams were prepared by using metakaolin or diatomite as a partial (or total) replacement of metakaolin, as precursor and metal silicon and whipped protein as blowing agents. The foamed systems were cured at defined temperature and time and then characterized by chemical point of view through Fourier transformed infrared spectroscopy and X-ray diffraction and by mechanical and morphological point of view by compression tests and scanning electron microscopy. The experimental findings highlighted that the replacement of diatomite in the formulation affected the morphological structure of the foams and consequently their mechanical properties, due to a different chemism between the sodium silicate and the solid phase. In particular, the consolidation mechanism in the diatomite based-hybrid foams changed from geopolymerization to a silicate polycondensation. Consequently, mechanical performances enhanced with increase of the diatomite content.
Collapse
Affiliation(s)
- Barbara Liguori
- Applied Chemistry Labs (ACLabs), Department of Chemical, Materials and Industrial Engineering, University of Naples Federico II, Naples, Italy
- Institute of Polymers, Composites and Biomaterials, National Research Council, Naples, Italy
| | - Ilaria Capasso
- Applied Chemistry Labs (ACLabs), Department of Chemical, Materials and Industrial Engineering, University of Naples Federico II, Naples, Italy
| | - Valentina Romeo
- Institute of Polymers, Composites and Biomaterials, National Research Council, Naples, Italy
| | - Marco D’Auria
- Institute of Polymers, Composites and Biomaterials, National Research Council, Naples, Italy
| | - Marino Lavorgna
- Institute of Polymers, Composites and Biomaterials, National Research Council, Naples, Italy
| | - Domenico Caputo
- Applied Chemistry Labs (ACLabs), Department of Chemical, Materials and Industrial Engineering, University of Naples Federico II, Naples, Italy
| | - Salvatore Iannace
- IMAST SCARL, Italy
- Institute for Macromolecular Studies (ISMAC-CNR), National Research Council, Milano, Italy
| | - Letizia Verdolotti
- Institute of Polymers, Composites and Biomaterials, National Research Council, Naples, Italy
- IMAST SCARL, Italy
| |
Collapse
|
16
|
Crispo A, Montella M, Buono G, Grimaldi M, D'Aiuto M, Capasso I, Esposito E, Amore A, Nocerino F, Augustin LSA, Giudice A, Di Bonito M, Giuliano M, Forestieri V, De Laurentiis M, Rinaldo M, Ciliberto G, De Placido S, Arpino G. Body weight and risk of molecular breast cancer subtypes among postmenopausal Mediterranean women. Curr Res Transl Med 2016; 64:15-20. [PMID: 27140595 DOI: 10.1016/j.retram.2016.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
Abstract
Breast cancer (BC) is the most common malignant tumor in women, obesity is associated with increased BC incidence and mortality and high levels of circulating insulin may negatively impact on cancer incidence. In the present study, we investigated whether the strength of several anthropometric and metabolic parameters varies between BC molecular subtypes. Eligible cases were 991 non-metastatic BC patients recruited between January 2009 and December 2013. Anthropometric, clinical and immunohistochemical features were measured. Multivariate logistic regression models were built to assess HER2 positive BC risk, comparing (a) triple positive (TP) with luminal A, luminal B and triple negative (TN) and (b) HER2-enriched group with luminal A, luminal B and TN. We stratified patients in pre- and post-menopause: significant differences emerged for luminal A in relation to age: they were more likely to be older compared to other groups. Among postmenopausal patients, the adjusted multivariate analysis showed that high BMI and high waist circumference were inversely correlated to TP subtype when compared to luminal B (OR=0.48 and OR=0.49, respectively). Conversely, HOMA-IR was a risk factor for TP when compared to luminal A and TN (OR=2.47 and OR=3.15, respectively). Our findings suggest a potential role of higher abdominal fat in the development of specific BC molecular subtypes in postmenopausal women. Moreover, they support a potential role of insulin resistance in the development of HER2 positive BC, although this role appears to be stronger when hormone receptors are co-expressed, suggesting a difference in the etiology of these two BC subtypes.
Collapse
Affiliation(s)
- A Crispo
- Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
| | - M Montella
- Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - G Buono
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - M Grimaldi
- Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - M D'Aiuto
- Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - I Capasso
- Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - E Esposito
- Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - A Amore
- Department of Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - F Nocerino
- Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - L S A Augustin
- Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, 61 Queen St. East, Toronto, Canada
| | - A Giudice
- Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - M Di Bonito
- Division of Pathology, National Cancer Institute, G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - M Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - V Forestieri
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - M De Laurentiis
- Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - M Rinaldo
- Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy
| | - G Ciliberto
- Scientific Direction, National Cancer Institute, G. Pascale Foundation, Cappella dei Cangiani 1, 80131 Naples, Italy
| | - S De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - G Arpino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| |
Collapse
|
17
|
Maurea N, Quagliariello V, Coppola C, Piscopo G, Galletta F, Esposito E, Capasso I, Iaffaioli R. 441 Relationship of serum high sensitivity C-reactive protein to metabolic syndrome and waist-hip ratio in cancer patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30275-1] [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: 11/27/2022]
|
18
|
Esposito E, Anninga B, Harris S, Capasso I, D'Aiuto M, Rinaldo M, Douek M. Intraoperative radiotherapy in early breast cancer. Br J Surg 2015; 102:599-610. [PMID: 25787293 DOI: 10.1002/bjs.9781] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/17/2014] [Accepted: 01/13/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Intraoperative radiotherapy (IORT) constitutes a paradigm shift from the conventional 3-5 weeks of whole-breast external beam radiotherapy (EBRT). IORT enables delivery of radiation at the time of excision of the breast tumour, targeting the area at highest risk of recurrence, while minimizing excessive radiation exposure to healthy breast tissue. The rationale for IORT is based on the observation that over 90 per cent of local recurrences after breast-conserving surgery occur at or near the original operation site. METHODS This article reviews trials of IORT delivered with different techniques and devices. RESULTS IORT is a very attractive option for delivering radiotherapy, reducing the traditional fractionated treatment to a single fraction administered at the time of surgery. IORT has been shown to be associated with reduced toxicity and has several potential benefits over EBRT. Only two randomized clinical trials have been published to date. The TARGIT-A and ELIOT trials have demonstrated that IORT is associated with a low rate of local recurrence, although higher than that after EBRT (TARGIT-A: 3·3 versus 1·3 per cent respectively, P = 0·042; ELIOT: 4·4 versus 0·4 per cent, P < 0·001). However, the local recurrence rate for IORT fell within the predefined 2·5 per cent non-inferiority margin in TARGIT-A, and the 7·5 per cent equivalence margin in ELIOT. CONCLUSION Longer follow-up data from existing trials, optimization of patient criteria and cost-effectiveness analyses are needed. Based on the current evidence, IORT can be offered as an alternative to EBRT to selected patients within agreed protocols, and outcomes should be monitored within national registries.
Collapse
Affiliation(s)
- E Esposito
- Research Oncology, Division of Cancer Studies, King's College London, Guy's Hospital, London, UK; Department of Breast Surgery, Istituto Nazionale per lo Studio e la cura dei tumori 'Fondazione Giovanni Pascale' - IRCCS, Naples, Italy
| | | | | | | | | | | | | |
Collapse
|
19
|
Esposito E, De Laurentiis M, Montella M, Maurea N, D'Aiuto M, Cavalcanti E, Grimaldi M, D'Aiuto G, Ciliberto G, Capasso I. P127 Metabolic syndrome and breast cancer risk by molecular subtype. Breast 2015. [DOI: 10.1016/s0960-9776(15)70169-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
20
|
Goirigolzarri Artaza J, Gallego Delgado M, Jaimes Castellanos C, Cavero Gibanel M, Pastrana Ledesma M, Alonso Pulpon L, Gonzalez Mirelis J, Al Ansi RZ, Sokolovic S, Cerin G, Szychta W, Popa BA, Botezatu D, Benea D, Manganiello S, Corlan A, Jabour A, Igual Munoz B, Osaca Asensi J, Andres La Huerta A, Maceira Gonzalez A, Estornell Erill J, Cano Perez O, Sancho-Tello M, Alonso Fernandez P, Sepulveda Sanchez P, Montero Argudo A, Palombo C, Morizzo C, Baluci M, Kozakova M, Panajotu A, Karady J, Szeplaki G, Horvath T, Tarnoki D, Jermendy A, Geller L, Merkely B, Maurovich-Horvat P, Moustafa S, Mookadam F, Youssef M, Zuhairy H, Connelly M, Prieur T, Alvarez N, Ashikhmin Y, Drapkina O, Boutsikou M, Demerouti E, Leontiadis E, Petrou E, Karatasakis G, Kozakova M, Morizzo C, Bianchi V, Marchi B, Federico G, Palombo C, Chatzistamatiou E, Moustakas G, Memo G, Konstantinidis D, Mpampatzeva Vagena I, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Goto M, Uejima T, Itatani K, Pedrizzetti G, Mada R, Daraban A, Duchenne J, Voigt J, Chiu DYY, Green D, Johnstone L, Sinha S, Kalra P, Abidin N, Sikora-Frac M, Zaborska B, Maciejewski P, Bednarz B, Budaj A, Nemes A, Sasi V, Gavaller H, Kalapos A, Domsik P, Katona A, Szucsborus T, Ungi T, Forster T, Ungi I, Pluchinotta F, Arcidiacono C, Saracino A, Carminati M, Bussadori C, Dahlslett T, Karlsen S, Grenne B, Sjoli B, Bendz B, Skulstad H, Smiseth O, Edvardsen T, Brunvand H, Vereckei A, Szelenyi Z, Szenasi G, Santoro C, Galderisi M, Niglio T, Santoro M, Stabile E, Rapacciuolo A, Spinelli L, De Simone G, Esposito G, Trimarco B, Hubert S, Jacquier A, Fromonot J, Resseguier C, Tessier A, Guieu R, Renard S, Haentjiens J, Lavoute C, Habib G, Menting ME, Koopman L, Mcghie J, Rebel B, Gnanam D, Helbing W, Van Den Bosch A, Roos-Hesselink J, Shiino K, Yamada A, Sugimoto K, Takada K, Takakuwa Y, Miyagi M, Iwase M, Ozaki Y, Hayashi T, Itatani K, Inuzuka R, Shindo T, Hirata Y, Shimizu N, Miyaji K, Henri C, Dulgheru R, Magne J, Kou S, Davin L, Nchimi A, Oury C, Pierard L, Lancellotti P, Kovalyova O, Honchar O, Tengku W, Ketaren A, Mingo Santos S, Monivas Palomero V, Restrepo Cordoba A, Rodriguez Gonzalez E, Goirigolzarri Artaza J, Sayago Silva I, Garcia Lunar I, Mitroi C, Cavero Gibanel M, Segovia Cubero J, Ryu S, Park J, Kim S, Choi J, Goh C, Byun Y, Choi J, Westholm C, Johnson J, Jernberg T, Winter R, Rio P, Moura Branco L, Galrinho A, Pinto Teixeira P, Viveiros Monteiro A, Portugal G, Pereira-Da-Silva T, Afonso Nogueira M, Abreu J, Cruz Ferreira R, Mazzone A, Botto N, Paradossi U, Chabane A, Francini M, Cerone E, Baroni M, Maffei S, Berti S, Ghattas A, Shantsila E, Griffiths H, Lip G, Galli E, Guirette Y, Daudin M, Auffret V, Mabo P, Donal E, Fabiani I, Conte L, Scatena C, Barletta V, Pratali S, De Martino A, Bortolotti U, Naccarato A, Di Bello V, Falanga G, Alati E, Di Giannuario G, Zito C, Cusma' Piccione M, Carerj S, Oreto G, Dattilo G, Alfieri O, La Canna G, Generati G, Bandera F, Pellegrino M, Alfonzetti E, Labate V, Guazzi M, Cengiz B, Sahin ST, Yurdakul S, Kahraman S, Bozkurt A, Aytekin S, Borges IP, Peixoto E, Peixoto R, Peixoto R, Marcolla V, Venkateshvaran A, Sola S, Dash PK, Thapa P, Manouras A, Winter R, Brodin L, Govind SC, Mizariene V, Verseckaite R, Bieseviciene M, Karaliute R, Jonkaitiene R, Vaskelyte J, Arzanauskiene R, Janenaite J, Jurkevicius R, Rosner S, Orban M, Nadjiri J, Lesevic H, Hadamitzky M, Sonne C, Manganaro R, Carerj S, Cusma-Piccione M, Caprino A, Boretti I, Todaro M, Falanga G, Oreto L, D'angelo M, Zito C, Le Tourneau T, Cueff C, Richardson M, Hossein-Foucher C, Fayad G, Roussel J, Trochu J, Vincentelli A, Cavalli G, Muraru D, Miglioranza M, Addetia K, Veronesi F, Cucchini U, Mihaila S, Tadic M, Lang R, Badano L, Polizzi V, Pino P, Luzi G, Bellavia D, Fiorilli R, Chialastri C, Madeo A, Malouf J, Buffa V, Musumeci F, Gripari P, Tamborini G, Bottari V, Maffessanti F, Carminati C, Muratori M, Vignati C, Bartorelli A, Alamanni F, Pepi M, Polymeros S, Dimopoulos A, Spargias K, Karatasakis G, Athanasopoulos G, Pavlides G, Dagres N, Vavouranakis E, Stefanadis C, Cokkinos D, Pradel S, Mohty D, Magne J, Darodes N, Lavergne D, Damy T, Beaufort C, Aboyans V, Jaccard A, Mzoughi K, Zairi I, Jabeur M, Ben Moussa F, Ben Chaabene A, Kamoun S, Mrabet K, Fennira S, Zargouni A, Kraiem S, Jovanova S, Arnaudova-Dezjulovic F, Correia CE, Cruz I, Marques N, Fernandes M, Bento D, Moreira D, Lopes L, Azevedo O, Keramida K, Kouris N, Kostopoulos V, Psarrou G, Giannaris V, Olympios C, Marketou M, Parthenakis F, Kalyva N, Pontikoglou C, Maragkoudakis S, Zacharis E, Patrianakos A, Roufas K, Papadaki H, Vardas P, Dominguez Rodriguez F, Monivas Palomero V, Mingo Santos S, Arribas Rivero B, Cuenca Parra S, Zegri Reiriz I, Vazquez Lopez-Ibor J, Garcia-Pavia P, Szulik M, Streb W, Wozniak A, Lenarczyk R, Sliwinska A, Kalarus Z, Kukulski T, Nemes A, Domsik P, Kalapos A, Forster T, Serra W, Lumetti F, Mozzani F, Del Sante G, Ariani A, Corros C, Colunga S, Garcia-Campos A, Diaz E, Martin M, Rodriguez-Suarez M, Leon V, Fidalgo A, Moris C, De La Hera J, Kylmala MM, Rosengard-Barlund M, Groop PH, Lommi J, Bruin De- Bon H, Bilt Van Der I, Wilde A, Brink Van Den R, Teske A, Rinkel G, Bouma B, Teixeira R, Monteiro R, Garcia J, Silva A, Graca M, Baptista R, Ribeiro M, Cardim N, Goncalves L, Duszanska A, Skoczylas I, Kukulski T, Polonski L, Kalarus Z, Choi JH, Park J, Ahn J, Lee J, Ryu S, Ahn J, Kim D, Lee H, Przewlocka-Kosmala M, Mlynarczyk J, Rojek A, Mysiak A, Kosmala W, Pellissier A, Larochelle E, Krsticevic L, Baron E, Le V, Roy A, Deragon A, Cote M, Garcia D, Tournoux F, Yiangou K, Azina C, Yiangou A, Zitti M, Ioannides M, Ricci F, Dipace G, Aquilani R, Radico F, Cicchitti V, Bianco F, Miniero E, Petrini F, De Caterina R, Gallina S, Jardim Prista Monteiro R, Teixeira R, Garcia J, Baptista R, Ribeiro M, Cardim N, Goncalves L, Chung H, Kim J, Joung B, Uhm J, Pak H, Lee M, Lee K, Ragab A, Abdelwahab A, Yazeed Y, El Naggar W, Spahiu K, Spahiu E, Doko A, Liesting C, Brugts J, Kofflard M, Kitzen J, Boersma E, Levin MD, Coppola C, Piscopo G, Rea D, Maurea C, Caronna A, Capasso I, Maurea N, Azevedo O, Tadeu I, Lourenco M, Portugues J, Pereira V, Lourenco A, Nesukay E, Kovalenko V, Cherniuk S, Danylenko O, Nemes A, Domsik P, Kalapos A, Lengyel C, Varkonyi T, Orosz A, Forster T, Castro M, Abecasis J, Dores H, Madeira S, Horta E, Ribeiras R, Canada M, Andrade M, Mendes M, Morosin M, Piazza R, Leonelli V, Leiballi E, Pecoraro R, Cinello M, Dell' Angela L, Cassin M, Sinagra G, Nicolosi G, Wierzbowska-Drabik K, Hamala P, Kasprzak J, O'driscoll J, Rossato C, Gargallo-Fernandez P, Araco M, Sharma S, Sharma R, Jakus N, Baricevic Z, Ljubas Macek J, Skoric B, Skorak I, Velagic V, Separovic Hanzevacki J, Milicic D, Cikes M, Deljanin Ilic M, Ilic S, Kocic G, Pavlovic R, Stoickov V, Ilic V, Nikolic L, Generati G, Bandera F, Pellegrino M, Alfonzetti E, Labate V, Guazzi M, Labate V, Bandera F, Generati G, Pellegrino M, Donghi V, Alfonzetti E, Guazzi M, Zakarkaite D, Kramena R, Aidietiene S, Janusauskas V, Rucinskas K, Samalavicius R, Norkiene I, Speciali G, Aidietis A, Kemaloglu Oz T, Ozpamuk Karadeniz F, Akyuz S, Unal Dayi S, Esen Zencirci A, Atasoy I, Osken A, Eren M, Fazendas PR, Caldeira D, Stuart B, Cruz I, Rocha Lopes L, Almeida AR, Sousa P, Joao I, Cotrim C, Pereira H, Fazendas PR, Caldeira D, Stuart B, Cruz I, Rocha Lopes L, Almeida AR, Joao I, Cotrim C, Pereira H, Sinem Cakal S, Elif Eroglu E, Baydar O, Beytullah Cakal B, Mehmet Vefik Yazicioglu M, Mustafa Bulut M, Cihan Dundar C, Kursat Tigen K, Birol Ozkan B, Ali Metin Esen A, Yagasaki H, Kawasaki M, Tanaka R, Minatoguchi S, Houle H, Warita S, Ono K, Noda T, Watanabe S, Minatoguchi S, Cho EJ, Park SJ, Lim HJ, Chang SA, Lee SC, Park SW, Cho EJ, Park SJ, Lim HJ, Chang SA, Lee SC, Park SW, Mornos C, Cozma D, Ionac A, Mornos A, Popescu I, Ionescu G, Pescariu S, Melzer L, Faeh-Gunz A, Seifert B, Attenhofer Jost CH, Storve S, Haugen B, Dalen H, Grue J, Samstad S, Torp H, Ferrarotti L, Maggi E, Piccinino C, Sola D, Pastore F, Marino P, Ranjbar S, Karvandi M, Hassantash S, Karvandi M, Ranjbar S, Tierens S, Remory I, Bala G, Gillis K, Hernot S, Droogmans S, Cosyns B, Lahoutte T, Tran N, Poelaert J, Al-Mallah M, Alsaileek A, Nour K, Celeng C, Horvath T, Kolossvary M, Karolyi M, Panajotu A, Kitslaar P, Merkely B, Maurovich Horvat P, Aguiar Rosa S, Ramos R, Marques H, Portugal G, Pereira Da Silva T, Rio P, Afonso Nogueira M, Viveiros Monteiro A, Figueiredo L, Cruz Ferreira R. Poster session 6. Eur Heart J Cardiovasc Imaging 2014; 15:ii235-ii264. [PMCID: PMC4453635 DOI: 10.1093/ehjci/jeu271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
|
21
|
Capasso I, Esposito E, Montella M, Crispo A, D'Aiuto M, De Laurentiis M, Fucito A, Grimaldi M, Ciliberto G, D'Aiuto G. 12. Is metabolic syndrome-breast cancer link relatable to specific molecular subtype? Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.010] [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: 10/24/2022] Open
|
22
|
Maurea N, Coppola C, Piscopo G, Rea D, Galletta F, Maurea C, Capasso I, Arra C, Iaffaioli R. Ranolazine Before and During Trastuzumab Treatment, Prevents Cardiotoxicity in Mice. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu325.15] [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
|
23
|
Crispo A, D'Aiuto G, Grimaldi M, Rinaldo M, Barba M, Capasso I, Botti G, Caolo G, Tsapakina K, D'Aiuto M, Amore A, Di Bonito M, De Laurentiis M, Frasci G, Montella M. Relapse in breast cancer: How much mode of breast cancer detection matters? Results from an Italian national cancer institute. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e12012] [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: 11/20/2022] Open
|
24
|
Capasso I, Esposito E, Crispo A, Montella M, Grimaldi M, De Marco M, Cavalcanti E, D'Aiuto M, Vecchione A, D'Aiuto G. P152 Metabolic syndrome: Breast cancer risk indicator in postmenopausal women. Breast 2011. [DOI: 10.1016/s0960-9776(11)70095-9] [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: 10/18/2022] Open
|
25
|
Frasci G, D’Aiuto G, Comella P, D’Aiuto M, Di Bonito M, Ruffolo P, Iodice G, Petrillo A, Lastoria S, Oliviero P, Capasso I, Montella M, Siani C, Santangelo M, Vizioli L, Comella G. Preoperative weekly cisplatin, epirubicin, and paclitaxel (PET) improves prognosis in locally advanced breast cancer patients: an update of the Southern Italy Cooperative Oncology Group (SICOG) randomised trial 9908. Ann Oncol 2010; 21:707-716. [DOI: 10.1093/annonc/mdp356] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
|
26
|
Capasso I, Crispo A, Montella M, Esposito E, Cavalcanti E, D'Aiuto M, Capasso A, Vecchione A, Pedicini T, D'Aiuto G. P11 Metabolic syndrome as modifiable risk factor in breast cancer. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70771-0] [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: 10/19/2022] Open
|
27
|
Capasso I, Esposito E, Montella M, Crispo A, Grimaldi M, D'Aiuto M, Beneduce G, Esposito G, De Marco M, D'Aiuto G. Metabolic syndrome, hyperinsulinaemia and body mass index as risk factors in breast cancer: National Cancer Institute of Naples experience. Breast Cancer Res 2009. [PMCID: PMC4284888 DOI: 10.1186/bcr2285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
|
28
|
Capasso I, Esposito E, Montella M, Crispo A, Grimaldi M, D'Aiuto M, Beneduce G, Esposito G, D'Aiuto G. Gail's model as first step for early diagnosis: National Cancer Institute of Naples experience. Breast Cancer Res 2009; 11 Suppl 1:P1-33, S1-22. [PMID: 19558730 PMCID: PMC4284887 DOI: 10.1186/bcr2284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
29
|
Frasci G, Crispo A, D'Aiuto G, Barba M, Rinaldo M, De Marco M, Grimaldi M, Capasso I, Botti G, Di Bonito M, Montella M. Outcome analysis of breast cancer patients receiving breast-conserving surgery in Southern Italy. J Chemother 2008; 20:269-77. [PMID: 18467256 DOI: 10.1179/joc.2008.20.2.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The purpose of the current analysis was to evaluate the outcome of patients enrolled at the National Cancer Institute of Naples between 1997 and 2000, who underwent breast-conserving surgery. Between January 1997 and December 2000, 946 patients had been diagnosed with T1 or T2 (<3 cm) breast carcinoma. At the time of the present analysis (31-12-2005), all patients had been followed for >5 years. A Cox proportional hazards model was performed. Overall, 7-year Locoregional Relapse-free survival (LRFS) and Distant Relapse-free Survival (DRFS) rates were 95.9% and 88.4%, respectively. Seven-year DRFS was 91.2% and 79.3% in T1 and T2 stage, respectively (p<0.0001). Multivariate Cox analysis indicated that number of positive lymph-nodes and hormone receptor status were significantly associated with prognosis. Our findings confirm that early diagnosed breast cancer, treated with breast-conserving surgery, is associated with a very good prognosis in patients referred to an Institution which may be considered as representative of similar Cancer Institutes of Southern Italy. The risk of local relapse was found to be very low (4%), although a longer follow-up is needed to draw definitive conclusions.
Collapse
Affiliation(s)
- G Frasci
- Unit of Medical Oncology A, National Cancer Institute of Naples, Naples, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Capasso I, Casamassimi A, Crispo A, Montella M, Esposito E, D'Aiuto M, Ciccodicola A, Frasci G, D'Aiuto G. Genetic counseling in breast cancerThe National Cancer Institute of Naples experience. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70401-4] [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: 10/22/2022] Open
|
31
|
Capasso I, Casamassimi A, Esposito E, D'aiuto M, Ciccodicola A, D'aiuto G. P15 Genetic counseling in breast cancer. The National Cancer Institute of Naples experience. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70247-7] [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: 11/17/2022] Open
|
32
|
Comella G, D'Aiuto, Comella P, Thomas R, Capasso I, Silvestro P, Russo A, Petrillo A, Lapenta L, Frasci G. Comparison of weekly cisplatin-epirubicin-paclitaxel (PET) with triweekly epirubicin-paclitaxel (ET) in locally advanced breast cancer (LABC). SICOG 9908 phase III tria. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
- G. Comella
- National Cancer Institute, Naples, Italy
| | - D'Aiuto
- National Cancer Institute, Naples, Italy
| | - P. Comella
- National Cancer Institute, Naples, Italy
| | - R. Thomas
- National Cancer Institute, Naples, Italy
| | - I. Capasso
- National Cancer Institute, Naples, Italy
| | | | - A. Russo
- National Cancer Institute, Naples, Italy
| | | | - L. Lapenta
- National Cancer Institute, Naples, Italy
| | - G. Frasci
- National Cancer Institute, Naples, Italy
| |
Collapse
|
33
|
Curci A, Capasso I, Romano A, Bruni P, Motti ML, Pignata S, D'Aiuto G, Casamassimi A, D'Urso M, Fusco A, Viglietto G. Characterization of 2 novel and 2 recurring BRCA1 germline mutations in breast and/or ovarian carcinoma patients from the area of Naples. Int J Oncol 2002; 20:963-70. [PMID: 11956590 DOI: 10.3892/ijo.20.5.963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We have analyzed 18 families with high incidence of breast cancer or breast and ovarian cancer for the presence of BRCA1 mutations. We identified 4 mutations in the BRCA1 gene in 4 unrelated probands who belong to families with at least 1 case of breast and 1 case of ovarian cancer. Two of the mutations reported in this study are novel (GAA(1172)-->TAA in family Naples 14, GAA(1765)-->TAA in family Naples 20) whereas the others are already present in the Breast Cancer Information Core Electronic Database (http://nchgr.nih.gov/ Intramural research/Lab transfer/Bic/) (5382insC in family Naples 18 and 2080delA in family Naples 19). Conversely, no mutation in the BRCA1 gene was detected in 14 families characterized by 2 or more cases of breast cancer only, even if bilateral and with early-onset. These results indicate that germline mutations in the BRCA1 gene highly predispose for a cancer syndrome that involves the presence of both breast and ovarian cancer.
Collapse
Affiliation(s)
- A Curci
- Istituto Nazionale Tumori, Fondazione Pascale, Naples, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Frasci G, D'Aiuto G, Comella P, Thomas R, Capasso I, Botti G, Cortino GR, De Rosa V, Comella G. Gemcitabine/cyclophosphamide/5-fluorouracil/folinic acid triplet combination in anthracycline- and taxane-refractory breast cancer patients: a Southern Italy Cooperative Oncology Group phase I/II study. Semin Oncol 2001; 28:50-6. [PMID: 11510034 DOI: 10.1053/sonc.2001.22533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We sought to define the recommended dose of cyclophosphamide (CTX) for subsequent phase II assessment when combined with fixed doses of gemcitabine (Gemzar; Eli Lilly and Company, Indianapolis, IN) and 5-fluorouracil/folinic acid in metastatic breast cancer patients previously treated with anthracyclines and taxanes. Patients age 70 or less, with an Eastern Cooperative Oncology Group performance status 0 to 2, were enrolled. Patients received gemcitabine 1,000 mg/m(2), 5-fluorouracil 425 mg/m(2), folinic acid 100 mg/m(2), and escalating doses of CTX (in 100-mg/m(2) increments), starting at 500 mg/m(2), on days 1 and 8 every 3 weeks. Since March 1999, 46 patients, with a median age of 51 years (range, 38 to 74 years), entered the trial in seven cohorts. Cyclophosphamide dose escalation was stopped at 600 mg/m(2) when three of six patients experienced dose-limiting toxicity (one each with grade 3 thrombocytopenia, grade 3 neutropenia, and persistent grade 2 neutropenia), and then continued with granulocyte colony-stimulating factor support. The CTX dose of 800 mg/m(2) was proven safe and was chosen for phase II study. Two complete and 15 partial responses provided an overall response rate of 37% (95% confidence interval, 23% to 51%). Gemcitabine/CTX/5-fluorouracil/folinic acid is well tolerated by metastatic breast cancer patients pretreated with anthracyclines/taxanes, up to a CTX dose of 800 mg/m(2). The phase II study is ongoing. Semin Oncol 28 (suppl 10):50-56.
Collapse
Affiliation(s)
- G Frasci
- Division of Medical Oncology, Department of Radiology, National Tumor Institute, via Mariano Semmola 80131, Naples, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
D'Apice L, De Berardinis P, Pasquinelli R, Capasso I, D'Aiuto M, D'Aiuto G, Anzisi AM, Favre R, Cermola M, Barba P, Guardiola J. Identification of a new subset of cells exhibiting dendritic phenotypes in patients affected by breast proliferative disorders. Hum Immunol 2000; 61:739-52. [PMID: 10980385 DOI: 10.1016/s0198-8859(00)00141-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/22/2022]
Abstract
We report that a subset of circulating cells reacting with a monoclonal antibody raised against a protein marker is significantly increased in the peripheral blood of women carrying benign or malignant breast diseases, particularly in patients under 55 years of age with ductal mammary carcinomas. These cells were statistically (confidence level of 99%) less represented in a control population including healthy women or women carrying carcinomas of origin other than breast. Double staining analysis showed that they harbor markers of dendritic cells and exhibit endo- cytic activity, as determined by their ability to internalize FITC-dextran particles. Their dendritic morphology was further demonstrated by electron microscopy of sorted antibody-positive cells. However, expression of surface molecules, such as CD34 and CD14, usually not present in differentiated populations of dendritic cells was also observed. Adherent cells of patients with breast ductal carcinoma including mostly cells of this new subset were efficient stimulators of mixed lymphocyte reaction, attaining maximal stimulatory activity attained after TNFalpha treatment. In conclusion, we have shown that a subset of cells characterized by a phenotype suggestive of a yet undescribed stage of maturation of the dendritic cell lineage is accumulated in the blood of patients affected by breast proliferative disorders.
Collapse
MESH Headings
- Adult
- Antibodies, Monoclonal/immunology
- Breast Neoplasms/blood
- Breast Neoplasms/immunology
- Breast Neoplasms/ultrastructure
- Carcinoma, Ductal, Breast/blood
- Carcinoma, Ductal, Breast/immunology
- Carcinoma, Ductal, Breast/ultrastructure
- Dendritic Cells/classification
- Dendritic Cells/immunology
- Dendritic Cells/ultrastructure
- Endocytosis/immunology
- Female
- Fetal Blood/cytology
- Fetal Blood/immunology
- Humans
- Immunophenotyping
- Leukocytes, Mononuclear/classification
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/ultrastructure
- Microscopy, Electron
- Middle Aged
- Staining and Labeling/methods
Collapse
Affiliation(s)
- L D'Apice
- Institute of Protein Biochemistry and Enzymology, CNR, Naples, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Frasci G, D'Aiuto G, Comella P, Thomas R, Capasso I, Di Bonito M, Rivellini F, Carteni G, De Lucia L, Maiorino L, D'Aniello R, Frezza P, Lapenta L, Comella G. Cisplatin-epirubicin-paclitaxel weekly administration with G-CSF support in advanced breast cancer. A Southern Italy Cooperative Oncology Group (SICOG) phase II study. Breast Cancer Res Treat 2000; 62:87-97. [PMID: 11016746 DOI: 10.1023/a:1006429205363] [Citation(s) in RCA: 18] [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: 11/12/2022]
Abstract
PURPOSE It has been shown in vitro that both cisplatin and epirubicin increase the antitumor activity of paclitaxel. Weekly administration could give a substantial improvement in the therapeutic index of cisplatin and paclitaxel. This study was aimed at defining the antitumor activity of a weekly cisplatin-epirubicin-paclitaxel (PET) administration in locally advanced or metastatic breast cancer patients. PATIENTS AND METHODS Sixty-eight breast cancer patients with advanced disease, who had not received prior chemotherapy (except adjuvant), received weekly cisplatin 30 mg/sqm, paclitaxel 120 mg/sqm and epirubicin 50 mg/sqm plus G-CSF (day 3-5), for a maximum of 12 cycles. Thirty-five patients had stage IIIB and 33 stage IV disease (14 with visceral metastases). RESULTS All patients were evaluable for response on an intent to treat basis. Overall, 21 complete and 38 partial responses have been recorded for an 87% ORR (95% CI = 76-94%). Fourteen CRs and 19 PRs have been registered in the 35 patients with locally advanced disease for a 94% ORR (95% CI = 81-99%) while 7 CRs and 19 PRs were observed in the 33 patients with metastatic disease for a 79% ORR (95% CI-61-91%). Surgery was performed in 33/35 women with locally advanced disease. Four of these patients (11%) showed no invasive cancer on pathologic examination, and in an additional 8 patients tumor < 1 cm was found in the breast. Only 4/33 patients who underwent surgery relapsed. The projected one-year RFS was greater than 80%. At an 11-month median follow-up (range, 3-19), 11 patients had progressed and 5 had died among the 33 patients with metastatic disease, the median progression-free survival in this group being 14 months. Severe hematologic toxicity was uncommon, grade 3-4 neutropenia and thrombocytopenia occurring in 32% and 4% of patients, respectively. Only 2 episodes of neutropenic sepsis were registered. Packed red blood cell transfusions were required in 7 patients. Vomiting, diarrhoea, mucositis and skin toxicity were severe in 6%, 9%, 10%, and 9% of patients, respectively. Peripheral neuropathy was observed in 47% of patients. CONCLUSIONS The weekly PET administration is a well tolerated and very effective approach in advanced breast cancer patients. It can produce a 40% clinical complete response rate, with a more than 10% pCR rate in patients with T4 disease, and an about 80% ORR in those with distant metastases. A phase III trial comparing PET with a standard every 3 weeks epirubicin-taxol administration is underway.
Collapse
Affiliation(s)
- G Frasci
- Division of Medical Oncology A, National Tumor Institute, Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Dello Iacovo R, Celentano E, Strollo AM, Iazzetta G, Capasso I, Randazzo G. Organochlorines and breast cancer. A study on Neapolitan women. Adv Exp Med Biol 2000; 472:57-66. [PMID: 10736616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- R Dello Iacovo
- Tumour/Tissues Central Bank, National Tumour Institute, Naples, Italy
| | | | | | | | | | | |
Collapse
|
38
|
Frasci G, Comella P, D'Aiuto G, Thomas R, Capasso I, Elmo M, Botti G, Cortino GR, Lapenta L, De Rosa V, Vallone P, Petrillo A, Comella G. Weekly docetaxel plus gemcitabine or vinorelbine in refractory advanced breast cancer patients: a parallel dose-finding study. Southern Italy Cooperative Oncology Group (SICOG). Ann Oncol 2000; 11:367-71. [PMID: 10811508 DOI: 10.1023/a:1008346708604] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The objective of this study was to determine the docetaxel MTD when combined with gemcitabine or vinorelbine in advanced breast cancer patients who had received previous anthracycline-based chemotherapy for advanced disease. PATIENTS AND METHODS Advanced breast cancer patients aged between 18 and 70 with ECOG PS 0-2 who had not responded to, or had relapsed after, first-line anthracycline-based chemotherapy, were randomized to receive either gemcitabine 1000 mg/m2 or vinorelbine 25 mg/m2 in combination with escalating doses of docetaxel (starting from 30 mg/m2), all on days 1 and 8 every three weeks. Escalation was stopped if > 33% of patients treated at a given dose level showed DLT at the first cycle. RESULTS A total of 34 patients with locally advanced (8) or metastatic disease (26) were treated, for a total of 94 cycles delivered. Nineteen patients received docetaxel in combination with gemcitabine and 15 with vinorelbine. All patients had been pretreated with anthracyclines, and 24 of 34 had also received weekly dose-dense paclitaxel. A docetaxel dose of 40/m2 proved to be safe when combined on days 1 and 8 with gemcitabine, while a dose of 35 mg/m2 was tolerated in combination with vinorelbine. Overall, nine episodes of DLT, all of them neutropenia, occurred at the first cycle. Considering all 94 cycles, grades 3 or 4 neutropenia and thrombocytopenia occurred in 15 (44%), and 7 (20%) patients. Non-hematologic toxicity was mild, except for three cases of grade 2 peripheral neuropathy. All patients were assessed for response on an 'intent-to-treat' basis. Overall, five partial responses were recorded (docetaxel + gemcitabine = 3 and docetaxel + vinorelbine = 2), for a 15% (95% CI: 5%-31%) overall response rate. Only 1 of 24 (4%) patients who had received weekly dose-dense paclitaxel responded to treatment. CONCLUSIONS The weekly docetaxel administration in combination with either gemcitabine or vinorelbine is a well-tolerated treatment for heavily pretreated advanced breast cancer patients. This approach, although sometimes capable of achieving a major response, does not seem advisable in advanced breast cancer patients refractory to both anthracyclines and paclitaxel.
Collapse
Affiliation(s)
- G Frasci
- Division of Medical Oncology A, National Tumor Institute of Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Montella M, Buonanno M, Biondi E, Crispo A, De Marco M, Tamburini M, Botti G, Fabbrocini G, Capasso I, D'Aiuto G. Changing patterns of breast cancer stage at diagnosis in southern italy: hospital data as indicators of progressive changes. Prev Med 2000; 30:174-7. [PMID: 10656845 DOI: 10.1006/pmed.1999.0595] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND In southern Italy diagnostic delay in breast cancer patients has been demonstrated to be related to the level of education and residency in rural areas. In order to verify whether late breast cancer diagnosis was actually in decline as a result of improving socioeconomic conditions and ongoing prevention programs, we evaluated clinical data from the tumor registry of the National Cancer Institute, Naples. METHODS Four thousand two hundred forty consecutive breast cancer patients admitted to our institution from 1986 to 1997 were grouped into four 3-year periods according to their admission date. Using multiple logistic regression, chi(2) for trend and beta-coefficient were calculated in each pT and pN categories in order to discover the trend for the 1986-1997 period. RESULTS A progressive, statistically significant decrease in the number of patients with advanced cancer at the time of diagnosis was observed over the study period. In particular, chi(2) values for trend for each pT category, over the study period, were pT1 119.4 (P < 0.001) with positive chi-coefficient, pT2 13.4 (P = 0.003) with negative beta, and pT3-pT4 152.2 (P < 0.001) with the strongest negative beta. CONCLUSIONS Changing patterns of breast cancer stage at diagnosis have been demonstrated in women living in Southern Italy. They are consistent with an increasing orientation toward prevention. Data from hospital tumor registries are a useful source of information on diagnostic delay.
Collapse
Affiliation(s)
- M Montella
- National Cancer Institute, Via Mariano Semmola, Naples, 80131, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Pasquinelli R, Barba P, Capasso I, D'Aiuto M, D'Aiuto G, Anzisi AM, De Berardinis P, Guardiola J. Circulating antibodies against the breast tumor marker GCDFP-15/gp17 in mammary carcinoma patients and in patients carrying benign breast conditions. Int J Cancer 1999; 84:568-72. [PMID: 10567900 DOI: 10.1002/(sici)1097-0215(19991222)84:6<568::aid-ijc5>3.0.co;2-g] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 11/12/2022]
Abstract
Sera samples from 111 women, including 73 breast cancer patients and 38 patients with benign diseases of the breast, were examined. These were compared with samples from healthy women or from patients carrying tumors of origin other than breast as controls. This was done to determine whether antibodies against GCDFP-15/gp17, a protein of gross cystic disease fluid also secreted by mammary apocrine tumor cells, could be found. We observed that 2.6% of mammary disease patients affected by benign conditions and 5.5% of patients carrying malignant mammary gland tumors expressed statistically significant amounts of antibodies against GCDFP-15/gp17 (p < 0.01). The highest circulating anti-GCDFP-15/gp17 antibody levels occurred in patients with highly malignant ductal or lobular carcinoma of the breast and in patients with dysplasia. No correlation was found between the presence of circulating antibodies and the size of the tumor or the age of the patients. A bimodal correlation with the percent of invaded lymph nodes was observed instead. IgM and IgG isotypes were detected among the circulating anti-GCDFP-15/gp17 antibodies, suggesting the involvement of a T-cell-mediated immunoresponse. Our findings raise the possibility that the anti-GCDFP-15/gp17 immune response may be useful as a tool for investigating some aspects of the mechanisms of breast disease progression and that GCDFP-15/gp17 may be explored as an antigen for anti-tumor vaccination. Int. J. Cancer (Pred. Oncol.) 84:568-572, 1999.
Collapse
Affiliation(s)
- R Pasquinelli
- Department of Oncology E, National Cancer Institute, Naples, Italy
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Frasci G, Comella P, Apicella A, D'Aiuto G, Thomas R, Capasso I, Di Bonito M, Lapenta L, Comella G. Weekly docetaxel (D) plus gemcitabine (G) or vinorelbine (V) in refractory advanced breast cancer (ABC) patients. A parallel dose-finding study. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
42
|
Pasquinelli R, Capasso I, D'Aiuto M, Barba P, Anzisi A, D'Aiuto G, Guardiola J. Circulating antibodies against a breast tumor antigen. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)80736-9] [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: 10/27/2022]
|
43
|
Frasci G, Comella P, D'Aiuto G, Apicella A, Thomas R, Capasso I, Carteni G, De Lucia L, Maiorino L, Comella G. Cisplatin — epirubicin — paclitaxel (PET) weekly administration with G-CSF support in advanced breast cancer (ABC). A phase II study. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81693-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
44
|
Capasso I, Tripodi A, D'Aiuto M, De Falco F, Foggia M, D'Aiuto G. Information an education programmes on breast cancer. The NCI of Naples experience. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81553-6] [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: 10/27/2022]
|
45
|
Frasci G, D'Aiuto G, Comella P, Apicella A, Thomas R, Capasso I, Di Bonito M, Cartenì G, Biglietto M, De Lucia L, Maiorino L, Piccolo S, Bianchi U, D'Aniello R, Lapenta L, Comella G. Cisplatin-epirubicin-paclitaxel weekly administration in advanced breast cancer: a phase I study of the Southern Italy Cooperative Oncology Group. Breast Cancer Res Treat 1999; 56:239-52. [PMID: 10573115 DOI: 10.1023/a:1006263226099] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE Both cisplatin and epirubicin have been shown to enhance the antitumor activity of paclitaxel in vitro. Weekly administration could result in a substantial improvement in the therapeutic index of cisplatin and paclitaxel. This study was aimed at determining the MTDs of epirubicin and paclitaxel given weekly with a fixed dose of cisplatin. PATIENTS AND METHODS Sixty-three breast cancer patients with advanced disease (24 locally advanced and 39 metastatic), who had not received prior chemotherapy (except adjuvant), received weekly cisplatin (CDDP) doses of 30 mg/m2 together with escalating doses of paclitaxel (PTX) and epirubicin (EPI) for a minimum of six cycles. The dose escalation was stopped if DLT occurred during the first six treatment cycles in > 33% of patients of a given cohort. RESULTS Nine different dose levels were tested, for a total of 506 weekly cycles delivered. G-CSF support on days 3-5 of each week was also given in the last four cohorts (24 patients). An overall 11 patients showed DLT in the first six cycles. EPI and PTX doses up to 40 and 85 mg/m2/week, respectively, were safely delivered without G-CSF support. However, the actually delivered mean dose intensity was only 64% in this cohort. Therefore, the dose escalation continued with the addition of filgrastim from day 3 to day 5 each week. Doses of EPI and PTX up to 50 and 120 mg/m2/week were administered without observing DLT in the first six cycles in more than one third of the patients enrolled. No toxic deaths were observed. Only two patients had to be hospitalized because of sepsis. Grade 3-4 neutropenia, thrombocytopenia, and anemia occurred in 25, 9, and 16 patients, respectively. Alopecia was almost universal. Other nonhematologic toxicities were generally mild, being of grade 3-4 in only eight patients (fatigue and loss of appetite in two cases, diarrhoea in four cases, peripheral neuropathy and mucositis in one case). Fifteen complete and 37 partial responses have been registered for an 82% (95% CI = 71-91) overall clinical response rate (ORR). Eight complete and 14 partial responses occurred in the 24 patients with locally advanced disease, for a 92% (95% CI = 73-99) ORR, as compared to seven complete and 23 partial responses in the 39 women with metastatic disease, 77% (95% CI = 61-89). A clear dose-response relationship was not observed, since an overall response rate of at least 70% was achieved at all dose levels. However, the ORR increased to 92% in the last four cohorts which included patients who received higher doses of EPI and PTX with G-CSF support. All of the 24 patients with locally advanced disease underwent modified radical mastectomy with axillary dissection. Three of them showed no invasive cancer on pathologic examination, and in another five patients a tumor smaller than 1 cm was found in the surgical specimen of the breast. At a nine-month median follow-up (range 2-14), 11 patients have progressed and three have died. Twenty-three out of 24 patients who underwent surgery are still free from progression. The one-year projected progression-free survival is 77% for the whole population. CONCLUSIONS The CDDP/EPI/PTX weekly administration is a well tolerated and very effective approach in advanced breast cancer patients. Full doses of all the three drugs can be delivered even in absence of G-CSF support. A very impressive increment of the dose-intensity can be obtained, however, by adding filgrastim. A phase II study is under way to better define the therapeutic efficacy of this regimen in patients with advanced breast cancer.
Collapse
Affiliation(s)
- G Frasci
- Division of Medical Oncology A, National Tumor Institute, Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Frasci G, Cornelia P, D'Aiuto G, Apicella A, Thomas R, Capasso I, Frasci G, Cornelia G, Cortino G, DiBonito M, Piccolo S. Weekly cisplatin-epirubicin-paclitaxel in advanced breast cancer: A phase I study. Eur J Cancer 1998. [DOI: 10.1016/s0959-8049(98)80046-4] [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: 10/27/2022]
|
47
|
Thomas R, Capasso I, de Matteis A, Labonia V, Landi G, Nuzzo F, Rossi E, Montedoro D, D'Aiuto M, D'Aiuto G, Melucci M. Long term survival in elderly breast cancer patients treated with tamoxifen (TAM) alone vs surgery followed by TAM. Eur J Cancer 1998. [DOI: 10.1016/s0959-8049(98)80534-0] [Citation(s) in RCA: 2] [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: 10/27/2022]
|
48
|
Frasci G, Comella P, D'Aiuto G, Budillon A, Barbarulo D, Thomas R, Capasso I, Casaretti R, Daponte A, Caponigro F, Gravina A, Maiorino L, Caratení G, Gentile A, Comella G. Weekly paclitaxel-cisplatin administration with G-CSF support in advanced breast cancer. A phase II study. Breast Cancer Res Treat 1998; 49:13-26. [PMID: 9694607 DOI: 10.1023/a:1005945218155] [Citation(s) in RCA: 20] [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: 02/08/2023]
Abstract
PURPOSE In a previous phase I study we found the MTDs of paclitaxel and cisplatin when given together weekly, with or without G-CSF support, in patients with advanced solid tumors. The present study was conducted to define the toxicity and efficacy of this regimen, when used with G-CSF support, in chemotherapy-naive or pretreated patients with advanced breast cancer, and to compare the antiproliferative activity of paclitaxel-cisplatin and paclitaxel-doxorubicin combinations on two human breast cancer cell lines. METHODS Patients with metastatic breast cancer received weekly paclitaxel (as a 3-hour i.v. infusion) at the dose of 85 mg/m2 (75 mg/m2 in pretreated women) followed by cisplatin (40 mg/m2) for a minimum of 6 weeks. An additional 6 weekly cycles were delivered in patients showing absence of documented disease progression after the first 6 weeks. After the 12th cycle only patients who had shown a substantial tumor shrinkage received 6 further cycles. G-CSF 5 microg/kg was also given, SC on days 3 to 5 of each week, for the whole duration of chemotherapy. The combination of paclitaxel with cisplatin or doxorubicin was also tested in vitro on two breast cancer cell lines (MCF-7 and MDAMB-231). RESULTS Forty-three women with metastatic breast cancer entered this trial between June 1995 and January 1997. Twenty-seven patients were previously untreated for their metastatic disease (but 23 had previously received adjuvant chemotherapy). The dominant site of disease involvement was visceral in 23, bone in 13, and soft tissues in 7 patients. Seven complete and 15 partial responses were observed in unpretreated patients, while no complete and 6 partial responses were achieved in the pretreated population. The overall response rate, assessed on an 'intent to treat' basis, was 81% (26% CRs) in patients unpretreated for metastatic disease and 37% in those who had received one or more previous chemotherapy regimens. Eighteen responder patients had previously received anthracyclines either as adjuvant chemotherapy (12) or in the treatment of metastatic disease (6). At a median potential follow-up of 12 (range, 3-21) months, 14/27 unpretreated and 12/16 pretreated patients had shown disease progression. The median time to treatment failure was 13 and 7 months, respectively, in the 2 subgroups. The 1-year survival probability was 95% in unpretreated patients. The treatment showed a moderate toxicity in both subgroups of patients. Both hematological toxicity and peripheral neuropathy occurred more frequently in pretreated patients. Treatment-related deaths did not occur, and severe myelosuppression was observed only in pretreated patients with massive liver involvement. Delays in chemotherapy administration were very uncommon, especially during the first 6 treatment cycles, and the average actually delivered dose intensity exceeded 90% in unpretreated patients. The in vitro data on MCF-7 and MDA-MB-231 human breast cancer cell lines showed that exposure to the combination of cisplatin and paclitaxel produced a tumor cell killing similar to that achievable with equivalent concentrations of doxorubicin and paclitaxel. CONCLUSIONS Weekly paclitaxel and cisplatin with G-CSF support is an active and particularly well tolerated treatment for patients with either unpretreated or pretreated metastatic breast cancer. This approach seems quite effective also in patients relapsing after anthracycline-based adjuvant chemotherapy. In view of the negligible hematological toxicity associated with this regimen, further clinical trials testing the addition of non cross-resistant drugs to this combination should be performed.
Collapse
Affiliation(s)
- G Frasci
- Division of Medical Oncology, National Tumor Institute, Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
De Matteis A, D'Aiuto G, Landi G, Nuzzo F, Labonia V, Montedoro D, Rossi E, Capasso I, Pizzorusso M. P16 Adjuvant Goserelin depot in premenopausal women with early breast cancer: Ovarian function, bone mineral density and survival. Preliminary data. Eur J Cancer 1998. [DOI: 10.1016/s0959-8049(97)89234-9] [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: 10/17/2022]
|
50
|
Viglietto G, Bruni P, Capasso I, Vento M, Squame E, D'Aiuto M, Buonagura S, Pizzorusso M, Esposito G, Chiappetta G, Aiuto G. P927. Analysis of BRCA-1 mutations in families from Southern Italy. Breast 1997. [DOI: 10.1016/s0960-9776(97)90096-5] [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: 10/26/2022] Open
|