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Krasniqi E, Sacconi A, Marinelli D, Pizzuti L, Mazzotta M, Sergi D, Capomolla E, Donzelli S, Carosi M, Bagnato A, Gamucci T, Tomao S, Natoli C, Marchetti P, Grassadonia A, Tinari N, De Tursi M, Vizza E, Ciliberto G, Landi L, Cappuzzo F, Barba M, Blandino G, Vici P. MicroRNA-based signatures impacting clinical course and biology of ovarian cancer: a miRNOmics study. Biomark Res 2021; 9:57. [PMID: 34256855 PMCID: PMC8276429 DOI: 10.1186/s40364-021-00289-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/26/2021] [Indexed: 02/06/2023] Open
Abstract
Background In Western countries, ovarian cancer (OC) still represents the leading cause of gynecological cancer-related deaths, despite the remarkable gains in therapeutical options. Novel biomarkers of early diagnosis, prognosis definition and prediction of treatment outcomes are of pivotal importance. Prior studies have shown the potentials of micro-ribonucleic acids (miRNAs) as biomarkers for OC and other cancers. Methods We focused on the prognostic and/or predictive potential of miRNAs in OC by conducting a comprehensive array profiling of miRNA expression levels in ovarian tissue samples from 17 non-neoplastic controls, and 60 tumor samples from OC patients treated at the Regina Elena National Cancer Institute (IRE). A set of 54 miRNAs with differential expression in tumor versus normal samples (T/N-deregulated) was identified in the IRE cohort and validated against data from the Cancer Genoma Atlas (TCGA) related to 563 OC patients and 8 non-neoplastic controls. The prognostic/predictive role of the selected 54 biomarkers was tested in reference to survival endpoints and platinum resistance (P-res). Results In the IRE cohort, downregulation of the 2 miRNA-signature including miR-99a-5p and miR-320a held a negative prognostic relevance, while upregulation of miR-224-5p was predictive of less favorable event free survival (EFS) and P-res. Data from the TCGA showed that downregulation of 5 miRNAs, i.e., miR-150, miR-30d, miR-342, miR-424, and miR-502, was associated with more favorable EFS and overall survival outcomes, while miR-200a upregulation was predictive of P-res. The 9 miRNAs globally identified were all included into a single biologic signature, which was tested in enrichment analysis using predicted/validated miRNA target genes, followed by network representation of the miRNA-mRNA interactions. Conclusions Specific dysregulated microRNA sets in tumor tissue showed predictive/prognostic value in OC, and resulted in a promising biological signature for this disease. Supplementary Information The online version contains supplementary material available at 10.1186/s40364-021-00289-6.
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Affiliation(s)
- E Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - A Sacconi
- UOSD Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - D Marinelli
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Medical Oncology Unit, Sapienza University, Via di Grottarossa 1035/1039, 00189, Rome, Italy
| | - L Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - M Mazzotta
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - D Sergi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - E Capomolla
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - S Donzelli
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - M Carosi
- Pathology Department IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - A Bagnato
- Preclinical Models and New Therapeutic Agents Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - T Gamucci
- Medical Oncology, Sandro Pertini Hospital, Via dei Monti Tiburtini 385, 00157, Rome, Italy
| | - S Tomao
- Department of Radiological Oncological and Pathological Sciences, Division of Medical Oncology A, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - C Natoli
- Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Via dei Vestini, 31, 66100, Chieti, Italy
| | - P Marchetti
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Medical Oncology Unit, Sapienza University, Via di Grottarossa 1035/1039, 00189, Rome, Italy
| | - A Grassadonia
- Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Via dei Vestini, 31, 66100, Chieti, Italy
| | - N Tinari
- Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Via dei Vestini, 31, 66100, Chieti, Italy
| | - M De Tursi
- Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Via dei Vestini, 31, 66100, Chieti, Italy
| | - E Vizza
- Department of Oncological Surgery, Gynecologic Oncologic Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - G Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - L Landi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - F Cappuzzo
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - M Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - G Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - P Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
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2
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Marinelli D, Mazzotta M, Scalera S, Terrenato I, Sperati F, D'Ambrosio L, Pallocca M, Corleone G, Krasniqi E, Pizzuti L, Barba M, Carpano S, Vici P, Filetti M, Giusti R, Vecchione A, Occhipinti M, Gelibter A, Botticelli A, De Nicola F, Ciuffreda L, Goeman F, Gallo E, Visca P, Pescarmona E, Fanciulli M, De Maria R, Marchetti P, Ciliberto G, Maugeri-Saccà M. KEAP1-driven co-mutations in lung adenocarcinoma unresponsive to immunotherapy despite high tumor mutational burden. Ann Oncol 2020; 31:1746-1754. [PMID: 32866624 DOI: 10.1016/j.annonc.2020.08.2105] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [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: 05/27/2020] [Revised: 08/07/2020] [Accepted: 08/12/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have demonstrated significant overall survival (OS) benefit in lung adenocarcinoma (LUAD). Nevertheless, a remarkable interpatient heterogeneity characterizes immunotherapy efficacy, regardless of programmed death-ligand 1 (PD-L1) expression and tumor mutational burden (TMB). KEAP1 mutations are associated with shorter survival in LUAD patients receiving chemotherapy. We hypothesized that the pattern of KEAP1 co-mutations and mutual exclusivity may identify LUAD patients unresponsive to immunotherapy. PATIENTS AND METHODS KEAP1 mutational co-occurrences and somatic interactions were studied in the whole MSKCC LUAD dataset. The impact of coexisting alterations on survival outcomes in ICI-treated LUAD patients was verified in the randomized phase II/III POPLAR/OAK trials (blood-based sequencing, bNGS cohort, N = 253). Three tissue-based sequencing studies (Rome, MSKCC and DFCI) were used for independent validation (tNGS cohort, N = 289). Immunogenomic features were analyzed using The Cancer Genome Atlas (TCGA) LUAD study. RESULTS On the basis of KEAP1 mutational co-occurrences, we identified four genes potentially associated with reduced efficacy of immunotherapy (KEAP1, PBRM1, SMARCA4 and STK11). Independent of the nature of co-occurring alterations, tumors with coexisting mutations (CoMut) had inferior survival as compared with single-mutant (SM) and wild-type (WT) tumors (bNGS cohort: CoMut versus SM log-rank P = 0.048, CoMut versus WT log-rank P < 0.001; tNGS cohort: CoMut versus SM log-rank P = 0.037, CoMut versus WT log-rank P = 0.006). The CoMut subset harbored higher TMB than the WT disease and the adverse significance of coexisting alterations was maintained in LUAD with high TMB. Significant immunogenomic differences were observed between the CoMut and WT groups in terms of core immune signatures, T-cell receptor repertoire, T helper cell signatures and immunomodulatory genes. CONCLUSIONS This study indicates that coexisting alterations in a limited set of genes characterize a subset of LUAD unresponsive to immunotherapy and with high TMB. An immune-cold microenvironment may account for the clinical course of the disease.
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Affiliation(s)
- D Marinelli
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - M Mazzotta
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S Scalera
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - I Terrenato
- Biostatistics-Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - F Sperati
- Biostatistics Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - L D'Ambrosio
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Pallocca
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - G Corleone
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - E Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - L Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S Carpano
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - P Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Filetti
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - R Giusti
- Medical Oncology Unit, Sant'Andrea Hospital, Rome, Italy
| | - A Vecchione
- Department of Clinical and Molecular Medicine, Pathology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - M Occhipinti
- Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - A Gelibter
- Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - A Botticelli
- Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - F De Nicola
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - L Ciuffreda
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - F Goeman
- Oncogenomic and Epigenetic Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
| | - E Gallo
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - P Visca
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - E Pescarmona
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Fanciulli
- SAFU Laboratory, Department of Research, Advanced Diagnostic, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - R De Maria
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Institute of General Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Marchetti
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy; Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - G Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Maugeri-Saccà
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
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Krasniqi E, Barchiesi G, Pizzuti L, Mazzotta M, Venuti A, Maugeri-Saccà M, Sanguineti G, Massimiani G, Sergi D, Carpano S, Marchetti P, Tomao S, Gamucci T, De Maria R, Tomao F, Natoli C, Tinari N, Ciliberto G, Barba M, Vici P. Immunotherapy in HER2-positive breast cancer: state of the art and future perspectives. J Hematol Oncol 2019; 12:111. [PMID: 31665051 PMCID: PMC6820969 DOI: 10.1186/s13045-019-0798-2] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/25/2019] [Indexed: 02/08/2023] Open
Abstract
Breast cancer (BC) is a complex disease with primary or acquired incurability characteristics in a significant part of patients. Immunotherapeutical agents represent an emerging option for breast cancer treatment, including the human epidermal growth factor 2 positive (HER2+) subtype. The immune system holds the ability to spontaneously implement a defensive response against HER2+ BC cells through complex mechanisms which can be exploited to modulate this response for obtaining a clinical benefit. Initial immune system modulating strategies consisted mostly in vaccine therapies, which are still being investigated and improved. However, the entrance of trastuzumab into the scenery of HER2+ BC treatment was the real game changing event, which embodied a dominant immune-mediated mechanism. More recently, the advent of the immune checkpoint inhibitors has caused a new paradigm shift for immuno-oncology, with promising initial results also for HER2+ BC. Breast cancer has been traditionally considered poorly immunogenic, being characterized by relatively low tumor mutation burden (TMB). Nevertheless, recent evidence has revealed high tumor infiltrating lymphocytes (TILs) and programmed cell death-ligand 1 (PD-L1) expression in a considerable proportion of HER2+ BC patients. This may translate into a higher potential to elicit anti-cancer response and, therefore, wider possibilities for the use and implementation of immunotherapy in this subset of BC patients. We are herein presenting and critically discussing the most representative evidence concerning immunotherapy in HER2+ BC cancer, both singularly and in combination with therapeutic agents acting throughout HER2-block, immune checkpoint inhibition and anti-cancer vaccines. The reader will be also provided with hints concerning potential future projection of the most promising immutherapeutic agents and approaches for the disease of interest.
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Affiliation(s)
- E Krasniqi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy
| | - G Barchiesi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy
| | - L Pizzuti
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy
| | - M Mazzotta
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea, Rome, Italy
| | - A Venuti
- HPV-UNIT, UOSD Tumor Immunology and Immunotherapy, Department of Research, Advanced Diagnostic and Technological Innovation (RIDAIT), Translational Research Functional Departmental Area, IRCSS Regina Elena National Cancer Institute, Rome, Italy
| | - M Maugeri-Saccà
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy
| | - G Sanguineti
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - G Massimiani
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy
| | - D Sergi
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy
| | - S Carpano
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy
| | - P Marchetti
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea, Rome, Italy.,Medical Oncology Unit B, Policlinico Umberto I, Rome, Italy
| | - S Tomao
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy
| | - T Gamucci
- Medical Oncology, Sandro Pertini Hospital, Rome, Italy
| | - R De Maria
- Institute of General Pathology, Catholic University of the Sacred Heart, Rome, Italy.,Department of Medical Oncology, Policlinico Universitario "A. Gemelli", Rome, Italy
| | - F Tomao
- Department of Gynecology-Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy
| | - C Natoli
- Department of Medical, Oral and Biotechnological Sciences and Center of Aging Science & Translational Medicine (CeSI-MeT), G. d'Annunzio University, Chieti, Italy
| | - N Tinari
- Department of Medical, Oral and Biotechnological Sciences and Center of Aging Science & Translational Medicine (CeSI-MeT), G. d'Annunzio University, Chieti, Italy
| | - G Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M Barba
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy.
| | - P Vici
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53-00144, Rome, Italy
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Fabbri M, Botticelli A, Omarini C, Cretella E, Fabi A, Alesini D, Pizzuti L, Piesco G, Vaccaro A, Atzori F, Piacentini F, Moscetti L, Orlandi A, Sini V, Mercanti A, Framarino M, Persano M, Ceccherini R, Ruggeri E. Efficacy and safety of neoadjuvant chemotherapy plus trastuzumab and pertuzumab in non-metastatic HER2-positive breast cancer in real life: NEOPEARL study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Orlandi A, Iattoni E, Pizzuti L, Fabbri M, Botticelli A, Di Dio C, Palazzo A, Garufi G, Indellicati G, Alesini D, Carbognin L, Paris I, vaccaro A, Moscetti L, Cassano A, Vici P, Giannarelli D, Marchetti P, Bria E, Tortora G. Palbociclib-fulvestrant (PALBO-FUL) and everolimus -exemestane (EVE-EXE) for second line hormonal treatment (HT) of metastatic breast cancer (MBC) with lobular histology: A propensity score matched analysis of a multicenter ‘real-world’ patients (pts) series. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fabi A, Giannarelli D, Botticelli A, Scagnoli S, Pellegrino A, Fabbri A, Corsi D, Magri V, Pizzuti L, Paris I, Bruni V, Pace R, Lanzetta G, Stani S, Moscetti L, Marchetti P, Piesco G, Cognetti F, Rossi V. Abstract P4-13-07: SEQUERPLUS: A multicenter real practice observational study investigating the endocrine-based (E) therapies sequential approach in hormonal receptor positive (HR+) HER2 negative (-) metastatic breast cancer (MBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-13-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Despite the sequential E therapy is recognized as the preferred approach for HR+/HER2- MBC, no data from clinical trials support the choice between the different sequential strategies.
Methods: In this retrospective study descriptive statistics are reported using the median (Interquartile range, IQR) or frequency. Progression Free Survival (PFS) curves were estimated with the Kaplan-Meier method and compared with the log-rank test. Analysis were performed by SPSS version 21.0 (SPSS Inc., Chicago, IL).
Results: From January 2006 to December 2017, 240 patients (pts) with HR+/HER2- MBC receiving at least two consecutive E therapies as first approach were selected from 12 italian cancer centers. The median age at the time of metastasis onset was 63.5 (IQR: 55-72.5) years; 184 (76.7%) pts were in menopausal status; 38 (16%) had de novo stage IV disease and the remaining 202 (84%) had recurrent BC with a median time of 78 months (5-396 months). At the beginning of MBC diagnosis, 148 (62%) pts had a single site of distant disease, 108 (45%) of whom had bone only disease and 45 (18.8%) presented visceral involvement too. The aromatase inhibitor (AI) was chosen as I-line therapy in 146 (60.9%) pts, followed by Fulvestrant (F) in 62 (25.8%) pts; the alternative I-line options were everolimus-exemestane (Eve-Exe), tamoxifene (T), Palbociclib (P)+AI and F+AI in 13 (5.4%), 14 (5.8%), 1 (0.4%) and 4 (1.7%) pts, respectively. The most favourite II-line option resulted F for 111 (46.2%) pts while the Eve-Exe combination was chosen in 70 (29.2%) pts, AI in 30 (12.5%) pts; T, AI+F, P+F and antiprogestincwere administered in 4 (1.7%), 4 (1.7%), 19 (7.9%) and 2 (0.8%) pts, respectively. For I and II-line, the AI followed by F (40%) and F followed by Eve-Exe (18%) were the most common sequential therapeutic approaches; the several alternative options were scanty used (in less than 10%). The median Progression-Free Survival (PFS) from first and second-line E therapies resulted 15.7 (95% CI 13.3-18.1) and 10.3 months (95% CI 8.7-11.9), respectively. Among 194 pts with disease progression after second-line E therapy, 87 (44.8%) received further E therapies with a median PFS 9.4 months (95% CI 7.9-10.9). The remaining 70 (29.2%) pts was treated with palliative chemotherapy. Interestingly, the median Overall Survival (OS) was even longer for pts receiving more lines of E therapies compared to the group with earlier introduction of chemotherapy (204.3 vs 92.8; p=0.007).
Finally, in the subgroup analyses a longer PFS benefit was observed in pts with disease recurrence over 12 months from initial diagnosis (38.1 vs 30.3 months p=0.04) and limited sites of disease involvement at the time of MBC diagnosis (37.6 vs 28.3 months, p=0.03)
Conclusions: The sequential use in first and second-line setting of E therapies for HR+/HER2- MBC improves median PFS up to 32.3 months. According to real practice experience the optimal sequences could be AIs followed by F and F followed by Eve-Exe. A role for these compounds should be redefined in the light of recently introduction of CDK 4/6 inhibitors in combination with AIs or F for the first or later lines.
Citation Format: Fabi A, Giannarelli D, Botticelli A, Scagnoli S, Pellegrino A, Fabbri A, Corsi D, Magri V, Pizzuti L, Paris I, Bruni V, Pace R, Lanzetta G, Stani S, Moscetti L, Marchetti P, Piesco G, Cognetti F, Rossi V. SEQUERPLUS: A multicenter real practice observational study investigating the endocrine-based (E) therapies sequential approach in hormonal receptor positive (HR+) HER2 negative (-) metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-13-07.
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Affiliation(s)
- A Fabi
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - D Giannarelli
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - A Botticelli
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - S Scagnoli
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - A Pellegrino
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - A Fabbri
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - D Corsi
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - V Magri
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - L Pizzuti
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - I Paris
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - V Bruni
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - R Pace
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - G Lanzetta
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - S Stani
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - L Moscetti
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - P Marchetti
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - G Piesco
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - F Cognetti
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
| | - V Rossi
- Istituto Regina Elena-IFO, Rome, Italy; S.Andrea Hospital, Rome, Italy; Policlinico Umberto I Hospital, Rome, Italy; San Pietro Hospital, Rome, Italy; Belcolle Hospital, Viterbo, VT, Italy; Fatebenefratelli Hospital, Rome, Italy; Policlinico Universitario A. Gemelli, Rome, Italy; Policlinico Campus Biomedico, Rome, Italy; San Camillo de Lellis, Rieti, Italy; Istituto Neurotraumatologico Italiano, Rome, Italy; Santo Spirito Hospital, Rome, Italy; Azienda Universitaria Ospedaliera of Modena, Modena, Italy; Breast Unit, S.Camillo-Forlanini Hospital, Rome, Italy
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Ricciardi G, Ficorella C, Iezzi L, Marchetti P, Pizzuti L, Prestifilippo A, Schifano S, Maimone S, Adamo V. Efficacy and safety of the combination of pertuzumab (P) plus trastuzumab (T) plus docetaxel (D) for HER-2 positive metastatic breast cancer (MBC) in pretreated patients (pts) with trastuzumab in the neo/adjuvant setting: a retrospective real-life study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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8
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Cazzaniga M, Orlando L, Melegari E, Arcangeli V, Butera A, Pinotti G, Vallini I, Mocerino C, Giovanardi F, Cretella E, Gambaro A, Pistelli M, Donati S, Pizzuti L, Spagnuolo A, Putzu C, Leonardi V, De Angelis C, Pedroli S, Torri V. Metronomic chemotherapy (mCHT) in HER2-ve advanced breast cancer (ABC) patients (pts): old drugs, new results. The multicenter VICTOR-6 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mentuccia L, Gelibter A, Sperduti I, D'Onofrio L, Botticelli A, Vici P, Cassano A, Moscetti L, Carbognin L, Graziano V, Barchiesi G, Rossi E, Cursano M, Pizzuti L, Paris I, Vaccaro A, Fabbri A, Rossi L, Samaritani R, Sarmiento R, Gamucci T. Efficacy of pertuzumab in combination with trastuzumab and a taxane in in first line treatment for metastatic breast cancer (MBC): a multicenter retrospective observational study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx424.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Moscetti L, Fabbri M, Vici P, Natoli C, Gamucci T, Sperduti I, Pizzuti L, Iezzi L, Iattoni E, Roma C, Vaccaro A, D'Auria G, Mauri M, Ruggeri E. Fulvestrant (FUL) 500 milligrams as endocrine therapy (ET) for hormone sensitive advanced breast cancer patients. The Ful500 prospective observational trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.44] [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: 11/15/2022] Open
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Pizzuti L, Sperduti I, Michelotti A, Omarini C, Gamucci T, Natoli C, D'Onofrio L, Giotta F, Ficorella C, Laudadio L, Cassano A, Marchetti P, Adamo V, Mauri M, Scinto A, Zampa G, Fabbri A, Mentuccia L, Barni S, Vici P. Trastuzumab emtansine (T-DM1) in patients (pts) with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC): Results from a multicenter retrospective analysis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pizzuti L, Sperduti I, Michelotti A, Omarini C, Gamucci T, Natoli C, D'Onofrio L, Giotta F, Ficorella C, Laudadio L, Cassano A, Marchetti P, Adamo V, Mauri M, Scinto A, Zampa G, Fabbri A, Mentuccia L, Barni S, Vici P. Trastuzumab Emtansine (T-DM1) in Patients (pts) With Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Metastatic Breast Cancer (MBC): results From a Multicenter Retrospective Analysis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw337.21] [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: 11/14/2022] Open
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13
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Moscetti L, Fabbri M, Vici P, Natoli C, Gamucci T, Sperduti I, Pizzuti L, Iezzi L, Iattoni E, Roma C, Vaccaro A, D'Auria G, Mauri M, Ruggeri E. Fulvestrant (FUL) 500 milligrams as endocrine therapy (ET) for hormone sensitive advanced breast cancer patients (pts). The Ful500 prospective observational trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw337.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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14
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Vici P, Pizzuti L, Mariani L, Zampa G, Santini D, Di Lauro L, Gamucci T, Natoli C, Marchetti P, Barba M, Maugeri-Saccà M, Sergi D, Tomao F, Vizza E, Di Filippo S, Paolini F, Curzio G, Corrado G, Michelotti A, Sanguineti G, Giordano A, De Maria R, Venuti A. Targeting immune response with therapeutic vaccines in premalignant lesions and cervical cancer: hope or reality from clinical studies. Expert Rev Vaccines 2016; 15:1327-36. [PMID: 27063030 PMCID: PMC5152541 DOI: 10.1080/14760584.2016.1176533] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [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] [Indexed: 11/01/2022]
Abstract
Human papillomavirus (HPV) is widely known as a cause of cervical cancer (CC) and cervical intraepithelial neoplasia (CIN). HPVs related to cancer express two main oncogenes, i.e. E6 and E7, considered as tumorigenic genes; their integration into the host genome results in the abnormal regulation of cell cycle control. Due to their peculiarities, these oncogenes represent an excellent target for cancer immunotherapy. In this work the authors highlight the potential use of therapeutic vaccines as safe and effective pharmacological tools in cervical disease, focusing on vaccines that have reached the clinical trial phase. Many therapeutic HPV vaccines have been tested in clinical trials with promising results. Adoptive T-cell therapy showed clinical activity in a phase II trial involving advanced CC patients. A phase II randomized trial showed clinical activity of a nucleic acid-based vaccine in HPV16 or HPV18 positive CIN. Several trials involving peptide-protein-based vaccines and live-vector based vaccines demonstrated that these approaches are effective in CIN as well as in advanced CC patients. HPV therapeutic vaccines must be regarded as a therapeutic option in cervical disease. The synergic combination of HPV therapeutic vaccines with radiotherapy, chemotherapy, immunomodulators or immune checkpoint inhibitors opens a new and interesting scenario in this disease.
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Affiliation(s)
- P Vici
- a Division of Medical Oncology 2 , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - L Pizzuti
- a Division of Medical Oncology 2 , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - L Mariani
- b HPV-UNIT Laboratory of Virology , 'Regina Elena' National Cancer Institute , Rome , Italy.,c Department of Gynecologic Oncology , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - G Zampa
- d Oncology Unit , Nuovo Regina Margherita Hospital , Rome , Italy
| | - D Santini
- e Department of Medical Oncology , University Campus Bio-Medico , Rome , Italy
| | - L Di Lauro
- a Division of Medical Oncology 2 , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - T Gamucci
- f Medical Oncology Unit, ASL Frosinone , Frosinone , Italy
| | - C Natoli
- g Department of Medical, Oral and Biotechnological Sciences, Experimental and Clinical Sciences , University 'G. d'Annunzio' , Chieti , Italy
| | - P Marchetti
- h Oncology Unit, Sant'Andrea Hospital , 'Sapienza' University of Rome , Rome , Italy
| | - M Barba
- a Division of Medical Oncology 2 , 'Regina Elena' National Cancer Institute , Rome , Italy.,i Scientific Direction , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - M Maugeri-Saccà
- a Division of Medical Oncology 2 , 'Regina Elena' National Cancer Institute , Rome , Italy.,i Scientific Direction , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - D Sergi
- a Division of Medical Oncology 2 , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - F Tomao
- j Department of Gynecologic and Obstetric Sciences , La Sapienza University of Rome , Rome , Italy
| | - E Vizza
- b HPV-UNIT Laboratory of Virology , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - S Di Filippo
- k Emergency Department , Santa Maria Goretti Hospital , Latina , Italy
| | - F Paolini
- b HPV-UNIT Laboratory of Virology , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - G Curzio
- b HPV-UNIT Laboratory of Virology , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - G Corrado
- c Department of Gynecologic Oncology , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - A Michelotti
- l Oncology Unit I , Azienda Ospedaliera Universitaria Pisana , Pisa , Italy
| | - G Sanguineti
- m Radiotherapy , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - A Giordano
- n Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology , Temple University , Philadelphia , PA , USA.,o Department of Human Pathology and Oncology , University of Siena , Siena , Italy
| | - R De Maria
- i Scientific Direction , 'Regina Elena' National Cancer Institute , Rome , Italy
| | - A Venuti
- b HPV-UNIT Laboratory of Virology , 'Regina Elena' National Cancer Institute , Rome , Italy
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15
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Barba M, Pizzuti L, Conti L, Mandoj C, Digiesi G, Antenucci A, Sergi D, Di Lauro L, Amodio A, Carpano S, Sperati F, Valle M, Garofalo A, Vizza E, Vincenzoni C, Corrado G, Maugeri-Saccà M, Vici P. The impact of fasting glucose on clinical-pathological features in epithelial ovarian cancer: results from a historic cohort. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv339.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Iezzi L, Mentuccia L, Vici P, Natoli C, Sperduti I, Astone A, Marchetti P, Pizzuti L, Michelotti A, Sini V, Cassano A, Ciancola F, Quadrini S, Moscetti L, Landucci E, Magnolfi E, Sergi D, Gamucci T. Predictive factors of response to neoadjuvant chemotherapy (NAT) in triple negative breast (TNBC) cancer patients: a restrospective multicenter observational study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.13] [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: 11/14/2022] Open
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17
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Pizzuti L, Barba M, Sperduti I, Natoli C, Gamucci T, Sergi D, Di Lauro L, Moscetti L, Izzo F, Rinaldi M, Mentuccia L, Vaccaro A, Iezzi L, Fancelli S, Grassadonia A, Michelotti A, Pescarmona E, Perracchio L, Maugeri-Saccà M, Vici P. Impact of Body Mass Index (BMI) on outcome of metastatic breast cancer (MBC) patients (pts) treated with Eribulin in a real-world population: a multicenter retrospective study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Mentuccia L, Fabi A, Cassano A, Vici P, Michelotti A, Sperduti I, Sarobba G, Marchetti P, Scognamiglio M, Vaccaro A, Rossi E, Pellegrini D, Nicoletta D, Pellegrino A, Sini V, Pizzuti L, Palleschi M, Moscetti L, Jamara G, Ciancola F, Gamucci T. Bevacizumab maintenance (BM) in first line treatment for metastatic breast cancer (MBC): a multicenter retrospective observational study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.27] [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: 11/14/2022] Open
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Bidoli P, Cappuzzo F, Favaretto A, Alabiso O, Tiseo M, Chella A, Gebbia V, Pizzuti L, Paz-Ares L, Perol M, Garon E, Lee P, Zimmermann A, Cuyun Carter G, Migliorino M. Update of REVEL: A randomized, double-blind, phase III study of docetaxel (DOC) and ramucirumab (RAM; IMC-1121B) versus DOC and placebo (PL) in the second-line (2L) treatment of stage IV non-small cell lung cancer (NSCLC) including subgroup analysis of histology. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv343.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Barni S, Fontanella C, Del Mastro L, Livraghi L, Morritti M, Pizzuti L, Michelotti A, Lutrino E, Ciccarese M, Musolino A, Quercia S, Garrone O, Pellegrino A, Pistelli M, Martella F, Iezzi L, Mentuccia L, Latorre A, D'Onofrio L, Porcu L. 1849 Italian observational study of Eribulin Mesylate in patients with advanced breast cancer: ESEMPiO study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30799-7] [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: 10/22/2022]
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Gamucci T, Mentuccia L, Vici P, Iezzi L, Sperduti I, Astone A, Marchetti P, Pizzuti L, Michelotti A, Sini V, Cassano A, Ciancola F, Quadrini S, Moscetti L, Landucci E, Sergi D, Magnolfi E, Natoli C. 1950 Predictive factors of response to neoadjuvant chemotherapy (NAT) in triple negative breast (TNBC) cancer patients: A restrospective multicenter observational study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30898-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Moscetti L, Vici P, Sperduti I, Fabbri M, Natoli C, Mancini M, Sini V, D'Onofrio L, Pizzuti L, Vaccaro A, Magnolfi E, Magri V, Trenta P, Ramponi S, Roma C, Ruggeri E. 1851 Safety analysis, correlation with response and previous treatments of the association of everolimus (EVE) and exemestane (EXE) in 181 metastatic breast cancer patients (MBC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30801-2] [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]
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Pizzuti L, Natoli C, Gamucci T, Sergi D, Di Lauro L, Moscetti L, Mentuccia L, Vaccaro A, Trenta P, Seminara P, Rapposelli I, Sini V, Santini D, Sperduti I, Marchetti P, Vici P. Her2-Positive Early Breast Cancer in the Pre-Trastuzumab and Trastuzumab Eras: a Triple Positive Subgroup Analysis of a Multicenter Retrospective Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mentuccia L, Vici P, Sperduti I, Pizzuti L, Moscetti L, Vaccaro A, Quadrini S, Magnolfi E, Fabbri M, Zampa G, Giampaolo M, Sergi D, Narducci F, Sacca MM, Gamucci T. Fact- B and Esas in Metastatic Breast Cancer (Mbc) Patients (Pts) Treated with Eribulin: Results of a Multicenter Prospective Observational Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu350.4] [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: 11/14/2022] Open
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Gamucci T, Moscetti L, Mentuccia L, Pizzuti L, Mauri M, Zampa G, Pavese I, Sperduti I, Vaccaro A, Vici P. Optimal tolerability and high efficacy of a modified schedule of lapatinib-capecitabine in advanced breast cancer patients. J Cancer Res Clin Oncol 2013; 140:221-6. [PMID: 24292401 PMCID: PMC3895217 DOI: 10.1007/s00432-013-1556-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 11/18/2013] [Indexed: 01/05/2023]
Abstract
PURPOSE Diarrhea in relation to the lapatinib-capecitabine regimen is a common and debilitating side effect which may interfere with optimal treatment delivery. We performed a post hoc analysis in human epidermal growth factor receptor 2-positive advanced breast cancer patients treated with a modified schedule in its administration, aimed primarily to evaluate grade (G) ≥ 2 diarrhea incidence and, secondarily, treatment efficacy. PATIENTS AND METHODS Treatment schedule consisted of lapatinib 1,250 mg daily for the first 10 days, then in combination with capecitabine, 2,000 mg/m(2), starting day 11 for the first cycle, and thereafter from day 8, for 14 days of a 21-day cycle, in 3 daily administrations. Lapatinib was dissolved in water, and cholestyramine was continuously given twice a day. RESULTS Among 38 patients treated and analyzed, the incidence of G ≥ 2 diarrhea was 13.2 %. In 28 patients diarrhea was not observed, while G1-2 diarrhea was reported in 9 (23.7 %) patients; a single episode of G3 diarrhea was observed in 1 (2.6 %) patient. Overall response rate was 34.2 %, clinical benefit 55.3 %, and median progression-free survival 10 months. CONCLUSION The results of the present post hoc analysis are very encouraging, both in terms of tolerability and treatment efficacy, and all data compare favorably with previous reports of "conventional" administration of the lapatinib-capecitabine regimen.
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Affiliation(s)
- T Gamucci
- Medical Oncology Unit, ASL Frosinone, Via Armando Fabi, 03100, Frosinone, Italy
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Gamucci T, Vaccaro A, Ciancola F, Pizzuti L, Sperduti I, Moscetti L, Longo F, Fabbri MA, Giampaolo MA, Mentuccia L, Di Lauro L, Vici P. Recurrence risk in small, node-negative, early breast cancer: a multicenter retrospective analysis. J Cancer Res Clin Oncol 2013; 139:853-60. [PMID: 23411686 PMCID: PMC3625404 DOI: 10.1007/s00432-013-1388-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 01/29/2013] [Indexed: 01/03/2023]
Abstract
PURPOSE Recurrences and deaths are known to occur, even if less frequently, in small, node-negative breast cancer patients, and decision on adjuvant treatments remains controversial. In the present analysis, we evaluate recurrence risk in patients with pT1 a, b, c, node-negative, breast cancer, accordingly with some prognostic biological factors. METHODS We retrospectively evaluated 900 node-negative patients (pT1a, b, c) surgery treated between 2000 and 2009 in four Italian oncologic centers. We defined 3 different cohorts: ER positive (ER+); Her-2 positive (Her-2+); and triple negative (TN). RESULTS pT1a was seen in 7.6% of patients, 37.7 % pT1b, 54.8 % pT1c. Concerning the 3 different cohorts, 58.2 % were ER+; 10.8 % were Her-2+; 8.2 % were TN. Overall, chemotherapy was given to 3.0 %, 27.2 %, 69.8 % of pT1a, b, c, respectively, and to 22.7 %, 58.8 %, 68.9 % of ER+, Her-2+, TN subgroups. At a median follow-up of 67 months, 5-year DFS was 96.3 %, 89.2 %, 89.4 % in pT1a, b, c, respectively (100 %, 93.6 %, 89.8 % in ER+; 100 %, 78.7 %, 85.0 % in Her-2+; 100 %, 76.8 %, 85.2 % in TN) (p = ns). At multivariate analysis, histologic grade and Ki-67 resulted independent prognostic factors. Overall, 5-year OS was 98 %, without differences among pT1a, b, c, or among the 3 cohorts. CONCLUSIONS Overall, 5-year DFS was very favorable in this series of small, node-negative breast cancers, but Her-2+ and TN cohorts have a higher recurrence rate than ER+ cohort (p < 0.0001); pT1c, but also pT1b, in Her-2+ and TN subgroups, have a worse outcome, and effective chemotherapy treatment should be considered in these unfavorable subgroups.
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Affiliation(s)
- T. Gamucci
- Medical Oncology Unit, ASL Frosinone, Via Armando Fabi, 03100 Frosinone, Italy
| | - A. Vaccaro
- Medical Oncology Unit, ASL Frosinone, Via Armando Fabi, 03100 Frosinone, Italy
| | - F. Ciancola
- Medical Oncology Unit, ASL Frosinone, Via Armando Fabi, 03100 Frosinone, Italy
| | - L. Pizzuti
- Medical Oncology B Division, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - I. Sperduti
- Department of Biostatistics, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - L. Moscetti
- Medical Oncology Unit, Belcolle Hospital, Strada Sammartinese 1, 01100 Viterbo, Italy
| | - F. Longo
- Medical Oncology Unit A, La Sapienza University of Rome, Viale del Policlinico 161, 00161 Rome, Italy
| | - M. A. Fabbri
- Medical Oncology Unit, Belcolle Hospital, Strada Sammartinese 1, 01100 Viterbo, Italy
| | - M. A. Giampaolo
- Medical Oncology Unit, ASL Frosinone, Via Armando Fabi, 03100 Frosinone, Italy
| | - L. Mentuccia
- Medical Oncology Unit, ASL Frosinone, Via Armando Fabi, 03100 Frosinone, Italy
| | - L. Di Lauro
- Medical Oncology B Division, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - P. Vici
- Medical Oncology B Division, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
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Vici P, Pizzuti L, Mottolese M, Sergi D, Di Benedetto A, Botti C, Perracchio L, Pescarmona E, Carpino A, Di Lauro L. Phase II Trial of Primary Systemic Therapy (PST) with Docetaxel (D) Followed by High-Dose Epirubicin in Combination with Cyclophosphamide (EC) Plus Concurrent Trastuzumab (T) For Stage II-III HER-2 Positive Breast Cancer Patients (PTS). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32973-2] [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: 11/15/2022] Open
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Vici P, Giotta F, Di Lauro L, Sergi D, Vizza E, Mariani L, Latorre A, Pizzuti L, D'Amico C, Giannarelli D, Colucci G. A multicenter phase II randomized trial of docetaxel/gemcitabine versus docetaxel/capecitabine as first-line treatment for advanced breast cancer: a Gruppo Oncologico Italia Meridionale study. Oncology 2011; 81:230-6. [PMID: 22094540 DOI: 10.1159/000334432] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 10/11/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate two docetaxel-based regimens as first-line treatment in advanced breast cancer patients. METHODS Patients were randomly assigned to docetaxel/gemcitabine (arm A: docetaxel 75 mg/m(2) on day 1, gemcitabine 1,000 mg/m(2) on days 1 and 8) or docetaxel/capecitabine (arm B: docetaxel 75 mg/m(2) on day 1, capecitabine 1,250 mg/m(2) twice daily on days 1-14); both chemotherapy regimens were repeated every 21 days. The primary objective of the study was to evaluate the response rate. RESULTS Seventy-two patients were enrolled (36 each in arms A and B). Responses according to intention-to-treat analysis were as follows: arm A, 41.7% [95% confidence interval (CI) 25.6-57.8]; arm B, 38.9% (95% CI 23-54.8). Median progression-free survival was 10.9 months (95% CI 8.1-13.7) in arm A and 10 months (95% CI 8.8-11.2) in arm B. Overall survival was 26 months (95% CI 22.0-30.0) in arm A and 28 months (95% CI 23.4-32.6) in arm B. Both treatments were well tolerated; myelosuppression was the dose-limiting toxicity, with grade 3-4 neutropenia in 13.8 and 19.4% of the patients in arms A and B, respectively. No relevant differences in other toxicities were observed in the two arms, except for diarrhea (13.9%) and hand-foot syndrome (11.1%), which occurred only in arm B. CONCLUSIONS Both regimens were active and well tolerated in advanced breast cancer.
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Affiliation(s)
- P Vici
- Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy.
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Vaccaro A, Ciancola F, Vici P, Sperduti I, Moscetti L, Pizzuti L, Di Seri M, Ruggeri E, Giampaolo M, Gamucci T. 5187 POSTER Unfavourable Prognosis in PT1b HER2 Positive and Triple Negative Breast Cancer Patients. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71629-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Felici A, Naso G, Di Segni S, Vici P, Antenucci A, Angelini F, Pizzuti L, Mandoj C, D'Auria G, Fabi A, Tata A, Cognetti F, Papaldo P. Fulvestrant administered in two different schedules: Pharmacokinetics, biological markers, and activity. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11026] [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
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Vaccaro A, Ciancola F, Pizzuti L, Sperduti I, Moscetti L, Vici P, Longo F, Ruggeri E, Di Seri M, Giampaolo MA, Gamucci T. High recurrence risk in pT1bc HER2-positive, triple-negative, node-negative early breast cancer patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.609] [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
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Vici P, Sergi D, Pizzuti L, Vincenzoni C, Vizza E, Tomao F, Morace N, Toglia G, Mancini E, Baiocco E, Di Lauro L, Botti C, Sindico S, Lopez M. [Specificity of action of anticancer agents]. Clin Ter 2011; 162:137-149. [PMID: 21533321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Since the first cancer chemotherapy use, efforts have been made in identifying drugs with an antitumor specific action, but cancer is a very complex situation to be cured with a single agent, and to increase drugs selective cytotoxicity new agent combinations, or innovative cellular cycle related schedule, or the use of pro-drugs have been developed. Notwithstanding some relevant improvements in results, chemotherapy remains often a palliative approach. The improved knowledge of the biology of cancer, and of molecular mechanisms and specific targets, has recently modified the approach to various tumors. In particular, the identification of a single and specific genetic alteration in some tumors such as myeloid chronic leukaemia or gastrointestinal stromal tumors (GIST) led to the development of imatinib, a "target" drug with a multikinase inhibitor activity towards the specific genetic alteration; this unique opportunity is not applicable to other tumors, because usually tumors have multiple genetic alterations with very complex molecular pathways. The development of drugs with a multitarget action is probably the best approach to the majority of human cancers, but other possibility are the combination of multiple agents, each with known selective activity towards a specific molecular target, or the choice of a chemotherapic drug in combination with one or more molecularly targeted drugs. The knowledge of the multiple and extremely complex molecular pathways of the neoplastic cells will hopefully drive oncologic science towards a more "exact" science, with the use of "personalized" treatment in each cancer patient.
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Affiliation(s)
- P Vici
- Divisione di Oncologia Medica B, Istituto Nazionale Tumori Regina Elena, Roma, Italy.
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Vici P, Sergi D, Pizzuti L, Vincenzoni C, Baiocco E, Mancini E, Lopez M, Vizza E, Lauro LD. Biological progression of breast cancer and clinical implications. Clin Ter 2011; 162:297-299. [PMID: 21912815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The classic view of tumor progression is that genetic mutation introduced in differentiated or progenitor cells causes tumors, through the acquisition of advantages for survival, and leading to phenotypic heterogeneity. Another theory (stem cell hypothesis) considers that tumor progression derives from cells within the tumor with stem cell characteristics of self-renewal and multiple differentiation potential. It is still unknown the timing of expression of various biological characteristics of breast cancer during the progression cascade, and the existence of clonal heterogeneity within primary tumor and synchronous or asynchronous distant metastases contributes to treatments failures.
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A.N. Silva F, Pizzuti L, H. Quina F, P. Souza S, F. Rosales P, M. Siqueira G, M.P. Pereira C, B.M. Barros S, P. Rivelli D. Antioxidant Capacity of 2-(3,5-diaryl-4,5-dihydro-1H-pyrazol-1-yl)-4-phenylthiazoles. LETT DRUG DES DISCOV 2010. [DOI: 10.2174/157018010792929513] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Silva F, Galluzzi M, Albuquerque B, Pizzuti L, Gressler V, Rivelli D, Barros S, Pereira C. Ultrasound Irradiation Promoted Large-Scale Preparation in Aqueous Media and Antioxidant Activity of Azoles. LETT DRUG DES DISCOV 2009. [DOI: 10.2174/1570180810906050323] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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