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Leonetti A, Perrone F, Puntoni M, Maglietta G, Bordi P, Bria E, Vita E, Gelsomino F, De Giglio A, Gelibter A, Siringo M, Mazzoni F, Caliman E, Genova C, Bertolini F, Guaitoli G, Passiglia F, Delcuratolo MD, Montrone M, Cerea G, Pasello G, Roca E, Belluomini L, Cecere FL, Guida A, Manzo A, Adamo V, Rastelli F, Bulotta A, Citarella F, Toschi L, Zoratto F, Cortinovis DL, Berardi R, Follador A, Carta A, Camerini A, Salerno F, Silva RR, Baldini E, Cortellini A, Brighenti M, Santoni M, Malorgio F, Caminiti C, Tiseo M. Real-world outcomes of Italian patients with advanced non-squamous lung cancer treated with first-line pembrolizumab plus platinum-pemetrexed. Eur J Cancer 2024; 202:114006. [PMID: 38489861 DOI: 10.1016/j.ejca.2024.114006] [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: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE The aim of this multi-center, retrospective/prospective cohort observational study was to evaluate outcomes in routine clinical practice of first-line chemo-immunotherapy with cis/carboplatin, pemetrexed and pembrolizumab in patients with advanced non-squamous non-small cell lung cancer (NSCLC) in 33 Italian centers. METHODS The outcome measure was to evaluate overall survival (OS) in a real-world patient population. Secondary endpoints were: progression-free survival (PFS), objective response rate (ORR), duration of response (DoR) and incidence of treatment-related adverse events (AEs). RESULTS 1068 patients were enrolled at the time of data cut-off (January 31st, 2023), and 812 (76.0%) belonged to the retrospective cohort. Median age was 66 years (27-85), ECOG PS was ≥ 2 in 91 (8.6%) patients; 254 (23.8%) patients had brain metastases at baseline; 38 (3.6%) patients had tumor with PD-L1 expression ≥ 50%. After a median follow-up of 17.0 months (95% CI, 16.1-17.9), median OS was 16.1 months (95% CI, 14.4-18.8) and PFS was 9.9 months (95% CI, 8.8-11.2). Median DoR (n = 493) was 14.7 months (95% CI, 13.6-17.1). ORR was 43.4% (95% CI, 40.4-46.4). Any-grade AEs occurred in 636 (59.6%) patients and grade ≥ 3 in 253 (23.7%) patients. Most common grade ≥ 3 AEs were neutropenia (6.3%) and anemia (6.3%). CONCLUSIONS First-line chemo-immunotherapy was effective and tolerable in this large, real-world Italian study of patients with advanced non-squamous NSCLC. Our results were in line with the KEYNOTE-189 registration study, also considering the low number of PD-L1 ≥ 50% patients included in our study.
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Affiliation(s)
| | - Fabiana Perrone
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
| | - Matteo Puntoni
- Clinical & Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - Giuseppe Maglietta
- Clinical & Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - Paola Bordi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Emilio Bria
- UOSD Oncologia Toraco-Polmonare, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Medical Oncology, Department of Traslational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuele Vita
- UOSD Oncologia Toraco-Polmonare, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Medical Oncology, Department of Traslational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Gelsomino
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea De Giglio
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alain Gelibter
- Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Marco Siringo
- Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | | | - Enrico Caliman
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - Carlo Genova
- Academic Oncology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - Federica Bertolini
- Division of Medical Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Giorgia Guaitoli
- Division of Medical Oncology, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Francesco Passiglia
- Department of Oncology, University of Turin, AOU San Luigi Gonzaga, Orbassano, Turin, Italy
| | | | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Giulio Cerea
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giulia Pasello
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Elisa Roca
- Thoracic Oncology - Lung Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Lorenzo Belluomini
- Medical Oncology, Department of Medicine, University of Verona Hospital Trust, Verona, Italy
| | | | - Annalisa Guida
- Department of Medical Oncology, St. Mary's Hospital, Terni, Italy
| | - Anna Manzo
- Thoracic Medical Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Vincenzo Adamo
- Medical Oncology Unit, Azienda Ospedaliera Papardo, Messina, Italy
| | - Francesca Rastelli
- Medical Oncology, AST (Azienda Sanitaria Territoriale) of Ascoli Piceno, Ascoli Piceno, Italy
| | - Alessandra Bulotta
- Department of Oncology, Istituto di Ricerca a Carattere Scientifico (IRCCS) San Raffaele Hospital, Milan, Italy
| | - Fabrizio Citarella
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Luca Toschi
- IRCCS Humanitas Clinical and Research Center - Humanitas Cancer Center, Rozzano, Milan, Italy
| | | | - Diego Luigi Cortinovis
- SC Medical Oncology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy; Medicine and Surgery Department, University of Milano Bicocca, Milan, Italy
| | - Rossana Berardi
- Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Alessandro Follador
- Medical Oncology Unit San Daniele - Tolmezzo, ASUFC Azienda Sanitaria Universitaria Friuli Centrale, Italy
| | - Annamaria Carta
- Pathology and Oncology Unit, Businco Oncological Hospital, Cagliari, Italy
| | - Andrea Camerini
- Medical Oncology, Versilia Hospital, Azienda USL Toscana Nord Ovest, Lido di Camaiore, Italy
| | - Flavio Salerno
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - Rosa Rita Silva
- Department of Oncology, ASUR Marche, Area Vasta 2, Fabriano, Italy
| | | | - Alessio Cortellini
- Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Roma, Italy; Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, UK
| | | | | | | | - Caterina Caminiti
- Clinical & Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - Marcello Tiseo
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
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Longo V, Della Corte CM, Russo A, Spinnato F, Ambrosio F, Ronga R, Marchese A, Del Giudice T, Sergi C, Casaluce F, Gilli M, Montrone M, Gristina V, Sforza V, Reale ML, Di Liello R, Servetto A, Lipari H, Longhitano C, Vizzini L, Manzo A, Cristofano A, Paolelli L, Nardone A, De Summa S, Perrone A, Bisceglia C, Derosa C, Nardone V, Viscardi G, Galetta D, Vitiello F. Consolidative thoracic radiation therapy for extensive-stage small cell lung cancer in the era of first-line chemoimmunotherapy: preclinical data and a retrospective study in Southern Italy. Front Immunol 2024; 14:1289434. [PMID: 38304255 PMCID: PMC10830694 DOI: 10.3389/fimmu.2023.1289434] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/18/2023] [Indexed: 02/03/2024] Open
Abstract
Background Consolidative thoracic radiotherapy (TRT) has been commonly used in the management of extensive-stage small cell lung cancer (ES-SCLC). Nevertheless, phase III trials exploring first-line chemoimmunotherapy have excluded this treatment approach. However, there is a strong biological rationale to support the use of radiotherapy (RT) as a boost to sustain anti-tumor immune responses. Currently, the benefit of TRT after chemoimmunotherapy remains unclear. The present report describes the real-world experiences of 120 patients with ES-SCLC treated with different chemoimmunotherapy combinations. Preclinical data supporting the hypothesis of anti-tumor immune responses induced by RT are also presented. Methods A total of 120 ES-SCLC patients treated with chemoimmunotherapy since 2019 in the South of Italy were retrospectively analyzed. None of the patients included in the analysis experienced disease progression after undergoing first-line chemoimmunotherapy. Of these, 59 patients underwent TRT after a multidisciplinary decision by the treatment team. Patient characteristics, chemoimmunotherapy schedule, and timing of TRT onset were assessed. Safety served as the primary endpoint, while efficacy measured in terms of overall survival (OS) and progression-free survival (PFS) was used as the secondary endpoint. Immune pathway activation induced by RT in SCLC cells was explored to investigate the biological rationale for combining RT and immunotherapy. Results Preclinical data supported the activation of innate immune pathways, including the STimulator of INterferon pathway (STING), gamma-interferon-inducible protein (IFI-16), and mitochondrial antiviral-signaling protein (MAVS) related to DNA and RNA release. Clinical data showed that TRT was associated with a good safety profile. Of the 59 patients treated with TRT, only 10% experienced radiation toxicity, while no ≥ G3 radiation-induced adverse events occurred. The median time for TRT onset after cycles of chemoimmunotherapy was 62 days. Total radiation dose and fraction dose of TRT include from 30 Gy in 10 fractions, up to definitive dose in selected patients. Consolidative TRT was associated with a significantly longer PFS than systemic therapy alone (one-year PFS of 61% vs. 31%, p<0.001), with a trend toward improved OS (one-year OS of 80% vs. 61%, p=0.027). Conclusion Multi-center data from establishments in the South of Italy provide a general confidence in using TRT as a consolidative strategy after chemoimmunotherapy. Considering the limits of a restrospective analysis, these preliminary results support the feasibility of the approach and encourage a prospective evaluation.
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Affiliation(s)
- Vito Longo
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori ”Giovanni Paolo II“, Bari, Italy
| | | | - Alessandro Russo
- Department of Hematology-Oncology, Papardo Hospital, Messina, Italy
| | - Francesca Spinnato
- UOC Oncologia Medica Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Francesca Ambrosio
- UOC Oncologia AORN Cardarelli, Hospital Antonio Cardarelli, Naples, Italy
| | - Riccardo Ronga
- UOC Oncologia AORN Cardarelli, Hospital Antonio Cardarelli, Naples, Italy
| | | | - Teresa Del Giudice
- Medical Oncology Unit, AOU Renato Dubecco De Lellis Hospital, Catanzaro, Italy
| | - Concetta Sergi
- UOC Oncologia ARNAS Garibaldi Catania, Azienda Sanitaria Provinciale di Catania, Catania, Italy
| | - Francesca Casaluce
- Divison of Medical Oncology, AORN S.G. Moscati Hospital (San Giuseppe Moscati Hospital of National Importance and High Specialty), Avellino, Italy
| | - Marina Gilli
- Department of Pulmonary Oncology, AORN Azienda Ospedaliera dei Colli Monaldi, Naples, Italy
| | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori ”Giovanni Paolo II“, Bari, Italy
| | - Valerio Gristina
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, University of Palermo, Palermo, Italy
| | - Vincenzo Sforza
- Oncologia Clinica Sperimentale Toraco-Polmonare, G. Pascale National Cancer Institute Foundation (IRCCS), Naples, Italy
| | | | | | - Alberto Servetto
- Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Helga Lipari
- Oncologia Ospedale Cannizzaro Catania, Medical Oncology Unit, Cannizzaro Hospital, Catania, Italy
| | | | - Laura Vizzini
- UOC Oncology Agrigento Health Authority, Agrigento, Italy
| | - Anna Manzo
- Oncologia Clinica Sperimentale Toraco-Polmonare, G. Pascale National Cancer Institute Foundation (IRCCS), Naples, Italy
| | - Antonella Cristofano
- Dipartimento di Oncologia e Oncoematologia, Ospedale Generale Regionale F. Miulli, Acquaviva, Italy
| | | | - Annalisa Nardone
- Unitá Opertiva Complessa di Radioterapia, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Simona De Summa
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Antonella Perrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori ”Giovanni Paolo II“, Bari, Italy
| | - Carmela Bisceglia
- Department of Pulmonary Oncology, AORN Azienda Ospedaliera dei Colli Monaldi, Naples, Italy
| | - Caterina Derosa
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Valerio Nardone
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giuseppe Viscardi
- Department of Pulmonary Oncology, AORN Azienda Ospedaliera dei Colli Monaldi, Naples, Italy
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori ”Giovanni Paolo II“, Bari, Italy
| | - Fabiana Vitiello
- Department of Pulmonary Oncology, AORN Azienda Ospedaliera dei Colli Monaldi, Naples, Italy
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Fanizzi A, Fadda F, Comes MC, Bove S, Catino A, Di Benedetto E, Milella A, Montrone M, Nardone A, Soranno C, Rizzo A, Guven DC, Galetta D, Massafra R. Comparison between vision transformers and convolutional neural networks to predict non-small lung cancer recurrence. Sci Rep 2023; 13:20605. [PMID: 37996651 PMCID: PMC10667245 DOI: 10.1038/s41598-023-48004-9] [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: 07/03/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Abstract
Non-Small cell lung cancer (NSCLC) is one of the most dangerous cancers, with 85% of all new lung cancer diagnoses and a 30-55% of recurrence rate after surgery. Thus, an accurate prediction of recurrence risk in NSCLC patients during diagnosis could be essential to drive targeted therapies preventing either overtreatment or undertreatment of cancer patients. The radiomic analysis of CT images has already shown great potential in solving this task; specifically, Convolutional Neural Networks (CNNs) have already been proposed providing good performances. Recently, Vision Transformers (ViTs) have been introduced, reaching comparable and even better performances than traditional CNNs in image classification. The aim of the proposed paper was to compare the performances of different state-of-the-art deep learning algorithms to predict cancer recurrence in NSCLC patients. In this work, using a public database of 144 patients, we implemented a transfer learning approach, involving different Transformers architectures like pre-trained ViTs, pre-trained Pyramid Vision Transformers, and pre-trained Swin Transformers to predict the recurrence of NSCLC patients from CT images, comparing their performances with state-of-the-art CNNs. Although, the best performances in this study are reached via CNNs with AUC, Accuracy, Sensitivity, Specificity, and Precision equal to 0.91, 0.89, 0.85, 0.90, and 0.78, respectively, Transformer architectures reach comparable ones with AUC, Accuracy, Sensitivity, Specificity, and Precision equal to 0.90, 0.86, 0.81, 0.89, and 0.75, respectively. Based on our preliminary experimental results, it appears that Transformers architectures do not add improvements in terms of predictive performance to the addressed problem.
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Affiliation(s)
- Annarita Fanizzi
- Struttura Semplice Dipartimentale Fisica Sanitaria, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Federico Fadda
- Struttura Semplice Dipartimentale Fisica Sanitaria, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Maria Colomba Comes
- Struttura Semplice Dipartimentale Fisica Sanitaria, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy.
| | - Samantha Bove
- Struttura Semplice Dipartimentale Fisica Sanitaria, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy.
| | - Annamaria Catino
- Unità Operativa Complessa di Oncologia Toracica, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Erika Di Benedetto
- Unità Operativa Complessa di Oncologia Medica, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Angelo Milella
- Dipartimento di ElettronicaInformazione e Bioingegneria, Politecnico di Milano, Via Giuseppe Ponzio, 34, 20133, Milan, Italy
| | - Michele Montrone
- Unità Operativa Complessa di Oncologia Toracica, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Annalisa Nardone
- Unità Operativa Complessa di Radioterapia, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Clara Soranno
- Struttura Semplice Dipartimentale Fisica Sanitaria, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Alessandro Rizzo
- Unità Operativa Complessa di Oncologia Medica 'Don Tonino Bello', I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, 06100, Sihhiye, Ankara, Turkey
| | - Domenico Galetta
- Unità Operativa Complessa di Oncologia Toracica, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
| | - Raffaella Massafra
- Struttura Semplice Dipartimentale Fisica Sanitaria, I.R.C.C.S. Istituto Tumori 'Giovanni Paolo II', Viale Orazio Flacco 65, 70124, Bari, Italy
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Pasello G, Lorenzi M, Crivellaro G, Capelletto E, Butticè S, Perrone F, Tiseo M, Scotti V, Polo V, Favaretto A, Montrone M, Berardi R, Zustovich F, Toschi L, Bearz A, Milella M, Frega S, Bonanno L, Guarneri V. 21P Bevacizumab plus atezolizumab and chemotherapy in NSCLC harbouring EGFR mutation previously treated with EGFR tyrosine kinase inhibitor: The BACH-NET study. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00275-7] [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: 04/03/2023]
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Longo V, Rizzo A, Catino A, Montrone M, Galetta D. Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta-analysis of randomized controlled trials. Thorac Cancer 2023; 14:1029-1035. [PMID: 36869579 PMCID: PMC10101844 DOI: 10.1111/1759-7714.14842] [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: 11/26/2022] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The addition of immune checkpoint inhibitors (ICIs) to chemotherapy is the new standard of care in the first-line treatment of small cell lung cancer (SCLC). However, although the concomitant use of immunotherapy and chemotherapy can increase the antitumor efficacy, it can also increase toxicity. The present study evaluated the tolerability of immune-based combinations in the first-line treatment of SCLC. METHODS Relevant trials were identified by searching electronic databases and conference meetings. Seven phase II and III randomized controlled trials and 3766 SCLC patients were included in the meta-analysis (immune-based combinations = 2133; chemotherapy = 1633). Outcomes of interest included treatment-related adverse events (TRAEs) and the rate of discontinuation due to TRAEs. RESULTS Immune-based combination treatment was associated with a higher risk of grade 3-5 TRAEs (odds ratio [OR], 1.16; 95% confidence interval [CI]: 1.01-1.35). Immune-based combinations were associated with a higher risk of TRAEs leading to discontinuation (OR, 2.30; 95% CI: 1.17-4.54). No differences were observed in grade 5 TRAEs (OR, 1.56; 95% CI: 0.93-2.63). CONCLUSION This meta-analysis indicates that the addition of immunotherapy to chemotherapy in SCLC patients is associated with a higher risk of toxicity and probably of treatment discontinuation. Tools for identifying SCLC patients that would not benefit from immune-based therapy are urgently needed.
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Affiliation(s)
- Vito Longo
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Alessandro Rizzo
- Struttura Semplice Dipartimentale Di Oncologia Medica per La Presa in Carico Globale Del Paziente Oncologico "Don Tonino Bello", I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Annamaria Catino
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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6
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Avian A, Clemente N, Mauro E, Isidoro E, Di Napoli M, Dudine S, Del Fabro A, Morini S, Perin T, Giudici F, Cammisuli T, Foschi N, Mocenigo M, Montrone M, Modena C, Polenghi M, Puzzi L, Tomaic V, Valenti G, Sola R, Zanolla S, Vogrig E, Riva E, Angeletti S, Ciccozzi M, Castriciano S, Pachetti M, Petti M, Centonze S, Gerin D, Banks L, Marini B, Canzonieri V, Sopracordevole F, Zanconati F, Ippodrino R. Correction: Clinical validation of full HR-HPV genotyping HPV Selfy assay according to the international guidelines for HPV test requirements for cervical cancer screening on clinician-collected and self-collected samples. J Transl Med 2023; 21:49. [PMID: 36703153 PMCID: PMC9878793 DOI: 10.1186/s12967-023-03882-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Alice Avian
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.438882.d0000 0001 0212 6916Molecular Genetics and Biotechnology PhD Study Programme, University of Nova Gorica, Nova Gorica, Slovenia
| | - Nicolò Clemente
- Ginecologia Oncologica, IRCCS—Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori—National Cancer Institute), Aviano, Italy
| | - Elisabetta Mauro
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Erica Isidoro
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/ SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Michela Di Napoli
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/ SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Sandra Dudine
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/ SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Anna Del Fabro
- Ginecologia Oncologica, IRCCS—Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori—National Cancer Institute), Aviano, Italy
| | - Stefano Morini
- Ginecologia Oncologica, IRCCS—Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori—National Cancer Institute), Aviano, Italy
| | - Tiziana Perin
- Ginecologia Oncologica, IRCCS—Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori—National Cancer Institute), Aviano, Italy
| | - Fabiola Giudici
- grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Tamara Cammisuli
- grid.418321.d0000 0004 1757 9741Anatomia Patologica, IRCCS—CRO (Istituto Nazionale Tumori - National Cancer Institute), Aviano, Italy
| | - Nicola Foschi
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Marco Mocenigo
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.438882.d0000 0001 0212 6916Molecular Genetics and Biotechnology PhD Study Programme, University of Nova Gorica, Nova Gorica, Slovenia
| | - Michele Montrone
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Chiara Modena
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Martina Polenghi
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Luca Puzzi
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Vjekoslav Tomaic
- grid.4905.80000 0004 0635 7705Institut Ruđer Bošković, Zagreb, Croatia
| | - Giulio Valenti
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Riccardo Sola
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Shivani Zanolla
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Enea Vogrig
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Elisabetta Riva
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | - Silvia Angeletti
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | - Massimo Ciccozzi
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | | | - Maria Pachetti
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.418712.90000 0004 1760 7415Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Matteo Petti
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Sandro Centonze
- Clinical Research Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Daniela Gerin
- Cervical Cancer Screening Coordination Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Lawrence Banks
- grid.425196.d0000 0004 1759 4810International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Bruna Marini
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Vincenzo Canzonieri
- grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy ,grid.418321.d0000 0004 1757 9741Anatomia Patologica, IRCCS—CRO (Istituto Nazionale Tumori - National Cancer Institute), Aviano, Italy
| | - Francesco Sopracordevole
- Ginecologia Oncologica, IRCCS—Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori—National Cancer Institute), Aviano, Italy
| | - Fabrizio Zanconati
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/ SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy ,grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Rudy Ippodrino
- Ulisse BioMed S.p.A, Area Science Park, SS 14, km 163.5, Trieste, Italy
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Bove S, Fanizzi A, Fadda F, Comes MC, Catino A, Cirillo A, Cristofaro C, Montrone M, Nardone A, Pizzutilo P, Tufaro A, Galetta D, Massafra R. A CT-based transfer learning approach to predict NSCLC recurrence: The added-value of peritumoral region. PLoS One 2023; 18:e0285188. [PMID: 37130116 PMCID: PMC10153708 DOI: 10.1371/journal.pone.0285188] [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] [Received: 01/16/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) represents 85% of all new lung cancer diagnoses and presents a high recurrence rate after surgery. Thus, an accurate prediction of recurrence risk in NSCLC patients at diagnosis could be essential to designate risk patients to more aggressive medical treatments. In this manuscript, we apply a transfer learning approach to predict recurrence in NSCLC patients, exploiting only data acquired during its screening phase. Particularly, we used a public radiogenomic dataset of NSCLC patients having a primary tumor CT image and clinical information. Starting from the CT slice containing the tumor with maximum area, we considered three different dilatation sizes to identify three Regions of Interest (ROIs): CROP (without dilation), CROP 10 and CROP 20. Then, from each ROI, we extracted radiomic features by means of different pre-trained CNNs. The latter have been combined with clinical information; thus, we trained a Support Vector Machine classifier to predict the NSCLC recurrence. The classification performances of the devised models were finally evaluated on both the hold-out training and hold-out test sets, in which the original sample has been previously divided. The experimental results showed that the model obtained analyzing CROP 20 images, which are the ROIs containing more peritumoral area, achieved the best performances on both the hold-out training set, with an AUC of 0.73, an Accuracy of 0.61, a Sensitivity of 0.63, and a Specificity of 0.60, and on the hold-out test set, with an AUC value of 0.83, an Accuracy value of 0.79, a Sensitivity value of 0.80, and a Specificity value of 0.78. The proposed model represents a promising procedure for early predicting recurrence risk in NSCLC patients.
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Affiliation(s)
- Samantha Bove
- I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | - Federico Fadda
- I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | | | - Angelo Cirillo
- I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | | | | | | | - Antonio Tufaro
- I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Bari, Italy
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8
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Passaro A, Russo GL, Passiglia F, D'Arcangelo M, Sbrana A, Russano M, Bonanno L, Giusti R, Metro G, Bertolini F, Grisanti S, Carta A, Cecere F, Montrone M, Massa G, Perrone F, Simionato F, Guaitoli G, Scotti V, Genova C, Lugini A, Bonomi L, Attili I, de Marinis F. Pralsetinib in RET fusion-positive non-small-cell lung cancer: A real-world data (RWD) analysis from the Italian expanded access program (EAP). Lung Cancer 2022; 174:118-124. [PMID: 36379124 DOI: 10.1016/j.lungcan.2022.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/24/2022] [Revised: 10/25/2022] [Accepted: 11/06/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The selective RET-inhibitor pralsetinib has shown therapeutic activity in early clinical trials in patients with non-small cell lung cancer (NSCLC) harboring rearranged during transfection (RET) gene fusions. To date, the real-world efficacy of pralsetinib in this population is unknown. MATERIALS AND METHODS A retrospective efficacy and safety analysis was performed on data from patients with RET-fusion positive NSCLC enrolled in the pralsetinib Italian expanded access program between July 2019 and October 2021. RESULTS Overall, 62 patients with RET-fusion positive NSCLC received pralsetinib at 20 Italian centers. Next-generation sequencing was used to detect RET alterations in 44 patients (73 %). The most frequent gene fusion partner was KIF5B (75 % of 45 evaluable). Median age was 62 years (range, 36-90), most patients were female (57 %) and never smokers (53 %). Brain metastases were known in 18 patients (29.5 %) at the time of pralsetinib treatment. 13 patients were treatment naïve (unfit for chemotherapy), 48 were pretreated (median number of previous lines: 1, range, 1-4). The objective response rate (ORR) was 66 % [95 % confidence interval (CI), 53-81] in the evaluable population (n = 59). The disease control rate (DCR) was 79 %. After a median follow-up of 10.1 months, the median progression free survival was 8.9 months (95 %CI, 4.7-NA). In patients with measurable brain metastases (n = 6) intracranial ORR was 83 %, intracranial DCR was 100 %. Overall, 83.6 % of patients experienced any-grade treatment-related adverse events (TRAEs), 39 % grade 3 or greater (G ≥ 3). The most common G ≥ 3 TRAEs were neutropenia (9.8 %), dry mouth/oral mucositis (8.2 %), and thrombocytopenia (6.6 %). Seven patients (12 %) discontinued pralsetinib due to TRAEs, twenty-six had at least one dose level modification due to TRAEs. Two treatment-related deaths were observed (1 sepsis, 1 typhlitis). CONCLUSIONS In the real-world setting, pralsetinib confirmed durable systemic activity and intracranial response in RET-fusion positive NSCLC. Toxicity profile was consistent with previous reports.
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Affiliation(s)
- Antonio Passaro
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy.
| | - Giuseppe Lo Russo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesco Passiglia
- Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, Orbassano (TO), Italy
| | | | - Andrea Sbrana
- Department of Surgical, Medical and Molecular Pathology and Critical Area Medicine, University of Pisa, Pisa, Italy
| | - Marco Russano
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Laura Bonanno
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | | | - Giulio Metro
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Federica Bertolini
- Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - Salvatore Grisanti
- Department of Medical Oncology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Annamaria Carta
- SC Oncologia Medica, Ospedale Businco - ARNAS G. Brotzu, Cagliari, Italy
| | - Fabiana Cecere
- Oncology 1, Regina Elena National Cancer Institute - IRCCS, Roma, Italy
| | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari 70124, Italy
| | - Giacomo Massa
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fabiana Perrone
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Francesca Simionato
- Department of Oncology, San Bortolo General Hospital, Azienda ULSS8 Berica, Vicenza, Italy
| | - Giorgia Guaitoli
- PhD Program Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Vieri Scotti
- Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Carlo Genova
- Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italia; Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, Italia
| | - Antonio Lugini
- AO San Giovanni Addolorata, UOC Oncologia Medica, Roma, Italy
| | - Lucia Bonomi
- Oncology, Department of Oncology and Hematology, ASST Papa Giovanni XXIII, Bergamo, Lombardia, Italy
| | - Ilaria Attili
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Filippo de Marinis
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy
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9
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Longo V, Pizzutilo P, Catino A, Montrone M, Pesola F, Marerch I, Galetta D. Prognostic factors for survival in extensive-stage small cell lung cancer: An Italian real-world retrospective analysis of 244 patients treated over the last decade. Thorac Cancer 2022; 13:3486-3495. [PMID: 36333988 PMCID: PMC9750807 DOI: 10.1111/1759-7714.14712] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Potential relationships with the prognosis of patients with extensive-stage non-small cell lung cancer (ES-SCLC) have been investigated without valid results. METHODS A retrospective analysis of real-world data of consecutive patients with ES-SCLC admitted to our Medical Thoracic Oncology Unit was carried out from 2010 to 2020, focusing on identification of prognostic factors. Kaplan-Meier analysis was used to represent progression-free survival (PFS) and overall survival (OS). Univariable and multivariable Cox models were used to investigate prognostic factors. RESULTS The analysis included 244 patients. The median OS was 8 months (95% confidence interval [CI]: 8-10) and the median PFS was 5 months (95% CI: 5-6). The univariable analysis showed that factors associated with shorter OS were older age (p = 0.047), TNM stage 4 versus 3 (p < 0.001), Eastern Cooperative Oncology Group (ECOG) performance status (PS) 1 and 2 versus 0 (p < 0.001), and >2 metastatic sites (p = 0.004). Mediastinal radiotherapy (RT) (p < 0.001), >1 irradiated site (p = 0.026), 3 and 4 chemotherapy (CT) lines versus 1 (p = 0.044 and 0.001, respectively), prophylactic cranial irradiation (PCI) (p < 0.001), and surgery (p = 0.001) correlated with longer OS. The multivariable analysis revealed statistically significant associations for TNM, ECOG PS 2 versus 0, number of CT lines, PCI, and surgery. A total of 23 patients (9.4%) survived ≥24 months, 39% of whom had received four CT lines and 48% had mediastinal RT. CONCLUSIONS Our data suggest that tumor burden, PS, and mediastinal RT strongly correlate with outcome. With the addition of immunotherapy to CT, the identification of new biomarkers as predictive factors is urgently required.
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Affiliation(s)
- Vito Longo
- Medical Thoracic Oncology UnitIRCCS Istituto Tumori "Giovanni Paolo II"BariItaly
| | - Pamela Pizzutilo
- Medical Thoracic Oncology UnitIRCCS Istituto Tumori "Giovanni Paolo II"BariItaly
| | - Annamaria Catino
- Medical Thoracic Oncology UnitIRCCS Istituto Tumori "Giovanni Paolo II"BariItaly
| | - Michele Montrone
- Medical Thoracic Oncology UnitIRCCS Istituto Tumori "Giovanni Paolo II"BariItaly
| | - Francesco Pesola
- Medical Thoracic Oncology UnitIRCCS Istituto Tumori "Giovanni Paolo II"BariItaly
| | - Ilaria Marerch
- Medical Thoracic Oncology UnitIRCCS Istituto Tumori "Giovanni Paolo II"BariItaly
| | - Domenico Galetta
- Medical Thoracic Oncology UnitIRCCS Istituto Tumori "Giovanni Paolo II"BariItaly
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10
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Rosati G, Montrone M, Pacilio C, Colombo A, Cicero G, Paragliola F, Vaia A, Annunziata L, Bilancia D. An Update on the Role of Anti-EGFR in the Treatment of Older Patients with Metastatic Colorectal Cancer. J Clin Med 2022; 11:jcm11237108. [PMID: 36498683 PMCID: PMC9739901 DOI: 10.3390/jcm11237108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/01/2022] [Revised: 11/10/2022] [Accepted: 11/27/2022] [Indexed: 12/02/2022] Open
Abstract
Although colorectal cancer is increasingly being diagnosed in older patients, their number is largely underrepresented in phase II or III clinical trials. Consequently, guidelines and the SIOG recommendations are not sufficiently clear regarding the treatment of these patients, particularly when chemotherapy is combined with monoclonal antibodies (bevacizumab, cetuximab, and panitumumab). Targeted therapy based on the use of anti-epidermal growth factor receptors (EGFRs) is conditioned by the potential for increased toxicity, making it more difficult to treat an older, rat sarcoma virus (RAS) and B rapidly accelerated fibrosarcoma (BRAF) wild-type patient. In light of a more detailed characterization of the older population, modernly differentiable between fit, vulnerable, or frail patients on the basis of the comprehensive geriatric assessment, and of the analysis of more recent studies, this review fully collects data from the literature, differentiating the results on functional status patients.
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Affiliation(s)
- Gerardo Rosati
- Medical Oncology Unit, “San Carlo” Hospital, 85100 Potenza, Italy
- Correspondence: ; Tel.: +39-0971-612273
| | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy
| | - Carmen Pacilio
- Medical Breast Cancer Department, IRCCS Istituto Tumori “G. Pascale”, 80131 Napoli, Italy
| | - Alfredo Colombo
- Medical Oncology Unit, CDC Macchiarella, 90138 Palermo, Italy
| | - Giuseppe Cicero
- Medical Oncology, Università degli Studi di Palermo, 90133 Palermo, Italy
| | | | - Angelo Vaia
- Medical Oncology Unit, “San Carlo” Hospital, 85100 Potenza, Italy
| | - Luigi Annunziata
- Medical Oncology Unit, “San Carlo” Hospital, 85100 Potenza, Italy
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11
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Passaro A, Lo Russo G, Passiglia F, D'Arcangelo M, Sbrana A, Russano M, Bonanno L, Giusti R, Metro G, Bertolini F, Grisanti S, Carta A, Cecere F, Montrone M, Massa G, Attili I, de Marinis F. 1124P Pralsetinib in RET fusion-positive non-small cell lung cancer: A real-world data (RWD) analysis from the Italian expanded access program (EAP). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1248] [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: 11/01/2022] Open
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12
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Ramella S, Morabito A, Silipigni S, Russo A, Capelletto E, Rossi S, Leonetti A, Montrone M, Facilissimo I, Romano G, Stasi I, Ceresoli G, Gridelli C, Lugini A, Pilotto S, Tagliaferri P, Bria E, Canova S, Rijavec E, Borghetti P, Brighenti M, Carta A, Ciuffreda L, Giusti R, Macerelli M, Verderame F, Zanelli F, Berardi R, Gregorc V, Sergi C, Vattemi E, Manglaviti S, Piovano P, Olmetto E, Borra G, Gori S, Aieta M, Bertolini A, Cecere F, Pasello G, Rocco D, Zulian M, Roncari B, Novello S. EP06.01-006 Multidisciplinary Team during the COVID-19 Pandemic: The BE-PACIFIC Italian Observational Study Analysis. J Thorac Oncol 2022. [PMCID: PMC9452007 DOI: 10.1016/j.jtho.2022.07.521] [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: 10/26/2022]
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13
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Pizzutilo E, Cerea G, Oresti S, Agostara A, Signorelli D, Stabile S, Lauricella C, Brambilla M, Mazzeo L, Giusti R, Montrone M, Russano M, Bennati C, Russo A, Viscardi G, Roca E, Gelibter A, Cortinovis D, Sartore Bianchi A, Siena S. 996P Activity of OsimeRTInib in NSCLC with UNcommon EGFR Mutations: Retrospective observational multicenter study (ARTICUNO). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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14
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F. Perrone AL, Puntoni M, Bordi P, Maglietta G, Carpana C, Gelsomino F, Passiglia F, Genova C, Montrone M, Caliman E, Cerea G, Pasello G, Cecere F, Manzo A, Adamo V, Citarella F, Toschi L, Gelibter A, Rastelli F, Carta A, Guida A, Camerini A, Paoloni F, Bertolini F, Tiseo M. EP08.01-007 Real-World Outcomes of Patients with Advanced Lung Adenocarcinoma Treated with First-Line Chemo-Immunotherapy in Italy. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Migliorino R, Landi L, Galetta D, Soregaroli D, Ricciardi S, Minuti G, Montrone M, Marech I, Morabito A, Berardi R, Novello S, Rocco D, Pilotto S, Zanelli F, Bengala C, Delmonte A, Aieta M, Cortinovis DL, Cappuzzo F. FoRT 05-BEAT: A phase II randomized trial comparing atezolizumab versus atezolizumab + bevacizumab as first-line treatment in patients with PD-L1 high advanced/metastatic NSCLC. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps9145] [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: 11/20/2022] Open
Abstract
TPS9145 Background: Several ongoing phase III studies are evaluating the efficacy of first-line atezolizumab in combination with chemotherapy in patients with non small-cell lung cancer (NSCLC). Among angiogenesis inhibitors, bevacizumab is approved as first-line therapy in combination with chemotherapy or in combination with erlotinib in patients with NSCLC harboring activating EGFR mutations. Recent evidence (Wallin 2016) suggests that the combination of atezolizumab and bevacizumab increases intra-tumoral CD8+T cells, suggesting that dual VEGF and PD-L1 inhibition improves antigen-specific T-cell migration. In addition, preliminary clinical data suggested a strong synergistic effects of bevacizumab with immune checkpoint inhibitors. There is therefore a strong rationale for investigating the combination of atezolizumab and bevacizumab in patients with advanced/metastatic NSCLC. The FoRT 05-BEAT is a multicenter, Italian, phase II, randomized study comparing atezolizumab monotherapy versus the combination of atezolizumab and bevacizumab in patients with chemo-naive metastatic NSCLC and high levels of PD-L1 expression. Methods: The trial was conducted in 35 Italian centers: chemotherapy naive metastatic NSCLC patients, with high levels of PD-L1 expression (PD-L1 TPS ≥50% or TC/IC 3 scoring) were randomly assigned to atezolizumab monotherapy (1200 mg every 3 weeks) or to the combination of atezolizumab (1200 mg every 3 weeks) and bevacizumab (15 mg/kg every 3 weeks).The primary endpoint is overall survival (OS) rate at 18 months. Secondary endpoints include response rate (RR), PFS, OS according to presence of bone and/or hepatic metastases. Safety considerations will be considered. Exploratory analysis of predictive biomarker on tumor tissue and blood samples has been planned. Sample size has been calculated assuming a 18 months OS of 50% in the atezolizumab arm. Therefore, a total of 186 patients is needed to detect an absolute improvement of 20%, thus obtaining a 18mOS of 70% in the combination arm, with a power of 80% at a significance level of 5%. Taking into account the percentage of patients lost-to-follow-up, the sample size has been increased by 10% (N = 206 patients, 103 per arm). At the drafting of this abstract, 57 patients have already been enrolled (47 randomized). Clinical trial information: NCT03896074.
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Affiliation(s)
- Rita Migliorino
- Pulmonary Oncology Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | | | - Domenico Galetta
- Medical Oncology Department, Clinical Cancer Center Giovanni Paolo II, Bari, Italy
| | | | | | - Gabriele Minuti
- UOC Oncologia Medica 2 Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | - Ilaria Marech
- Istituto Tumori “Giovanni Paolo II” IRCCS, National Cancer Research Center Onc, Bari, Italy
| | | | - Rossana Berardi
- Clinical Oncology, Polytechnic University of Marche, AOU Ospedali Riuniti, Ancona, Italy
| | - Silvia Novello
- University of Turin, Department of Oncology, S. Luigi Hospital, Torino, Italy
| | - Danilo Rocco
- Pneumology and Oncology Department, AORN dei Colli, Naples, Italy
| | - Sara Pilotto
- U.O.C. Oncology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | - Angelo Delmonte
- Istituto Romagnolo per lo Studio dei Tumori Dino Amadori-RCCS, Meldola, Italy
| | - Michele Aieta
- IRCCS Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture (Potenza), Italy
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Avian A, Clemente N, Mauro E, Isidoro E, Di Napoli M, Dudine S, Del Fabro A, Morini S, Perin T, Giudici F, Cammisuli T, Foschi N, Mocenigo M, Montrone M, Modena C, Polenghi M, Puzzi L, Tomaic V, Valenti G, Sola R, Zanolla S, Vogrig E, Riva E, Angeletti S, Ciccozzi M, Castriciano S, Pachetti M, Petti M, Centonze S, Gerin D, Banks L, Marini B, Canzonieri V, Sopracordevole F, Zanconati F, Ippodrino R. Clinical validation of full HR-HPV genotyping HPV Selfy assay according to the international guidelines for HPV test requirements for cervical cancer screening on clinician-collected and self-collected samples. J Transl Med 2022; 20:231. [PMID: 35581584 PMCID: PMC9115952 DOI: 10.1186/s12967-022-03383-x] [Citation(s) in RCA: 6] [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: 02/25/2022] [Accepted: 04/07/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND According to international guidelines, Human Papillomavirus (HPV) DNA tests represent a valid alternative to Pap Test for primary cervical cancer screening, provided that they guarantee balanced clinical sensitivity and specificity for cervical intraepithelial neoplasia grade 2 or more (CIN2+) lesions. The study aimed to assess whether HPV Selfy (Ulisse BioMed - Trieste, Italy), a full-genotyping HPV DNA test that detects and differentiates 14 high-risk HPV (HR-HPV) types, meets the criteria for primary cervical cancer screening described in the international guidelines, on clinician-collected as well as on self-collected samples. METHODS For each participant woman, consecutively referring to Azienda Sanitaria Universitaria Giuliano Isontina (Trieste, Italy) and CRO-National Cancer Institute (Aviano, Italy) for the cervical cancer screening program, the following samples were tested: (a) a clinician-collected cervical specimen, analyzed with the reference test (Hybrid Capture®2 test, HC2) and HPV Selfy; and (b) a self-collected vaginal sample, analyzed with HPV Selfy. Enrolled women were also asked to fulfill a questionnaire about self-sampling acceptability. As required by guidelines, a non-inferiority test was conducted to compare the clinical performance of the test under evaluation with its reference test. RESULTS HPV Selfy clinical sensitivity and specificity resulted non-inferior to those of HC2. By analysis of a total of 889 cervical liquid-based cytology samples from a screening population, of which 98 were from women with CIN2+, HPV Selfy showed relative sensitivity and specificity for CIN2+ of 0.98 and 1.00 respectively (non-inferiority score test: P = 0.01747 and P = 0.00414, respectively); the test reached adequate intra- and inter-laboratory reproducibility. Moreover, we demonstrated that the performance of HPV Selfy on self-collected vaginal samples was non-inferior to the performance obtained on clinician-collected cervical specimen (0.92 relative sensitivity and 0.97 relative specificity). Finally, through HPV Selfy genotyping, we were able to describe HPV types prevalence in the study population. CONCLUSIONS HPV Selfy fulfills all the requirements of the international Meijer's guidelines and has been clinically validated for primary cervical cancer screening purposes. Moreover, HPV Selfy has also been validated for self-sampling according to VALHUDES guidelines. Therefore, at date, HPV Selfy is the only full-genotyping test validated both for screening purposes and for self-sampling. Trial registration ASUGI Trieste n. 16008/2018; CRO Aviano n.17149/2018.
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Affiliation(s)
- Alice Avian
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.438882.d0000 0001 0212 6916Molecular Genetics and Biotechnology PhD Study Programme, University of Nova Gorica, Nova Gorica, Slovenia
| | - Nicolò Clemente
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Elisabetta Mauro
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Erica Isidoro
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Michela Di Napoli
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Sandra Dudine
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy
| | - Anna Del Fabro
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Stefano Morini
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Tiziana Perin
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Fabiola Giudici
- grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Tamara Cammisuli
- grid.418321.d0000 0004 1757 9741Anatomia Patologica, IRCCS – CRO (Istituto Nazionale Tumori - National Cancer Institute), Aviano, Italy
| | - Nicola Foschi
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Marco Mocenigo
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.438882.d0000 0001 0212 6916Molecular Genetics and Biotechnology PhD Study Programme, University of Nova Gorica, Nova Gorica, Slovenia
| | - Michele Montrone
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Chiara Modena
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Martina Polenghi
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Luca Puzzi
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Vjekoslav Tomaic
- grid.4905.80000 0004 0635 7705Institut Ruđer Bošković, Zagreb, Croatia
| | - Giulio Valenti
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Riccardo Sola
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Shivani Zanolla
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Enea Vogrig
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Elisabetta Riva
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | - Silvia Angeletti
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | - Massimo Ciccozzi
- grid.488514.40000000417684285Policlinico Universitario Campus Biomedico, Rome, Italy
| | | | - Maria Pachetti
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy ,grid.418712.90000 0004 1760 7415Institute of Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Matteo Petti
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Sandro Centonze
- Clinical Research Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Daniela Gerin
- Cervical Cancer Screening Coordination Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Lawrence Banks
- grid.425196.d0000 0004 1759 4810International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
| | - Bruna Marini
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
| | - Vincenzo Canzonieri
- grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy ,grid.418321.d0000 0004 1757 9741Anatomia Patologica, IRCCS – CRO (Istituto Nazionale Tumori - National Cancer Institute), Aviano, Italy
| | - Francesco Sopracordevole
- grid.418321.d0000 0004 1757 9741Ginecologia Oncologica, IRCCS - Centro Di Riferimento Oncologico (CRO) (Istituto Nazionale Tumori – National Cancer Institute), Aviano, Italy
| | - Fabrizio Zanconati
- grid.413694.dAzienda Sanitaria Universitaria Giuliano Isontina UCO/SC Anatomia e Istologia Patologica, Cattinara Hospital, Trieste, Italy ,grid.5133.40000 0001 1941 4308Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Rudy Ippodrino
- Ulisse BioMed S.P.a, Area Science Park, SS 14, km 163.5, Trieste, Italy
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Rodrigues A, Chauhan J, Sagkriotis A, Aasaithambi S, Montrone M. Understanding the lived experience of lung cancer: a European social media listening study. BMC Cancer 2022; 22:475. [PMID: 35490223 PMCID: PMC9055221 DOI: 10.1186/s12885-022-09505-4] [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: 12/22/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Social media platforms are increasingly being used by stakeholders to generate, access, and share health-related information and experiences. Lung cancer is the most common cancer, impacting > 2 million patients globally. This observational study utilized a social listening approach to analyze social media trends and gain insights into stakeholder perceptions of lung cancer. Methods This social media study retrospectively collated data from open access blogs, forums, and social networking sites. Social media posts were collected between June 2019–May 2020 from 14 European countries. Using social media aggregator tools, posts comprising lung cancer and non-small cell lung cancer-specific terms were extracted. Manual and automated relevancy algorithms filtered the extracted information to provide the relevant dataset. This contextualized dataset was further mined to generate the final data for analysis. Results Of 1360 conversations analyzed, 42% were generated by patients/caregivers and 14% by healthcare professionals (HCPs). A majority of patients were 51–70 years old (approximately 50%) and 91% (n = 500/550) had late-stage cancer. Treatment (35%) and disease awareness (30%) were among the most discussed topic of the patient journey. Although the overall treatment sentiment was neutral, chemotherapy was the treatment type with the highest associated negative sentiment (28%); fewer negative sentiments were associated with immunotherapy (9%) and targeted therapy (2%), due to perceptions of longer survival outcomes and fewer side effects. In conversations that discussed clinical endpoints, “survivability” and “overall survival” (47 and 30%, respectively; n = 539) were most frequently mentioned by stakeholders. HCPs mostly used technical terms, whereas patients and caregivers used colloquial terms such as “getting rid of cancer”. Emotional wellness was identified to have a huge impact on quality of life in lung cancer. Delay or treatment cancellations due to COVID-19, lack of effective treatments and funding, and lack of empathy by physicians emerged as the key unmet needs among patients/caregivers. Conclusions Social listening proved to be an effective tool to explore stakeholders’ perceptions and their key unmet needs, typically not available in published literature or databases, and provides HCPs with valuable insights into the distress, doubts, and needs of lung cancer patients and caregivers. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09505-4.
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Affiliation(s)
- Ana Rodrigues
- Medical Oncology, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal.
| | - Jyoti Chauhan
- Novartis Healthcare Pvt Ltd (H.A.), Hyderabad, India
| | | | | | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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18
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Massafra R, Catino A, Perrotti PMS, Pizzutilo P, Fanizzi A, Montrone M, Galetta D. Informative Power Evaluation of Clinical Parameters to Predict Initial Therapeutic Response in Patients with Advanced Pleural Mesothelioma: A Machine Learning Approach. J Clin Med 2022; 11:jcm11061659. [PMID: 35329985 PMCID: PMC8950691 DOI: 10.3390/jcm11061659] [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: 02/07/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/10/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare neoplasm whose early diagnosis is challenging and systemic treatments are generally administered as first line in the advanced disease stage. The initial clinical response may represent a useful parameter in terms of identifying patients with a better long-term outcome. In this report, the initial therapeutical response in 46 patients affected with advanced/unresectable pleural mesothelioma was investigated. The initial therapeutic response was assessed by CT scan and clinical examination after 2–3 treatment cycles. Our preliminary evaluation shows that the group of patients treated with regimens including antiangiogenetics and/or immunotherapy had a significantly better initial response as compared to patients only treated with standard chemotherapy, exhibiting a disease control rate (DCR) of 100% (95% IC, 79.40–100%) and 80.0% (95% IC, 61.40–92.30%), respectively. Furthermore, the therapeutic response was correlated with the disease stage, blood leukocytes and neutrophils, high albumin serum levels, and basal body mass index (BMI). Specifically, the patients with disease stage III showed a DCR of 95.7% (95% IC, 78.1–99.9%), whereas for disease stage IV the DCR decreased to 66.7% (95% IC, 34.9–9.1%). Moreover, a better initial response was observed in patients with a higher BMI, who reached a DCR of 96.10% (95% IC, 80.36–99.90%). Furthermore, in order to evaluate in the predictive power of the collected features a multivariate way, we report the preliminary results of a machine learning model for predicting the initial therapeutic response. We trained a state-of-the-art algorithm combined to a sequential forward feature selection procedure. The model reached a median AUC value, accuracy, sensitivity, and specificity of 77.0%, 75%, 74.8%, and 83.3%, respectively. The features with greater informational power were gender, histotype, BMI, smoking habits, packs/year, and disease stage. Our preliminary data support the possible favorable correlation between innovative treatments and therapeutic response in patients with unresectable/advanced pleural mesothelioma. The small sample size does not allow concrete conclusions to be drawn; nevertheless, this work is the basis of an ongoing study that will also involve radiomics in a larger dataset.
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Affiliation(s)
- Raffaella Massafra
- Struttura Semplice Dipartimentale di Fisica Sanitaria, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy;
| | - Annamaria Catino
- Struttura Semplice Dipartimentale di Oncologia Medica per la Patologia Toracica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy; (A.C.); (P.P.); (M.M.); (D.G.)
| | - Pia Maria Soccorsa Perrotti
- Struttura Semplice Dipartimentale di Radiologia, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy;
| | - Pamela Pizzutilo
- Struttura Semplice Dipartimentale di Oncologia Medica per la Patologia Toracica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy; (A.C.); (P.P.); (M.M.); (D.G.)
| | - Annarita Fanizzi
- Struttura Semplice Dipartimentale di Fisica Sanitaria, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy;
- Correspondence: ; Tel.: +39-080-555-5111
| | - Michele Montrone
- Struttura Semplice Dipartimentale di Oncologia Medica per la Patologia Toracica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy; (A.C.); (P.P.); (M.M.); (D.G.)
| | - Domenico Galetta
- Struttura Semplice Dipartimentale di Oncologia Medica per la Patologia Toracica, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy; (A.C.); (P.P.); (M.M.); (D.G.)
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19
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Montrone M, Chauhan J, Sagkriotis A, Aasaithambi S, Rodrigues A. 1343P Understanding patient and caregiver perceptions of quality of life (QoL) impacts in lung cancer through social listening. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Perrone F, Belluomini L, Mazzotta M, Bianconi M, Di Noia V, Meacci F, Montrone M, Pignataro D, Prelaj A, Rinaldi S, Russano M, Sartori G, Bironzo P, Facchinetti F, Menis J, Tiseo M, Galetta D, Novello S, Pilotto S. Exploring the role of respiratory microbiome in lung cancer: A systematic review. Crit Rev Oncol Hematol 2021; 164:103404. [PMID: 34214609 DOI: 10.1016/j.critrevonc.2021.103404] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 09/14/2020] [Revised: 06/22/2021] [Accepted: 06/26/2021] [Indexed: 12/13/2022] Open
Abstract
Giving the potential contribute in cancer initiation and progression, lung microbiota represents a promising topic in cancer research, although still unexplored. We performed a systematic literature search to identify clinical studies evaluating lung microbiota composition, its correlation with lung cancer patients' clinico-pathological features and prognosis. Of the identified 370 studies, 21 were eligible and included. Although studies were heterogeneous, lung cancer resulted to be enriched in peculiar microbial communities, with differences in composition and diversity according to clinico-pathological parameters. Few studies explored how lung microbiota influences cancer outcome. In light of these findings and borrowing the suggestions coming from gut microbiota, we speculate that respiratory microbiome may influence pathogenesis, progression and outcome of lung cancer. Taking advantage of the experience of chronical lung diseases, prospective studies should be designed to evaluate lung microbiota changes throughout any phase of lung cancer course, particularly with the advent of immunotherapy as pivotal treatment.
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Affiliation(s)
| | - Lorenzo Belluomini
- Section of Oncology, Department of Medicine, University of Verona and Verona University Hospital Trust, Verona, Italy.
| | - Marco Mazzotta
- Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy.
| | - Maristella Bianconi
- U.O. Oncologia, ASUR Marche AV3, Civitanova Marche Hospital, Civitanova Marche (MC), Italy.
| | - Vincenzo Di Noia
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Fiammetta Meacci
- Department of Oncology Radiation Therapy Unit, Careggi University Hospital, Florence, Italy.
| | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
| | | | - Arsela Prelaj
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Department of Electronics, Information, and Bioengineering, Polytechnic University of Milan, Milano, Italy.
| | - Silvia Rinaldi
- Medical Oncology, Augusto Murri Hospital Fermo, Fermo, Italy.
| | - Marco Russano
- Department of Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy.
| | - Giulia Sartori
- Medical Oncology, Berica Local Health Unit, Vicenza, Italy.
| | - Paolo Bironzo
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy.
| | - Francesco Facchinetti
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France.
| | - Jessica Menis
- Section of Oncology, Department of Medicine, University of Verona and Verona University Hospital Trust, Verona, Italy.
| | - Marcello Tiseo
- Medical Oncology Unit, University Hospital of Parma, Italy.
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
| | - Silvia Novello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy.
| | - Sara Pilotto
- Section of Oncology, Department of Medicine, University of Verona and Verona University Hospital Trust, Verona, Italy.
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21
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Bafunno D, Catino A, Lamorgese V, Longo V, Montrone M, Pesola F, Pizzutilo P, Petrillo P, Varesano N, Zacheo A, Del Bene G, Lapadula V, Mastrandrea A, Ricci D, Di Lauro A, Cassiano S, Galetta D. Smoking Prevalence, Knowledge and Perceptions on Tobacco Control Among Healthcare Professionals: A Survey in an Italian Cancer Center. J Community Health 2021; 46:597-602. [PMID: 32789714 DOI: 10.1007/s10900-020-00907-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Smoking is recognized as the major cause of lung cancer. Healthcare professionals play an important role in lung cancer prevention policies, as they act as a source of guidance for patients and advocates. The following survey evaluated prevalence, knowledge, and attitudes toward tobacco smoking among a sample of workers in "IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, an Italian cancer hospital. An anonymous questionnaire was completed by 104 healthcare professionals to collect personal and occupational data about smoking status, knowledge about the harms of smoking, current legislation in place, Second-Hand Smoke (SHS) awareness, and, for ex-smokers, the reasons for quitting. Among participants, 17.8% were current smokers, 26.2% former smokers, and 56% never smoked. Only 40% acknowledged that the smoking ban is generally respected, and 63.2% reported that they smoke during working hours. Most of the participants perceived tobacco control policy as an efficient way to protect public health. Currently, the implementation of Italian anti-smoking legislation has so far improved neither smoking cessation rates nor the will to quit smoking completely. Our experience highlights that to date the anti-smoking strategies have limited efficacy even in a cancer center; in fact, there is still a large prevalence of smokers among hospital personnel. Therefore, it is strongly suggested that interventions be shared with all healthcare workers, specifically aimed at developing a culture of health promotion.
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Affiliation(s)
- Daniela Bafunno
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Annamaria Catino
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy.
| | - Vito Lamorgese
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Vito Longo
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Michele Montrone
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Francesco Pesola
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Pamela Pizzutilo
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Patrizia Petrillo
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Niccolò Varesano
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Antonella Zacheo
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Gabriella Del Bene
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Vittoria Lapadula
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Angelica Mastrandrea
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Donata Ricci
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Alessandra Di Lauro
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Sandro Cassiano
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
| | - Domenico Galetta
- IRCCS Istituto Tumori "Giovanni Paolo II" 65, Viale Orazio Flacco, 70124, Bari, Italy
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22
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Longo V, Catino A, Montrone M, Pizzutilo P, Pesola F, Marech I, Capone I, Prelaj A, Galetta D. Successful treatment of triple EGFR mutation T785A/L861Q/H297_E298 with afatinib. Thorac Cancer 2021; 12:2031-2034. [PMID: 34008923 PMCID: PMC8258364 DOI: 10.1111/1759-7714.13953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/14/2021] [Accepted: 03/14/2021] [Indexed: 12/26/2022] Open
Abstract
Patients with non‐small cell lung cancer (NSCLC) and uncommon epidermal growth factor receptor (EGFR) mutation are characterized by high heterogeneity, and globally considered to have a worse prognosis than patients with the two common mutations; exon 19 deletion, and exon 21 L858R. Nevertheless, some uncommon mutations do confer sensitivity to tyrosine kinase inhibitors (TKIs) which is comparable with common mutations. In particular, some compound EGFR mutations seem to be characterized by a favorable prognosis. Unfortunately, the rarity of complex EGFR mutations results in difficult clinical decision‐making. Herein, to the best of our knowledge, we report the first case of an NSCLC patient with an EGFR triple mutation containing T785A/L861Q/H297_E298 who was successfully treated with afatinib.
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Affiliation(s)
- Vito Longo
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Annamaria Catino
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Pamela Pizzutilo
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Francesco Pesola
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Ilaria Marech
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Iolanda Capone
- Pathology and Laboratory Medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Arsela Prelaj
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Electronics, Information, and Bioengineering, Polytechnic University of Milan, Milan, Italy
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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23
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Bafunno D, Romito F, Lagattolla F, Delvino VA, Minoia C, Loseto G, Dellino M, Guarini A, Catino A, Montrone M, Longo V, Pizzutilo P, Galetta D, Giotta F, Latorre AC, Russo A, Lorusso V, Cormio C. Psychological well-being in cancer outpatients during COVID-19. J BUON 2021; 26:1127-1134. [PMID: 34268981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The psychological status of cancer outpatients receiving anti-neoplastic treatment during the lockdown in a Italian non-COVID Cancer Center, was been investigated with the following aims: to measure the levels of post-traumatic stress symptoms, depression and anxiety; to compare patients with different cancer sites; to compare the anxiety and depression levels measured in this emergency period between cancer and non-cancer patients and between cancer patients before and after the emergency. METHODS The following questionnaires were used: The Hospital Anxiety and Depression Scale (HADs) and the Impact of Event Scale-Revised (IES-R).Worries regarding the COVID-19 on patients' lives, socio-demographic and clinical details were collected using a brief structured questionnaire. RESULTS One-hundred seventy-eight outpatients were enrolled. We found that 55% of patients were above the cut-off for HADS general scale and 23.7% had severe level of PTSD. The 68% of patients declared that their worries have increased during the pandemic especially for women. Patients with lung cancer have higher general distress compared with patients with breast cancer and lymphoma. The non cancer sample had values significantly higher both for the IES-R scales and for HADS Depression subscale. Finally, cancer patients who experienced the health emergency showed higher levels of anxiety than those measured 2 years ago. CONCLUSION Cancer out-patients of the present sample have severe post-traumatic stress symptoms and psychological distress, those with lung cancer are at higher risk and may need special attention. Non-oncological subjects have higher depression levels than cancer patients.
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Affiliation(s)
- Daniela Bafunno
- 1 Thoracic Oncology Unit-IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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Banna GL, Cortellini A, Cortinovis DL, Tiseo M, Aerts JGJV, Barbieri F, Giusti R, Bria E, Grossi F, Pizzutilo P, Berardi R, Morabito A, Genova C, Mazzoni F, Di Noia V, Signorelli D, Gelibter A, Macerelli M, Rastelli F, Chiari R, Rocco D, Gori S, De Tursi M, Di Marino P, Mansueto G, Zoratto F, Filetti M, Montrone M, Citarella F, Marco R, Cantini L, Nigro O, D'Argento E, Buti S, Minuti G, Landi L, Guaitoli G, Lo Russo G, De Toma A, Donisi C, Friedlaender A, De Giglio A, Metro G, Porzio G, Ficorella C, Addeo A. The lung immuno-oncology prognostic score (LIPS-3): a prognostic classification of patients receiving first-line pembrolizumab for PD-L1 ≥ 50% advanced non-small-cell lung cancer. ESMO Open 2021; 6:100078. [PMID: 33735802 PMCID: PMC7988288 DOI: 10.1016/j.esmoop.2021.100078] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 12/30/2022] Open
Abstract
Background To stratify the prognosis of patients with programmed cell death-ligand 1 (PD-L1) ≥ 50% advanced non-small-cell lung cancer (aNSCLC) treated with first-line immunotherapy. Methods Baseline clinical prognostic factors, the neutrophil-to-lymphocyte ratio (NLR), PD-L1 tumour cell expression level, lactate dehydrogenase (LDH) and their combination were investigated by a retrospective analysis of 784 patients divided between statistically powered training (n = 201) and validation (n = 583) cohorts. Cut-offs were explored by receiver operating characteristic (ROC) curves and a risk model built with validated independent factors by multivariate analysis. Results NLR < 4 was a significant prognostic factor in both cohorts (P < 0.001). It represented 53% of patients in the validation cohort, with 1-year overall survival (OS) of 76.6% versus 44.8% with NLR > 4, in the validation series. The addition of PD-L1 ≥ 80% (21% of patients) or LDH < 252 U/l (25%) to NLR < 4 did not result in better 1-year OS (of 72.6% and 74.1%, respectively, in the validation cohort). Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2 [P < 0.001, hazard ratio (HR) 2.04], pretreatment steroids (P < 0.001, HR 1.67) and NLR < 4 (P < 0.001, HR 2.29) resulted in independent prognostic factors. A risk model with these three factors, namely, the lung immuno-oncology prognostic score (LIPS)-3, accurately stratified three OS risk-validated categories of patients: favourable (0 risk factors, 40%, 1-year OS of 78.2% in the whole series), intermediate (1 or 2 risk factors, 54%, 1-year OS 53.8%) and poor (>2 risk factors, 5%, 1-year OS 10.7%) prognosis. Conclusions We advocate the use of LIPS-3 as an easy-to-assess and inexpensive adjuvant prognostic tool for patients with PD-L1 ≥ 50% aNSCLC. Immunotherapy/chemoimmunotherapy combinations are currently not superior to immunotherapy alone for high PD-L1 aNSCLC. NLR with a cut-off of 4 was validated as an independent prognostic factor for immunotherapy in high PD-L1 aNSCLC. The addition of either PD-L1 ≥ 80% or LDH < 252 U/l to NLR < 4 did not result in better prognostic stratification. The LIPS-3 is a validated 3-class prognostic classification based on the NLR, ECOG PS and pretreatment steroids. The LIPS-3 is a routinely assessable adjuvant prognostic tool for high PD-L1 aNSCLC patients.
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Affiliation(s)
- G L Banna
- Oncology Department, Portsmouth University Hospitals NHS Trust, Portsmouth, UK
| | - A Cortellini
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - M Tiseo
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - J G J V Aerts
- Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, the Netherlands
| | - F Barbieri
- Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - R Giusti
- Medical Oncology, St. Andrea Hospital, Rome, Italy
| | - E Bria
- Comprehensive Cancer Center, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy; Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Grossi
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Pizzutilo
- Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Temorid 'Giovanni Paolo II', Bari, Italy
| | - R Berardi
- Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - A Morabito
- Thoracic Medical Oncology, Istituto Nazionale Tumori 'Fondazione G Pascale', IRCCS, Napoli, Italy
| | - C Genova
- Lung Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - F Mazzoni
- Department of Oncology, Careggi University Hospital, Florence, Italy
| | - V Di Noia
- Medical Oncology, University Hospital of Foggia, Foggia, Italy
| | - D Signorelli
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Gelibter
- Medical Oncology (B), Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy
| | - M Macerelli
- Department of Oncology, University Hospital Santa Maria Della Misericordia, Udine, Italy
| | - F Rastelli
- Medical Oncology, Fermo Area Vasta 4, Fermo, Italy
| | - R Chiari
- Medical Oncology, Ospedali Riuniti Padova Sud 'Madre Teresa Di Calcutta', Monselice, Italy
| | - D Rocco
- Pneumo-Oncology Unit, Monaldi Hospital, Naples, Italy
| | - S Gori
- Oncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella VR, Italy
| | - M De Tursi
- Department of Medical, Oral & Biotechnological Sciences University G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - P Di Marino
- Clinical Oncology Unit, S.S. Annunziata Hospital, Chieti, Italy
| | - G Mansueto
- Medical Oncology, F. Spaziani Hospital, Frosinone, Italy
| | - F Zoratto
- Medical Oncology, Santa Maria Goretti Hospital, Latina, Italy
| | - M Filetti
- Medical Oncology, St. Andrea Hospital, Rome, Italy
| | - M Montrone
- Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Temorid 'Giovanni Paolo II', Bari, Italy
| | - F Citarella
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - R Marco
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - L Cantini
- Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, the Netherlands; Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - O Nigro
- Medical Oncology, ASST-Sette Laghi, Varese, Italy
| | - E D'Argento
- Comprehensive Cancer Center, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy
| | - S Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - G Minuti
- Department of Oncology and Hematology, AUSL Romagna, Ravenna, Italy
| | - L Landi
- Department of Oncology and Hematology, AUSL Romagna, Ravenna, Italy
| | - G Guaitoli
- Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - G Lo Russo
- Medical Oncology (B), Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy
| | - A De Toma
- Medical Oncology (B), Policlinico Umberto I, 'Sapienza' University of Rome, Rome, Italy
| | - C Donisi
- Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari, Italy
| | - A Friedlaender
- Oncology Department, University Hospital of Geneva, Geneva, Switzerland
| | - A De Giglio
- Division of Medical Oncology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - G Metro
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - G Porzio
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
| | - C Ficorella
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy; Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
| | - A Addeo
- Oncology Department, University Hospital of Geneva, Geneva, Switzerland
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Pizzutilo P, Catino A, Montrone M, Longo V, Ricci D, Pesola F, Marech I, Mastrandrea A, Petrillo P, Zacheo A, Varesano N, Lamorgese V, Bafunno D, Galetta D. P75.14 Gender-Related Safety and Outcome in Advanced NSCLC Patients Treated with Immune Checkpoint-Inhibitors. A Real-World Experience. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Catino A, Bafunno D, Cormio C, Romito F, Minoia C, Loseto G, Dellino M, Opinto G, Silvestris E, Guarini A, Giotta F, Latorre A, Montrone M, Pizzutilo P, Longo V, Mastrandrea A, Ricci D, Pesola F, Galetta D. FP06.04 Psychological Distress in Outpatients with Lymphoma, Lung and Breast Cancer during COVID-19 pandemic. J Thorac Oncol 2021. [PMCID: PMC7976877 DOI: 10.1016/j.jtho.2021.01.100] [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: 11/06/2022]
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Catino A, Perrotti P, Cassiano S, Montrone M, Longo V, Galetta D. [RET rearrangements in advanced lung cancer: a target to always look for.]. Recenti Prog Med 2021; 112:33e-36e. [PMID: 33624634 DOI: 10.1701/3559.35382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Introduction . RET rearrangements have been recently aroused growing interest, due to the availability of target therapies increasingly active and safe. The search for these oncogenic alterations in patients with advanced lung adenocarcinoma has become an integral part of the biomolecular tumoral assessment, in order to possibly provide a selective therapeutical option also for rare subgroups of patients, but belonging to lung cancer that is considered a "big killer", representing the most frequent cause of cancer-related death worldwide. Following to the introduction of modern biomolecular techniques, such as the comprehensive genome profiling (CGP), that has been added to the immunohistochemistry (IHC) and the "in situ fluorescent ibridation" (FISH), the availability of techniques based on genomic sequencing such as the next generation sequencing (NGS), achievable either on tumoral tissue or on plasma, has made it easier to identify oncogenic alterations that, although rare, are potentially treatable with molecularly targeted drugs. A complete molecular assessment should preferable be obtained at the first diagnosis, in order not to neglect the possibility of using target drugs if indicated, but it is possible and desiderable to complete or to re-determine the biomolecular profile also during the clinical course, due to the possibility of spontaneous or drug-induced resistance mechanisms that can modify the biomolecular tumoral characteristics; this reassessment is achievable both through tissutal rebiopsy and by plasma test, the so-called "liquid biopsy". Clinical case . In this report, we describe the case of a patient with advanced lung adenocarcinoma, pretreated with multiple chemo- and immuno-therapic lines of treatment; at baseline, the biomolecular profile was not complete, as well as during the clinical course through repeated re-biopsies. Conclusions . At the time of further disease progression, a liquid biopsy with NGS revealed the presence of a RET rearrangement. This clinical case underscores the importance of a complete biomolecolar assessment in order to identify target linked to effective and innovative treatment options; it is also highlighted the usefulness of the modern CGP techniques, applicable to tumoral tissue and plasma.
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Affiliation(s)
- Annamaria Catino
- SSD Oncologia Medica per la Patologia Toracica, IRCCS Istituto Tumori "Giovanni Paolo II", Bari
| | - Pia Perrotti
- SSD Oncologia Medica per la Patologia Toracica, IRCCS Istituto Tumori "Giovanni Paolo II", Bari
| | - Sandro Cassiano
- SSD Oncologia Medica per la Patologia Toracica, IRCCS Istituto Tumori "Giovanni Paolo II", Bari
| | - Michele Montrone
- SSD Oncologia Medica per la Patologia Toracica, IRCCS Istituto Tumori "Giovanni Paolo II", Bari
| | - Vito Longo
- SSD Oncologia Medica per la Patologia Toracica, IRCCS Istituto Tumori "Giovanni Paolo II", Bari
| | - Domenico Galetta
- SSD Oncologia Medica per la Patologia Toracica, IRCCS Istituto Tumori "Giovanni Paolo II", Bari
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28
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Cortellini A, De Giglio A, Cannita K, Cortinovis DL, Cornelissen R, Baldessari C, Giusti R, D'Argento E, Grossi F, Santoni M, Catino A, Berardi R, Sforza V, Rossi G, Antonuzzo L, Di Noia V, Signorelli D, Gelibter A, Occhipinti MA, Follador A, Rastelli F, Chiari R, Gravara LD, Inno A, De Tursi M, Di Marino P, Mansueto G, Zoratto F, Filetti M, Montrone M, Citarella F, Pensieri MV, Russano M, Cantini L, Nigro O, Leonetti A, Bordi P, Minuti G, Landi L, De Toma A, Donisi C, Ricciardi S, Migliorino MR, Napoli VM, Leone G, Metro G, Banna GL, Friedlaender A, Addeo A, Ficorella C, Porzio G. Smoking status during first-line immunotherapy and chemotherapy in NSCLC patients: A case-control matched analysis from a large multicenter study. Thorac Cancer 2021; 12:880-889. [PMID: 33527756 PMCID: PMC7952794 DOI: 10.1111/1759-7714.13852] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/11/2022] Open
Abstract
Background Improved outcome in tobacco smoking patients with non‐small cell lung cancer (NSCLC) following immunotherapy has previously been reported. However, little is known regarding this association during first‐line immunotherapy in patients with high PD‐L1 expression. In this study we compared clinical outcomes according to the smoking status of two large multicenter cohorts. Methods We compared clinical outcomes according to the smoking status (never smokers vs. current/former smokers) of two retrospective multicenter cohorts of metastatic NSCLC patients, treated with first‐line pembrolizumab and platinum‐based chemotherapy. Results A total of 962 NSCLC patients with PD‐L1 expression ≥50% who received first‐line pembrolizumab and 462 NSCLC patients who received first‐line platinum‐based chemotherapy were included in the study. Never smokers were confirmed to have a significantly higher risk of disease progression (hazard ratio [HR] = 1.49 [95% CI: 1.15–1.92], p = 0.0022) and death (HR = 1.38 [95% CI: 1.02–1.87], p = 0.0348) within the pembrolizumab cohort. On the contrary, a nonsignificant trend towards a reduced risk of disease progression (HR = 0.74 [95% CI: 0.52–1.05], p = 0.1003) and death (HR = 0.67 [95% CI: 0.45–1.01], p = 0.0593) were reported for never smokers within the chemotherapy cohort. After a random case–control matching, 424 patients from both cohorts were paired. Within the matched pembrolizumab cohort, never smokers had a significantly shorter progression‐free survival (PFS) (HR = 1.68 [95% CI: 1.17–2.40], p = 0.0045) and a nonsignificant trend towards a shortened overall survival (OS) (HR = 1.32 [95% CI: 0.84–2.07], p = 0.2205). On the contrary, never smokers had a significantly longer PFS (HR = 0.68 [95% CI: 0.49–0.95], p = 0.0255) and OS (HR = 0.66 [95% CI: 0.45–0.97], p = 0,0356) compared to current/former smoker patients within the matched chemotherapy cohort. On pooled multivariable analysis, the interaction term between smoking status and treatment modality was concordantly statistically significant with respect to ORR (p = 0.0074), PFS (p = 0.0001) and OS (p = 0.0020), confirming the significantly different impact of smoking status across the two cohorts. Conclusions Among metastatic NSCLC patients with PD‐L1 expression ≥50% receiving first‐line pembrolizumab, current/former smokers experienced improved PFS and OS. On the contrary, worse outcomes were reported among current/former smokers receiving first‐line chemotherapy.
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Affiliation(s)
- Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea De Giglio
- Division of Medical Oncology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Katia Cannita
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
| | | | - Robin Cornelissen
- Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cinzia Baldessari
- Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | | | - Ettore D'Argento
- Comprehensive Cancer Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Francesco Grossi
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Annamaria Catino
- Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Rossana Berardi
- Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Vincenzo Sforza
- Thoracic Medical Oncology, Istituto Nazionale Tumori 'Fondazione G Pascale', IRCCS, Naples, Italy
| | - Giovanni Rossi
- Lung Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lorenzo Antonuzzo
- Department of Oncology, Careggi University Hospital, Florence, Italy
| | - Vincenzo Di Noia
- Unità di Oncologia medica e Terapia Biomolecolare, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Foggia, Foggia, Italy
| | - Diego Signorelli
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alain Gelibter
- Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | | | - Alessandro Follador
- Department of Oncology, University Hospital Santa Maria Della Misericordia, Udine, Italy
| | | | - Rita Chiari
- Medical Oncology, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta", Monselice, Italy
| | | | - Alessandro Inno
- Oncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Michele De Tursi
- Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | | | | | | | | | - Michele Montrone
- Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | - Maria Vittoria Pensieri
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Marco Russano
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Luca Cantini
- Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, The Netherlands.,Oncology Clinic, Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Olga Nigro
- Medical Oncology, ASST-Sette Laghi, Varese, Italy
| | | | - Paola Bordi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Gabriele Minuti
- Department of Oncology and Hematology, AUSL Romagna, Ravenna, Italy
| | - Lorenza Landi
- Division of Medical Oncology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Alessandro De Toma
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Clelia Donisi
- Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari, Italy
| | - Serena Ricciardi
- Pneumo-Oncology Unit, St. Camillo-Forlanini Hospital, Rome, Italy
| | | | - Valerio Maria Napoli
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Italy
| | - Giulio Metro
- Department of Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Giuseppe L Banna
- Oncology Department, Queen Alexandra University Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Alex Friedlaender
- Oncology Department, University Hospital of Geneva, Geneva, Switzerland
| | - Alfredo Addeo
- Oncology Department, University Hospital of Geneva, Geneva, Switzerland
| | - Corrado Ficorella
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.,Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
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29
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Montrone M, Longo V, Catino A, Pizzutilo P, Galetta D. [Efficacy of pralsetinib in a patient with advanced lung adenocarcinoma positive for RET rearrangement: the importance of Comprehensive Genomic Profiling.]. Recenti Prog Med 2021; 112:10e-13e. [PMID: 33512367 DOI: 10.1701/3525.35132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Modern gene profiling techniques have allowed in recent years considerable progresses in the knowledge of molecular alterations in the context of non-small cell lung cancer (NSCLC). In some cases, these alterations have been recognized as having a pathogenic role and targeted therapies capable of inhibiting tumor proliferation by selective and specific blocking of the enzymatic activity of the related abnormal proteins have been developed. This has made it possible to improve the effectiveness of the treatments by minimizing toxicity. Today it is essential to apply Comprehensive Genomic Profiling methods also in clinical practice, in order to allow the best treatment available for each patient, possibly also in the context of clinical trials. Below we report the clinical history of a patient with advanced stage adenocarcinoma of the lung with molecular diagnosis of RET fusion, treated with pralsetinib with excellent clinical and radiological response and good tolerability. This clinical case emphasizes the importance of the broader molecular profiling in patients with advanced NSCLC (especially for non-squamous histology) from the diagnosis before starting first-line treatment.
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Affiliation(s)
- Michele Montrone
- IRCCS Istituto Tumori Giovanni Paolo II, SSD Oncologia Medica per la Patologia Toracica, Bari
| | - Vito Longo
- IRCCS Istituto Tumori Giovanni Paolo II, SSD Oncologia Medica per la Patologia Toracica, Bari
| | - Annamaria Catino
- IRCCS Istituto Tumori Giovanni Paolo II, SSD Oncologia Medica per la Patologia Toracica, Bari
| | - Pamela Pizzutilo
- IRCCS Istituto Tumori Giovanni Paolo II, SSD Oncologia Medica per la Patologia Toracica, Bari
| | - Domenico Galetta
- IRCCS Istituto Tumori Giovanni Paolo II, SSD Oncologia Medica per la Patologia Toracica, Bari
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30
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Gazzin S, Dal Ben M, Montrone M, Jayanti S, Lorenzon A, Bramante A, Bottin C, Moretti R, Tiribelli C. Curcumin Prevents Cerebellar Hypoplasia and Restores the Behavior in Hyperbilirubinemic Gunn Rat by a Pleiotropic Effect on the Molecular Effectors of Brain Damage. Int J Mol Sci 2020; 22:ijms22010299. [PMID: 33396688 PMCID: PMC7795686 DOI: 10.3390/ijms22010299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 01/08/2023] Open
Abstract
Bilirubin toxicity to the central nervous system (CNS) is responsible for severe and permanent neurologic damage, resulting in hearing loss, cognitive, and movement impairment. Timely and effective management of severe neonatal hyperbilirubinemia by phototherapy or exchange transfusion is crucial for avoiding permanent neurological consequences, but these therapies are not always possible, particularly in low-income countries. To explore alternative options, we investigated a pharmaceutical approach focused on protecting the CNS from pigment toxicity, independently from serum bilirubin level. To this goal, we tested the ability of curcumin, a nutraceutical already used with relevant results in animal models as well as in clinics in other diseases, in the Gunn rat, the spontaneous model of neonatal hyperbilirubinemia. Curcumin treatment fully abolished the landmark cerebellar hypoplasia of Gunn rat, restoring the histological features, and reverting the behavioral abnormalities present in the hyperbilirubinemic rat. The protection was mediated by a multi-target action on the main bilirubin-induced pathological mechanism ongoing CNS damage (inflammation, redox imbalance, and glutamate neurotoxicity). If confirmed by independent studies, the result suggests the potential of curcumin as an alternative/complementary approach to bilirubin-induced brain damage in the clinical scenario.
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Affiliation(s)
- Silvia Gazzin
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
- Correspondence:
| | - Matteo Dal Ben
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
| | - Michele Montrone
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
| | - Sri Jayanti
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
| | - Andrea Lorenzon
- SPF Animal Facility, CBM Scarl, Bldg. Q2, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (A.L.); (A.B.)
| | - Alessandra Bramante
- SPF Animal Facility, CBM Scarl, Bldg. Q2, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (A.L.); (A.B.)
| | - Cristina Bottin
- Department of Medical Sciences, Ospedale di Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Rita Moretti
- Neurology Clinic, Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Claudio Tiribelli
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (M.D.B.); (M.M.); (S.J.); (C.T.)
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Montrone M, Catino A, Palmieri VO, Longo V, Galetta D. Favourable outcome of coronavirus disease 2019 in a patient with anaplastic lymphoma kinase-positive non-small-cell lung cancer receiving alectinib. Eur J Cancer 2020; 138:109-112. [PMID: 32871524 PMCID: PMC7418649 DOI: 10.1016/j.ejca.2020.07.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/11/2020] [Accepted: 07/26/2020] [Indexed: 01/11/2023]
Affiliation(s)
- Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
| | - Annamaria Catino
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Vincenzo O Palmieri
- Division of Internal Medicine, Clinica Medica "Augusto Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Vito Longo
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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Prelaj A, Lo Russo G, Proto C, Signorelli D, Ferrara R, Galli G, De Toma A, Randon G, Pagani F, Trevisan B, Ganzinelli M, Zilembo N, Montrone M, Longo V, Pesola F, Pizzutilo P, Del Bene G, Varesano N, Galetta D, Torri V, Garassino MC, Di Maio M, Catino A. DiM: Prognostic Score for Second- or Further-line Immunotherapy in Advanced Non–Small-Cell Lung Cancer: An External Validation. Clin Lung Cancer 2020; 21:e337-e348. [DOI: 10.1016/j.cllc.2020.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 12/21/2019] [Accepted: 01/20/2020] [Indexed: 11/16/2022]
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Brascia D, De Iaco G, Schiavone M, Panza T, Signore F, Geronimo A, Sampietro D, Montrone M, Galetta D, Marulli G. Resectable IIIA-N2 Non-Small-Cell Lung Cancer (NSCLC): In Search for the Proper Treatment. Cancers (Basel) 2020; 12:cancers12082050. [PMID: 32722386 PMCID: PMC7465235 DOI: 10.3390/cancers12082050] [Citation(s) in RCA: 8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 12/25/2022] Open
Abstract
Locally advanced non-small cell lung cancer accounts for one third of non-small cell lung cancer (NSCLC) at the time of initial diagnosis and presents with a wide range of clinical and pathological heterogeneity. To date, the combined multimodality approach involving both local and systemic control is the gold standard for these patients, since occult distant micrometastatic disease should always be suspected. With the rapid increase in treatment options, the need for an interdisciplinary discussion involving oncologists, surgeons, radiation oncologists and radiologists has become essential. Surgery should be recommended to patients with non-bulky, discrete, or single-level N2 involvement and be included in the multimodality treatment. Resectable stage IIIA patients have been the subject of a number of clinical trials and retrospective analysis, discussing the efficiency and survival benefits on patients treated with the available therapeutic approaches. However, most of them have some limitations due to their retrospective nature, lack of exact pretreatment staging, and the involvement of heterogeneous populations leading to the awareness that each patient should undergo a tailored therapy in light of the nature of his tumor, its extension and his performance status.
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Affiliation(s)
- Debora Brascia
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70121 Bari, Italy; (D.B.); (G.D.I.); (M.S.); (T.P.); (F.S.); (A.G.); (D.S.)
| | - Giulia De Iaco
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70121 Bari, Italy; (D.B.); (G.D.I.); (M.S.); (T.P.); (F.S.); (A.G.); (D.S.)
| | - Marcella Schiavone
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70121 Bari, Italy; (D.B.); (G.D.I.); (M.S.); (T.P.); (F.S.); (A.G.); (D.S.)
| | - Teodora Panza
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70121 Bari, Italy; (D.B.); (G.D.I.); (M.S.); (T.P.); (F.S.); (A.G.); (D.S.)
| | - Francesca Signore
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70121 Bari, Italy; (D.B.); (G.D.I.); (M.S.); (T.P.); (F.S.); (A.G.); (D.S.)
| | - Alessandro Geronimo
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70121 Bari, Italy; (D.B.); (G.D.I.); (M.S.); (T.P.); (F.S.); (A.G.); (D.S.)
| | - Doroty Sampietro
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70121 Bari, Italy; (D.B.); (G.D.I.); (M.S.); (T.P.); (F.S.); (A.G.); (D.S.)
| | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70121 Bari, Italy; (M.M.); (D.G.)
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70121 Bari, Italy; (M.M.); (D.G.)
| | - Giuseppe Marulli
- Thoracic Surgery Unit, Department of Organ Transplantation and Emergency, University Hospital of Bari, 70121 Bari, Italy; (D.B.); (G.D.I.); (M.S.); (T.P.); (F.S.); (A.G.); (D.S.)
- Correspondence: or
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Longo V, Catino AM, Montrone M, Pesola F, Pizzutilo P, Delbene G, Gatti P, Ferrante A, Galetta D. Development of Complex Renal Cysts during Crizotinib Treatment and Also during Alectinib Treatment: A Possible Drug Class Effect? J Thorac Oncol 2020; 14:e170-e172. [PMID: 31345340 DOI: 10.1016/j.jtho.2019.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Vito Longo
- Medical Thoracic Oncology Unit, Scientific Research and Treatment Institute Giovanni Paolo II, Bari, Italy.
| | - Anna Maria Catino
- Medical Thoracic Oncology Unit, Scientific Research and Treatment Institute Giovanni Paolo II, Bari, Italy
| | - Michele Montrone
- Medical Thoracic Oncology Unit, Scientific Research and Treatment Institute Giovanni Paolo II, Bari, Italy
| | - Francesco Pesola
- Medical Thoracic Oncology Unit, Scientific Research and Treatment Institute Giovanni Paolo II, Bari, Italy
| | - Pamela Pizzutilo
- Medical Thoracic Oncology Unit, Scientific Research and Treatment Institute Giovanni Paolo II, Bari, Italy
| | - Gabriela Delbene
- Medical Thoracic Oncology Unit, Scientific Research and Treatment Institute Giovanni Paolo II, Bari, Italy
| | - Pietro Gatti
- Department of Internal Medicine, Perrino Hospital, Brindisi, Italy
| | - Annunziata Ferrante
- Department of Radiology, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
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Bafunno D, Catino A, Lamorgese V, Del Bene G, Longo V, Montrone M, Pesola F, Pizzutilo P, Cassiano S, Mastrandrea A, Ricci D, Petrillo P, Varesano N, Zacheo A, Galetta D. Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: a systematic review. J Thorac Dis 2020; 12:3844-3856. [PMID: 32802466 PMCID: PMC7399441 DOI: 10.21037/jtd.2020.02.23] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article investigates the effects of tobacco control policies on smoking initiation, cessation and prevalence by examining the papers published in the last 5 years. Twenty-one articles have been selected by two authors and sorted by four types of tobacco control: tobacco prices, anti-smoking campaigns for young people, mass media intervention and public smoking bans. Price/tax increase has deterrent effect on smoking initiation but does not promote smoking cessation; intervention on young people could reduce the smoking initiation if carried out at an early age and if acted on social skills and with peer-led approach, as opposed to restraining measures which hare generally easily circumvented by young people. The mass media campaigns showed positive effect on attempts to quit among smokers if carried forward over time and by involving multiple communication channels (TV, internet, radio). The bans in public have little effect on smoking cessation but could improve the overall well-being of non-smokers. Heterogeneous results have been described by different studies probably because of different research methodologies, cultural aspects and the really effective implementation of the rules for each country. In conclusion, comprehensive tobacco control interventions to reduce smoking prevalence and modify the smoking behavior are recommended. Moreover, the use of e-cigarettes and heat-not-burn (HnB) products, as possible helping tool for smoke cessation, currently remains controversial.
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Affiliation(s)
- Daniela Bafunno
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Annamaria Catino
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Vito Lamorgese
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Gabriella Del Bene
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Vito Longo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Michele Montrone
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Francesco Pesola
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Pamela Pizzutilo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Sandro Cassiano
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | - Donata Ricci
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Patrizia Petrillo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Niccolò Varesano
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Antonella Zacheo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Domenico Galetta
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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Longo V, Catino A, Montrone M, Pizzutilo P, Ugenti I, Lacalamita R, Del Bene G, Pesola F, Marech I, Galetta D. Esophageal Stricture Caused by ALK-Positive NSCLC Esophageal Metastasis Resolved After a Few Days of Lorlatinib Therapy Without Stent Placement. JTO Clin Res Rep 2020; 1:100044. [PMID: 34589934 PMCID: PMC8474242 DOI: 10.1016/j.jtocrr.2020.100044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Vito Longo
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
- Corresponding author. Address for correspondence: Vito Longo, MD, PhD, Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Viale Orazio Flacco 65, Bari 70124, Italy.
| | - Annamaria Catino
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | - Michele Montrone
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | - Pamela Pizzutilo
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | - Ippazio Ugenti
- Digestive Endoscopy Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | - Rosanna Lacalamita
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | - Gabriella Del Bene
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | - Francesco Pesola
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | - Ilaria Marech
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II,” Bari, Italy
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Prelaj A, Rebuzzi SE, Pizzutilo P, Bilancia M, Montrone M, Pesola F, Longo V, Del Bene G, Lapadula V, Cassano F, Petrillo P, Bafunno D, Varesano N, Lamorgese V, Mastrandrea A, Ricci D, Catino A, Galetta D. EPSILoN: A Prognostic Score Using Clinical and Blood Biomarkers in Advanced Non-Small-cell Lung Cancer Treated With Immunotherapy. Clin Lung Cancer 2020; 21:365-377.e5. [PMID: 32245624 DOI: 10.1016/j.cllc.2019.11.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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: 04/08/2019] [Revised: 07/14/2019] [Accepted: 11/24/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Second-line immunotherapy (IO) has shown an overall survival benefit. However, only 18% to 20% of patients with advanced non-small-cell lung cancer (aNSCLC) will respond, with a median progression-free survival (PFS) of 2 to 4 months. Thus, biomarkers to select those patients most likely to benefit from IO are greatly needed. PATIENTS AND METHODS We conducted a retrospective analysis of 154 patients with aNSCLC who had received anti-programmed cell death 1 therapy as second line or further treatment. We assessed the absolute neutrophil, lymphocyte, monocyte, and eosinophil counts at baseline (T0) and the second (T1) and third (T2) cycles. The neutrophil/lymphocyte ratio (NLR), derived-NLR (dNLR), lymphocyte/monocyte ratio (LMR), and their percentage of change at T1 and T2 compared with T0 were evaluated. The clinical characteristics and lactate dehydrogenase (LDH) level were also considered. Univariate and multivariate analyses were performed. Significant biomarkers for PFS on multivariate analysis were combined in a prognostic score. RESULTS For overall survival, the negative prognostic biomarkers were Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2, NLR at T0, and dNLR at T1; the LMR at T0, T1, and T2 was identified as a positive prognostic biomarker. For PFS, the negative prognostic biomarkers were ECOG PS 2, liver metastases, NLR at T0, dNLR at T1 and T2, and ≥ 30% increase of NLR from T0 to T1; the positive prognostic biomarkers were heavy smoking, LDH, and LMR at T2. The ≥ 30% increase of LMR from T0 to T1 and T0 to T2 correlated with the overall response rate. A prognostic score (EPSILoN score; smoking, ECOG PS, liver metastases, LDH, NLR) identified 3 prognostic groups (median PFS, 10.2, 4.9, and 1.7 months, respectively; P < .001). CONCLUSIONS The EPSILoN score combines 5 baseline clinical and blood biomarkers and can help to identify patients with aNSCLC who will most likely benefit from second-line IO. Further studies are warranted.
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Affiliation(s)
- Arsela Prelaj
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy; Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | | | - Pamela Pizzutilo
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Massimo Bilancia
- Ionic Department in Legal and Economic System of Mediterranean: Society, Environment, and Culture, University of Bari Aldo Moro, Taranto, Italy
| | - Michele Montrone
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Francesco Pesola
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Vito Longo
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Gabriella Del Bene
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Vittoria Lapadula
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Flavio Cassano
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Patrizia Petrillo
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Daniela Bafunno
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Niccolò Varesano
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Vito Lamorgese
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Angelica Mastrandrea
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Donatella Ricci
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Annamaria Catino
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | - Domenico Galetta
- Medical Thoracic Oncology Unit, Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
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De Summa S, Petriella D, Lacalamita R, Galetta D, Montrone M, Catino A, Pizzutilo P, Botticella M, Zito F, Zambetti M, Zonno A, Pinto R, Tommasi S. P1.04-58 Uncovering the Tumor Microenvironment of KRAS-Driven Lung Adenocarcinoma: The Link Between Th17 Signaling and B Cell. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.961] [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: 10/25/2022]
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Catino A, De Gennaro G, Di Gilio A, Facchini L, Galetta D, Mongelli T, Palmisani J, Porcelli F, Varesano N, Pizzutilo P, Montrone M, Longo V, Del Bene G, Mastrandrea A, Pesola F, Ricci D, Petrillo P, Zacheo A. MA10.05 Breath Analysis: New Key-Challenges for Early Detection of Lung and Pleural Neoplasms. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.577] [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: 10/25/2022]
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Longo V, Catino A, Galetta D, Del Bene G, Lacalamita R, Montrone M, Pesola F, Petriella D, Pizzutilo P, Tommasi S. EP1.01-56 Co-Presentation of Adenocarcinoma and Squamous Cell Lung Carcinoma Harbouring ALK Rearrangement in Different Sites. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2028] [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: 10/25/2022]
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Prelaj A, Lo Russo G, Proto C, Signorelli D, Ferrara R, Galli G, De Toma A, Randon G, Zilembo N, Trevisan B, Montrone M, Longo V, Pesola F, Varesano N, Del Bene G, Pizzutilo P, Galetta D, Garassino MC, Di Maio M, Catino A. Prognostic score for second or further line immunotherapy in advanced non-small cell lung cancer (aNSCLC): An external validation. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14077] [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: 11/20/2022] Open
Abstract
e14077 Background: Beyond PD-L1, nowadays oncologists can only use clinical characteristics to candidate patients for immunotherapy (IO). Previously, a clinical prognostic score composed by ECOG performance status (PS), sex, histology, stage, uses of platin-based therapy at first-line (1L) and response to 1L categorized 3 different prognostic groups for patients treated with second-line (2L) chemotherapy (CHT) (Di Maio, EJC. 2010 Mar;46(4):735-43.). The aim of this study is to assess if the same score is able to discriminate the outcome of aNSCLC pts treated in 2L or further-line IO, potentially helping decision making. Methods: We recorded data of patients collected from two institutional databases: Istituto Nazionale Tumori of Milan and IRCCS Oncologico Giovanni Paolo II of Bari, Italy. Overall survival (OS) was the primary endpoint and also progression-free survival (PFS) was assessed. Prognostic score was generated, and pts were divided into 3 prognostic groups: best (B: < 5), intermediate (I:5-9), worst (W: > 9). Results: Overall, 347 pts were included in the analysis (193 from Milan and 154 from Bari). Median age was 66 years (y) (30 – 88y), most were < 70 y (67.5%), male (70.7%), smokers (79.5%) and adenocarcinoma (74.6%). ECOG PS was: 0 (23%), 1 (54.5%) and 2 (22.5%). Pts distribution was: 28%, 51% and 21% in the B, I and W groups, respectively. Median OS was 18.0 months for B group, 8.5 months for I group (HR vs B 1.83, 95%CI 1.35 – 2.47, p < 0.001) and 2.6 months for W group (HR vs B 5.77, 95%CI 3.99 – 8.33, p < 0.001). Median PFS was 3.4 months for B group, 3.7 months for I group (HR vs B 1.35, 95% CI 1.03 – 1.77, p = 0.032) and 1.9 months for W group (HR vs B 2.51. 95% CI 1.80- 3.50, p < 0.001). Similar results were obtained stratifying the model by Institution. Conclusions: This clinical prognostic score, that was generated in patients treated with second-line chemotherapy, is able to highly predict outcomes of patients treated with IO. These results demonstrated that in pre-treated aNSCLC pts, the worst category has a dismal absolute life expectancy, and probably would not benefit from any active systemic therapy (independently if CHT or IO). Perhaps for these pts best supportive care could be the best choice.
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Affiliation(s)
- Arsela Prelaj
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Claudia Proto
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Roberto Ferrara
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy
| | - Giulia Galli
- Division of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Giovanni Randon
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | | | - Vito Longo
- Clinical Cancer Center Giovanni Paolo II, Bari, Italy
| | | | | | | | | | - Domenico Galetta
- Medical Oncology Department, Clinical Cancer Center Giovanni Paolo II, Bari, Italy
| | | | - Massimo Di Maio
- Medical Oncology, Mauriziano Hospital; Department of Oncology, University of Turin, Torino, Italy
| | - Annamaria Catino
- Medical Oncology Department, Clinical Cancer Center Giovanni Paolo II, Bari, Italy
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Prelaj A, Rebuzzi S, Pizzutilo P, Bilancia M, Montrone M, Pesola F, Longo V, Del Bene G, Lapadula V, Cassano F, Petrillo P, Bafunno D, Varesano N, Lamorgese V, Mastranrdea A, Ricci D, Catino A, Galetta D. Time-series of peripheral blood biomarkers as biomarkers for immunotherapy in advanced non-small cell lung cancer (aNSCLC) patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz067.004] [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: 11/12/2022] Open
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Prelaj A, Rebuzzi S, Pizzutilo P, Bilancia M, Montrone M, Pesola F, Longo V, Del Bene G, Lapadula V, Cassano F, Petrillo P, Bafunno D, Varesano N, Lamorgese V, Mastranrdea A, Ricci D, Catino A, Galetta D. Peripheral blood biomarkers as prognostic factors for immunotherapy in advanced non-small cell lung cancer (aNSCLC) patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.054] [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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Prelaj A, Rebuzzi S, Pizzutilo P, Montrone M, Pesola F, Longo V, Lapadula V, Cassano F, Petrillo P, Bafunno D, Varesano N, Lamorgese V, Mastrandrea A, Ricci D, Catino A, Domenico G. Predictive score using clinical and blood biomarkers in advanced non-small cell lung cancer (aNSCLC) patients treated with immunotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy493.005] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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Prelaj A, Pizzutilo P, Montrone M, Cassano F, Pesola F, Lapadula V, Petrillo P, Varesano N, Lamorgese V, Mastrandrea A, Ricci D, Catino A, Galetta D. P3.04-12 Prognostic and Predictive Role of Peripheral Blood Biomarkers in NSCLC Patients Treated with Checkpoint, a Single-Center Experience. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1719] [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: 10/28/2022]
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Finocchiaro CY, Rota A, Barbieri V, Bettini A, Bianco R, Borra G, Buffoni L, Bulotta A, Carta A, Cortinovis D, Costanzo R, Cusmai A, Danesi R, D’Argento E, Del Conte A, Franchina T, Gilli M, Gregorc V, Irtelli L, Landi L, Malorgio F, Mancuso G, Martelli O, Mazzanti P, Melotti B, Migliorino MR, Minotti V, Montrone M, Morabito A, Roca E, Romano G, Rossi A, Savio G, Tiseo M, Boscardini I, Piccolo L, Pilotto S, Malapelle U. Listening understanding and acting (lung): focus on communicational issue in thoracic oncology. Transl Cancer Res 2018; 8:S16-S22. [PMID: 35117061 PMCID: PMC8798889 DOI: 10.21037/tcr.2018.12.32] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 12/21/2018] [Indexed: 12/03/2022]
Abstract
Background In the field of oncological assistance, nowadays we have to deal with a complex scenario where patients got used to obtain a huge amount of information through internet or social media and to apply them in performing their health-related decisions. This landscape requires that clinicians become able to handle therapeutical approaches and adequate skills in communication tools to satisfy the current needs. Our project aimed to build a communication model based on clinical oncologists’ real experiences in order to find a simple way to share with patients all the innovative therapeutical opportunities today available in lung cancer. The final goal is to design a flexible and personalized model adaptable to clinician’s personal characteristics and to the specific patient he is facing. We applied both traditional educational tools and innovative techniques in order to make the results effective and applicable to support peer learning. Methods The first step consisted in a Board synthesized the definition of the diagnostic process, the identification of treatment strategies and any potential communication barrier clinicians may face dealing with patients. The second step consisted in teamwork including a theoretical part and a training part. In the third step we produce five training videos and video interviews regarding communication praxis and a “Small communication manual”. The last step consisted in the publication of the produced material on website and its diffusion through the social media. Results In medicine, the universal application of a single model of communication does not represent the optimal solution. By contrary, the availability of simple and practical suggestions to improve the communicative style could allow clinicians to abandon stereotyped formulas identically repurposed to all patients. The “from bottom to top” training, starting from real-life to take advantage of the clinician’s experience, give the clinicians the possibility to meditate about their own communicative style and to train in the context of a protected environment. Applying these rules, we design an effective communication model, based on healthcare humanization, which could represent a fundamental support for the patient in order to be gently driven by the clinician to the most appropriate therapeutical choice, balancing efficacy and quality of life. The relational training may improve the quality of clinician-patient communication and could be widespread to other clinicians through the media. Conclusions Considering the innovative therapeutical options available, particularly for lung cancer patients, and the increasing access of health-related information through internet or social media the clinician-patient communication has become crucial to support the achievement of the most appropriate therapeutical choice for the patient, facing the intricate illness experience. Building a shareable and easy-to-apply communication model represents a challenge aimed to help clinicians and including technology not as a threat, but as a positive tool.
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Affiliation(s)
| | | | - Vito Barbieri
- UO Oncologia Medica, AOU “Mater Domini”, Germaneto, Catanzaro, Italy
| | - Anna Bettini
- ASST Papa Giovanni XXIII, UO Oncologia, Bergamo, Italy
| | | | - Gloria Borra
- AOU Maggiore della Carità di Novara, Novara, Italy
| | - Lucio Buffoni
- AOU San Luigi Orbassano, Oncologia Medica, Torino, Italy
| | - Alessandra Bulotta
- Dipartimento di Oncologia Medica, IRCCS Ospedale Scientifico San Raffaele, Milano, Italy
| | - Annamaria Carta
- AOB Cagliari, UO Oncologia Medica, Ospedale Businco, Cagliari, Italy
| | - Diego Cortinovis
- Struttura Semplice Lung Unit, Ospedale San Gerardo, ASST Monza, Monza, Italy
| | - Raffaele Costanzo
- UO Complessa di Oncologia medica Toraco-Polmonare, Istituto Nazionale Tumori, Napoli, Italy
| | | | - Romano Danesi
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy
| | - Ettore D’Argento
- UOC di Oncologia Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Alessandro Del Conte
- IRCCS, Centro di Riferimento Oncologico, SOC Oncologia Medica e dei Tumori Immunocorrelati, Aviano (PN), Italy
| | - Tindara Franchina
- Dipartimento di Patologia Umana “G.Barresi”, Università degli studi di Messina, Messina, Italy
| | - Marina Gilli
- AORN dei Colli, UOSD DH PNL Oncologico, Napoli, Italy
| | - Vanesa Gregorc
- Dipartimento di Oncologia Medica, IRCCS Ospedale Scientifico San Raffaele, Milano, Italy
| | - Luciana Irtelli
- Clinica Oncologica, ASL Lanciano Vasto Chieti, Chieti, Italy
| | - Lorenza Landi
- Unità Operativa di Oncologia ed Ematologia, AUSL Romagna, Ravenna, Italy
| | | | | | - Olga Martelli
- AO Complesso Ospedaliero San Giovanni-Addolorata, Roma, Italy
| | - Paola Mazzanti
- UO Clinica Oncologica, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Barbara Melotti
- Oncologia Medica, Azienda Ospedaliera S.Orsola-Malpighi, Bologna, Italy
| | - Maria Rita Migliorino
- UOSD di Pneumologia Oncologica Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy
| | - Vincenzo Minotti
- Divisione Struttura Complessa Oncologia Medica, Ospedale S. Maria della Misericordia Perugia, Perugia, Italy
| | - Michele Montrone
- SSD Oncologia Medica per la Patologia Toracica, IRCCS Istituto Tumori “Giovanni Paolo II” di Bari, Bari, Italy
| | - Alessandro Morabito
- Struttura Complessa Oncologia Medica Toraco-Polmonare, Divisione di Oncologia Medica, Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy
| | - Elisa Roca
- Oncologia Medica, Spedali Civili di Brescia, Brescia, Italy
| | | | - Antonio Rossi
- Divisione di Oncologia Medica, Fondazione IRCCS Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Foggia, Italy
| | | | - Marcello Tiseo
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Parma, Italy
| | - Ivano Boscardini
- Docente di tecniche di comunicazione, CREMS Centro di Ricerca in Economia e Management in Sanità e nel Sociale, Università Cattaneo LIUC, Castellanza, VA, Italy
| | | | - Sara Pilotto
- Università degli Studi di Verona, UO Oncologia Medica, AOUI Verona, Verona, Italy
| | - Umberto Malapelle
- Anatomia Patologica, Dip.to di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
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Galetta D, Cinieri S, Pisconti S, Gebbia V, Morabito A, Borsellino N, Maiello E, Febbraro A, Catino A, Rizzo P, Montrone M, Misino A, Logroscino A, Rizzi D, Di Maio M, Colucci G. Cisplatin/Pemetrexed Followed by Maintenance Pemetrexed Versus Carboplatin/Paclitaxel/Bevacizumab Followed by Maintenance Bevacizumab in Advanced Nonsquamous Lung Cancer: The GOIM (Gruppo Oncologico Italia Meridionale) ERACLE Phase III Randomized Trial. Clin Lung Cancer 2014; 16:262-73. [PMID: 25582493 DOI: 10.1016/j.cllc.2014.12.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 11/26/2014] [Accepted: 12/01/2014] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Cisplatin with pemetrexed (CP) and carboplatin with paclitaxel and bevacizumab (CbTB) are standard first-line treatments for patients with advanced nonsquamous (NS) non-small-cell lung cancer (NSCLC). Quality of life (QoL) is a key objective in the management of advanced NSCLC. Thus, effect on QoL could be an additional factor in the choice of treatment. PATIENTS AND METHODS Patients with untreated stage IIIB/IV NS-NSCLC and Eastern Cooperative Oncology Group performance status of 0 or 1 were randomized to receive first-line chemotherapy with cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2), every 3 weeks, for 6 cycles followed by maintenance pemetrexed; or carboplatin area under the curve 6, paclitaxel 200 mg/m(2), and bevacizumab 15 mg/kg, every 3 weeks, for 6 cycles followed by maintenance bevacizumab. The primary end point was the difference in QoL between the 2 treatment arms after 12 weeks of maintenance, measured using the EuroQoL 5 Dimensions-Index (EQ5D-I) and EQ5D-visual analogue scale (EQ5D-VAS). RESULTS One hundred eighteen patients were randomized to CP (n = 60) or CbTB (n = 58). Baseline characteristics were well balanced. The proportion of patients evaluable for the primary end point was lower than planned. After 12 weeks of maintenance, the difference between mean changes in EQ5D-I was 0.137, favoring CP (95% confidence interval [CI], -0.02 to 0.29, Wilcoxon P = .078), although not statistically significant; and the difference between mean changes in EQ5D-VAS was 0.97 (95% CI, -9.37 to 11.31, Wilcoxon P = .41). CONCLUSION Although the study was underpowered because of a small number of patients evaluable for the primary end point, QoL did not differ between treatment arms. Other factors such as comorbidities and schedule should be used when deciding on first-line treatment.
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Affiliation(s)
- Domenico Galetta
- Medical Oncology Unit, National Cancer Research Center "Giovanni Paolo II", Bari, Italy.
| | - Saverio Cinieri
- Medical Oncology Department and Breast Unit - "Sen. Perrino" Hospital Strada Statale 7 per Mesagne, Brindisi, Italy
| | | | - Vittorio Gebbia
- Medical Oncology Division, "La Maddalena" Hospital, Palermo, Italy
| | - Alessandro Morabito
- Thoraco-Pulmonary Medical Oncology, National Cancer Institute "Fondazione G. Pascale" - IRCCS, Napoli, Italy
| | | | - Evaristo Maiello
- Medical Oncology Division, "Casa Sollievo della Sofferenza" Hospital, Foggia, Italy
| | - Antonio Febbraro
- Medical Oncology Division, "Fatebenefratelli" Hospital, Benevento, Italy
| | - Annamaria Catino
- Medical Oncology Unit, National Cancer Research Center "Giovanni Paolo II", Bari, Italy
| | - Pietro Rizzo
- Medical Oncology Department and Breast Unit - "Sen. Perrino" Hospital Strada Statale 7 per Mesagne, Brindisi, Italy
| | - Michele Montrone
- Medical Oncology Division, "S.G. Moscati" Hospital, Taranto, Italy
| | - Andrea Misino
- Medical Oncology Unit, National Cancer Research Center "Giovanni Paolo II", Bari, Italy
| | - Antonio Logroscino
- Medical Oncology Unit, National Cancer Research Center "Giovanni Paolo II", Bari, Italy
| | - Daniele Rizzi
- Gruppo Oncologico Italia Meridionale (GOIM), Bari, Italy
| | - Massimo Di Maio
- Clinical Trials Unit, National Cancer Institute "Fondazione G. Pascale" - IRCCS, Napoli, Italy
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Nacci A, Lotesoriere C, Montrone M, Pisconti S, Orlando L, Fedele P, Rizzo P, Calvani N, Mazzoni E, Cinefra M, Marino A, Sponziello F, Cinieri S. Maintenance chemotherapy with pemetrexed in epiteliomorfe malignant pleural mesothelioma. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e18545] [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: 11/20/2022] Open
Abstract
e18545 Background: Maintenance chemotherapy with pemetrexed is not the standard treatment of choice in patients with locally advanced or metastatic epiteliomorfe malignant pleural mesothelioma (EMPM). We would assess the safety and efficacy of a treatment with pemetrexed until progression disease after 4 or 6 cycles of induction therapy with or without platin. Methods: From July 2008 to September 2012, 21 patients (18 males and 3 females with a median age of 67 years range 58-84) with locally advanced or metastatic epiteliomorfe malignant pleural mesothelioma (EMPM) were enrolled. In all patients histology was epiteliomorfe malignant mesothelioma. Only 15 patients (71,4%) had a PS 0 whereas 6 (28,6%) had a PS 1. All patients received an induction therapy with or without platin. Each patient received an average of 5,6 cycles of induction chemotherapy. Then all patients received a maintenance chemotherapy with pemetrexed 500 mg/mq intavenously over 10 minutes every 3 weeks. Each patient received an average of 7,3 cycles of maintenance chemotherapy. All patients received folic acid and vitamin B12 supplementation to improve safety. Results: At the time of analysis all patients were evaluable for response. Fourteen patients (66,6 %) had a partial response and two of these underwent surgery and obtained a complete response. Six patients (28,5%) had a stable disease. The median overall survival was 13 months, while median progression-free survival was 11 months. Grade 2-3 of WHO haematological toxicities (anemia and neutropenia) occurred in 4 patient (19%). We also observed grade 2-3 of WHO gastrointestinal toxicities (diarrhea, nausea and vomiting) in 2 patient (9.5%). Grade 2 of lack of appetite and asthenia occurred in 3 patients (14.3%). Conclusions: Our data show that a maintenance chemotherapy with pemetrexed in EMPM resulted in a moderate overall survival (13 months). These results indicate that patients with EMPM could benefit from a maintenance treatment with pemetrexed.
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Galetta D, Pisconti S, Cinieri S, Gebbia V, Morabito A, Borsellino N, Maiello E, Febbraro A, Catino A, Rizzo P, Montrone M, Simone G, Lorusso V, Rizzi D, Pappagallo GL, Colucci G. First-line pemetrexed plus cisplatin followed by maintenance pemetrexed versus carboplatin-paclitaxel plus bevacizumab followed by maintenance bevacizumab (ERACLE) in advanced nonsquamous NSCLC: A quality-of-life-oriented, multicenter randomized phase III trial of the GOIM (Gruppo Oncologico Italia Meridionale). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.8071] [Citation(s) in RCA: 2] [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: 11/20/2022] Open
Abstract
8071 Background: In absence of oncogenic driver chemotherapy (CT) for advanced non-squamous non-small cell lung cancer (NS-NSCLC) remains palliative with similar efficacy and survival among different regimens. Histotype, maintenance therapy (m) and quality of life (QoL) have been explored to improve patients (pts) outcome. ERACLE trial (NCT01303926), a QoL-oriented phase III trial was designed to compare the QoL for two CT regimens. Methods: Pts with stage IIIB/IV NS-NSCLC (ECOG 0/1) were randomized (1:1) to receive first-line CT. ARM A received 6 cycles of Cisplatin (C) (75 mg/m2) - Pemetrexed (P) (500 mg/m2) q3w, followed by mP (500 mg/m2) while ARM B received Carboplatin (Cb) AUC 6 - Paclitaxel (T) 200 mg/m2plus Bevacizumab (Be) 15 mg/kg q3w for 6 cycles and mBe 15 mg/kg. Both treatments were administered until progression, unacceptable toxicity or death. Stratification was based on Study Centre and disease stage. Co-Primary endpoints were EQ5D Index (EQ5D-I) and EQ5D-VAS (Euro-QoL questionnaire) at 12 weeks during m. Secondary endpoints were QoL over time, activity and safety of CT arms. A sample of 49 pts per arm (not progressed during initial CT and during m therapy for at least 12 weeks) will have 91% chance to have 12-point Minimal Interesting Difference (MID) between arms for EQ5D-VAS, and 87% chance to find 0.137 MID between arms for EQ5D-I. It is assumed that about 20% of pts in both arms experienced a PD before to evaluate primary endpoint. The study sample was then increased to 118. Results: From 1/2011 to 3/2012, 118 pts were randomized to CP (n=60) or CbTBe (n=58). Baseline demographics were well balanced across arms; overall 74% male, 79% PS 0 and 94% stage IV. Treatment differences (mean change from baseline), EQ5D-VAS = 1.82 (95%CI -8.60 to 12.24; P=0.73), EQ5D-I = 0.15 (95%CI 0.01 to 0.29), favoured arm A. Conclusions: CP-mP showed better (over the MID) health profile (EQ5D-I) at 12 weeks as compared to CbBe-mBe. EQ5D-VAS didn’t find any significant difference between treatment arms. Clinical trial information: NCT01303926.
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Affiliation(s)
| | | | - Saverio Cinieri
- Medical Oncology & Breast Unit, Senatore Antonio Perrino Hospital, Brindisi, Italy
| | | | | | - Nicolo Borsellino
- Medical Oncology Unit - Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy
| | - Evaristo Maiello
- IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Annamaria Catino
- Medical Oncology Department National Cancer Research Centre Giovanni Paolo II, Bari, Italy
| | | | - Michele Montrone
- Medical Oncology Division San Giuseppe Moscati Hospital, Taranto, Italy
| | - Giovanni Simone
- National Cancer Research Center Giovanni Paolo II, Bari, Italy
| | | | - Daniele Rizzi
- Data Management “Giovanni Paolo II” Oncology Institute, Bari, Italy
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Lotesoriere C, Perrucci B, Montrone M, Bruno M, Russo F, Pisconti S. 7 A PATIENT WITH UNRESECTABLE ADVACED PANCREATIC CANCER ACHIEVING LONG-TERM SURVIVAL WITH GEMCITABINE-BASED CHEMOTHERAPY. Cancer Treat Rev 2010. [DOI: 10.1016/s0305-7372(10)70033-5] [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: 11/24/2022]
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