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Leone AG, Miceli R, Trapani D, Massagrande M, Morano F, Marsoni S, La Verde N, Berardi R, Casolino R, Lambertini M, Dalu D, Di Maio M, Beretta GD, Perrone F, Cinieri S, Pietrantonio F. Cancer care in transgender and gender-diverse persons: results from two national surveys among providers and health service users by the Italian Association of Medical Oncology. ESMO Open 2023; 8:101578. [PMID: 37270870 DOI: 10.1016/j.esmoop.2023.101578] [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: 02/25/2023] [Revised: 04/23/2023] [Accepted: 04/29/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Transgender and gender-diverse (TGD) population represents an underserved group across the cancer care continuum. To assess the perspective of both oncology health care providers (OHPs) and TGD individuals in Italy, we conducted two national surveys: one among 2407 OHPs about their attitudes, knowledge and behavior toward TGD patients, and one among TGD persons about their health needs, experiences and barriers encountered in the use of health services across the cancer continuum. MATERIALS AND METHODS The surveys were self-compiled web-based computer-aided web interview, conducted in Italy within the 'OncoGender-Promoting Inclusion in Oncology' project, led by the Italian national cancer society [Associazione Italiana di Oncologia Medica (AIOM)]-associated researchers. All members of AIOM were invited by e-mail to participate in the OHP survey. TGD persons were reached through advocacy groups and consumers' panel. The recruitment was completed on a voluntary basis. Survey data were collected and managed using an online platform managed by ELMA Research, an independent pharmaceutical marketing agency. RESULTS A total of 305 OHPs (13% of AIOM members) and 190 TGD individuals participated in the surveys. Only 19% of OHPs felt competent in providing care to TGD patients and 21% declared not to feel comfortable in treating TGD patients. Seventy-one percent of TGD persons reported that they had never joined any cancer screening program; 32% reported one or more acts of discrimination by health care providers. Seventy-two percent of OHPs recognized the lack of specific education on cancer care for TGD patients and deemed it necessary to receive adequate training. CONCLUSIONS A general lack of knowledge among OHPs about TGD health issues seems to be the main driver of difficulties in providing assistance and of discriminatory attitudes against TGD individuals. Ultimately, this whole issue generates access barriers and contributes to lack of trust in health care services. Educational interventions and an implementation of person-centric cancer policies are urgently needed.
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Affiliation(s)
- A G Leone
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Miceli
- Department of Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - D Trapani
- European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy; Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | | | - F Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Marsoni
- IFOM-The FIRC Institute of Molecular Oncology, Milan, Italy
| | - N La Verde
- Department of Oncology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - R Berardi
- Oncology Clinic, Università Politecnica delle Marche, AOU delle Marche, Ancona, Italy
| | - R Casolino
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - D Dalu
- Department of Oncology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M Di Maio
- Department of Oncology, University of Turin, A.O. Ordine Mauriziano, Turin, Italy
| | - G D Beretta
- UOC Oncologia Medica, ASL Pescara P.O., Pescara, Italy
| | - F Perrone
- Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - S Cinieri
- Medical Oncology Unit, Ospedale di Summa A. Perrino, Brindisi, Italy
| | - F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Chiappella A, Guidetti A, Dodero A, Bramanti S, Zinzani P, Santoro A, Casadei B, Di Rocco A, Carrabba M, Chiusolo P, Martino M, Barbui AM, Tisi MC, Miceli R, Carniti C, Corradini P. FIRST REPORT OF THE REAL‐LIFE PROSPECTIVE OBSERVATIONAL STUDY “CAR‐T CELL IN DIFFUSE LARGE B‐CELL AND PRIMARY MEDIASTINAL LYMPHOMAS” OF THE ITALIAN SOCIETY OF HEMATOLOGY. Hematol Oncol 2021. [DOI: 10.1002/hon.187_2880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- A. Chiappella
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - A. Guidetti
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - A. Dodero
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Hematology and Stem Cell Transplantation Milano Italy
| | - S. Bramanti
- Humanitas Clinical and Research Center IRCCS Hematology Rozzano Italy
| | - P. Zinzani
- University of Bologna Institute of Hematology "Seràgnoli" Bologna Italy
| | - A. Santoro
- Humanitas Clinical and Research Center IRCCS Hematology Rozzano Italy
| | - B. Casadei
- University of Bologna Institute of Hematology "Seràgnoli" Bologna Italy
| | - A. Di Rocco
- 'Sapienza' University of Rome Department of Translational and Precision Medicine Roma Italy
| | - M. Carrabba
- San Raffaele Hospital IRCCS Hematology and Bone Marrow Transplantation Unit Milano Italy
| | - P. Chiusolo
- Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Department of Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Hematology Section Department of Scienze Radiologiche ed Ematologiche Roma Italy
| | - M. Martino
- Grande Ospedale Metropolitano “Bianchi‐Melacrino‐Morelli” Stem Cell Transplant and Cellular Therapies Unit Reggio Calabria Italy
| | - A. M. Barbui
- Azienda Socio Sanitaria Territoriale (ASST), Ospedale Papa Giovanni XXIII Hematology Unit Bergamo Italy
| | - M. C. Tisi
- San Bortolo Hospital Cell Therapy and Hematology Vicenza Italy
| | - R. Miceli
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Unit of Clinical Epidemiology and Trial Organization Department of Applied Research and Technological Development Milano Italy
| | - C. Carniti
- Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy Laboratory of Hematology Division of Hematology and Stem Cell Transplantation Milano Italy
| | - P. Corradini
- Chair of Hematology University of Milano Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Division of Hematology and Stem Cell Transplantation Milano Italy
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Stacchiotti S, Miah AB, Frezza AM, Messiou C, Morosi C, Caraceni A, Antonescu CR, Bajpai J, Baldini E, Bauer S, Biagini R, Bielack S, Blay JY, Bonvalot S, Boukovinas I, Bovee JVMG, Boye K, Brodowicz T, Callegaro D, De Alava E, Deoras-Sutliff M, Dufresne A, Eriksson M, Errani C, Fedenko A, Ferraresi V, Ferrari A, Fletcher CDM, Garcia Del Muro X, Gelderblom H, Gladdy RA, Gouin F, Grignani G, Gutkovich J, Haas R, Hindi N, Hohenberger P, Huang P, Joensuu H, Jones RL, Jungels C, Kasper B, Kawai A, Le Cesne A, Le Grange F, Leithner A, Leonard H, Lopez Pousa A, Martin Broto J, Merimsky O, Merriam P, Miceli R, Mir O, Molinari M, Montemurro M, Oldani G, Palmerini E, Pantaleo MA, Patel S, Piperno-Neumann S, Raut CP, Ravi V, Razak ARA, Reichardt P, Rubin BP, Rutkowski P, Safwat AA, Sangalli C, Sapisochin G, Sbaraglia M, Scheipl S, Schöffski P, Strauss D, Strauss SJ, Sundby Hall K, Tap WD, Trama A, Tweddle A, van der Graaf WTA, Van De Sande MAJ, Van Houdt W, van Oortmerssen G, Wagner AJ, Wartenberg M, Wood J, Zaffaroni N, Zimmermann C, Casali PG, Dei Tos AP, Gronchi A. Epithelioid hemangioendothelioma, an ultra-rare cancer: a consensus paper from the community of experts. ESMO Open 2021; 6:100170. [PMID: 34090171 PMCID: PMC8182432 DOI: 10.1016/j.esmoop.2021.100170] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 12/22/2022] Open
Abstract
Epithelioid hemangioendothelioma (EHE) is an ultra-rare, translocated, vascular sarcoma. EHE clinical behavior is variable, ranging from that of a low-grade malignancy to that of a high-grade sarcoma and it is marked by a high propensity for systemic involvement. No active systemic agents are currently approved specifically for EHE, which is typically refractory to the antitumor drugs used in sarcomas. The degree of uncertainty in selecting the most appropriate therapy for EHE patients and the lack of guidelines on the clinical management of the disease make the adoption of new treatments inconsistent across the world, resulting in suboptimal outcomes for many EHE patients. To address the shortcoming, a global consensus meeting was organized in December 2020 under the umbrella of the European Society for Medical Oncology (ESMO) involving >80 experts from several disciplines from Europe, North America and Asia, together with a patient representative from the EHE Group, a global, disease-specific patient advocacy group, and Sarcoma Patient EuroNet (SPAEN). The meeting was aimed at defining, by consensus, evidence-based best practices for the optimal approach to primary and metastatic EHE. The consensus achieved during that meeting is the subject of the present publication. This consensus paper provides key recommendations on the management of epithelioid hemangioendothelioma (EHE). Recommendations followed a consensus meeting between experts and a representative of the EHE advocacy group and SPAEN. Authorship includes a multidisciplinary group of experts from different institutions from Europe, North America and Asia.
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Affiliation(s)
- S Stacchiotti
- Adult Mesenchymal Tumor and Rare Cancer Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - A B Miah
- The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - A M Frezza
- Adult Mesenchymal Tumor and Rare Cancer Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - C Messiou
- Department of Radiology, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - C Morosi
- Radiology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - A Caraceni
- Palliative Care Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - C R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - J Bajpai
- Medical Oncology Department, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - E Baldini
- Department of Radiation Oncology, Dana-Farber Cancer Center/Brigham and Women's Hospital, Boston, USA
| | - S Bauer
- Department of Medical Oncology, West German Cancer Center, Sarcoma Center, University of Duisburg-Essen, University Hospital, Essen, Germany
| | - R Biagini
- Orthopaedic Department, Regina Elena National Cancer Institute, Rome, Italy
| | - S Bielack
- Klinikum Stuttgart - Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart Cancer Center, Pädiatrische Onkologie, Hämatologie, Immunologie, Stuttgart, Germany
| | - J Y Blay
- Department of Medical Oncology, Centre Leon Berard, Université Claude Bernard Lyon, Unicancer, Lyon, France
| | - S Bonvalot
- Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | | | - J V M G Bovee
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - K Boye
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - T Brodowicz
- Medical University Vienna & General Hospital Department of Internal Medicine 1/Oncology, Vienna, Austria
| | - D Callegaro
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E De Alava
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain; Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, Seville, Spain
| | | | - A Dufresne
- Department of Medical Oncology, Centre Leon Berard, Université Claude Bernard Lyon, Unicancer, Lyon, France
| | - M Eriksson
- Department of Oncology, Skane University Hospital and Lund University, Lund, Sweden
| | - C Errani
- Orthopaedic Service, Musculoskeletal Oncology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Fedenko
- Medical Oncology Division, P.A. Herzen Cancer Research Institute, Moscow, Russian Federation
| | - V Ferraresi
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - A Ferrari
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - C D M Fletcher
- Department of Pathology Brigham & Women's Hospital, Boston, USA
| | - X Garcia Del Muro
- University of Barcelona and Genitourinary Cancer and Sarcoma Unit Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - R A Gladdy
- University of Toronto and Lunenfeld-Tanenbaum Research Institute, Toronto, Canada
| | - F Gouin
- Department of Surgery, Centre Leon Berard, Lyon, France
| | - G Grignani
- Division of Medical Oncology, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, Italy
| | - J Gutkovich
- The EHE Foundation, Wisconsin, USA; NUY Langone Medical Center, New York, USA
| | - R Haas
- Department of Radiotherapy, the Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Radiotherapy, the Leiden University Medical Center, Leiden, the Netherlands
| | - N Hindi
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla), Seville, Spain
| | - P Hohenberger
- Division of Surgical Oncology & Thoracic Surgery, Mannheim University Medical Center, University of Heidelberg, Heidelberg, Germany
| | - P Huang
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - H Joensuu
- Department of Oncology, Helsinki University Hospital & Helsinki University, Helsinki, Finland
| | - R L Jones
- Department of Cancer, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - C Jungels
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - B Kasper
- University of Heidelberg, Mannheim University Medical Center, Sarcoma Unit, Mannheim, Germany
| | - A Kawai
- Musculoskeletal Oncology and Rehabilitation Medicine, Rare Cancer Center National Cancer Center Hospital, Tokyo, Japan
| | - A Le Cesne
- International Department, Gustave Roussy, Villejuif, France
| | - F Le Grange
- UCLH - University College London Hospitals NHS Foundation Trust, London, UK
| | - A Leithner
- Department of Orthopaedics and Trauma Medical University Graz, Graz, Austria
| | - H Leonard
- Chair of Trustees of the EHE Rare Cancer Charity (UK), Charity number 1162472
| | - A Lopez Pousa
- Medical Oncology Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain
| | - J Martin Broto
- Hospital Universitario Fundación Jimenez Diaz, Madrid, Spain
| | - O Merimsky
- Unit of Soft Tissue and Bone Oncology, Division of Oncology, Tel-Aviv Medical Center affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - P Merriam
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - R Miceli
- Department of Clinical Epidemiology and Trial Organisation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - O Mir
- Sarcoma Group, Gustave Roussy, Villejuif, France
| | - M Molinari
- University of Pittsburgh Medical Center, Thomas Starzl Transplant Institute, Pittsburgh, USA
| | | | - G Oldani
- Division of Abdominal Surgery, University Hospitals of Geneva, Geneva, Switzerland
| | - E Palmerini
- Chemotherapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M A Pantaleo
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - S Patel
- Sarcoma Center, The University of Texas M.D. Anderson Cancer Center, Houston, USA
| | | | - C P Raut
- Department of Surgery, Brigham and Women's Hospital, Boston, USA; Center for Sarcoma and Bone Oncology, Harvard Medical School, Boston, USA; Dana Farber Cancer Center, Harvard Medical School, Boston, USA
| | - V Ravi
- Sarcoma Center, The University of Texas M.D. Anderson Cancer Center, Houston, USA
| | - A R A Razak
- Princess Margaret Cancer Centre and Sinai Healthcare System & Faculty of Medicine, University of Toronto, Toronto, Canada
| | - P Reichardt
- Helios Klinikum Berlin-Buch, Department of Oncology and Palliative Care, Berlin, Germany
| | - B P Rubin
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, USA
| | - P Rutkowski
- Maria Sklodowska-Curie National Research Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw, Poland
| | - A A Safwat
- Aarhus University Hospital, Aarhus, Denmark
| | - C Sangalli
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - G Sapisochin
- Multi-Organ Transplant and HPB Surgical Oncology, Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - M Sbaraglia
- Department of Pathology, Azienda Ospedaliera Università Padova, Padua, Italy
| | - S Scheipl
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | | | - D Strauss
- Department of Surgery, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - S J Strauss
- University College London Hospital, London, UK
| | - K Sundby Hall
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | - W D Tap
- Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - A Trama
- Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - A Tweddle
- Palliative Care, The Royal Marsden Hospital and The Institute of Cancer Research London
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M A J Van De Sande
- Department of Orthopedic Surgery Bone and Soft Tissue Tumor Unit, Leiden University Medical Center, Leiden, The Netherlands
| | - W Van Houdt
- Sarcoma and Melanoma Unit, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - G van Oortmerssen
- Co-Chair of Sarcoma Patients EuroNet (SPAEN), Woelfersheim, Germany & Chairman of the Dutch organisation for sarcoma patients (Patiëntenplatform Sarcomen), Guest researcher at Leiden University (Leiden Institute for Advanced Computer Science), Leiden University, Leiden, The Netherlands
| | - A J Wagner
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - M Wartenberg
- Chair of the Board of Directors of Sarcoma Patients EuroNet (SPAEN), Sarcoma Patients EuroNet (SPAEN), Woelfersheim, Germany
| | - J Wood
- The Royal Marsden NHS Foundation Trust, London, UK
| | - N Zaffaroni
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - C Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre and Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Canada
| | - P G Casali
- Adult Mesenchymal Tumor and Rare Cancer Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - A P Dei Tos
- Department of Pathology, Azienda Ospedaliera Università Padova, Padua, Italy
| | - A Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Di Cosimo S, Depretto C, Miceli R, Baili P, Sant M, Pruneri G, Vingiani A, Folli S, Bini M, De Santis M, Scaperrotta G. 64P Mammographic density to predict response to neoadjuvant chemotherapy for breast cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ortolan E, Appierto V, Silvestri M, Miceli R, Veneroni S, Folli S, Pruneri G, Vingiani A, Belfiore A, Cappelletti V, Vismara M, Dell'Angelo F, De Cecco L, Bianchi GV, de Braud FG, Daidone MG, Di Cosimo S. Blood-based genomics of triple-negative breast cancer progression in patients treated with neoadjuvant chemotherapy. ESMO Open 2021; 6:100086. [PMID: 33743331 PMCID: PMC8010400 DOI: 10.1016/j.esmoop.2021.100086] [Citation(s) in RCA: 30] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 12/19/2022] Open
Abstract
Background As neoadjuvant chemotherapy (NAC) is increasingly used in triple-negative breast cancer (TNBC), we investigated the value of circulating tumor DNA (ctDNA) for patient monitoring prior, during, and after NAC, and circulating tumor cells (CTCs) for disease characterization at clinical progression. Materials and methods Forty-two TNBC patients undergoing NAC were prospectively enrolled. Primary tumor mutations identified by targeted-gene sequencing were validated and tracked in 168 plasma samples longitudinally collected at multiple time-points by droplet digital polymerase chain reaction. At progression, plasma DNA underwent direct targeted-gene assay, and CTCs were collected and analyzed for copy number alterations (CNAs) by low-pass whole genome sequencing. Results ctDNA detection after NAC was associated with increased risk of relapse, with 2-year event-free survival estimates being 44.4% [95% confidence interval (CI) 21.4%-92.3%] versus 77.4% (95% CI 57.8%-100%). ctDNA prognostic value remained worthy even after adjusting for age, residual disease, systemic inflammatory indices, and Ki-67 [hazard ratio (HR) 1.91; 95% CI 0.51-7.08]. During follow-up, ctDNA was undetectable in non-recurrent cases with the unique exception of one showing a temporary peak over eight samples. Conversely, ctDNA was detected in 8/11 recurrent cases, and predated the clinical diagnosis up to 13 months. Notably, recurrent cases without ctDNA developed locoregional, contralateral, and bone-only disease. At clinical progression, CTCs presented chromosome 10 and 21q CNAs whose network analysis showed connected modules including HER/PI3K/Ras/JAK signaling and immune response. Conclusion ctDNA is not only associated with but is also predictive of prognosis in TNBC patients receiving NAC, and represents an exploitable tool, either alone or with CTCs, for personalized TNBC management. ctDNA was detected in 77% of early-stage TNBC patients undergoing neoadjuvant chemotherapy. Patients with still detectable ctDNA after NAC were more than twice as likely to relapse as those with undetectable levels. Detection of ctDNA during follow-up antedated clinical overt metastases up to 13 months. ctDNA was undetectable in all but one non-recurrent patient with a temporary peak in only 1 of 8 samples tested. CTCs of progressing cases lacked epithelial surface markers and showed therapeutically exploitable molecular features.
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Affiliation(s)
- E Ortolan
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Appierto
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Silvestri
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Miceli
- Clinical Epidemiology and Trial Organization Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Veneroni
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Folli
- Breast Cancer Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Pruneri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Vingiani
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Belfiore
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Cappelletti
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Vismara
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Dell'Angelo
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L De Cecco
- Integrated Biology Platform, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G V Bianchi
- Department of Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F G de Braud
- Department of Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M G Daidone
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - S Di Cosimo
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Frezza AM, Napolitano A, Miceli R, Badalamenti G, Brunello A, Buonomenna C, Casali PG, Caraceni A, Grignani G, Gronchi A, Infante G, Morosi C, Saita L, Simeone N, Zaffaroni N, Vincenzi B, Stacchiotti S. Clinical prognostic factors in advanced epithelioid haemangioendothelioma: a retrospective case series analysis within the Italian Rare Cancers Network. ESMO Open 2021; 6:100083. [PMID: 33714008 PMCID: PMC7957151 DOI: 10.1016/j.esmoop.2021.100083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/14/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/30/2022] Open
Abstract
Background This multicentric, retrospective study conducted within the Italian Rare Cancer Network describes clinical features and explores their possible prognostic relevance in patients with advanced epithelioid haemangioendothelioma (EHE) started on surveillance. Patients and methods We collected data on adult patients with molecularly confirmed, advanced EHE consecutively referred at five sarcoma reference centres between January 2010 and June 2018, with no evidence of progressive disease (PD) and started on surveillance. Overall survival (OS) and progression-free survival (PFS) univariable and multivariable Cox analyses were performed. In the latter, due to the low number of cases and events, penalized likelihood was applied, and variable selection was performed using a random forest model. Results Sixty-seven patients were included. With a median follow-up of 50.2 months, 51 (76%) patients developed PD and 16 (24%) remained stable. PD at treatment start did not meet RECIST version 1.1 in 15/51 (29%) patients. The 3-year PFS and OS were 25.4% and 71.1%, respectively, in the whole population. Tumour-related pain (TRP) was the most common baseline symptom (32.8%), followed by temperature (20.9%), fatigue (17.9%), and weight loss (16.4%). Baseline TRP (P = 0.0002), development of TRP during follow-up (P = 0.005), baseline temperature (P = 0.002), and development of fatigue during follow-up (P = 0.007) were associated with a significantly worst PFS. An association between baseline TRP (P < 0.0001), development of TRP during follow-up (P = 0.0009), evidence of baseline serosal effusion (P = 0.121), and OS was recorded. Conclusion Because of the poor outcome observed in EHE patients presenting with serosal effusion, TRP, temperature, or serosal effusion, upfront treatment in this subgroup could be considered. Prognosis prediction in advanced EHE at presentation remains a challenge. This study explores the prognostic value of clinical and radiological features in advanced EHE patients on surveillance. Given their prognostic impact, symptoms and serosal effusion in EHE patients on surveillance should be regularly checked. In advanced EHE patients presenting with pain, temperature, or serosal effusion, upfront treatment could be considered.
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Affiliation(s)
- A M Frezza
- Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy.
| | - A Napolitano
- Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - R Miceli
- Department of Clinical Epidemiology and Trial Organisation, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - G Badalamenti
- Medical Oncology, Policlinico Paolo Giaccone, Palermo, Italy
| | - A Brunello
- Department of Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology, IRCCS, Padua, Italy
| | - C Buonomenna
- Department of Radiology, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - P G Casali
- Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A Caraceni
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - G Grignani
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - A Gronchi
- Department of Surgery, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - G Infante
- Department of Clinical Epidemiology and Trial Organisation, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - C Morosi
- Department of Radiology, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - L Saita
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - N Simeone
- Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - N Zaffaroni
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS - Istituto Nazionale Tumori, Milan, Italy
| | - B Vincenzi
- Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - S Stacchiotti
- Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
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7
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Mennitto A, Verzoni E, Cognetti F, Miceli R, Milella M, Mosca A, Chiuri VE, Bearz A, Morelli F, Ortega C, Atzori F, Donini M, Claps M, Guadalupi V, Sepe P, Cappelletti V, de Braud FG, Procopio G. Radical metastasectomy followed by sorafenib versus observation in patients withclear cell renal cell carcinoma: extended follow -up of efficacy results from the randomized phase II RESORT trial. Expert Rev Clin Pharmacol 2021; 14:261-268. [PMID: 33472450 DOI: 10.1080/17512433.2021.1879639] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The RESORT trial showed no longer relapse free survival (RFS) with sorafenib following radical metastasectomy in metastatic renal cell carcinoma. We present the updated 42-month follow-up data.Methods: The phase II RESORT trial randomized patients to sorafenib or observation within 12 weeks from surgery. RFS was the primary endpoint.Results: We analyzed 68 patients (32 in sorafenib and 36 in the observation arm), randomized between November 2012 and November 2017. Eighty-one percent in the sorafenib arm and 80% in the observation arm had one metastasis . At a median follow-up of 42 months (interquartile range 31-58), in the observation arm the median RFS was 35 months, RFS probability was 57% (95% CI 42-76%) at 24 and 44% (95% CI 30-65%) at 48 months. In the sorafenib arm, median RFS was 21 months, RFS probability was 50% (95% CI 34-71%) at 24 and 32% (95% CI 18-57%) at 48 months (p = 0.342;HR 1.35;95% CI 0.72-2.54). Forty-seven percent and 37.5% of the patients in the two arms, respectively, are disease free. The site of relapses was independent of the previous metastasectomy site.Expert commentary: Sorafenib after metastasectomy did not improve RFS, but surgery in selected patients should be considered in order to potentially improve survival.Clinical trial registration: www.clinicaltrials.gov identifier is NCT0144480.
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Affiliation(s)
- A Mennitto
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Verzoni
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Cognetti
- Medical Oncology Department, Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - R Miceli
- Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Milella
- Department of Medicine, Medical Oncology, University and Hospital Trust of Verona, Verona, Italy
| | - A Mosca
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - V E Chiuri
- Medical Oncology Department, Ospedale Vito Fazzi, Lecce, Italy
| | - A Bearz
- Medical Oncology Department, National Cancer Institute, Aviano, Italy
| | - F Morelli
- Medical Oncology Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - C Ortega
- Department of Medical Oncology, Ospedale S. Lazzaro ASL CN2 Alba-Bra, Cuneo, Italy
| | - F Atzori
- Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy
| | - M Donini
- Medical Oncology Department, Ospedale di Cremona, Cremona, Italy
| | - M Claps
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Guadalupi
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Sepe
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - V Cappelletti
- Biomarker Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy
| | - F G de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - G Procopio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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8
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Procopio G, Cognetti F, Miceli R, Milella M, Mosca A, Chiuri V, Bearz A, Morelli F, Ortega C, Atzori F, Donini M, Passalacqua R, Mennitto A, Sepe P, Martinetti A, Montone R, Apollonio G, Guadalupi V, Verzoni E, Claps M. 736P Updated data on patients (pts) with metastatic renal cell carcinoma (mRCC) treated with sorafenib (SOR) vs observation (obs) after radical metastasectomy in the RESORT trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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9
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Haas R, Bonvalot S, Miceli R, Strauss D, Swallow C, Hohenberger P, Van Coevorden F, Rutkowski P, Callegaro D, Hayes A, Honoré C, Fairweather M, Gladdy R, Jakob J, Szacht M, Fiore M, Chung P, Van Houdt W, Raut C, Gronchi A. OC-0070 Radiation Therapy for Retroperitoneal Liposarcoma – A report from TARPSWG. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30490-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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10
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Ferella L, Cavallo A, Miceli R, lacovelli N, Giandini T, Pignoli E, Calareso G, Bossi P, Gravina G, Nicolai P, Castelnuovo P, Piazza C, Licitra L, Fallai C, Orlandi E. PO-160 Tumor and retropharyngeal nodal GTVs prognostic role in unresectable non-glandular sinonasal cancers. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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11
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Dodero A, Guidetti A, Tucci A, Barretta F, Novo M, Devizzi L, Re A, Passi A, Pellegrinelli A, Pruneri G, Miceli R, Testi A, Pennisi M, Di Chio MC, Matteucci P, Carniti C, Facchetti F, Rossi G, Corradini P. Dose-adjusted EPOCH plus rituximab improves the clinical outcome of young patients affected by double expressor diffuse large B-cell lymphoma. Leukemia 2019; 33:1047-1051. [PMID: 30631117 PMCID: PMC6756077 DOI: 10.1038/s41375-018-0320-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/05/2018] [Accepted: 11/06/2018] [Indexed: 01/15/2023]
Affiliation(s)
- A Dodero
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - A Guidetti
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. .,Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy.
| | - A Tucci
- Department of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - F Barretta
- Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M Novo
- Department of Hematology, Azienda Ospedaliero Universitaria Citta' della Salute e della Scienza di Torino, Torino, Italy
| | - L Devizzi
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - A Re
- Department of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - A Passi
- Department of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - A Pellegrinelli
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - G Pruneri
- Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy.,Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - R Miceli
- Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - A Testi
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M Pennisi
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - M C Di Chio
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - P Matteucci
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - C Carniti
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - F Facchetti
- Department of Pathology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - G Rossi
- Department of Hematology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - P Corradini
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.,Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy
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12
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Procopio G, Cognetti F, Miceli R, Milella M, Mosca A, Chiuri V, Bearz A, Morelli F, Ortega C, Atzori F, Passalacqua R, Ratta R, de Braud F, Cappelletti V, Verzoni E. Subgroups analysis and circulating biomarkers evaluation of RESORT trial: A randomized phase II study in metastatic renal cell carcinoma (mRCC) patients (pts) to evaluate the efficacy of sorafenib after metastasectomy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.089] [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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13
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Cavalieri S, Perrone F, Miceli R, Ascierto PA, Locati LD, Bergamini C, Granata R, Alfieri S, Resteghini C, Galbiati D, Busico A, Paielli N, Patuzzo R, Maurichi A, Gallino G, Ruggeri R, Mariani L, Palla M, Licitra L, Bossi P. Efficacy and safety of single-agent pan-human epidermal growth factor receptor (HER) inhibitor dacomitinib in locally advanced unresectable or metastatic skin squamous cell cancer. Eur J Cancer 2018; 97:7-15. [PMID: 29734047 DOI: 10.1016/j.ejca.2018.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 10/23/2017] [Revised: 12/07/2017] [Accepted: 04/05/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND In recurrent or metastatic (R/M) skin squamous cell cancer (sSCC) not amenable to radiotherapy (RT) or surgery, chemotherapy (CT) has a palliative intent and limited clinical responses. The role of oral pan-HER inhibitor dacomitinib in this setting was investigated within a clinical trial. METHODS Patients with diagnosis of R/M sSCC were treated. Dacomitinib was started at a dose of 30 mg daily (QD) for 15 d, followed by 45 mg QD. Primary end-point was response rate (RR). Tumour samples were analysed through next-generation sequencing using a custom panel targeting 36 genes associated with sSCC. RESULTS Forty-two patients (33 men; median age 77 years) were treated. Most (86%) received previous treatments consisting in surgery (86%), RT (50%) and CT (14%). RR was 28% (2% complete response; 26% partial response), disease control rate was 86%. Median progression-free survival and overall survival were 6 and 11 months, respectively. Most patients (93%) experienced at least one adverse event (AE): diarrhoea, skin rash (71% each), fatigue (36%) and mucositis (31%); AEs grade 3-4 occurred in 36% of pts. In 16% of cases, treatment was discontinued because of drug-related toxicity. TP53, NOTCH1/2, KMT2C/D, FAT1 and HER4 were the most frequently mutated genes. BRAF, NRAS and HRAS mutations were more frequent in non-responders, and KMT2C and CASP8 mutations were restricted to this subgroup. CONCLUSIONS In sSCC, dacomitinib showed activity similar to what was observed with anti-epidermal growth factor receptor agents, and durable clinical benefit was observed. Safety profile was comparable to previous experiences in other cancers. Molecular pt selection could improve therapeutic ratio.
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Affiliation(s)
- S Cavalieri
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy
| | - F Perrone
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Department of Pathology, Unit of Experimental Molecular Pathology, Milan, Italy
| | - R Miceli
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Clinical Epidemiology and Trial Organization, Milan, Italy
| | - P A Ascierto
- Istituto Nazionale Tumori Fondazione "G. Pascale", Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy, Naples, Italy
| | - L D Locati
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy
| | - C Bergamini
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy
| | - R Granata
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy
| | - S Alfieri
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy
| | - C Resteghini
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy
| | - D Galbiati
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy
| | - A Busico
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Department of Pathology, Unit of Experimental Molecular Pathology, Milan, Italy
| | - N Paielli
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Department of Pathology, Unit of Experimental Molecular Pathology, Milan, Italy
| | - R Patuzzo
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Melanoma and Sarcoma Surgery Unit, Milan, Italy
| | - A Maurichi
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Melanoma and Sarcoma Surgery Unit, Milan, Italy
| | - G Gallino
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Melanoma and Sarcoma Surgery Unit, Milan, Italy
| | - R Ruggeri
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Melanoma and Sarcoma Surgery Unit, Milan, Italy
| | - L Mariani
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Clinical Epidemiology and Trial Organization, Milan, Italy
| | - M Palla
- Istituto Nazionale Tumori Fondazione "G. Pascale", Unit of Melanoma, Cancer Immunotherapy and Innovative Therapy, Naples, Italy
| | - L Licitra
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy; Università Degli Studi di Milano, Medical Oncology Department, Milan, Italy
| | - P Bossi
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Medical Oncology/Head and Neck Unit, Milan, Italy.
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14
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De Palo G, Camerini T, Marubini E, Costa A, Formelli F, Del Vecchio M, Mariani L, Miceli R, Mascotti G, Magni A, Campa T, Di Mauro MG, Attili A, Maltoni C, Del Turco MR, Decensi A, D'Aiuto G, Veronesi U. Chemoprevention Trial of Contralateral Breast Cancer with Fenretinide. Rationale, Design, Methodology, Organization, Data Management, Statistics and Accrual. Tumori 2018; 83:884-94. [PMID: 9526578 DOI: 10.1177/030089169708300603] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Fenretinide (4-HPR) Breast Cancer Study is a randomized multicenter clinical trial originally designed and conducted by the investigators of the Istituto Nazionale Tumori of Milan. The study is sponsored by the National Cancer Institute of Bethesda and by the Italian National Research Council. The trial was designed to evaluate the effectiveness of the synthetic retinoid 4-HPR, at a dose of 200 mg per os every day for 5 years, in reducing the incidence of contralateral breast cancer in a population of patients previously operated on for breast cancer. Between 1987 and 1993, the Istituto Nazionale Tumori of Milan and 9 other collaborating Centers enrolled 2,972 women between the ages of 30 and 70 years who had been previously operated on for T1-T2 N- M0 breast cancer. This paper describes the rationale, design, methodology, organization, data management, statistics and accrual of the participating population.
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Affiliation(s)
- G De Palo
- Istituto Nazionale Tumori, University of Milan, Italy
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15
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Bozzetti F, Mariani L, Miceli R, Montalto F, Baratti D, Andreola S. Impact of Distal Clearance Margin on Oncologic Outcome after Restorative Resection of the Rectum. Tumori 2018; 83:907-11. [PMID: 9526582 DOI: 10.1177/030089169708300607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is considerable controversy about the distal clearance margin that needs to be maintained beyond the extent of a rectal tumor in order to reduce the risk of local recurrence. We investigated the rate of local recurrence, distant metastases and survival in 87 patients who had undergone radical restorative resection of the rectum for cancer and had been followed up for a median period of over 6 years, and we analyzed the statistical relation (log-rank test for trend) with the length of the distal margin. The distal margin length was divided into three categories: 1 cm, 2 cm, and ≥3 cm. No significant correlation was found between the length of the distal clearance margin and the oncologic outcome. Taken together, our data suggest that if the resection line distally falls on healthy tissue, there is no need to resect additional rectum in order to achieve a better outcome.
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Affiliation(s)
- F Bozzetti
- Division of Surgery of the Digestive Tract, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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16
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Foa P, Fornier M, Miceli R, Seregni E, Santambrogio L, Nosotti M, Massaron S, Cataldo I, Oldani S, Iurlo A, Caldiera S, Bombardieri E. Preoperative CEA, NSE, SCC, TPA and CYFRA 21.1 Serum Levels as Prognostic Indicators in Resected Non-Small Cell Lung Cancer. Int J Biol Markers 2018; 14:92-8. [PMID: 10399628 DOI: 10.1177/172460089901400206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In 62 patients affected by resectable non-small cell lung cancer (NSCLC) submitted to radical surgery we evaluated the prognostic significance of CEA, NSE, SCC, TPA and CYFRA 21.1 serum levels at diagnosis, as well as the predictive ability of these tumor markers with respect to histological type and pathological stage. The group was composed of 56 male and 6 female patients; the median age was 62 years (range 29–73 years). Thirty-four patients had a histological diagnosis of adenocarcinoma and 28 of squamous cell carcinoma; with regard to pathological stage, 32 patients had stage I, 4 patients stage II and 23 patients stage IIIA disease. A good predictive ability with respect to histological type was obtained with SCC serum levels; as for pathological stage, TPA and CYFRA 21.1 were found to have moderate predictive ability. In this series of patients, at a median follow-up of 55 months after surgery, we found that both TPA and CYFRA 21.1 serum levels at diagnosis were reliable predictors of overall survival, high values of these markers being associated with a worse prognosis.
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Affiliation(s)
- P Foa
- Istituto di Scienze Mediche, Università degli Studi, Milano, Italy
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17
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Martinetti A, Seregni E, Ripamonti C, Ferrari L, De Conno F, Miceli R, Pallotti F, Coliva A, Biancolini D, Bombardieri E. Serum Levels of Tartrate-Resistant Acid Phosphatase-5B in Breast Cancer Patients Treated with Pamidronate. Int J Biol Markers 2018; 17:253-8. [PMID: 12521129 DOI: 10.1177/172460080201700406] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A novel immunoassay specific for the osteoclast-produced TRAP isoform 5b has been developed recently. By means of this assay we studied the usefulness of serum TRAP-5b in monitoring the response to palliative treatment with pamidronate in breast cancer patients with bone metastases. We correlated serum TRAP-5b levels with pain intensity and intake of analgesics to assess the possible utility of the marker in identifying patients who could benefit from pamidronate treatment. Twenty-eight advanced breast cancer patients with bone metastases entered the study. Patients were treated according to the following schedule: two two-week cycles of 60 mg/week pamidronate IV, with a three-week interval in between (six infusions over seven weeks), followed by one infusion every three weeks for a total of 24 infusions over a treatment period of 61 weeks. Blood samples were taken before the start of treatment and before each infusion during two treatment cycles. To measure serum TRAP levels we employed the new immunoassay kit BoneTRAP® produced by Suomen Bioanalytiikka Oy (SBA), Oulu, Finland. In order to assess the usefulness of this marker in evaluating the response to pamidronate treatment we divided patients into two groups (group A, worsened; group B, improved) with respect to pain trend and analgesic intake. Our results did not show any statistically significant difference in baseline serum TRAP levels in the two groups. However, one week after the first pamidronate infusion TRAP-5b serum levels decreased by 39% and 18% in groups A and B, respectively (p=0.01); these levels persisted throughout the treatment period. In conclusion, a decrease in TRAP-5b serum levels may reflect the pharmacological activity of pamidronate and seems to predict pain relief and a reduction in analgesic consumption.
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Affiliation(s)
- A Martinetti
- Nuclear Medicine Division, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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Cavalleri A, Colombo C, Venturelli E, Miceli R, Mariani L, Cornelli U, Pala V, Berrino F, Secreto G. Evaluation of Reactive oxygen Metabolites in Frozen Serum Samples. Effect of Storage and Repeated Thawing. Int J Biol Markers 2018; 19:250-3. [PMID: 15503829 DOI: 10.1177/172460080401900312] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Measuring the free radical activity in serum samples from prospective studies is the best way to investigate the association between oxidative stress and human diseases. Prospective studies require the analysis of serum samples that have often been stored for a long time. Our study was designed to determine the effect of storage at –30°C and –80°C for two years on free radical activity. We analyzed the free radical activity by measuring circulating hydroperoxides in a pool of sera at baseline and after one day, one week, one month and 25 months of storage, using a photometric method (d-ROMs test). Measurements were performed in aliquots thawed only once at each time point and in aliquots frozen and thawed repeatedly over the study period. After two years we observed a small but statistically significant 4% decrease in the hydroperoxide concentration, which was substantially unaffected by storage temperatures and repeated freeze-thaw cycles. We also carried out the d-ROMs test in sera from ten apparently healthy volunteers at 2, 8, 24, and 48 hours after collection and storage at 4°C and did not observe any significant variation. In conclusion, the d-ROMs test is a simple method suitable to evaluate the free radical activity in frozen serum samples after long-term storage.
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Affiliation(s)
- A Cavalleri
- Hormone Research Laboratory, Department of Preventive Medicine, National Cancer Institute, Milan--Italy
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Pietrantonio F, Miceli R, Rimassa L, Lonardi S, Aprile G, Mennitto A, Marmorino F, Bozzarelli S, Antonuzzo L, Tamburini E, Morano F, Rossini D, Battaglin F, Baretti M, Berenato R, Formica V, Mosconi S, Petrelli F, Ghidini M, Loupakis F, Spada D, Cinieri S, Beretta G, Falcone A, de Braud F, Cremolini C. Estimating 12-week death probability in patients with refractory metastatic colorectal cancer: the Colon Life nomogram. Ann Oncol 2017; 28:555-561. [PMID: 27864220 DOI: 10.1093/annonc/mdw627] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Regorafenib and TAS-102 have recently demonstrated statistically significant survival gains in patients with refractory metastatic colorectal cancer (mCRC). Life expectancy ≥12 weeks was an inclusion criterion in registrative trials, and the identification of proper clinical selection tools for the daily use of these drugs in heavily pre-treated patients is needed to improve the cost-benefit ratio. We aimed at building a nomogram able to predict death probability within 12 weeks from the date of assessment of refractory mCRC. Patients and methods Four hundred eleven refractory mCRC patients with ECOG performance status (PS) ≤2 receiving regorafenib, TAS-102 or other treatments were used as developing set. Putative prognostic variables were selected using a random forest model and included in a binary logistic model from which the nomogram was developed. The nomogram was externally validated and its performance was evaluated by examining calibration (how close predictions were to the actual outcome) and discriminative ability (Harrell C index) both on developing (internal validation) and validating (external validation) sets. Results Four variables were selected and included in the nomogram: PS (P < 0.0001), primary tumor resection (P = 0.027), LDH value (P = 0.0001) and peritoneal involvement (P = 0.081). In the developing set, the nomogram discriminative ability was high (C = 0.778), and was confirmed in the validating set (C = 0.778), where the overall outcome was better as a consequence of the enrichment in patients receiving regorafenib or TAS-102 (46% versus 34%; P < 0.0001). Conclusions Our nomogram may be a useful tool to predict the probability of death within 12 weeks in patients with refractory mCRC. Based on four easy-to-collect variables, the 'Colon Life' nomogram and free app for smartphones may improve mCRC patients' selection for later-line therapies and assist researchers for the enrollment in clinical trials in this setting.
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Affiliation(s)
- F Pietrantonio
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy
| | - R Miceli
- Trial Office and Biomedical Statistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - L Rimassa
- Medical Oncology and Hematology Unit, Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan
| | - S Lonardi
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Istituto Oncologico Veneto - IRCCS, Padova
| | - G Aprile
- Department of Oncology, University and General Hospital, Udine
| | - A Mennitto
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy
| | - F Marmorino
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - S Bozzarelli
- Medical Oncology and Hematology Unit, Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan
| | - L Antonuzzo
- S.C. Oncologia Medica 1, Azienda Ospedaliero Universitaria Careggi, Firenze.,Department of Medical Biotechnologies, University of Siena, Siena
| | - E Tamburini
- Medical Oncology Unit, Rimini Hospital, Rimini
| | - F Morano
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy
| | - D Rossini
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - F Battaglin
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Istituto Oncologico Veneto - IRCCS, Padova
| | - M Baretti
- Medical Oncology and Hematology Unit, Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan
| | - R Berenato
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy
| | - V Formica
- Medical Oncology Unit, Policlinico Tor Vergata University Hospital, Roma
| | - S Mosconi
- Unit of Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo
| | - F Petrelli
- Department of Oncology, ASST Bergamo Ovest, Treviglio, Bergamo
| | - M Ghidini
- Division of Medicine and Medical Oncology, Azienda Istituti Ospitalieri, Cremona
| | - F Loupakis
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Istituto Oncologico Veneto - IRCCS, Padova
| | - D Spada
- ASL Lecce-Presidio Ospedaliero Vito Fazzi, UOC Oncologia Medica, Lecce
| | - S Cinieri
- Medical Oncology, Hospital A. Perrino, Brindisi
| | - G Beretta
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo
| | - A Falcone
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - F de Braud
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy.,Oncology and Hemato-Oncology Department, University of Milan, Italy
| | - C Cremolini
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa
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Martelli G, Miceli R, Folli S, Guzzetti E, Chifu C, Maugeri I, Ferranti C, Bianchi G, Capri G, Carcangiu M, Paolini B, Agresti R, Ferraris C, Piromalli D, Greco M. Sentinel node biopsy after primary chemotherapy in cT2 N0/1 breast cancer patients: Long-term results of a retrospective study. Eur J Surg Oncol 2017; 43:2012-2020. [DOI: 10.1016/j.ejso.2017.07.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 07/15/2017] [Accepted: 07/18/2017] [Indexed: 10/19/2022] Open
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21
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Bossi P, Miceli R, Locati LD, Ferrari D, Vecchio S, Moretti G, Denaro N, Caponigro F, Airoldi M, Moro C, Vaccher E, Sponghini A, Caldara A, Rinaldi G, Ferrau F, Nolè F, Lo Vullo S, Tettamanzi F, Hollander L, Licitra L. A randomized, phase 2 study of cetuximab plus cisplatin with or without paclitaxel for the first-line treatment of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck. Ann Oncol 2017; 28:2820-2826. [PMID: 28950305 DOI: 10.1093/annonc/mdx439] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND B490 (EudraCT# 2011-002564-24) is a randomized, phase 2b, noninferiority study investigating the efficacy and safety of first-line cetuximab plus cisplatin with/without paclitaxel (CetCis versus CetCisPac) in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). PATIENTS AND METHODS Eligible patients had confirmed R/M SCCHN (oral cavity/oropharynx/larynx/hypopharynx/paranasal sinus) and no prior therapy for R/M disease. Cetuximab was administered on day 1 (2-h infusion, 400 mg/m2), then weekly (1-h infusions, 250 mg/m2). Cisplatin was given as a 1-h infusion (CetCis arm: 100 mg/m2; CetCisPac arm: 75 mg/m2) on day 1 of each cycle for a maximum of six cycles. Paclitaxel was administered as a 3-h infusion (175 mg/m2) on day 1 of each cycle. After six cycles, maintenance cetuximab was administered until disease progression or unacceptable toxicity. The primary end point was progression-free survival (PFS). We assumed a noninferiority margin of 1.40 as compatible with efficacy. RESULTS A total of 201 patients were randomized 1 : 1 to each regimen; 191 were assessable. PFS with CetCis (median, 6 months) was noninferior to PFS with CetCisPac (median, 7 months) [HR for CetCis versus CetCisPac 0.99; 95% CI: 0.72-1.36, P = 0.906; margin of noninferiority (90% CI of 1.4) not reached]. Median overall survival was 13 versus 11 months (HR = 0.77; 95% CI: 0.53-1.11, P = 0.117). The overall response rates were 41.8% versus 51.7%, respectively (OR = 0.69; 95% CI: 0.38-1.20, P = 0.181). Grade ≥3 adverse event rates were 76% and 73% for CetCis versus CetCisPac, respectively, while grade 4 toxicities were lower in the two-drug versus three-drug arm (14% versus 33%, P = 0.015). No toxic death or sepsis were reported and cardiac events were negligible (1%). CONCLUSION The two-drug CetCis regimen proved to be noninferior in PFS to a three-drug combination with CetCisPac. The median OS of both regimens is comparable with that observed in EXTREME, while the life-threatening toxicity rate appeared reduced. CLINICAL TRIAL NUMBER EudraCT# 2011-002564-24.
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Affiliation(s)
- P Bossi
- Head and Neck Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan University of Milan, Milan
| | - R Miceli
- Clinical Epidemiology and Trial Organization, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan
| | - L D Locati
- Head and Neck Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan University of Milan, Milan
| | - D Ferrari
- Medical Oncology, Ospedale San Paolo, Milan
| | - S Vecchio
- Medical Oncology, IRCCS San Martino, IST National Cancer Institute, Genova and University of Genova, Genova
| | - G Moretti
- Medical Oncology, Azienda Ospedaliera Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia
| | - N Denaro
- Medical Oncology, St. Croce & Carle University Teaching Hospital, and ARCO Foundation, Cuneo
| | - F Caponigro
- Medical Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione Pascale, Naples
| | - M Airoldi
- 2nd Medical Oncology Division, Città della Salute e della Scienza Hospital of Turin, Turin
| | - C Moro
- Medical Oncology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo
| | - E Vaccher
- Medical Oncology, Centro di Riferimento Oncologico, Aviano
| | - A Sponghini
- Medical Oncology, A.O. Universitaria Maggiore della Carità, Novara
| | - A Caldara
- Medical Oncology, Ospedale Santa Chiara, Trento
| | - G Rinaldi
- Medical Oncology, AOU Policlinico "Paolo Giaccone," Palermo
| | - F Ferrau
- Medical Oncology, Ospedale San Vincenzo, Taormina
| | - F Nolè
- Medical Oncology, Istituto Europeo di Oncologia, Milan
| | - S Lo Vullo
- Clinical Epidemiology and Trial Organization, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan
| | - F Tettamanzi
- Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - L Hollander
- Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - L Licitra
- Head and Neck Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan University of Milan, Milan.
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Bossi P, Cavalieri S, Perrone F, Miceli R, Ascierto P, Locati L, Bergamini C, Granata R, Alfieri S, Resteghini C, Galbiati D, Busico A, Paielli N, Patuzzo R, Maurichi A, Gallino G, Ruggeri R, Mariani L, Palla M, Licitra L. A phase II trial of dacomitinib in locally advanced unresectable or metastatic skin squamous cell carcinoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx428] [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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23
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Granata R, Orlandi E, Infante G, Iacovelli N, Miceli R, Cavallo A, Alfieri S, Bergamini C, Resteghini C, Galbiati D, Cavalieri S, Locati L, Tana S, Naimo S, Fallai C, Licitra L, Bossi P. Subsite-dependent prognostic impact of age in patients with nasopharyngeal and oropharyngeal cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx430.005] [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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24
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Guidetti A, Mazzocchi A, Miceli R, Paterno' E, Taverna F, Spina F, Crippa F, Farina L, Corradini P, Gianni AM, Viviani S. Early reduction of serum TARC levels may predict for success of ABVD as frontline treatment in patients with Hodgkin Lymphoma. Leuk Res 2017; 62:91-97. [PMID: 28992524 DOI: 10.1016/j.leukres.2017.09.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 09/01/2017] [Accepted: 09/25/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND Many efforts have been made to predict prognosis of newly diagnosed Hodgkin Lymphoma (HL) patients. Objective of this study was to investigate the association between early reduction of Thymus and Activation-Regulated Chemokine after the first ABVD cycle (TARC-1) and prognosis of HL patients. METHODS Serum samples of 116 HL patients were collected at baseline, after every ABVD cycle and during follow-up. The 99th centile of TARC distribution in a group of 156 independent healthy subjects (800pg/ml) was considered as cut-off for discriminating between abnormal and normal TARC values. FINDINGS 101 patients out of 116 had baseline TARC above 800pg/ml (median value 27515pg/ml (IQR, 11001-68139)) and were the object of this analysis. TARC-1 significantly decreased to a median value of 556pg/ml (IQR, 378-977pg/ml). TARC-1 values below 800pg/ml were associated with success of therapy (p=0.0003) and PET-2 negativity (p=0.001). TARC-1≤800pg/ml identified a population with a significantly higher 5-years PFS in the whole cohort (90.1% vs 55.6%; p<0.0001) and in both subgroups of advanced (p=0.003) and early stage patients (p=0.021). At multivariable analysis, TARC-1 was significant independent predictor of PFS (p=0.0035). INTERPRETATION Early reduction of TARC serum levels can predict success of treatment, being associated with achievement of interim PET-2 negative and favorable long-term outcome in HL patients receiving ABVD as front-line therapy.
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Affiliation(s)
- A Guidetti
- Department of Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Onco-Hematology, University of Milano, Milan, Italy
| | - A Mazzocchi
- Immunohematology and Transfusion Medicine Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Miceli
- Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Paterno'
- Department of Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Taverna
- Immunohematology and Transfusion Medicine Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Spina
- Department of Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Crippa
- Department of Nuclear Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Farina
- Department of Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Corradini
- Department of Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Onco-Hematology, University of Milano, Milan, Italy
| | - A M Gianni
- Department of Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Viviani
- Department of Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Milione M, Miceli R, Pellegrinelli A, Centonze G, Barretta F, Pusceddu S, Giacomelli L, Coppa J, Mazzaferro V, Sozzi G, Anichini A, de Braud F. Predictive factors in GEP-NEN: The integrated role of Ki67, beta-catenin and morphology. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx368.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pietrantonio F, Barretta F, Fanotto V, Niger M, Morano F, Bergamo F, Silvestris N, Fornaro L, Bordonaro R, Baretti M, Santini D, Tomasello G, Antonuzzo L, Noventa S, Avallone A, Di Donato S, Maiello E, De Vita F, Miceli R, Aprile G. Estimating 12-weeks life expectancy in metastatic gastric cancer (mGC) patients (pts) candidates for second-line treatment: The “Gastric Life” nomogram. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.052] [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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27
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Bossi P, Hollander L, Miceli R, Ferrari D, Vecchio S, Moretti G, Merlano M, Caponigro F, Moro C, Vaccher E, Alabisio O, Caldara A, Russo A, Ferrau F, Nolè F, Licitra L. First line cetuximab and cisplatin with or without paclitaxel in recurrent/metastatic head and neck cancer: A randomized phase IIb trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Cecchi F, Catenacci D, Schwartz S, Sellappan S, Tian Y, Miceli R, Pietrantonio F, Pellegrinelli A, Martinetti A, Di Bartolomeo M, Hembrough T. Predicting response to chemotherapy in gastric cancer patients randomized to docetaxel: A reevaluation of the ITACA-S trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.062] [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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Imburgia A, Romano P, Caruso M, Viola F, Miceli R, Riva Sanseverino E, Madonia A, Schettino G. Contributed Review: Review of thermal methods for space charge measurement. Rev Sci Instrum 2016; 87:111501. [PMID: 27910572 DOI: 10.1063/1.4968029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The space charge accumulation phenomenon has garnered great interest over the last two decades because of the increased use of direct current in high voltage electrical systems. In this context, a significant relevance has been achieved by the thermal methods, used for solid dielectrics. This paper presents a review of this non-destructive measurement system used for the measurement of space charge. The thermal pulse method, the thermal step method, and the laser intensity modulation method are described. For each configuration, the principle of operation, the thicknesses analyzed, and the spatial resolution are described, reporting also the main related applications.
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Affiliation(s)
- A Imburgia
- DEIM, University of Palermo, Palermo 90128, Italy
| | - P Romano
- DEIM, University of Palermo, Palermo 90128, Italy
| | - M Caruso
- DEIM, University of Palermo, Palermo 90128, Italy
| | - F Viola
- DEIM, University of Palermo, Palermo 90128, Italy
| | - R Miceli
- DEIM, University of Palermo, Palermo 90128, Italy
| | | | - A Madonia
- DEIM, University of Palermo, Palermo 90128, Italy
| | - G Schettino
- DEIM, University of Palermo, Palermo 90128, Italy
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Mazzaferro V, Sposito C, Coppa J, Miceli R, Bhoori S, Bongini M, Camerini T, Milione M, Regalia E, Spreafico C, Gangeri L, Buzzoni R, de Braud FG, De Feo T, Mariani L. The Long-Term Benefit of Liver Transplantation for Hepatic Metastases From Neuroendocrine Tumors. Am J Transplant 2016; 16:2892-2902. [PMID: 27134017 DOI: 10.1111/ajt.13831] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [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: 08/23/2015] [Revised: 04/10/2016] [Accepted: 04/10/2016] [Indexed: 01/25/2023]
Abstract
Selection criteria and benefit of liver transplantation for hepatic metastases from neuroendocrine tumors (NETs) remain uncertain. Eighty-eight consecutive patients with metastatic NETs eligible for liver transplantation according to Milan-NET criteria were offered transplant (n = 42) versus nontransplant options (n = 46) depending on list dynamics, patient disposition, and age. Tumor burden between groups did not differ. Transplant patients were younger (40.5 vs. 55.5 years; p < 0.001). Long-term outcomes were compared after matching between groups made on multiple Cox models adjusted for propensity score built on logistic models. Survival benefit was the difference in mean survival between transplant versus nontransplant options. No patients were lost or died without recurrence. Median follow-up was 122 months. The transplant group showed a significant advantage over nontransplant strategies at 5 and 10 years in survival (97.2% and 88.8% vs. 50.9% and 22.4%, respectively; p < 0.001) and time-to-progression (13.1% and 13.1% vs. 83.5% and 89%; p < 0.001). After adjustment for propensity score, survival advantage of the transplant group was significant (hazard ratio = 7.4; 95% confidence interval (CI): 2.4-23.0; p = 0.001). Adjusted transplant-related survival benefit was 6.82 months (95% CI: 1.10-12.54; p = 0.019) and 38.43 months (95% CI: 21.41-55.45; p < 0.001) at 5 and 10 years, respectively. Liver transplantation for metastatic NETs under restrictive criteria provides excellent long-term outcome. Transplant-related survival benefit increases over time and maximizes after 10 years.
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Affiliation(s)
- V Mazzaferro
- Surgery and Hepatology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), University of Milan, Milan, Italy
| | - C Sposito
- Surgery and Hepatology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), University of Milan, Milan, Italy
| | - J Coppa
- Surgery and Hepatology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), University of Milan, Milan, Italy
| | - R Miceli
- Trial Office and Biomedical Statistics, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), Milan, Italy
| | - S Bhoori
- Surgery and Hepatology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), University of Milan, Milan, Italy
| | - M Bongini
- Surgery and Hepatology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), University of Milan, Milan, Italy
| | - T Camerini
- Trial Office and Biomedical Statistics, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), Milan, Italy
| | - M Milione
- Pathology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), Milan, Italy
| | - E Regalia
- Surgery and Hepatology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), University of Milan, Milan, Italy
| | - C Spreafico
- Interventional Radiology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), Milan, Italy
| | - L Gangeri
- Psychology, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), Milan, Italy
| | - R Buzzoni
- Medical Oncology Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), University of Milan, Milan, Italy
| | - F G de Braud
- Medical Oncology Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), University of Milan, Milan, Italy
| | - T De Feo
- North Italian Transplant Procurement Agency, Organ and Tissue Transplant Immunology, IRCCS Policlinico Hospital, Milan, Italy
| | - L Mariani
- Trial Office and Biomedical Statistics, Fondazione IRCCS Istituto Nazionale Tumori (National Cancer Institute), Milan, Italy
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Siano M, Infante G, Miceli R, Resteghini C, Locati L, Licitra L, Bossi P. Baseline neutrophil-to-lymphocyte ratio is associated with outcome in recurrent/metastatic head and neck squamous cell cancer patients treated with platinum and cetuximab in first line setting. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.45] [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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32
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Pasquino M, Stasi M, Mancosu P, Russo S, Villaggi E, Gasperi C, Casale M, Loi G, Strigari L, Miceli R, Raza G, Fedele D, Vaiano A, Falco M, Moretti E, Giglioli F, Nigro R, Talamonti C, Pastore G, Luxardo S, Menghi E, Benecchi G, Clemente S, Marino C, Borzi G, Nardiello B, Ardu V, Paladini L, Cagni E, Russo G, Spiazzi L, Vittorini F. Dosimetric characterization of linac small beams using a plastic scintillator detector: A multicenter study. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.466] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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33
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Bossi P, Miceli R, Benasso M, Corvò R, Bacigalupo A, Sanguineti G, Fallai C, Merlano M, Infante G, Dani C, Di Giannantonio V, Licitra L. Individual patient data meta-analysis of the impact of treatment expertise on the outcome of head and neck cancer patients treated within 6 randomized trials. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw340.01] [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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34
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Talamonti C, Russo S, Barone TL, Benecchi G, Borzi G, Bresciani S, Cagni E, Carbonino C, Casale M, Clemente S, Consorti R, D’Alessio V, Dicastro E, Donofrio G, Falco M, Fedele D, Fiandra C, Frassanito C, Gasperi C, Giglioli F, Iervolino C, Infusino E, Linsalata S, Loi G, Lorenzini E, Marino C, Martinotti S, Masi L, Menghi E, Miceli R, Moretti E, Nardiello B, Nigro R, Pastore G, Pressello M, Pimpinella M, Raza G, Rosica F, Ruggeri R, Spiazzi L, Stasi M, Strigari L, Tremolada V, Vaiano A, Vigorito S, Villaggi E, Vittorini F, Mancosu P. Small beam dosimetry: A multi-center multi-detector italian project. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Bianchi E, Bosisio M, Capri G, Mariani P, Miceli R, Borreani C. The psychological consequences after adjuvant aromatase inhibitor therapy in breast cancer women. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw342.01] [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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Granata R, Bossi P, Bergamini C, Alfieri S, Resteghini C, Galbiati D, Orlandi E, Iacovelli N, Fallai C, Guzzo M, Infante G, Locati L, Miceli R, Mariani L, Licitra L. Role of induction chemotherapy in the multimodal management of locally advanced epithelial sinonasal cancer: a single center experience. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw340.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nichetti F, Infante G, Miceli R, Berenato R, Caporale M, Morano F, Falvella F, Niger M, Bossi I, Fucà G, Mennitto A, Di Bartolomeo M, Prof de Braud F, Pietrantonio F. Pharmacogenomic evaluation of single nucleotide polymorphisms associated with oxaliplatin-induced peripheral neuropathy: a preliminary study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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38
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Giussani M, Landoni E, Merlino G, Turdo F, Veneroni S, Cappelletti V, Daidone M, Miceli R, Orlandi R, Triulzi T, Tagliabue E. Extracellular matrix proteins derived from the tumor microenvironment as circulating breast cancer diagnostic markers. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pietrantonio F, Cremolini C, Rimassa L, Lonardi S, Mennitto A, Morano F, Iacono D, Berenato R, Caporale M, Niger M, Marmorino F, Bozzarelli S, Bergamo F, Rossini D, Baretti M, Battaglin F, Bonotto M, Loupakis F, de Braud F, Miceli R. O-013 A new nomogram for estimating 12-weeks survival in patients (pts) with chemorefractory metastatic colorectal cancer (mCRC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw198.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tuovinen N, Pasquale FD, Caravasso CF, Giudice E, Miceli R, Ingrosso G, Santoni R, Laprie A, Sabatini U. EP-1883: Functional brain connectivity in glioblastoma patients pre- and post-radiotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33134-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Falvella FS, Cremolini C, Miceli R, Nichetti F, Cheli S, Antoniotti C, Infante G, Martinetti A, Marmorino F, Sottotetti E, Berenato R, Caporale M, Colombo A, de Braud F, Di Bartolomeo M, Clementi E, Loupakis F, Pietrantonio F. Variant alleles in factor V, prothrombin, plasminogen activator inhibitor-1, methylenetetrahydrofolate reductase and risk of thromboembolism in metastatic colorectal cancer patients treated with first-line chemotherapy plus bevacizumab. Pharmacogenomics J 2016; 17:331-336. [DOI: 10.1038/tpj.2016.22] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/02/2016] [Accepted: 02/12/2016] [Indexed: 12/21/2022]
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Miceli R, Ingrosso G, Ponti E, Di Cristino D, Lancia A, Bove P, De Pasquale F, Santoni R. Prostate movements analysis during radiotherapy using volumetric intraprostatic gold coils information. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.154] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Necchi A, Miceli R, Bregni M, Bokemeyer C, Berger LA, Oechsle K, Schumacher K, Kanfer E, Bourhis JH, Massard C, Laszlo D, Montoro J, Flechon A, Arpaci F, Secondino S, Wuchter P, Dreger P, Crysandt M, Worel N, Kruger W, Ringhoffer M, Unal A, Nagler A, Campos A, Wahlin A, Michieli M, Sucak G, Donnini I, Schots R, Ifrah N, Badoglio M, Martino M, Raggi D, Giannatempo P, Rosti G, Pedrazzoli P, Lanza F. Prognostic impact of progression to induction chemotherapy and prior paclitaxel therapy in patients with germ cell tumors receiving salvage high-dose chemotherapy in the last 10 years: a study of the European Society for Blood and Marrow Transplantation Solid Tumors Working Party. Bone Marrow Transplant 2015; 51:384-90. [DOI: 10.1038/bmt.2015.300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/21/2015] [Accepted: 10/24/2015] [Indexed: 11/09/2022]
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Raggi D, Miceli R, Sonpavde G, Giannatempo P, Mariani L, Galsky MD, Bellmunt J, Necchi A. Second-line single-agent versus doublet chemotherapy as salvage therapy for metastatic urothelial cancer: a systematic review and meta-analysis. Ann Oncol 2015; 27:49-61. [PMID: 26487582 DOI: 10.1093/annonc/mdv509] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/12/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The efficacy and safety of a combination of chemotherapeutic agent compared with single-agent chemotherapy in the second-line setting of advanced urothelial carcinoma (UC) are unclear. We aimed to study the survival impact of single-agent compared with doublet chemotherapy as second-line chemotherapy of advanced UC. PATIENTS AND METHODS Literature was searched for studies including single-agent or doublet chemotherapy in the second-line setting after platinum-based chemotherapy. Random-effects models were used to pool trial-level data according to treatment arm, including median progression-free survival (PFS), overall survival (OS), objective response rate (ORR) probability, and grade 3-4 toxicity. Univariable and multivariable analyses, including sensitivity analyses, were carried out, adjusting for the percent of patients with ECOG performance status ≥1 and hepatic metastases. RESULTS Forty-six arms of trials including 1910 patients were selected: 22 arms with single agent (n = 1202) and 24 arms with doublets (n = 708). The pooled ORR with single agents was 14.2% [95% confidence interval (CI) 11.1-17.9] versus 31.9% [95% CI 27.3-36.9] with doublet chemotherapy. Pooled median PFS was 2.69 and 4.05 months, respectively. The pooled median OS was 6.98 and 8.50 months, respectively. Multivariably, the odds ratio for ORR and the pooled median difference of PFS were statistically significant (P < 0.001 and P = 0.002) whereas the median difference in OS was not (P = 0.284). When including single-agent vinflunine or taxanes only, differences were significant only for ORR (P < 0.001) favoring doublet chemotherapy. No statistically significant differences in grade 3-4 toxicity were seen between the two groups. CONCLUSIONS Despite significant improvements in ORR and PFS, doublet regimens did not extend OS compared with single agents for the second-line chemotherapy of UC. Prospective trials are necessary to elucidate the role of combination chemotherapy, with or without targeted agents, in the salvage setting. Currently, improvements in this field should be pursued considering single-agent chemotherapy as the foundation for new more active combinations.
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Affiliation(s)
- D Raggi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Miceli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Sonpavde
- UAB Comprehensive Cancer Center, Birmingham
| | - P Giannatempo
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Mariani
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M D Galsky
- Mount Sinai School of Medicine, Tisch Cancer Institute, New York
| | - J Bellmunt
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - A Necchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Raggi D, Miceli R, Sonpavde G, Giannatempo P, Nicolai N, Salvioni R, Procopio G, De Braud F, Mariani L, Necchi A. Single agent versus doublet chemotherapy as second-line therapy of metastatic urothelial carcinoma (UC): a meta-analysis. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv341.08] [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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Resteghini C, Siano M, Cau M, Alfieri S, Bergamini C, Granata R, Miceli R, Infante G, Imbimbo M, Locati L, Licitra L, Bossi P. Outcome of systemic treatments after first line platinum and cetuximab treatment in patients with recurrent/metastatic (RM) head and neck squamous cell cancer (HNSCC): a retrospective analysis. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv342.11] [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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Falvella S, Cremolini C, Miceli R, Niger M, Berenato R, Cheli S, Antoniotti C, Nichetti F, Infante G, Caporale M, Martinetti A, Marmorino F, Sottotetti E, Colombo A, Bossi I, Di Bartolomeo M, de Braud F, Clementi E, Loupakis F, Pietrantonio F. Risk of thromboembolic events (TEE) in metastatic colorectal cancer (mCRC) patients with single nucleotide polymorphisms (SNPs) in Factor V Leiden (FVL), Prothrombin, Plasminogen Activator Inhibitor-1 (PAI-1) and Methylenetetrahydrofolate Reductase (MTHFR). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Falvella F, Cremolini C, Miceli R, Nichetti F, Cheli S, Antoniotti C, Infante G, Martinetti A, Loupakis F, Bartolomeo MD, Marmorino F, Sottotetti E, Bossi I, Berenato R, Caporale M, Niger M, Colombo A, Braud FD, Clementi E, Pietrantonio F. 416 Variant Alleles in Factor V Leiden (FVL), Prothrombin, Plasminogen Activator Inhibitor-1 (PAI-1) or Methylenetetrahydrofolate Reductase (MTHFR) and risk of thromboembolic events (TEE) in metastatic colorectal cancer (mCRC) patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30250-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Raut C, Miceli R, Strauss D, Swallow C, Hohenberger P, Coevorden FV, Rutkowski P, Fiore M, Callegaro D, Casali P, Haas R, Hayes A, Honore C, Cannell A, Jakob J, Szacht M, Fairweather M, Pollock R, Bonvalot S, Gronchi A. 3404 External validation of a nomogram predicting disease-free (DFS) and overall survival (OS) in patients (pts) with primary retroperitoneal sarcoma (pRPS). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31879-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Siano M, Resteghini C, Cau M, Alfieri S, Bergamini C, Granata R, Miceli R, Infante G, Locati L, Licitra L, Bossi P. 2865 Outcome of systemic treatments after first line platinum and cetuximab treatment in patients with recurrent/metastatic (RM) head and neck squamous cell cancer (HNSCC): A retrospective analysis. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31603-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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