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Polano M, Bedon L, Dal Bo M, Sorio R, Bartoletti M, De Mattia E, Cecchin E, Pisano C, Lorusso D, Lissoni AA, De Censi A, Cecere SC, Scollo P, Marchini S, Arenare L, De Giorgi U, Califano D, Biagioli E, Chiodini P, Perrone F, Pignata S, Toffoli G. Machine Learning Application Identifies Germline Markers of Hypertension in Patients With Ovarian Cancer Treated With Carboplatin, Taxane, and Bevacizumab. Clin Pharmacol Ther 2023; 114:652-663. [PMID: 37243926 DOI: 10.1002/cpt.2960] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
Pharmacogenomics studies how genes influence a person's response to treatment. When complex phenotypes are influenced by multiple genetic variations with little effect, a single piece of genetic information is often insufficient to explain this variability. The application of machine learning (ML) in pharmacogenomics holds great potential - namely, it can be used to unravel complicated genetic relationships that could explain response to therapy. In this study, ML techniques were used to investigate the relationship between genetic variations affecting more than 60 candidate genes and carboplatin-induced, taxane-induced, and bevacizumab-induced toxicities in 171 patients with ovarian cancer enrolled in the MITO-16A/MaNGO-OV2A trial. Single-nucleotide variation (SNV, formerly SNP) profiles were examined using ML to find and prioritize those associated with drug-induced toxicities, specifically hypertension, hematological toxicity, nonhematological toxicity, and proteinuria. The Boruta algorithm was used in cross-validation to determine the significance of SNVs in predicting toxicities. Important SNVs were then used to train eXtreme gradient boosting models. During cross-validation, the models achieved reliable performance with a Matthews correlation coefficient ranging from 0.375 to 0.410. A total of 43 SNVs critical for predicting toxicity were identified. For each toxicity, key SNVs were used to create a polygenic toxicity risk score that effectively divided individuals into high-risk and low-risk categories. In particular, compared with low-risk individuals, high-risk patients were 28-fold more likely to develop hypertension. The proposed method provided insightful data to improve precision medicine for patients with ovarian cancer, which may be useful for reducing toxicities and improving toxicity management.
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Affiliation(s)
- Maurizio Polano
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Luca Bedon
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Michele Dal Bo
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Roberto Sorio
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Michele Bartoletti
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Elena De Mattia
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Erika Cecchin
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Carmela Pisano
- Uro-Gynecologic Oncology Unit, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione G. Pascale, Naples, Italy
| | - Domenica Lorusso
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Department of Life Science and Public Health, Catholic University of Sacred Heart Largo Agostino Gemelli, Rome, Italy
| | - Andrea Alberto Lissoni
- Clinica Ostetrica e Ginecologica, Istituto di Ricovero e Cura a Carattere Scientifico S. Gerardo Monza, Università di Milano Bicocca, Milano, Italy
| | | | - Sabrina Chiara Cecere
- Uro-Gynecologic Oncology Unit, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione G. Pascale, Naples, Italy
| | - Paolo Scollo
- Unità Operativa Ostetricia e Ginecologia, Dipartimento Materno-Infantile, Ospedale Cannizzaro, Catania, Italy
| | - Sergio Marchini
- Molecular Pharmacology laboratory, Group of Cancer Pharmacology Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital, Rozzano, Italy
| | - Laura Arenare
- Clinical Trial Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione G. Pascale, Naples, Italy
| | - Ugo De Giorgi
- Istituto di Ricovero e Cura a Carattere Scientifico Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Daniela Califano
- Microenvironment Molecular Targets Unit, Istituto Nazionale Tumori IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Elena Biagioli
- Department Of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS Milano, Milano, Italy
| | - Paolo Chiodini
- Department of Mental Health and Public Medicine, Section of Statistics, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Perrone
- Clinical Trial Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione G. Pascale, Naples, Italy
| | - Sandro Pignata
- Uro-Gynecologic Oncology Unit, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione G. Pascale, Naples, Italy
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
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Pignata S, Scambia G, Schettino C, Arenare L, Pisano C, Lombardi D, De Giorgi U, Andreetta C, Cinieri S, De Angelis C, Priolo D, Casanova C, Rosati M, Greco F, Zafarana E, Schiavetto I, Mammoliti S, Cecere SC, Salutari V, Scalone S, Farolfi A, Di Napoli M, Lorusso D, Gargiulo P, Califano D, Russo D, Spina A, De Cecio R, Chiodini P, Perrone F, Accinno V, Altavilla C, Andreetta C, Antonelli G, Arenare L, Artioli G, Avola F, Barbara B, Barbato V, Bartoletti M, Bevilacqua S, Bordonaro R, Borghese O, Buonfanti G, Califano D, Camarda F, Canzanella G, Carbone V, Carbone MR, Carlo Stella G, Casanova C, Cassani C, Castagna F, Cattaneo M, Cecere SC, Chiodini P, Cinefra M, Cinieri S, Colombo N, Corsetti S, Dall'Agata M, D'Amico M, Daniele G, De Angelis C, De Cecio R, De Giorgi U, De Marino E, De Matteis G, De Placido S, Del Bene G, Del Giudice A, Del Monte F, Del Sesto M, Di Napoli M, Donini M, Drudi G, Falcone G, Farolfi A, Favaretto A, Ferrera G, Florio M, Forestieri V, Gallo MS, Gallo C, Gargiulo P, Garibaldi F, Gerevini F, Ghizzoni V, Giganti MO, Gimigliano A, Giudice E, Gnocchi N, Gravina A, Greco F, Greggi S, Iaia ML, Ilardi A, Iovine G, Ippoliti G, Irollo G, Isidori I, Lapresa M, Lavenia G, Lombardi D, Longhitano L, Lorusso D, Lucia B, Luzi G, Mammoliti S, Mariano S, Marino V, Marrapese G, Martino M, Matocci R, Mazzoni E, Mercuri D, Mirto M, Mollo G, Montinaro A, Moscatelli M, Mosconi AM, Musacchio L, Nanni N, Natalucci P, Nicoloso MS, Orditura M, Parma GM, Passalacqua R, Pelone M, Perri MT, Perrone F, Perrucci B, Piancastelli A, Piccirillo MC, Piccolo A, Pignata S, Pisano C, Priolo D, Rapisardi S, Ravaglia G, Ribecco T, Ricci C, Roccio M, Romano F, Rosati M, Russo D, Salutari V, Sambataro D, Savio A, Sbriglia A, Scaffa C, Scalone S, Scambia G, Schettino C, Schiavetto I, Sergi C, Sgandurra F, Sorio R, Spina A, Stabile S, Tabaro G, Tambaro M, Tamberi S, Tecchiato A, Trujillo AM, Zaccarelli E, Zafarana E. Carboplatin and paclitaxel plus avelumab compared with carboplatin and paclitaxel in advanced or recurrent endometrial cancer (MITO END-3): a multicentre, open-label, randomised, controlled, phase 2 trial. Lancet Oncol 2023; 24:286-296. [PMID: 37052965 DOI: 10.1016/s1470-2045(23)00016-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Adding immunotherapy to first-line chemotherapy might improve outcomes for patients with advanced or recurrent endometrial cancer. We aimed to compare carboplatin and paclitaxel versus avelumab plus carboplatin and paclitaxel as first-line treatment with avelumab given concurrent to chemotherapy and as maintenance after the end of chemotherapy. METHODS MITO END-3 is an open-label, randomised, controlled, phase 2 trial conducted at 31 cancer institutes, hospitals, and universities in Italy. Eligible patients were aged 18 years or older with histologically confirmed advanced (FIGO stage III-IV) or recurrent endometrial cancer, an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, and no previous systemic anticancer therapy as primary treatment for advanced or metastatic disease. Participants were randomly assigned (1:1) using a computerised minimisation procedure stratified by centre, histology, and stage at study entry, to either receive carboplatin (area under the curve [AUC] 5 mg/mL × min) and paclitaxel (175 mg/m2; standard group) intravenously every 3 weeks for six to eight cycles or avelumab (10 mg/kg intravenously) added to carboplatin and paclitaxel (experimental group) every 3 weeks and then every 2 weeks as a single maintenance treatment after the end of chemotherapy until disease progression or unacceptable toxicity. Patients, treating clinicians, and those assessing radiological examinations were not masked to study treatment. The primary endpoint was investigator-assessed progression-free survival, measured in the intention-to-treat (ITT) population. Patients who received at least one dose of study drug were included in the safety analysis. Experimental group superiority was tested with 80% power and one-tailed α 0·20. This trial is registered with ClinicalTrials.gov (NCT03503786) and EudraCT (2016-004403-31). FINDINGS From April 9, 2018, to May 13, 2021, 166 women were assessed for eligibility and 39 were excluded. 125 eligible patients were randomly assigned to receive carboplatin and paclitaxel (n=62) or avelumab plus carboplatin and paclitaxel (n=63) and included in the ITT population. The median follow-up was 23·3 months (IQR 13·2-29·6) and was similar between the two groups. 91 progression-free survival events were reported, with 49 events in 62 patients in the standard group and 42 events in 63 patients in the experimental group. The median progression-free survival was 9·9 months (95% CI 6·7-12·1) in the standard group and 9·6 months (7·2-17·7) in the experimental group (HR of progression or death 0·78 [60% CI 0·65-0·93]; one-tailed p=0·085). Serious adverse events were reported more frequently in the experimental group (24 vs seven events in the standard group); neutrophil count decrease was the most frequent grade 3-4 adverse event (19 [31%] of 61 patients in the experimental group vs 26 [43%] of 61 patients in the standard group). Two deaths occurred in the experimental group during treatment (one respiratory failure following severe myositis [possibly related to treatment] and one cardiac arrest [not related to treatment]). INTERPRETATION Adding avelumab to first-line chemotherapy deserves further testing in patients with advanced or recurrent endometrial cancer, although consideration of mismatch repair status is warranted. FUNDING Pfizer.
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Bartoletti M, Montico M, Mazzeo R, De Scordilli M, Musacchio L, Lucia E, Giorda G, Massarut S, Urbani M, Miolo G, Viel A, Garutti M, Da Ros L, Scalone S, Nicoloso M, Corsetti S, Sorio R, Lorusso D, Pignata S, Puglisi F. Breast cancer incidence in patients with BRCA-related advanced ovarian cancer receiving olaparib-based maintenance therapy: A pooled analysis from phase III clinical trials. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.5566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5566 Background: As the prognosis of BRCA-related advanced ovarian cancer (AOC) continues to improve thanks to the introduction of targeted therapies like poly ADP-ribose polymerase inhibitors (PARPi) and bevacizumab, the occurrence of second primary tumors, in particular breast cancer (BC), is assumed to be more common. Despite this, data on the incidence of BC in this population are poor and guidelines for BC screening or risk reducing strategies are lacking. Methods: Published data from recent PARPi-based, phase III clinical trials involving germline BRCA mutated AOC were reviewed and analyzed. Only studies in which the incidence of at least one second primary solid tumor was reported were included. Cases of second primary BC cancers were pooled to calculate cumulative incidence according to the median follow-up period for each trial. 95% confidence interval (CI) was considered. Results: Four trials (SOLO1, PAOLA1, SOLO2 and SOLO3) involving 1186 germline BRCA 1-2 mutated AOC patients were included ( BRCA1, n = 816; BRCA2, n = 360; BRCA1 + BRCA2, n = 4; missing, n = 6). In all trials, patients were randomized to receive olaparib +/- bevacizumab (n = 788) versus placebo or standard therapies (n = 398). Median age at diagnosis of AOC was 56 years (range, 29-87). With a follow-up ranging from 3.9 months to 5 years, 16 new cases of BC were recorded, 10 in PARPi-based arms and 6 in control arms. Only two patients had a previous history of BC. The total cumulative incidence of BC was 1.37% (95% CI, 0.77-2.18), while cumulative incidences were 1.26% (95% CI, 0.61-2.31) and 1.51% (95% CI, 0.55-3.25) in PARPi-based arms and control arms, respectively. In a sensitivity analysis excluding the SOLO3 trial with the shortest follow-up, the total cumulative incidence was 1.63% (95% CI, 0.92-2.67). Other 20 cases of second primary solid tumors were registered, including 4 cases of non-small cell lung cancer. Conclusions: Patients with germline BRCA-related AOC receiving PARPi-based maintenance therapy can be reassured about the risk of second primary BC and intensive screening should be avoided at least in early treatment phase. More data with long term follow-up are needed.
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Affiliation(s)
- Michele Bartoletti
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Marcella Montico
- Clinical Trial Office, Scientific Direction, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Roberta Mazzeo
- Department of Medicine, University of Udine, Udine, Italy, Udine, Italy
| | | | - Lucia Musacchio
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Emilio Lucia
- Unit of Gynecologic Oncology Surgery, IRCCS CRO Aviano, National Cancer Institute, Aviano, Italy, Aviano, Italy
| | - Giorgio Giorda
- Dipartimento di Oncologia Chirurgica Ginecologica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy, Aviano, Italy
| | | | - Martina Urbani
- Department of Radiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Gianmaria Miolo
- Centro di Riferimento Oncologico di Avano (CRO) IRCCS, Aviano, Italy
| | | | - Mattia Garutti
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Lucia Da Ros
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Simona Scalone
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Milena Nicoloso
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Serena Corsetti
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Roberto Sorio
- MITO and Centro di Riferimento Oncologico-IRCCS, Aviano, Italy
| | | | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli IRCCS Fondazione G Pascale, Naples, Italy
| | - Fabio Puglisi
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
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Falcone F, Malzoni M, Carnelli M, Cormio G, De Iaco P, Di Donato V, Ferrandina G, Raspagliesi F, Sorio R, Losito NS, Greggi S. Fertility-sparing treatment for serous borderline ovarian tumors with extra-ovarian invasive implants: Analysis from the MITO14 study database. Gynecol Oncol 2022; 165:302-308. [DOI: 10.1016/j.ygyno.2022.02.018] [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] [Received: 01/22/2022] [Revised: 02/12/2022] [Accepted: 02/21/2022] [Indexed: 11/04/2022]
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de Scordilli M, Bartoletti M, Palazzari E, Mazzeo R, Michelotti A, Alberti M, Gerratana L, Nicoloso M, Corsetti S, Scalone S, Gigante M, Forte S, Clemente N, Del Fabro A, Lucia E, Ganis A, Giorda G, Canzonieri V, Sorio R, Puglisi F. 800P Tailoring adjuvant treatments in high-risk early stage endometrial cancer: Clinical outcomes of sequential chemoradiation in a real-word scenario. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1242] [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: 10/20/2022] Open
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Bartoletti M, Cecere SC, Musacchio L, Sorio R, Puglisi F, Pignata S. Recurrent ovarian cancer in the era of poly-ADP ribose polymerase inhibitors: time to re-assess established clinical practices. ESMO Open 2021; 6:100135. [PMID: 33930658 PMCID: PMC8100608 DOI: 10.1016/j.esmoop.2021.100135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 02/02/2023] Open
Affiliation(s)
- M Bartoletti
- Department of Medicine (DAME), University of Udine, Udine, Italy; Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), Aviano (PN), Italy
| | - S C Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - L Musacchio
- Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - R Sorio
- Department of Medicine (DAME), University of Udine, Udine, Italy; Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), Aviano (PN), Italy
| | - F Puglisi
- Department of Medicine (DAME), University of Udine, Udine, Italy; Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), Aviano (PN), Italy.
| | - S Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
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Pignata S, Scambia G, Villanucci A, Naglieri E, Ibarbia MA, Brusa F, Bourgeois H, Sorio R, Casado A, Reichert D, Dopchie C, De Rivas B, de Sande LM. A European, Observational, Prospective Trial of Trabectedin Plus Pegylated Liposomal Doxorubicin in Patients with Platinum-Sensitive Ovarian Cancer. Oncologist 2021; 26:e658-e668. [PMID: 33289956 PMCID: PMC8018301 DOI: 10.1002/onco.13630] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/25/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The noninterventional, prospective NIMES-ROC phase IV study (NCT02825420) evaluated trabectedin plus pegylated liposomal doxorubicin (PLD) in real-life clinical practice. PATIENTS AND METHODS Eligible participants included adults with platinum-sensitive recurrent ovarian cancer (PS-ROC) who had received one or more cycles of trabectedin/PLD before inclusion according to the marketing authorization. The primary endpoint was progression-free survival (PFS) according to investigator criteria. RESULTS Two hundred eighteen patients from five European countries were evaluated, 72.5% of whom were pretreated with at least two prior chemotherapy lines and received a median of six cycles of trabectedin/PLD (range: 1-24). Median PFS was 9.46 months (95% confidence interval [CI], 7.9-10.9), and median overall survival (OS) was 23.56 months (95% CI, 18.1-34.1). Patients not pretreated with an antiangiogenic drug obtained larger median PFS (p < .007) and OS (p < .048), largely owning to differences between the two populations. Twenty-four patients (11.0%) had a complete response, and 57 patients (26.1%) achieved a partial response for an objective response rate (ORR) of 37.2%. Fifty-nine patients (27.1%) had disease stabilization for a disease control rate of 64.2%. No statistically significant difference in PFS, OS, or ORR was observed by BRCA1/2 status and platinum sensitivity. Most common grade 3/4 adverse events (AEs) were neutropenia (30.3%), anemia (6.4%), thrombocytopenia (5.5%), and asthenia (5.0%). No deaths attributed to treatment-related AEs or unexpected AEs occurred. CONCLUSION The combination of trabectedin/PLD represents a clinically meaningful and safe option for patients with PS-ROC regardless of prior treatment with an antiangiogenic drug, being comparable with previously observed outcomes in selected and less pretreated patients from clinical trials. IMPLICATIONS FOR PRACTICE This noninterventional, prospective study, conducted in 57 reference sites across Europe, consistently confirmed that trabectedin plus pegylated liposomal doxorubicin (PLD) in routine clinical practice represents a clinically meaningful and safe option for women with platinum-sensitive recurrent ovarian cancer. Although the study population represented a heterogeneous, older, and more pretreated population than those in prospective clinical trials, the combination of trabectedin plus PLD induced comparable clinical benefits, with a similar and manageable safety profile. Overall, these findings show that trabectedin in combination with PLD maintains antitumor activity when administered to heavily pretreated patients in real-life clinical practice.
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Affiliation(s)
- Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)–Fondazione G. Pascale NapoliNaplesItaly
| | | | - Alessandro Villanucci
- Unità Ospedaliera (UO) Translational Oncology, Department of Oncology, Azienda Ospedaliero Universitaria Careggi FirenzeFlorenceItaly
| | | | | | | | | | - Roberto Sorio
- Centro di Riferimento Oncologico di Aviano–IRCCSAvianoItaly
| | | | - Dietmar Reichert
- Onkologie Westerstede, Medizinische Studiengesellschaft Nord‐West GmbHWesterstedeGermany
| | - Catherine Dopchie
- Centre Hospitalier Wallonie Picarde site Institut Médico‐Chirurgical, Centre Hospitalier Wallonie PicardeTournaiBelgium
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Falcone F, Breda E, Ferrandina G, Malzoni M, Perrone AM, Cormio G, Di Donato V, Frigerio L, Mangili G, Raspagliesi F, Festi A, Scibilia G, Biglia N, Sorio R, Vizza E, Losito NS, Greggi S. Fertility-sparing treatment in advanced-stage serous borderline ovarian tumors. An analysis from the MITO14 study database. Gynecol Oncol 2021; 161:825-831. [PMID: 33781554 DOI: 10.1016/j.ygyno.2021.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/20/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate oncological and reproductive outcomes of women undergoing fertility-sparing surgery (FSS) for stage II-III serous borderline ovarian tumors (BOTs). METHODS A multi-institutional retrospective study was conducted within the MITO Group. RESULTS A total of 91 patients were recruited. The median follow-up time from primary cytoreduction was 127 months (IQR range 91-179). Forty-nine patients (53.8%) experienced at least one recurrence (median time to first relapse 22 months, IQR range 9.5-57). At univariable analysis, significant predictors of relapse were: size of largest extra-ovarian lesion, peritoneal cancer index, completeness of cytoreduction, type of implants. After multivariable analysis, the size of extra-ovarian lesions and the presence of invasive implants resulted as the only independent predictors of recurrence. Median disease-free survival (DFS) was 96 months (95% CI, 24.6-167.3), while median disease-specific survival (DSS) was not reached. Twenty-nine patients (31.8%) attempted to conceive: 20 (68.9%) achieved at least one pregnancy and 18 (62%) gave birth to a healthy child. At the end of the observation period, 88 patients (96.7%) showed no evidence of disease, 2 (2.2%) were alive with disease, and 1 patient (1.1%) died from BOT. CONCLUSIONS Despite the recurrence high rate, FSS provides good chances of reproductive success with no impact on DSS. The presence of invasive peritoneal implants affects the DFS but not DSS nor reproductive outcome. The risk of recurrence would not seem to be related to the ovarian preservation per se, but to the natural history of the initial peritoneal spread.
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Affiliation(s)
- Francesca Falcone
- Department of Gynecologic Oncology, Istituto Nazionale Tumori, IRCSS, "Fondazione G. Pascale", Naples, Italy
| | - Enrico Breda
- Medical Oncology Unit, Ospedale S. Giovanni Calibita Fatebenefratelli, Rome, Italy
| | - Gabriella Ferrandina
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Mario Malzoni
- Endoscopica Malzoni, Center for Advanced Endoscopic Gynecologic Surgery, Avellino, Italy
| | - Anna M Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gennaro Cormio
- Department of Biomedical Sciences and Human Oncology, Unit of Obstetrics and Gynecology, University of Bari "Aldo Moro", Bari, Italy
| | - Violante Di Donato
- Department of Maternal and Child Health and Urological Sciences, Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Luigi Frigerio
- Obstetrics and Gynecology Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Anna Festi
- Gynecology and Obstetrics, University of Verona, Verona, Italy
| | - Giuseppe Scibilia
- Gynecology and Obstetrics, Maternal and Child Department, Cannizzaro Hospital, Catania, Italy
| | - Nicoletta Biglia
- Division of Gynecology and Obstetrics, Umberto I Hospital, Turin, Italy
| | - Roberto Sorio
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Enrico Vizza
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Nunzia S Losito
- Surgical Pathology Unit, Istituto Nazionale Tumori, IRCSS, "Fondazione G. Pascale", Naples, Italy
| | - Stefano Greggi
- Department of Gynecologic Oncology, Istituto Nazionale Tumori, IRCSS, "Fondazione G. Pascale", Naples, Italy.
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9
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Viotto D, Russo F, Anania I, Segatto I, Rampioni Vinciguerra GL, Dall'Acqua A, Bomben R, Perin T, Cusan M, Schiappacassi M, Gerratana L, D'Andrea S, Citron F, Vit F, Musco L, Mattevi MC, Mungo G, Nicoloso MS, Sonego M, Massarut S, Sorio R, Barzan L, Franchin G, Giorda G, Lucia E, Sulfaro S, Giacomarra V, Polesel J, Toffolutti F, Canzonieri V, Puglisi F, Gattei V, Vecchione A, Belletti B, Baldassarre G. CDKN1B mutation and copy number variation are associated with tumor aggressiveness in luminal breast cancer. J Pathol 2020; 253:234-245. [PMID: 33140857 PMCID: PMC7839435 DOI: 10.1002/path.5584] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/12/2020] [Accepted: 10/29/2020] [Indexed: 12/28/2022]
Abstract
The CDKN1B gene, encoding for the CDK inhibitor p27kip1, is mutated in defined human cancer subtypes, including breast, prostate carcinomas and small intestine neuroendocrine tumors. Lessons learned from small intestine neuroendocrine tumors suggest that CDKN1B mutations could be subclonal, raising the question of whether a deeper sequencing approach could lead to the identification of higher numbers of patients with mutations. Here, we addressed this question and analyzed human cancer biopsies from breast (n = 396), ovarian (n = 110) and head and neck squamous carcinoma (n = 202) patients, using an ultra‐deep sequencing approach. Notwithstanding this effort, the mutation rate of CDKN1B remained substantially aligned with values from the literature, showing that essentially only hormone receptor‐positive breast cancer displayed CDKN1B mutations in a relevant number of cases (3%). However, the analysis of copy number variation showed that another fraction of luminal breast cancer displayed loss (8%) or gain (6%) of the CDKN1B gene, further reinforcing the idea that the function of p27kip1 is important in this type of tumor. Intriguingly, an enrichment for CDKN1B alterations was found in samples from premenopausal luminal breast cancer patients (n = 227, 4%) and in circulating cell‐free DNA from metastatic luminal breast cancer patients (n = 59, 8.5%), suggesting that CDKN1B alterations could correlate with tumor aggressiveness and/or occur later during disease progression. Notably, many of the identified somatic mutations resulted in p27kip1 protein truncation, leading to loss of most of the protein or of its C‐terminal domain. Using a gene‐editing approach in a luminal breast cancer cell line, MCF‐7, we observed that the expression of p27kip1 truncating mutants that lose the C‐terminal domains failed to rescue most of the phenotypes induced by CDKN1B gene knockout, indicating that the functions retained by the C‐terminal portion are critical for its role as an oncosuppressor, at least in luminal breast cancer. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Davide Viotto
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Francesca Russo
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy.,University of Trieste, Trieste, Italy
| | - Ilaria Anania
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Ilenia Segatto
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Gian Luca Rampioni Vinciguerra
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy.,Department of Clinical and Molecular Medicine, University of Rome 'Sapienza', Sant'Andrea Hospital, Rome, Italy
| | - Alessandra Dall'Acqua
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Riccardo Bomben
- Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Tiziana Perin
- Pathology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Martina Cusan
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Monica Schiappacassi
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Lorenzo Gerratana
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy.,Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Sara D'Andrea
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Francesca Citron
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Filippo Vit
- University of Trieste, Trieste, Italy.,Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Lorena Musco
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy.,University of Trieste, Trieste, Italy
| | - Maria Chiara Mattevi
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Giorgia Mungo
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Milena S Nicoloso
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Maura Sonego
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Samuele Massarut
- Breast Surgery Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Roberto Sorio
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Luigi Barzan
- Division of Otorhinolaryngology, General Hospital of Pordenone Santa Maria degli Angeli, Pordenone, Italy
| | - Giovanni Franchin
- Radiotherapy Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Giorgio Giorda
- Gynecological Surgery Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Emilio Lucia
- Gynecological Surgery Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Sandro Sulfaro
- Unit of Pathology, General Hospital of Pordenone Santa Maria degli Angeli, Pordenone, Italy
| | - Vittorio Giacomarra
- Division of Otorhinolaryngology, General Hospital of Pordenone Santa Maria degli Angeli, Pordenone, Italy
| | - Jerry Polesel
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Vincenzo Canzonieri
- Pathology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Fabio Puglisi
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy.,Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Valter Gattei
- Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Andrea Vecchione
- Department of Clinical and Molecular Medicine, University of Rome 'Sapienza', Sant'Andrea Hospital, Rome, Italy
| | - Barbara Belletti
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
| | - Gustavo Baldassarre
- Molecular Oncology Unit, Centro di Riferimento Oncologico di Aviano (CRO Aviano), IRCCS, National Cancer Institute, Aviano, Italy
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10
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Bartoletti M, Mazzeo R, De Scordilli M, Del Fabro A, Vitale MG, Bortot L, Nicoloso MS, Corsetti S, Bonotto M, Scalone S, Giorda G, Sorio R, Andreetta C, Meacci ML, De Vivo R, Fasola G, Sopracordevole F, Puglisi F. Human epidermal growth factor receptor-2 (HER2) is a potential therapeutic target in extramammary Paget’s disease of the vulva. Int J Gynecol Cancer 2020; 30:1672-1677. [DOI: 10.1136/ijgc-2020-001771] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 12/15/2022] Open
Abstract
BackgroundInvasive vulvar Paget’s disease with over-expression of the human epidermal growth factor receptor 2 (HER2) protein is potentially suitable for targeted therapy, especially in a metastatic setting where no effective treatments are available.MethodsFour consecutive patients with HER2 positive advanced vulvar Paget’s disease, treated with weekly trastuzumab (loading dose 4 mg/kg, then 2 mg/kg) and paclitaxel (80 mg/m2) followed by 3-weekly trastuzumab maintenance (6 mg/kg), are reported.ResultsMedian age and follow-up of patients were 62.5 years (45–74) and 16 months (6-54), respectively. Complete or partial responses were observed in all patients. Median time to response was 3 months (range 2–4), while median duration of response was 10 months (range 2–34). Case 1 presented with pulmonary and lymph nodes involvement. She experienced a radiological complete response after 24 treatment administrations, and a progression-free survival of 36 months. At disease progression, treatment re-challenge achieved partial response. She is currently receiving treatment with trastuzumab–emtansine. Case 2 was a 74-year-old woman who developed pulmonary metastasis after first-line cisplatin treatment. She had a partial response and a progression-free survival of 10 months. Case 3 had inguinal and para-aortic lymphadenopathy in complete response after 18 treatment administrations. She developed brain metastasis while receiving trastuzumab maintenance. Case 4 was treated for locally advanced disease and experienced a subjective benefit with relief in perineal pain and itching. No unexpected treatment-related side effects were reported.ConclusionsAdvanced vulvar Paget’s disease is a rare disorder and no standard treatment is available. In the sub-group of HER2 positive disease, weekly paclitaxel–trastuzumab appears to be active and safe, and may be considered a therapeutic option in these patients.
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11
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Gagno S, Bartoletti M, Romualdi C, Poletto E, Scalone S, Sorio R, Zanchetta M, De Mattia E, Roncato R, Cecchin E, Giorda G, Toffoli G. Pharmacogenetic score predicts overall survival, progression-free survival and platinum sensitivity in ovarian cancer. Pharmacogenomics 2020; 21:995-1010. [PMID: 32894980 DOI: 10.2217/pgs-2020-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To define the impact of polymorphisms in genes involved in platinum-taxane and estrogen activity in the outcome of platinum-based treated ovarian cancer patients (OCP). Patients & Methods: Two hundred and thirty OCP were analyzed for 124 germ-line polymorphisms to generate a prognostic score for overall survival (OS), progression-free survival (PFS) and platinum-free interval (PFI). Results: ABCG2 rs3219191D>I, UGT1A rs10929302G>A and UGT1A rs2741045T>C polymorphisms were significantly associated with all three parameters (OS, PFS and PFI) and were used to generate a score. Patients in high-risk group had a poorer OS (hazard ratio [HR]: 1.8; 95% CI: 1.3-2.7; p = 0.0019), PFS (HR: 2.0; 95% CI: 1.4-2.9; p < 0.0001) and PFI (HR: 1.9; 95% CI: 1.4-2.8; p = 0.0002) compared with those in low-risk group. Conclusion: The prognostic-score including polymorphisms involved in drug and estrogen pathways stratifies OCP according to OS, PFS and PFI.
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Affiliation(s)
- Sara Gagno
- Experimental & Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Michele Bartoletti
- Department of Medicine (DAME), University of Udine, Via Palladio 8, 33100, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Chiara Romualdi
- Department of Biology, University of Padova, Via Ugo Bassi 58/B, 35122, Padova, Italy
| | - Elena Poletto
- Department of Oncology, ASUI Udine University Hospital, Via Pozzuolo 330, 33100, Udine, Italy
| | - Simona Scalone
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Roberto Sorio
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Martina Zanchetta
- Experimental & Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Elena De Mattia
- Experimental & Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Rossana Roncato
- Experimental & Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Erika Cecchin
- Experimental & Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Giorgio Giorda
- Gynaecological Oncology Unit, Centro di Riferimento Oncologico (CRO) di Aviano, IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Giuseppe Toffoli
- Experimental & Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
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12
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Bartoletti M, Pelizzari G, Gerratana L, Bortot L, Lombardi D, Nicoloso M, Scalone S, Giorda G, Baldassarre G, Sorio R, Puglisi F. Bevacizumab or PARP-Inhibitors Maintenance Therapy for Platinum-Sensitive Recurrent Ovarian Cancer: A Network Meta-Analysis. Int J Mol Sci 2020; 21:ijms21113805. [PMID: 32471250 PMCID: PMC7312982 DOI: 10.3390/ijms21113805] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction: Targeted agents such as bevacizumab (BEV) or poly (ADP-ribose) polymerase inhibitors (PARPi) which have been added as concomitant or maintenance therapies have been shown to improve progression-free survival (PFS) in patients with platinum-sensitive recurrent ovarian cancer (PS rOC). In the absence of direct comparison, we performed a network meta-analysis considering BRCA genes status. Methods: We searched PubMed, EMBASE, and MEDLINE for trials involving patients with PS rOC treated with BEV or PARPi. Different comparisons were performed for patients included in the PARPi trials, according to BRCA genes status as follows: all comers (AC) population, BRCA 1/2 mutated (BRCAm), and BRCA wild type patients (BRCAwt). Results: In the overall population, PARPi prolonged PFS with respect to BEV (hazard ratio (HR) = 0.70, 95% CI 0.54–0.91). In the BRCA mutated carriers, the PFS improvement in favor of PARPi appeared to be higher (HR = 0.46, 95% CI 0.36–0.59) while in BRCAwt patients the superiority of PARPi over BEV failed to reach a statistically significance level (HR = 0.87, 95% CI 0.63–1.20); however, according to the SUCRA analysis, PARPi had the highest probability of being ranked as the most effective therapy (90% and 60%, for PARPi and BEV, respectively). Conclusions: PARPi performed better as compared with BEV in terms of PFS for the treatment of PS rOC, especially in BRCAm patients who had not previously received PARPi.
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Affiliation(s)
- Michele Bartoletti
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (G.P.); (L.G.); (L.B.); (F.P.)
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (D.L.); (S.S.); (R.S.)
- Correspondence: ; Tel.: +39-0434-659-139
| | - Giacomo Pelizzari
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (G.P.); (L.G.); (L.B.); (F.P.)
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (D.L.); (S.S.); (R.S.)
| | - Lorenzo Gerratana
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (G.P.); (L.G.); (L.B.); (F.P.)
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (D.L.); (S.S.); (R.S.)
| | - Lucia Bortot
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (G.P.); (L.G.); (L.B.); (F.P.)
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (D.L.); (S.S.); (R.S.)
| | - Davide Lombardi
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (D.L.); (S.S.); (R.S.)
| | - Milena Nicoloso
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (M.N.); (G.B.)
| | - Simona Scalone
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (D.L.); (S.S.); (R.S.)
| | - Giorgio Giorda
- Unit of Gynecological Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy;
| | - Gustavo Baldassarre
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (M.N.); (G.B.)
| | - Roberto Sorio
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (D.L.); (S.S.); (R.S.)
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (G.P.); (L.G.); (L.B.); (F.P.)
- Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (D.L.); (S.S.); (R.S.)
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13
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Gagno S, Poletto E, Bartoletti M, Quartuccio L, Romualdi C, Garziera M, Scalone S, Sorio R, Dreussi E, Zanusso C, De Mattia E, Roncato R, Cecchin E, Giorda G, De Vita S, Dal Bo M, Puglisi F, Toffoli G. A TGF-β associated genetic score to define prognosis and platinum sensitivity in advanced epithelial ovarian cancer. Gynecol Oncol 2020; 156:233-242. [DOI: 10.1016/j.ygyno.2019.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 12/19/2022]
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14
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Sonego M, Poletto E, Pivetta E, Nicoloso MS, Pellicani R, Rampioni Vinciguerra GL, Citron F, Sorio R, Mongiat M, Baldassarre G. TIMP-1 is Overexpressed and Secreted by Platinum Resistant Epithelial Ovarian Cancer Cells. Cells 2019; 9:cells9010006. [PMID: 31861382 PMCID: PMC7016675 DOI: 10.3390/cells9010006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 02/05/2023] Open
Abstract
Epithelial Ovarian Cancer (EOC) is the most lethal gynecological cancer in developed countries, and the development of new strategies to overcome chemoresistance is an awaited clinical need. Angiogenesis, the development of new blood vessels from pre-existing vasculature, has been validated as a therapeutic target in this tumor type. The aim of this study is to verify if EOC cells with acquired resistance to platinum (PT) treatment display an altered angiogenic potential. Using a proteomic approach, we identified the tissue inhibitor of metalloproteinases 1 (TIMP-1) as the only secreted factor whose expression was up-regulated in PT-resistant TOV-112D and OVSAHO EOC cells used as study models. We report that TIMP-1 acts as a double-edged sword in the EOC microenvironment, directly affecting the response to PT treatment on tumor cells and indirectly altering migration and proliferation of endothelial cells. Interestingly, we found that high TIMP-1 levels in stage III–IV EOC patients associate with decreased overall survival, especially if they were treated with PT or bevacizumab. Taken together, these results pinpoint TIMP-1 as a key molecule involved in the regulation of EOC PT-resistance and progression disclosing the possibility that it could be used as a new biomarker of PT-resistance and/or therapeutic target.
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Affiliation(s)
- Maura Sonego
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
- Correspondence: (M.S.); (M.M.); (G.B.); Tel.: +39-0434-659-761 (M.S.); +39-0434-659-561 (M.M.); +39-0434-659-759 (G.B.); Fax: +39-0434-659-428 (M.S. & M.M. & G.B.)
| | - Evelina Poletto
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
| | - Eliana Pivetta
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
| | - Milena S. Nicoloso
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
- Deparment of Medical Oncology Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy;
| | - Rosanna Pellicani
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
| | - Gian Luca Rampioni Vinciguerra
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
| | - Francesca Citron
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
| | - Roberto Sorio
- Deparment of Medical Oncology Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy;
| | - Maurizio Mongiat
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
- Correspondence: (M.S.); (M.M.); (G.B.); Tel.: +39-0434-659-761 (M.S.); +39-0434-659-561 (M.M.); +39-0434-659-759 (G.B.); Fax: +39-0434-659-428 (M.S. & M.M. & G.B.)
| | - Gustavo Baldassarre
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (E.P.); (E.P.); (M.S.N.); (R.P.); (G.L.R.V.); (F.C.)
- Correspondence: (M.S.); (M.M.); (G.B.); Tel.: +39-0434-659-761 (M.S.); +39-0434-659-561 (M.M.); +39-0434-659-759 (G.B.); Fax: +39-0434-659-428 (M.S. & M.M. & G.B.)
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15
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Piccirillo MC, Scambia G, Bologna A, Signoriello S, Vergote I, Baumann K, Lorusso D, Murgia V, Sorio R, Ferrandina G, Sacco C, Cormio G, Breda E, Cinieri S, Natale D, Mangili G, Pisano C, Cecere SC, Di Napoli M, Salutari V, Raspagliesi F, Arenare L, Bergamini A, Bryce J, Daniele G, Gallo C, Pignata S, Perrone F. Quality-of-life analysis of the MITO-8, MaNGO, BGOG-Ov1, AGO-Ovar2.16, ENGOT-Ov1, GCIG study comparing platinum-based versus non-platinum-based chemotherapy in patients with partially platinum-sensitive recurrent ovarian cancer. Ann Oncol 2019; 29:1189-1194. [PMID: 29462248 DOI: 10.1093/annonc/mdy062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background MITO-8 showed that prolonging platinum-free interval by introducing non-platinum-based chemotherapy (NPBC) does not improve prognosis of patients with partially platinum-sensitive recurrent ovarian cancer. Quality of life (QoL) was a secondary outcome. Patients and methods Ovarian cancer patients recurring or progressing 6-12 months after previous platinum-based chemotherapy (PBC) were randomized to receive PBC or NPBC as first treatment. QoL was assessed at baseline, third and sixth cycles, with the EORTC C-30 and OV-28 questionnaires. Mean changes and best response were analysed. Progression-free survival, response rate, and toxicity are also reported for proper interpretation of data. All analyses were based on intention-to-treat. Results Out of the 215 patients, 151 (70.2%) completed baseline questionnaire, balanced between the arms; thereafter, missing rate was higher in the NPBC arm. At mean change analysis, C30 scores were prevalently worse in the NPBC than PBC arm, statistical significance being attained for emotional functioning, global health status/QoL, fatigue, and dyspnoea (effect sizes ranging from 0.30 to 0.51). Conversely, as for OV28 scale, the other chemotherapy side-effects item was significantly worse with PBC at three and six cycles, with a larger effect size (0.70 and 0.54, respectively). At best response analysis, improvement of emotional functioning and pain and worsening of peripheral neuropathy and other chemotherapy side-effects were significantly more frequent in the PBC arm. Progression-free survival (median 9 versus 5 months, P = 0.001) and objective response rate (51.6% versus 19.4%, P = 0.0001) were significantly better with PBC. Allergy, blood cell count, alopecia, nausea, musculoskeletal, and neurological side-effects were more frequent and severe with PBC; hand-foot skin reaction, rash/desquamation, mucositis, and vascular events were more frequent with NPBC. Conclusion MITO-8 QoL analysis shows that deterioration of some functioning and symptom scales is lower with PBC, with improvement of emotional functioning and pain, despite worsening of toxicity-related items. ClinicalTrials.gov NCT00657878.
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Affiliation(s)
- M C Piccirillo
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
| | - G Scambia
- Department of Protection of Women's Health, Rising Life, Child and Adolescent, Università Cattolica del Sacro Cuore, Roma
| | - A Bologna
- Medical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia
| | - S Signoriello
- Medical Statistics, Università degli Studi della Campania "Luigi Vanvitelli", Napoli
| | - I Vergote
- University Hospital Leuven, Leuven; Leuven Cancer Institute, Leuven, Belgium
| | - K Baumann
- UKGM Gynecology, Frauenklinik, Marburg, Germany
| | - D Lorusso
- Department of Protection of Women's Health, Rising Life, Child and Adolescent, Università Cattolica del Sacro Cuore, Roma; Gynaecologic Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano
| | - V Murgia
- Medical Oncology, Ospedale S. Chiara, Trento
| | - R Sorio
- Medical Oncology C, Centro di Riferimento Oncologico, Aviano, PN
| | - G Ferrandina
- Department of Protection of Women's Health, Rising Life, Child and Adolescent, Università Cattolica del Sacro Cuore, Roma; Gynaecologic Oncology, Centro di Ricerca e Formazione ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso
| | - C Sacco
- Oncology Department, AO S. Maria della Misericordia, Udine
| | - G Cormio
- Università di Bari, Bari; Ginecoloy Oncology, Istituto Oncologico "Giovanni Paolo II", Bari
| | - E Breda
- Medical Oncology, Ospedale S.Giovanni Calibita Fatebenefratelli, Roma
| | - S Cinieri
- Medical Oncology, Ospedale Antonio Perrino, Brindisi
| | - D Natale
- Medical Oncology, Ospedale San Massimo, Penne, PE
| | - G Mangili
- Obstertic and Gynaecologic Department, Ospedale San Raffaele, Milano
| | - C Pisano
- Uro-Gynaecologic Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli, Italy
| | - S C Cecere
- Uro-Gynaecologic Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli, Italy
| | - M Di Napoli
- Uro-Gynaecologic Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli, Italy
| | - V Salutari
- Department of Protection of Women's Health, Rising Life, Child and Adolescent, Università Cattolica del Sacro Cuore, Roma
| | | | - L Arenare
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
| | - A Bergamini
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli; Obstertic and Gynaecologic Department, Ospedale San Raffaele, Milano
| | - J Bryce
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
| | - G Daniele
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
| | - C Gallo
- Medical Statistics, Università degli Studi della Campania "Luigi Vanvitelli", Napoli
| | - S Pignata
- Uro-Gynaecologic Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli, Italy.
| | - F Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
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16
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Garziera M, Cecchin E, Polesel J, Canzonieri V, Sorio R, Gagno S, Scalone S, Roncato R, De Mattia E, Poletto E, Giorda G. TP53 hotspot mutations as immunoreactive neoantigens define a signature with differential survival outcomes in advanced ovarian cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Garziera M, Cecchin E, Giorda G, Sorio R, Scalone S, De Mattia E, Roncato R, Gagno S, Poletto E, Romanato L, Ecca F, Canzonieri V, Toffoli G. Clonal Evolution of TP53 c.375+1G>A Mutation in Pre- and Post- Neo-Adjuvant Chemotherapy (NACT) Tumor Samples in High-Grade Serous Ovarian Cancer (HGSOC). Cells 2019; 8:cells8101186. [PMID: 31581548 PMCID: PMC6829309 DOI: 10.3390/cells8101186] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/22/2019] [Accepted: 09/30/2019] [Indexed: 12/25/2022] Open
Abstract
Carboplatin/paclitaxel is the reference regimen in the treatment of advanced high-grade serous ovarian cancer (HGSOC) in neo-adjuvant chemotherapy (NACT) before interval debulking surgery (IDS). To identify new genetic markers of platinum-resistance, next-generation sequencing (NGS) analysis of 26 cancer-genes was performed on paired matched pre- and post-NACT tumor and blood samples in a patient with stage IV HGSOC treated with NACT-IDS, showing platinum-refractory/resistance and poor prognosis. Only the TP53 c.375+1G>A somatic mutation was identified in both tumor samples. This variant, associated with aberrant splicing, was in trans configuration with the 72Arg allele of the known germline polymorphism TP53 c.215C>G (p. Pro72Arg). In the post-NACT tumor sample we observed the complete expansion of the TP53 c.375+1G>A driver mutant clone with somatic loss of the treatment-sensitive 72Arg allele. NGS results were confirmed with Sanger method and immunostaining for p53, BRCA1, p16, WT1, and Ki-67 markers were evaluated. This study showed that (i) the splice mutation in TP53 was present as an early driver mutation at diagnosis; (ii) the mutational profile was shared in pre- and post-NACT tumor samples; (iii) the complete expansion of a single dominant mutant clone through loss of heterozygosity (LOH) had occurred, suggesting a possible mechanism of platinum-resistance in HGSOC under the pressure of NACT.
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Affiliation(s)
- Marica Garziera
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Erika Cecchin
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Giorgio Giorda
- Gynecological Oncology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Roberto Sorio
- Medical Oncology Unit C, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Simona Scalone
- Medical Oncology Unit C, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Elena De Mattia
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Rossana Roncato
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Sara Gagno
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Elena Poletto
- Medical Oncology, "Santa Maria della Misericordia" University Hospital, ASUIUD, 33100 Udine, Italy.
| | - Loredana Romanato
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Fabrizio Ecca
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Vincenzo Canzonieri
- Pathology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy.
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
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18
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Bartoletti M, Gagno S, Poletto E, Garziera M, Scalone S, Dreussi E, Zanusso C, Roncato R, Cecchin E, De Mattia E, Sorio R, Giorda G, Quartuccio L, De Vita S, Romualdi C, Puglisi F, Toffoli G. Advanced ovarian cancer: Is residual disease after debulking surgery affected by genetics factors involved in angiogenesis and immunity pathways? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.023] [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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19
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Garziera M, Roncato R, Montico M, De Mattia E, Gagno S, Poletto E, Scalone S, Canzonieri V, Giorda G, Sorio R, Cecchin E, Toffoli G. New Challenges in Tumor Mutation Heterogeneity in Advanced Ovarian Cancer by a Targeted Next-Generation Sequencing (NGS) Approach. Cells 2019; 8:cells8060584. [PMID: 31197119 PMCID: PMC6627128 DOI: 10.3390/cells8060584] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/06/2019] [Accepted: 06/13/2019] [Indexed: 12/12/2022] Open
Abstract
Next-generation sequencing (NGS) technology has advanced knowledge of the genomic landscape of ovarian cancer, leading to an innovative molecular classification of the disease. However, patient survival and response to platinum-based treatments are still not predictable based on the tumor genetic profile. This retrospective study characterized the repertoire of somatic mutations in advanced ovarian cancer to identify tumor genetic markers predictive of platinum chemo-resistance and prognosis. Using targeted NGS, 79 primary advanced (III-IV stage, tumor grade G2-3) ovarian cancer tumors, including 64 high-grade serous ovarian cancers (HGSOCs), were screened with a 26 cancer-genes panel. Patients, enrolled between 1995 and 2011, underwent primary debulking surgery (PDS) with optimal residual disease (RD < 1 cm) and platinum-based chemotherapy as first-line treatment. We found a heterogeneous mutational landscape in some uncommon ovarian histotypes and in HGSOC tumor samples with relevance in predicting platinum sensitivity. In particular, we identified a poor prognostic signature in patients with HGSOC harboring concurrent mutations in two driver actionable genes of the panel. The tumor heterogeneity described, sheds light on the translational potential of targeted NGS approach for the identification of subgroups of patients with distinct therapeutic vulnerabilities, that are modulated by the specific mutational profile expressed by the ovarian tumor.
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Affiliation(s)
- Marica Garziera
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Rossana Roncato
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Marcella Montico
- Scientific Directorate, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Elena De Mattia
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Sara Gagno
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Elena Poletto
- Medical Oncology, "Santa Maria della Misericordia" University Hospital, ASUIUD, 33100 Udine, Italy.
| | - Simona Scalone
- Medical Oncology Unit C, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Vincenzo Canzonieri
- Pathology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy.
| | - Giorgio Giorda
- Gynecological Oncology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Roberto Sorio
- Medical Oncology Unit C, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Erika Cecchin
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, Italy.
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20
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Bartoletti M, Pelizzari G, Gerratana L, Garattini SK, Basile D, Lisanti C, Bortot L, Corvaja C, Garutti M, Scalone S, Nicoloso M, Bolzonello S, Torrisi E, Da Ros L, Di Nardo P, Lombardi D, Giorda G, Baldassarre G, Sorio R, Puglisi F. Bevacizumab or PARP-inhibitors maintenance therapy for platinum-sensitive (PS) recurrent ovarian cancer (rOC)? A network meta-analysis (NMA). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5564 Background: Patients (pts) experiencing a PS rOC are generally re-exposed to a platinum based-chemotherapy (CT). In this setting, the addition of a targeted agent like bevacizumab (BEV) or PARP inhibitors (PARPi) as concomitant and/or maintenance therapy has shown to improve progression free survival (PFS). In the absence of direct comparison in randomized trials (RCTs), we have performed a NMA to evaluate differences in terms of efficacy between BEV and PARPi in pts with PS rOC, according to BRCA status. Methods: We searched PubMed, Embase and Medline for RCTs involving pts with PS rOC treated with BEV (n = 3, 1563 pts) or PARPi (n = 5, 1839 pts). Only trials with PFS as primary endpoint were included. Trials in first line setting were excluded. Analyses have been done pooling pts who had received PARPi in three groups, according to the available data on BRCA genes status: all comers (AC), BRCA mutated pts (BRCAm) and BRCA wild-type pts (BRCAwt). A frequentist approach has been used with R statistical software. To rank the effect size of treatments, surface under the cumulative ranking value (SUCRA) has been applied. Results: In AC pts, PARPi improved PFS compared to BEV (hazard ratio [HR] = 0.70, 95% CI 0.54-0.91, test of heterogeneity [I2] = 40.5%). In BRCAm pts the gain in PFS for PARPi was even higher compared to BEV (HR = 0.46, 95% CI 0.36-0.59, I2= 17.2%). In BRCAwt pts the benefit of PARPi over BEV was not statistically significant (HR = 0.87, 95% CI 0.63-1.20, I2= 35.7%) but PARPi had the highest likelihood of being ranked as the best treatment in terms of efficacy according to SUCRA (90% and 60%, respectively for PARPi and BEV). Hazard ratio for PFS between PARPi, BEV and CT in the three cohorts are reported in the table. Conclusions: According to indirect comparisons, PARPi performed the best for the treatment of PS rOC, especially in BRCAm pts who had not previously received PARPi. BEV could be still an option in BRCAwt pts. [Table: see text]
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Affiliation(s)
- Michele Bartoletti
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - Giacomo Pelizzari
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - Lorenzo Gerratana
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - Silvio Ken Garattini
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - Debora Basile
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - Camilla Lisanti
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - Lucia Bortot
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - Carla Corvaja
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | | | - Simona Scalone
- Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | - Milena Nicoloso
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Silvia Bolzonello
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy, Aviano, Italy
| | - Elena Torrisi
- Medical Oncology Dept. RCCS CRO Aviano-National Cancer Institute, Aviano, Italy
| | - Lucia Da Ros
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Paola Di Nardo
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Davide Lombardi
- Centro di Riferimento Oncologico-National Cancer Institute, Aviano, Italy
| | - Giorgio Giorda
- Dipartimento di Oncologia Chirurgica Ginecologica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy, Aviano, Italy
| | - Gustavo Baldassarre
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Roberto Sorio
- MITO and Centro di Riferimento Oncologico-IRCCS, Aviano, Italy
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
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21
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Daniele G, Arenare L, Scambia G, Pisano C, Sorio R, Breda E, De Placido S, Savarese A, Ferrandina G, Raspagliesi F, Panici PB, Ferro A, Rimanti A, Cormio G, Lorusso D, Cecere SC, Scalone S, Marsico VA, Cardalesi C, Cognetti F, Salutari V, Attademo L, Guizzaro L, Schettino C, Piccirillo MC, Perrone F, Gallo C, Pignata S. Prognostic role of chemotherapy-induced neutropenia in first-line treatment of advanced ovarian cancer. A pooled analysis of MITO2 and MITO7 trials. Gynecol Oncol 2019; 154:83-88. [PMID: 31029508 DOI: 10.1016/j.ygyno.2019.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/03/2019] [Accepted: 04/07/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chemotherapy-induced neutropenia (CIN) has been associated with improved prognosis in several cancer conditions. Contrasting data have been produced in ovarian cancer.
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Affiliation(s)
- Gennaro Daniele
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia.
| | - Laura Arenare
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia.
| | - Giovanni Scambia
- Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy.
| | - Carmela Pisano
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia.
| | - Roberto Sorio
- Oncologia B, Centro di Riferimento Oncologico, 33081 Aviano, PN, Italy.
| | - Enrico Breda
- Oncologia Medica, Ospedale S. Giovanni Calibita Fatebenefratelli, 00186 Roma, Italy
| | - Sabino De Placido
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, Napoli, Italy.
| | - Antonella Savarese
- Oncologia Medica 1, IRCCS Istituto Nazionale Tumori Regina Elena, 00144 Roma, Italy.
| | - Gabriella Ferrandina
- Ginecologia Oncologica, Centro di Ricerca e Formazione ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, 86100 Campobasso, Italy
| | | | | | | | | | - Gennaro Cormio
- Ginecologia Oncologica, IRCCS Istituto Oncologico "Giovanni Paolo II", Bari & Department of Biomedical Sciences and Oncology, University "Aldo Moro" Bari, 70124 Bari, Italy.
| | - Domenica Lorusso
- Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
| | - Sabrina Chiara Cecere
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia.
| | - Simona Scalone
- Oncologia B, Centro di Riferimento Oncologico, 33081 Aviano, PN, Italy.
| | | | - Cinzia Cardalesi
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, Napoli, Italy.
| | - Francesco Cognetti
- Oncologia Medica 1, IRCCS Istituto Nazionale Tumori Regina Elena, 00144 Roma, Italy.
| | - Vanda Salutari
- Ginecologia Oncologica, Centro di Ricerca e Formazione ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, 86100 Campobasso, Italy
| | - Laura Attademo
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia
| | - Lorenzo Guizzaro
- Statistica Medica, Università della Campania Luigi Vanvitelli, 80138 Napoli, Italy
| | - Clorinda Schettino
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia.
| | - Maria Carmela Piccirillo
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia.
| | - Francesco Perrone
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia.
| | - Ciro Gallo
- Statistica Medica, Università della Campania Luigi Vanvitelli, 80138 Napoli, Italy.
| | - Sandro Pignata
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli, Italia.
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22
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Dall'Acqua A, Sonego M, Pellizzari I, Pellarin I, Canzonieri V, D'Andrea S, Benevol S, Sorio R, Giorda G, Califano D, Bagnoli M, Militello L, Mezzanzanica D, Chiappetta G, Armenia J, Belletti B, Schiappacassi M, Baldassarre G. CDK6 protects epithelial ovarian cancer from platinum-induced death via FOXO3 regulation. EMBO Mol Med 2018; 9:1415-1433. [PMID: 28778953 PMCID: PMC5623833 DOI: 10.15252/emmm.201607012] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Epithelial ovarian cancer (EOC) is an infrequent but highly lethal disease, almost invariably treated with platinum‐based therapies. Improving the response to platinum represents a great challenge, since it could significantly impact on patient survival. Here, we report that silencing or pharmacological inhibition of CDK6 increases EOC cell sensitivity to platinum. We observed that, upon platinum treatment, CDK6 phosphorylated and stabilized the transcription factor FOXO3, eventually inducing ATR transcription. Blockage of this pathway resulted in EOC cell death, due to altered DNA damage response accompanied by increased apoptosis. These observations were recapitulated in EOC cell lines in vitro, in xenografts in vivo, and in primary tumor cells derived from platinum‐treated patients. Consistently, high CDK6 and FOXO3 expression levels in primary EOC predict poor patient survival. Our data suggest that CDK6 represents an actionable target that can be exploited to improve platinum efficacy in EOC patients. As CDK4/6 inhibitors are successfully used in cancer patients, our findings can be immediately transferred to the clinic to improve the outcome of EOC patients.
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Affiliation(s)
- Alessandra Dall'Acqua
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Maura Sonego
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Ilenia Pellizzari
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Ilenia Pellarin
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Vincenzo Canzonieri
- Division of Pathology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Sara D'Andrea
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Sara Benevol
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Roberto Sorio
- Division of Medical Oncology C, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Giorgio Giorda
- Division of Gynecology-Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Daniela Califano
- Genomica Funzionale, Istituto Nazionale Tumori -IRCCS- Fondazione G Pascale, Naples, Italy
| | - Marina Bagnoli
- Molecular Therapies Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Milan, Italy
| | - Loredana Militello
- Division of Medical Oncology C, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Delia Mezzanzanica
- Molecular Therapies Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Milan, Italy
| | - Gennaro Chiappetta
- Genomica Funzionale, Istituto Nazionale Tumori -IRCCS- Fondazione G Pascale, Naples, Italy
| | - Joshua Armenia
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Barbara Belletti
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Monica Schiappacassi
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
| | - Gustavo Baldassarre
- Division of Molecular Oncology, CRO Aviano, IRCCS, National Cancer Institute, Aviano, Italy
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23
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Garziera M, Cecchin E, Canzonieri V, Sorio R, Giorda G, Scalone S, De Mattia E, Roncato R, Gagno S, Poletto E, Romanato L, Sartor F, Polesel J, Toffoli G. Identification of Novel Somatic TP53 Mutations in Patients with High-Grade Serous Ovarian Cancer (HGSOC) Using Next-Generation Sequencing (NGS). Int J Mol Sci 2018; 19:ijms19051510. [PMID: 29783665 PMCID: PMC5983728 DOI: 10.3390/ijms19051510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/26/2018] [Accepted: 05/16/2018] [Indexed: 02/07/2023] Open
Abstract
Somatic mutations in TP53 are a hallmark of high-grade serous ovarian cancer (HGSOC), although their prognostic and predictive value as markers is not well defined. Next-generation sequencing (NGS) can identify novel mutations with high sensitivity, that may be repurposed as potential druggable anti-cancer targets and aid in therapeutic decisions. Here, a commercial NGS cancer panel comprising 26 genes, including TP53, was used to identify new genetic markers of platinum resistance and patient prognosis in a retrospective set of patients diagnosed with epithelial ovarian cancer. Six novel TP53 somatic mutations in untreated tumors from six distinct patients diagnosed with HGSOC were identified: TP53 c.728_739delTGGGCGGCATGA (p.Met243_Met247del, in-frame insertion or deletion (INDEL); TP53 c.795_809delGGGACGGAACAGCTT (p.Gly266_Phe270del, in-frame INDEL); TP53 c.826_827GC>AT (p.Ala276Ile, missense); TP53 c.1022insT (p.Arg342Profs*5, frameshift INDEL); TP53 c.1180delT (p.Ter394Aspfs*28, frameshift INDEL); and TP53 c.573insT (p.Gln192Serfs*17, frameshift INDEL). Novel TP53 variants were validated by classical sequencing methods and their impact on protein expression in tumors explored by immunohistochemistry. Further insights into the potential functional effect of the mutations were obtained by different in silico approaches, bioinformatics tools, and structural modeling. This discovery of previously unreported TP53 somatic mutations provides an opportunity to translate NGS technology into personalized medicine and identify new potential targets for therapeutic applications.
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Affiliation(s)
- Marica Garziera
- Experimental and Clinical Pharmacology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Erika Cecchin
- Experimental and Clinical Pharmacology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Vincenzo Canzonieri
- Pathology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Roberto Sorio
- Medical Oncology Unit C, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Giorgio Giorda
- Gynecological Oncology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Simona Scalone
- Medical Oncology Unit C, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Elena De Mattia
- Experimental and Clinical Pharmacology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Rossana Roncato
- Experimental and Clinical Pharmacology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Sara Gagno
- Experimental and Clinical Pharmacology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Elena Poletto
- Medical Oncology Department, Azienda Sanitaria Universitaria Integrata di Udine, via Pozzuolo 330, 33100 Udine (UD), Italy.
| | - Loredana Romanato
- Experimental and Clinical Pharmacology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Franca Sartor
- Experimental and Clinical Pharmacology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Jerry Polesel
- Unit of Cancer Epidemiology, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, CRO Aviano-National Cancer Institute, IRCCS, via F. Gallini 2, 33081 Aviano (PN), Italy.
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24
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Libra M, Talamini R, Crivellari D, Buonadonna A, Freschi A, Stefanovski P, Berretta M, De Cicco M, Balestreri L, Merlo A, Volpe R, Galligioni E, Sorio R. Long-Term Survival in Patients with Metastatic Renal Cell Carcinoma Treated with Continuous Intravenous Infusion of Recombinant Interleukin-2: The Experience of a Single Institution. Tumori 2018; 89:400-4. [PMID: 14606643 DOI: 10.1177/030089160308900410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim and background Metastatic renal cell carcinoma is one of the few tumors for which a clear benefit of immunotherapy has been demonstrated. The aim of this study was to evaluate the long-term survival of patients with metastatic renal cell carcinoma, along with response rate and other prognostic and predictive factors. Patients and methods Between July 1989 and May 1995, 56 patients with metastatic renal cell carcinoma were treated in a single institution with high-dose recombinant interleukin-2 in continuous infusion. Survival was measured by the Kaplan and Meier method. Prognostic factors were assessed by univariate and multivariate analyses of survival (Cox proportional hazard ratio model). Results Of 56 patients, 15 had objective responses (26.8%), 16 stable disease (28.6%), 18 disease progressions (32.1%), and 7 (12.5%) were not valuable for response. Median overall survival was 20 months, and probability of 2- and 5-year survival was 41% and 21%, respectively. At multivariate analysis, the increased risk of death for: performance status ≥2 vs 0 (HR = 6.20), stable disease (HR = 1.87), disease progression (HR = 10.61) vs partial or complete remission, and for hypotension and oliguria toxicity, G3 + G4 vs G1 + G2 (HR = 2.19). Conclusions Our study confirms the activity of IL-2 based immunotherapy in renal cell carcinoma. Moreover, ECOG performance status, clinical response, hypotension and oliguria toxicity resulted as independent survival prognostic factors.
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Affiliation(s)
- Massimo Libra
- Division of Medical Oncology, Centro di Riferimento Oncologico, IRCCS, Aviano, PN, Italy
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25
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26
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Lombardi D, Crivellari D, Scuderi C, Magri MD, Spazzapan S, Sorio R, Di Lauro V, Scalone S, Veronesi A. Long-Term, weekly One-Hour Infusion of Paclitaxel in Patients with Metastatic Breast Cancer: A Phase II Monoinstitutional Study. Tumori 2018; 90:285-8. [PMID: 15315306 DOI: 10.1177/030089160409000304] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background A dose-dense therapy with weekly paclitaxel given as a 1-hr infusion yielded a 53% overall response rate in breast cancer patients resistant to anthracyclines, with a remarkable lack of neutropenia (Seidman, 1998). We performed a monoinstitutional phase II trial in order to confirm these interesting results. Patients and methods Eligibility criteria included advanced breast cancer and no taxane pretreatment. Paclitaxel was administered weekly at the dose of 90 mg/m2 (60 mg/m2 in patients at high risk of toxicity) by 1-hr iv infusion. Fifty-eight patients entered the trial. Median age was 54 years (range, 38-72). Performance status was good (median 1; range, 0-2). Fifty-two patients were pretreated with anthracyclines. Results A total of 1,004 weekly paclitaxel infusions were administered (median, 19 per patient; range, 4-43). The median delivered dose intensity was 67.4 mg/m2/week (range, 43-86). Twenty-eight of the 58 assessable patients obtained an objective response (48%), 15 had stable disease (26%) and 15 progressed (26%). The overall response rate was 48% (95% confidence interval, 35-61%) with 5 complete responses (8%). In anthracycline-pretreated patients, 23/52 (44%) responses were observed. Median duration of response was 5 months (range, 3-27). Toxicity was acceptable apart from a case of pulmonary embolism in a 70-year-old patient, 1 case of congestive heart failure in an anthracycline-pretreated patient aged 64, and 9 cases of G3 neutropenia. Peripheral neuropathy was observed in 38 patients (64%), usually of a mild grade; alopecia in 45 patients (78%) and onychopathy in 16 (28%), usually of a mild grade apart from 2 cases requiring treatment interruption. Tachycardia and atrial fibrillation occurred in a 55-year-old woman. Conclusions Our data seem to confirm the activity and safety of this approach even in a heavily pretreated population of patients. Its combination with other active drugs needs to be further investigated in clinical trials.
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Affiliation(s)
- Davide Lombardi
- Division of Medical Oncology C, Centro di Riferimento Oncologico, Aviano, Italy.
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27
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Libra M, Sorio R, Buonadonna A, Berretta M, Stefanovski P, Toffoli G, Mazzaglia G, Cordani N, Stivala F, Boiocchi M. Cisplatin may be a Valid Alternative Approach in Ovarian Carcinoma with Carboplatin Hypersensitivity. Report of Three Cases. Tumori 2018; 89:311-3. [PMID: 12908789 DOI: 10.1177/030089160308900315] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Platinum-based therapy is considered the standard treatment for patients with advanced ovarian cancer. Carboplatin has a more favorable toxicity profile than cisplatin; however, hypersensitivity reactions to carboplatin have been reported occasionally. We reviewed 112 cases of ovarian cancer treated with carboplatin at our institute to identify the hypersensitivity reactions to this chemotherapeutic agent. Hypersensitivity reactions were documented in nine cases (8%). No deaths occurred, but the reactions were judged severe in three of the 112 patients (2.6%). In our own experience with patients showing idiosyncrasy to carboplatin we observed successful resolution after retreatment with cisplatin. Since patients who relapse after initial treatment with carboplatin often respond to it a second time, it is important to continue this treatment.
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Affiliation(s)
- Massimo Libra
- Division of Medical Ontology, Centro di Riferimento Oncologico, Aviano, Italy
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28
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Arcuri C, Sorio R, Tognon G, Gambino A, Scalone S, Lucenti A, Caffo O, Valduga F, Arisi E, Galligioni E. A Phase II Study of Liposomal Doxorubicin in Recurrent Epithelial Ovarian Carcinoma. Tumori 2018; 90:556-61. [PMID: 15762356 DOI: 10.1177/030089160409000604] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background We conducted a phase II trial to evaluate the efficacy and safety of liposomal formulation of doxorubicin in recurrent ovarian carcinoma patients. Methods Thirty patients were included in the study after having obtained an informed consent. Their main characteristics were: median age, 64 years (range, 45-80), ECOG performance status 0 in 17 patients (56%), 1 in 11 patients (36%) and 2 in 2 patients (6.6%). Eighteen patients had metastatic disease and 12 locally advanced disease. All patients were pretreated with a platinum-based chemotherapy: 3 were considered refractory to platinum (progression or stable disease), 2 were platinum resistant (relapse <12 months), and 7 were platinum sensitive (relapse ≥12 months). Treatment consisted of liposomal doxorubicin, 50 mg/m2 every 4 weeks. Results The overall response rate was 26.6%, with 2 complete responses and 6 partial responses lasting 3.5 months. The incidence of grade 3-4 toxicity was 23.3% for neutropenia, 10% for mucositis and 10% for plantar-palmar erythrodysesthesia. Median survival was 12+ months (range, 2-26+). Conclusions Liposomal doxorubicin appears to be a moderately active drug in pretreated patients, and its activity seems to be similar to that reported for other active regimens in terms of response rate. The toxicological profile of liposomal doxorubicin suggests that it may be combined with other drugs in the treatment of patients with ovarian cancer.
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Affiliation(s)
- Carmela Arcuri
- Division of Medical Oncology, St. Chiara Hospital, Trento, Italy.
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29
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Crivellari D, Carbone A, Sigon R, Buonadonna A, Cannizzaro R, Sorio R, Rossi C, Monfardini S. Gastric Cancer with Bone Marrow Invasion at Presentation: Case-Report and Review of the Literature. Tumori 2018; 81:74-6. [PMID: 7754548 DOI: 10.1177/030089169508100117] [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
A case of extensive bone marrow infiltration due to gastric cancer is reported. A 65-year old man with an acute episode of anemia (Hb 4.1 mg/dl) and dyspnea was admitted to the Medical Department of a general hospital. Bone marrow biopsy showed extensive paratrabecular infiltration of a poorly differentiated adenocarcinoma of gastric origin. The primary tumor in the stomach was confirmed, and the patient was referred to our Institute and treated with combination chemotherapy (FAMTX) for 6 cycles. Due to the disappearance of bone marrow infiltration, the patient was considered for curative resection of the primary gastric cancer. After 27 months the patient is alive and in clinical complete remission.
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Affiliation(s)
- D Crivellari
- Division of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
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30
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Boccardo F, Rubagotti A, Canobbio L, Galligioni E, Sorio R, Lucenti A, Cognetti F, Ruggeri E, Landonio G, Baiocchi C, Besana C, Citterio G, De Rosa M, Calabresi F. Interleukin-2, Interferon-α and Interleukin-2 plus Interferon-α in Renal Cell Carcinoma. A Randomized Phase Ii Trial. Tumori 2018; 84:534-9. [PMID: 9862512 DOI: 10.1177/030089169808400505] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 11/15/2022]
Abstract
Background The purpose of the present study was to investigate the therapeutic effectiveness of interleukin-2 (IL-2) and interferon (IFN), either alone or in combination, in comparable groups of patients affected by advanced renal cell carcinoma (RCC). Patients and methods In order to limit selection biases, treatment was allocated on a random basis. Patients randomized to IL-2 alone were scheduled to receive eight rIL-2 24-hour i.v. infusion cycles, days 1 to 4, at a daily dose of 18 x 106 IU/m2 for a total of 25 weeks. Patients randomized to IFN alone were scheduled to receive rIFN-α at a daily dose of 6 x 106 IU/m2, days 1, 3 and 5, every week for a total of 52 weeks. Patients randomized to the combination of IFN and IL-2 were given the same drugs at the same daily doses for a total of 24 weeks. Drug dose was modified according to toxicity. Results Twenty-three percent (95% CI: ± 17.5) of patients treated with IL-2 alone showed an objective response to treatment (9% CR). The corresponding figures in patients treated with IFN alone or IFN plus IL-2 were 9% (95% CI: ± 11.9) and 9% (95% CI: ± 11.9), respectively. Complete responses were observed only in patients treated with IL-2. The median duration of response in the IL-2 arm was 18 months (range, 9.5-24). The duration of the two responses achieved by IFN alone was seven and nine, months, respectively. The corresponding figures in the two patients responding to the combination of IFN with IL-2 were 19 and 27 months, respectively. Total IL-2 dose appeared to be a major predictor of response. Only a minority of patients experienced grade 3-4 toxicity, the incidence being higher in those treated with IL-2 or IL-2 plus IFN. Conclusions Neither IFN nor IL-2 or the combination of the two appear to be very active in patients with advanced RCC, even when trial entry was restricted to patients with relatively indolent disease. This stresses the need for the development of new approaches.
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Affiliation(s)
- F Boccardo
- Department of Medical Oncology II, National Institute for Cancer Research, Genoa, Italy
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31
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Perrone F, Baldassarre G, Indraccolo S, Signoriello S, Chiappetta G, Esposito F, Ferrandina G, Franco R, Mezzanzanica D, Sonego M, Zulato E, Zannoni GF, Canzonieri V, Scambia G, Sorio R, Savarese A, Breda E, Scollo P, Ferro A, Tamberi S, Febbraro A, Natale D, Di Maio M, Califano D, Scognamiglio G, Lorusso D, Canevari S, Losito S, Gallo C, Pignata S. Biomarker analysis of the MITO2 phase III trial of first-line treatment in ovarian cancer: predictive value of DNA-PK and phosphorylated ACC. Oncotarget 2018; 7:72654-72661. [PMID: 27655643 PMCID: PMC5341934 DOI: 10.18632/oncotarget.12056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 08/03/2016] [Indexed: 12/12/2022] Open
Abstract
Background No biomarker is available to predict prognosis of patients with advanced ovarian cancer (AOC) and guide the choice of chemotherapy. We performed a prospective-retrospective biomarker study within the MITO2 trial on the treatment of AOC. Patients and methods: MITO2 is a randomised multicentre phase 3 trial conducted with 820 AOC patients assigned carboplatin/paclitaxel (carboplatin: AUC5, paclitaxel: 175 mg/m², every 3 weeks for 6 cycles) or carboplatin/PLD-pegylated liposomal doxorubicin (carboplatin: AUC5, PLD: 30 mg/m², every 3 weeks for 6 cycles) as first line treatment. Sixteen biomarkers (pathways of adhesion/invasion, apoptosis, transcription regulation, metabolism, and DNA repair) were studied in 229 patients, in a tissue microarray. Progression-free and overall survival were analysed with multivariable Cox model. Results After 72 months median follow-up, 594 progressions and 426 deaths were reported; there was no significant difference between the two arms in the whole trial. No biomarker had significant prognostic value. Statistically significant interactions with treatment were found for DNA-dependent protein kinase (DNA-PK) and phosphorylated acetyl-coenzymeA carboxylase (pACC), both predicting worse outcome for patients receiving carboplatin/paclitaxel. Conclusion These data show that in presence of DNA-PK or pACC overexpression, carboplatin/paclitaxel might be less effective than carboplatin/PLD as first line treatment of ovarian cancer patients. Further validation of these findings is warranted.
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Affiliation(s)
- Francesco Perrone
- Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione G.Pascale, IRCCS, Napoli, Italy
| | | | | | - Simona Signoriello
- Dipartimento di Salute Mentale, Fisica e Medicina Preventiva, Statistica Medica, Seconda Università, Napoli, Italy
| | - Gennaro Chiappetta
- Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione G.Pascale, IRCCS, Napoli, Italy
| | | | | | - Renato Franco
- Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione G.Pascale, IRCCS, Napoli, Italy.,Dipartimento di Salute mentale, Fisica e Medicina Preventiva, Anatomia Patologica, Seconda Università, Napoli Italy
| | | | - Maura Sonego
- Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy
| | | | | | | | | | - Roberto Sorio
- Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy
| | | | - Enrico Breda
- Ospedale S. Giovanni Calibita Fatebenefratelli, Roma, Italy
| | | | | | | | | | | | - Massimo Di Maio
- Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione G.Pascale, IRCCS, Napoli, Italy.,Università degli Studi, Torino, Italy
| | - Daniela Califano
- Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione G.Pascale, IRCCS, Napoli, Italy
| | - Giosuè Scognamiglio
- Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione G.Pascale, IRCCS, Napoli, Italy
| | | | | | - Simona Losito
- Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione G.Pascale, IRCCS, Napoli, Italy
| | - Ciro Gallo
- Dipartimento di Salute Mentale, Fisica e Medicina Preventiva, Statistica Medica, Seconda Università, Napoli, Italy
| | - Sandro Pignata
- Istituto Nazionale per lo Studio e la Cura dei Tumori - Fondazione G.Pascale, IRCCS, Napoli, Italy
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32
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Posocco B, Buzzo M, Follegot A, Giodini L, Sorio R, Marangon E, Toffoli G. A new high-performance liquid chromatography-tandem mass spectrometry method for the determination of paclitaxel and 6α-hydroxy-paclitaxel in human plasma: Development, validation and application in a clinical pharmacokinetic study. PLoS One 2018; 13:e0193500. [PMID: 29474420 PMCID: PMC5825125 DOI: 10.1371/journal.pone.0193500] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/12/2018] [Indexed: 11/24/2022] Open
Abstract
Paclitaxel belongs to the taxanes family and it is used, alone or in multidrug regimens, for the therapy of several solid tumours, such as breast-, lung-, head and neck-, and ovarian cancer. Standard dosing of chemotherapy does not take into account the many inter-patient differences that make drug exposure highly variable, thus leading to the insurgence of severe toxicity. This is particularly true for paclitaxel considering that a relationship between haematological toxicity and plasma exposure was found. Therefore, in order to treat patients with the correct dose of paclitaxel, improving the overall benefit–risk ratio, Therapeutic Drug Monitoring is necessary. In order to quantify paclitaxel and its main metabolite, 6α-hydroxy-paclitaxel, in patients’ plasma, we developed a new, sensitive and specific HPLC–MS/MS method applicable to all paclitaxel dosages used in clinical routine. The developed method used a small volume of plasma sample and is based on quick protein precipitation. The chromatographic separation of the analytes was achieved with a SunFire™ C18 column (3.5 μM, 92 Å, 2,1 x 150 mm); the mobile phases were 0.1% formic acid/bidistilled water and 0.1% formic acid/acetonitrile. The electrospray ionization source worked in positive ion mode and the mass spectrometer operated in selected reaction monitoring mode. Our bioanalytical method was successfully validated according to the FDA-EMA guidelines on bioanalytical method validation. The calibration curves resulted linear (R2 ≥0.9948) over the concentration ranges (1–10000 ng/mL for paclitaxel and 1–1000 ng/mL for 6α-hydroxy-paclitaxel) and were characterized by a good accuracy and precision. The intra- and inter-day precision and accuracy were determined on three quality control concentrations for paclitaxel and 6α-hydroxy-paclitaxel and resulted respectively <9.9% and within 91.1–114.8%. In addition, to further verify the assay reproducibility, we tested this method by re-analysing the incurred samples. This bioanalytical method was employed with success to a genotype-guided phase Ib study of weekly paclitaxel in ovarian cancer patients treated with a wide range of drug’s dosages.
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Affiliation(s)
- Bianca Posocco
- Experimental and Clinical Pharmacology, CRO- National Cancer Institute, Aviano, Pordenone, Italy
| | - Mauro Buzzo
- Experimental and Clinical Pharmacology, CRO- National Cancer Institute, Aviano, Pordenone, Italy
| | - Andrea Follegot
- Experimental and Clinical Pharmacology, CRO- National Cancer Institute, Aviano, Pordenone, Italy
| | - Luciana Giodini
- Experimental and Clinical Pharmacology, CRO- National Cancer Institute, Aviano, Pordenone, Italy
| | - Roberto Sorio
- Oncology Unit B, CRO- National Cancer Institute, Aviano, Pordenone, Italy
| | - Elena Marangon
- Experimental and Clinical Pharmacology, CRO- National Cancer Institute, Aviano, Pordenone, Italy
- * E-mail:
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology, CRO- National Cancer Institute, Aviano, Pordenone, Italy
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Crivellari D, Spazzapan S, Lombardi D, Militello L, Torrisi E, Russo AE, Sorio R, Talamini R, Miolo G, Carli P, Veronesi A. Lapatinib-Based Therapy in Heavily Pretreated HER2-Positive Metastatic Breast Cancer: A Single Institution Experience. Tumori 2018; 98:33-8. [DOI: 10.1177/030089161209800104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background Lapatinib in combination with capecitabine is feasible in patients with HER2-positive metastatic breast cancer pretreated with anthracyclines, taxanes and trastuzumab, but inferior results were reported in the global lapatinib expanded access program in comparison with the phase III registration trial. Methods and Study Design Women with HER2-positive metastatic breast carcinoma after antracycline, taxane and trastuzumab-based regimens were treated at progression with lapatinib plus capecitabine. The outcome of these patients was evaluated. From April 2007 to August 2010, 68 patients were treated overall. Results Median progression-free survival was 6 months (range, 1–29), and median overall survival was 26 months (range, 1–39). Eight (12%; 95% CI, 4–25) patients experienced a complete response. Partial response was observed in 22 patients (31%; 95% CI, 20–42), for an overall response rate of 43% (95% CI, 31–55). The treatment with lapatinib plus capecitabine was well tolerated, with grade 3–4 toxicity reported in few patients, and no treatment-related deaths were noted. Of note, no cardiac toxicity was reported in this highly pretreated group of patients or in the subgroup of 10 elderly patients. Conclusions Our data confirm that lapatinib plus capecitabine is an active regimen even in heavily pretreated patients with visceral and brain metastases and is feasible and active also in selected elderly patients.
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Affiliation(s)
- Diana Crivellari
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
| | - Simon Spazzapan
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
| | - Davide Lombardi
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
| | - Loredana Militello
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
- Dept of Biomedical Sciences, University of Catania, Catania
| | - Elena Torrisi
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
- Dept of Biomedical Sciences, University of Catania, Catania
| | - Alessia E Russo
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
- Dept of Biomedical Sciences, University of Catania, Catania
| | - Roberto Sorio
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
| | | | - Gianmaria Miolo
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
| | - Paolo Carli
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
| | - Andrea Veronesi
- National Cancer Institute, Division of Medical Oncology C, CRO, Aviano (PN)
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Miolo G, Baldo P, Bidoli E, Lombardi D, Scalone S, Sorio R, Veronesi A. Incidence of Palmar-Plantar Erythrodysesthesia in Pretreated and Unpretreated Patients Receiving Pegylated Liposomal Doxorubicin. Tumori 2018; 95:687-90. [DOI: 10.1177/030089160909500608] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background Association between pegylated liposomal doxorubicin-based regimens and palmar-plantar erythrodysesthesia have just been emphasized, whereas the relationship between previous treatment and palmar-plantar erythrodysesthesia is still a matter of discussion. We evaluate the relationship between previous chemotherapy treatments and the development of palmar-plantar erythrodysesthesia in patients receiving pegylated liposomal doxorubicin-based regimens. Methods Between January 2005 and November 2006, 92 patients received regimens including pegylated liposomal doxorubicin. Patients were divided into three groups based on pegylated liposomal doxorubicin dosing interval length, different dose chosen, and previous chemotherapy. Results Among pretreated patients receiving regimens including 30 mg/m2 of pegylated liposomal doxorubicin repeated every three weeks, the incidence of palmar-plantar erythrodysesthesia was not significantly higher than in unpretreated patients receiving the same weekly schedule ( P = 0.4). There was no difference in the incidence of palmar-plantar erythrodysesthesia between pretreated patients with regimens including 30 mg/m2 of pegylated liposomal doxorubicin every three weeks and pretreated patients receiving 20 mg/m2 of pegylated liposomal doxorubicin every two weeks ( P = 0.8). The prevalence of palmar-plantar erythrodysesthesia observed in the unpretreated group exposed to 30 mg/m2 every three weeks was comparable to that of the pretreated group receiving 20 mg/m2 biweekly ( P = 0.3). However, excluding all the patients who developed grade 1 palmar-plantar erythrodysesthesia, the incidence of grade 2 and 3 palmar-plantar erythrodysesthesia observed in pretreated patients receiving regimens including 20 mg/m2 of pegylated liposomal doxorubicin biweekly was significantly higher than in unpretreated patients receiving 30 mg/m2 of pegylated liposomal doxorubicin every three weeks ( P = 0.001). Conclusions Our findings indicate that the pretreatment is not involved in the increased incidence of any grade palmar-plantar erythrodysesthesia. On the contrary, the study could suggest that the type of previous treatment may be an important factor in the development of more severe forms of palmar-plantar erythrodysesthesia.
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Affiliation(s)
- GianMaria Miolo
- Division of Medical Oncology C, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | - Paolo Baldo
- Pharmacy Unit, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | - Ettore Bidoli
- Epidemiology Unit, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | - Davide Lombardi
- Division of Medical Oncology C, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | - Simona Scalone
- Division of Medical Oncology C, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | - Roberto Sorio
- Division of Medical Oncology C, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
| | - Andrea Veronesi
- Division of Medical Oncology C, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy
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Nicoloso MS, Schiappacassi M, Dall’Acqua A, D’Andrea S, Benevol S, Sorio R, Canzonieri V, Giorda G, Baldassarre G. SRSF2 mutations in epithelial ovarian cancer. ACTA ACUST UNITED AC 2017. [DOI: 10.19156/cbn.2017.0056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Resistance to platinum chemotherapy regimens represents a major obstacle in the successful treatment of epithelial ovarian cancer (EOC) patients. Among the molecular mechanism responsible for resistance to platinum, alternative splicing, which is induced upon platinum treatment, can control apoptosis by regulating the expression of apoptotic protein variants with opposite functions. Alterations in alternative splicing are found in tumors and can hinder apoptotic response. In the present study we sequenced SRSF2, a splicing factor that regulates Caspase-8 and Caspase-9 variants, in search of mutations that could possibly explain alternative mechanisms of platinum resistant in EOC.
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Garziera M, Cecchin E, Polesel J, Roncato R, Gagno S, De Mattia E, Sorio R, Scalone S, Poletto E, Toffoli G. Association of p53-autoantibodies with TP53 somatic mutational profile detected by next generation sequencing in advanced high-grade ovarian cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.022] [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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Pignata S, Scambia G, Bologna A, Signoriello S, Vergote IB, Wagner U, Lorusso D, Murgia V, Sorio R, Ferrandina G, Sacco C, Cormio G, Breda E, Cinieri S, Natale D, Mangili G, Pisano C, Cecere SC, Di Napoli M, Salutari V, Raspagliesi F, Arenare L, Bergamini A, Bryce J, Daniele G, Piccirillo MC, Gallo C, Perrone F. Randomized Controlled Trial Testing the Efficacy of Platinum-Free Interval Prolongation in Advanced Ovarian Cancer: The MITO-8, MaNGO, BGOG-Ov1, AGO-Ovar2.16, ENGOT-Ov1, GCIG Study. J Clin Oncol 2017; 35:3347-3353. [PMID: 28825853 DOI: 10.1200/jco.2017.73.4293] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Platinum-based chemotherapy (PBC) for patients with progressing ovarian cancer (OC) is more effective with a longer time interval from previous platinum treatment (platinum-free interval [PFI]). In 1999, it was hypothesized that prolonging PFI with single-agent non-PBC (NPBC) may offer a strategy to improve overall outcome. MITO-8 aimed to verify this hypothesis commonly used in clinical practice although it has not been prospectively tested. Methods MITO-8 is an open-label, prospective, randomized, superiority trial. Patients with OC who experienced disease progression 6 to 12 months after their last platinum treatment were randomly assigned 1:1 to the experimental sequence of NPBC followed by PBC at subsequent relapse or the standard reverse treatment sequence. Overall survival (OS) was the primary end point. Results Two hundred fifteen patients were enrolled (standard arm [n = 108]; experimental arm [n = 107]). The trial ended before planned because of slow enrollment. PFI was prolonged in the experimental arm (median, 7.8 v 0.01 months). There was no OS benefit in the experimental arm (median, 21.8 v 24.5 months; hazard ratio, 1.38; 95% CI, 0.99 to 1.94; P = .06). Progression-free survival after the sequence was significantly shorter in the experimental arm (median, 12.8 v 16.4 months; hazard ratio, 1.41; 95% CI, 1.04 to 1.92; P = .025). Global quality-of-life change after three cycles was worse in the experimental arm. Slight differences were observed in the incidence of adverse effects. Conclusion MITO-8 supports the recommendation that PBC not be delayed in favor of an NPBC in patients with partially platinum-sensitive OC. PBC should be used as a control arm in future trials of new drugs in this setting.
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Affiliation(s)
- Sandro Pignata
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Giovanni Scambia
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Alessandra Bologna
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Simona Signoriello
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Ignace B Vergote
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Uwe Wagner
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Domenica Lorusso
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Viviana Murgia
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Roberto Sorio
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Gabriella Ferrandina
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Cosimo Sacco
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Gennaro Cormio
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Enrico Breda
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Saverio Cinieri
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Donato Natale
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Giorgia Mangili
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Carmela Pisano
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Sabrina Chiara Cecere
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Marilena Di Napoli
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Vanda Salutari
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Francesco Raspagliesi
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Laura Arenare
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Alice Bergamini
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Jane Bryce
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Gennaro Daniele
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Maria Carmela Piccirillo
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Ciro Gallo
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
| | - Francesco Perrone
- Sandro Pignata, Carmela Pisano, Sabrina Chiara Cecere, Marilena Di Napoli, Laura Arenare, Alice Bergamini, Jane Bryce, Gennaro Daniele, Maria Carmela Piccirillo, and Francesco Perrone, Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione G. Pascale, IRCCS; Simona Signoriello and Ciro Gallo, Università degli Studi della Campania Luigi Vanvitelli, Naples; Giovanni Scambia, Domenica Lorusso, Gabriella Ferrandina, and Vanda Salutari, Università Cattolica del Sacro Cuore; Enrico Breda, Ospedale San Giovanni Calibita Fatebenefratelli, Rome; Alessandra Bologna, Azienda Ospedaliea Santa Maria Nuova, IRCCS, Reggio Emilia; Domenica Lorusso and Francesco Raspagliesi, Fondazione IRCCS Istituto Nazionale dei Tumori; Giorgia Mangili and Alice Bergamini, Ospedale San Raffaele, Milan; Viviana Murgia, Ospedale Santa Chiara, Trento; Roberto Sorio, Centro di Riferimento Oncologico, Aviano; Gabriella Ferrandina, Centro di Ricerca e Formazione Ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso; Cosimo Sacco, Azienda Ospedaliera di Perugia Santa Maria della Misericordia, Udine; Gennaro Cormio, Ginecologia Oncologica, Università di Bari e Istituto Oncologico "Giovanni Paolo II" Bari; Saverio Cinieri, Ospedale Antonio Perrino, Brindisi; Donato Natale, Ospedale San Massimo, Penne, Italy; Ignace B. Vergote, University Hospital Leuven and Belgian and Luxembourg Gynaecological Oncology Group, Leuven Cancer Institute, Leuven, Belgium; and Uwe Wagner, Uniklinkum Giessen und Marburg Gynäkologie, Marburg, Germany
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Sorio R, Roemer-Becuwe C, Hilpert F, Gibbs E, García Y, Kaern J, Huizing M, Witteveen P, Zagouri F, Coeffic D, Lück HJ, González-Martín A, Kristensen G, Levaché CB, Lee CK, Gebski V, Pujade-Lauraine E. Safety and efficacy of single-agent bevacizumab-containing therapy in elderly patients with platinum-resistant recurrent ovarian cancer: Subgroup analysis of the randomised phase III AURELIA trial. Gynecol Oncol 2017; 144:65-71. [DOI: 10.1016/j.ygyno.2016.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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Garziera M, Cecchin E, Montico M, Roncato R, Gagno S, De Mattia E, Sorio R, Scalone S, Poletto E, Toffoli G. Impact of humoral immune response against p53 on clinical outcome of High-Grade Serous Ovarian Cancer (HGSOC) patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw525.24] [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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Piccirillo M, Scambia G, Bologna A, Vergote I, Baumann K, Raspagliesi F, Murgia V, Pisano C, Salutari V, Sorio R, Ferrandina G, Sacco C, Cormio G, Breda E, Cinieri S, Cecere S, Daniele G, Gallo C, Perrone F, Pignata S. The MITO8 phase 3 international multicenter randomized study testing the effect on survival of prolonging platinum-free interval (PFI) in patients with ovarian cancer (OC) recurring between 6 and 12 months after previous platinum based chemotherapy. A collaboration of MITO, Mango, AGO Study Group, BGOG, ENGOT, and GCIG. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw331.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bagnoli M, Canevari S, Califano D, Losito S, Maio MD, Raspagliesi F, Carcangiu ML, Toffoli G, Cecchin E, Sorio R, Canzonieri V, Russo D, Scognamiglio G, Chiappetta G, Baldassarre G, Lorusso D, Scambia G, Zannoni GF, Savarese A, Carosi M, Scollo P, Breda E, Murgia V, Perrone F, Pignata S, De Cecco L, Mezzanzanica D. Development and validation of a microRNA-based signature (MiROvaR) to predict early relapse or progression of epithelial ovarian cancer: a cohort study. Lancet Oncol 2016; 17:1137-1146. [PMID: 27402147 DOI: 10.1016/s1470-2045(16)30108-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/21/2016] [Accepted: 04/21/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Risk of relapse or progression remains high in the treatment of most patients with epithelial ovarian cancer, and development of a molecular predictor could be a valuable tool for stratification of patients by risk. We aimed to develop a microRNA (miRNA)-based molecular classifier that can predict risk of progression or relapse in patients with epithelial ovarian cancer. METHODS We analysed miRNA expression profiles in three cohorts of samples collected at diagnosis. We used 179 samples from a Multicenter Italian Trial in Ovarian cancer trial (cohort OC179) to develop the model and 263 samples from two cancer centres (cohort OC263) and 452 samples from The Cancer Genome Atlas epithelial ovarian cancer series (cohort OC452) to validate the model. The primary clinical endpoint was progression-free survival, and we adapted a semi-supervised prediction method to the miRNA expression profile of OC179 to identify miRNAs that predict risk of progression. We assessed the independent prognostic role of the model using multivariable analysis with a Cox regression model. FINDINGS We identified 35 miRNAs that predicted risk of progression or relapse and used them to create a prognostic model, the 35-miRNA-based predictor of Risk of Ovarian Cancer Relapse or progression (MiROvaR). MiROvaR was able to classify patients in OC179 into a high-risk group (89 patients; median progression-free survival 18 months [95% CI 15-22]) and a low-risk group (90 patients; median progression-free survival 38 months [24-not estimable]; hazard ratio [HR] 1·85 [1·29-2·64], p=0·00082). MiROvaR was a significant predictor of progression in the two validation sets (OC263 HR 3·16, 95% CI 2·33-4·29, p<0·0001; OC452 HR 1·39, 95% CI 1·11-1·74, p=0·0047) and maintained its independent prognostic effect when adjusted for relevant clinical covariates using multivariable analyses (OC179: adjusted HR 1·48, 95% CI 1·03-2·13, p=0·036; OC263: adjusted HR 3·09 [2·24-4·28], p<0·0001; and OC452: HR 1·41 [1·11-1·79], p=0·0047). INTERPRETATION MiROvaR is a potential predictor of epithelial ovarian cancer progression and has prognostic value independent of relevant clinical covariates. MiROvaR warrants further investigation for the development of a clinical-grade prognostic assay. FUNDING AIRC and CARIPLO Foundation.
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Affiliation(s)
- Marina Bagnoli
- Molecular Therapies Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Silvana Canevari
- Functional Genomics, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniela Califano
- Functional Genomic Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - Simona Losito
- Surgical Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - Massimo Di Maio
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - Francesco Raspagliesi
- Unit of Gynaecological Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maria Luisa Carcangiu
- Anatomic Pathology 1 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico, Istituto Ricovero e Cura Carattere Scientifico (CRO-IRCCS), Aviano, Italy
| | - Erika Cecchin
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico, Istituto Ricovero e Cura Carattere Scientifico (CRO-IRCCS), Aviano, Italy
| | - Roberto Sorio
- Medical Oncology C, Centro di Riferimento Oncologico, Istituto Ricovero e Cura Carattere Scientifico (CRO-IRCCS), Aviano, Italy
| | - Vincenzo Canzonieri
- Unit of Pathology, Centro di Riferimento Oncologico, Istituto Ricovero e Cura Carattere Scientifico (CRO-IRCCS), Aviano, Italy
| | - Daniela Russo
- Functional Genomic Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - Giosué Scognamiglio
- Surgical Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - Gennaro Chiappetta
- Functional Genomic Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - Gustavo Baldassarre
- Division of Experimental Oncology 2, Centro di Riferimento Oncologico, Istituto Ricovero e Cura Carattere Scientifico (CRO-IRCCS), Aviano, Italy
| | - Domenica Lorusso
- Unit of Gynaecological Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanni Scambia
- Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy
| | - Gian Franco Zannoni
- Department of Human Pathology, Division of Gynecologic Pathology, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonella Savarese
- Division of Medical Oncology 1, Regina Elena Cancer Institute, Rome, Italy
| | | | - Paolo Scollo
- Department of Obstetrics and Gynecology, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Enrico Breda
- Medical Oncology Unit Ospedale S Giovanni Calibita Fatebenefratelli, Rome, Italy
| | | | - Francesco Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - Sandro Pignata
- Department of Urogynaecological Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - Loris De Cecco
- Functional Genomics, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Delia Mezzanzanica
- Molecular Therapies Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Pignata S, Scambia G, Raspagliesi F, Murgia V, Pisano C, Salutari V, Bologna A, Sorio R, Ferrandina G, Sacco C, Vergote I, Cormio G, Breda E, Cinieri S, Cecere SC, Wagner UAG, Daniele G, Gallo C, Perrone F, Piccirillo MC. The MITO8 phase III international multicenter randomized study testing the effect on survival of prolonging platinum-free interval (PFI) in patients with ovarian cancer (OC) recurring between 6 and 12 months after previous platinum-based chemotherapy: A collaboration of MITO, MANGO, AGO, BGOG, ENGOT, and GCIG. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sandro Pignata
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, IRCCS, Napoli, Italy
| | - Giovanni Scambia
- Universita Cattolica del Sacro Cuore di Roma, Unità di Ginecologia Oncologica UOC, Rome, Italy
| | | | | | - Carmela Pisano
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, IRCCS, Napoli, Italy
| | - Vanda Salutari
- Universita Cattolica del Sacro Cuore di Roma, Unità di Ginecologia Oncologica UOC, Rome, Italy
| | - Alessandra Bologna
- Medical Oncology Unit, IRCCS-Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Roberto Sorio
- Centro di Riferimento Oncologico-IRCCS, Aviano, Italy
| | - Gabriella Ferrandina
- Centro di Ricerca e Formazione ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - Cosimo Sacco
- Dipartimento di Oncologia, Azienda Ospedaliero-Universitaria S. M. della Misericordia, Udine, Italy
| | | | | | - Enrico Breda
- S. Giovanni Calibita- Fatebenefratelli Hospital, Roma, Italy
| | | | - Sabrina Chiara Cecere
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, IRCCS, Napoli, Italy
| | | | - Gennaro Daniele
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, IRCCS, Napoli, Italy
| | | | - Francesco Perrone
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, IRCCS, Napoli, Italy
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Lorusso D, Scambia G, Pignata S, Sorio R, Amadio G, Lepori S, Mosconi A, Pisano C, Mangili G, Maltese G, Sabbatini R, Artioli G, Gamucci T, Di Napoli M, Capoluongo E, Ludovini V, Raspagliesi F, Ferrandina G. Prospective phase II trial of trabectedin in BRCA-mutated and/or BRCAness phenotype recurrent ovarian cancer patients: the MITO 15 trial. Ann Oncol 2015; 27:487-93. [PMID: 26681678 DOI: 10.1093/annonc/mdv608] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/09/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Current evidence suggest that trabectedin is particularly effective in cells lacking functional homologous recombination repair mechanisms. A prospective phase II trial was designed to evaluate the activity of trabectedin in the treatment of recurrent ovarian cancer patients presenting BRCA mutation and/or BRCAness phenotype. PATIENTS AND METHODS A total of 100 patients with recurrent BRCA-mutated ovarian cancer and/or BRCAness phenotype (≥2 previous responses to platinum) were treated with trabectedin 1.3 mg/mq i.v. q 3 weeks. The activity of the drug with respect to BRCA mutational status and to a series of polymorphisms [single-nucleotide polymorphisms (SNPs)] involved in DNA gene repair was analyzed. RESULTS Ninety-four were evaluable for response; in the whole population, 4 complete and 33 partial responses were registered for an overall response rate (ORR) of 39.4. In the platinum-resistant (PR) and -sensitive (PS) population, an ORR of 31.2% and 47.8%, and an overall clinical benefit of 54.2% and 73.9%, respectively, were registered. In the whole series, the median progression-free survival (PFS) was 18 weeks and the median overall survival (OS) was 72 weeks; PS patients showed a more favorable PFS and OS compared with PR patients. BRCA gene mutational status was available in 69 patients. There was no difference in ORR, PFS and OS according to BRCA 1-2 status nor any association between SNPs of genes involved in DNA repair and NER machinery and response to trabectedin was reported. CONCLUSIONS Our data prospectively confirmed that the signature of 'repeated platinum sensitivity' identifies patients highly responsive to trabectedin. In this setting, the activity of trabectedin seems comparable to what could be obtained using platinum compounds and the drug may represent a valuable alternative option in patients who present contraindication to receive platinum. EUDRACT NUMBER 2011-001298-17.
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Affiliation(s)
- D Lorusso
- Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan
| | - G Scambia
- Department of Obstetrics and Gynecology, Catholic University of Rome
| | - S Pignata
- Department of Gynecologic and Urologic Oncology, Fondazione Pascale, National Cancer Institute of Naples
| | - R Sorio
- Department of Oncology, CRO Aviano, Aviano
| | - G Amadio
- Department of Obstetrics and Gynecology, Catholic University of Rome
| | - S Lepori
- Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan
| | - A Mosconi
- Medical Oncology Unit, University Hospital S. Maria della Misericordia, Perugia
| | - C Pisano
- Department of Gynecologic and Urologic Oncology, Fondazione Pascale, National Cancer Institute of Naples
| | - G Mangili
- Department of Obstetrics and Gynecology, San Raffaele Hospital, Milan
| | - G Maltese
- Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan
| | - R Sabbatini
- Department of Oncology Haematology and Respiratory Disease, AOU Policlinico di Modena, Modena
| | - G Artioli
- Medical Oncology Unit, Hospital of Mirano, Mirano
| | - T Gamucci
- Medical Oncology Unit, Hospital 'SS. Trinità', Sora
| | - M Di Napoli
- Department of Gynecologic and Urologic Oncology, Fondazione Pascale, National Cancer Institute of Naples
| | - E Capoluongo
- Department of Molecular Biology, Catholic University of Rome
| | - V Ludovini
- Molecular Biology Unit, University Hospital S. Maria della Misericordia, Perugia, Italy
| | - F Raspagliesi
- Gynecologic Oncology Unit, Fondazione IRCCS National Cancer Institute, Milan
| | - G Ferrandina
- Department of Obstetrics and Gynecology, Catholic University of Rome
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Garziera M, Montico M, Bidoli E, Scalone S, Sorio R, Giorda G, Lucia E, Toffoli G. Prognostic Role of Serum Antibody Immunity to p53 Oncogenic Protein in Ovarian Cancer: A Systematic Review and a Meta-Analysis. PLoS One 2015; 10:e0140351. [PMID: 26451959 PMCID: PMC4599823 DOI: 10.1371/journal.pone.0140351] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 09/24/2015] [Indexed: 01/21/2023] Open
Abstract
Objective Serum p53 autoantibodies (p53-AAbs) are the product of an endogenous immune response against p53 overexpression driven by the ovarian tumour. The p53-AAbs are detectable only in a subset of patients. To date, the evidence of an association between the presence of p53-AAbs and ovarian cancer outcomes has been poorly investigated. Methods A systematic literature search was performed to identify eligible studies investigating the association of serum p53-AAbs and overall survival (OS) and disease free survival (DFS). Associations between presence of serum p53-AAbs and baseline tumour characteristics were also evaluated. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CI) were computed to estimate the prognostic impact of serum p53-AAbs. Heterogeneity between studies was assessed. Results A total of 583 patients (7 studies) for OS and 356 patients (4 studies) for DFS were included in the meta-analysis. Presence of p53-AAbs was not associated to OS (pooled uni- multivariate HR = 1.09; 95% CI: 0.55–2.16), and a large heterogeneity was found. When only multivariate HRs were pooled together (4 studies), presence of p53-AAbs was significantly associated to a better OS (pooled HR = 0.57; 95% CI: 0.40–0.81), and no significant heterogeneity was observed. A reduced DFS was associated to p53-AAbs (pooled uni- multivariate HR = 1.37; 95% CI: 0.83–2.25), though not significantly and with a moderate heterogeneity. Conclusions The prognostic significance of serum p53-AAbs in ovarian cancer was diverging according to uni or multivariate models used. Since the results of this work were based on only few investigations, large prospective studies are needed to better define the role of antibody immunity against p53.
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Affiliation(s)
- Marica Garziera
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy
- * E-mail:
| | - Marcella Montico
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy
| | - Ettore Bidoli
- Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy
| | - Simona Scalone
- Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy
| | - Roberto Sorio
- Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy
| | - Giorgio Giorda
- Department of Gynecological Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy
| | - Emilio Lucia
- Department of Gynecological Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, (PN), Italy
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Lorusso D, Ferrandina G, Colombo N, Pignata S, Salutari V, Maltese G, Pisano C, Lapresa M, Savarese A, Tagliaferri P, Sorio R, Cinieri S, Breda E, Sabbatini R, Lepori S, Conte C, Cecere SC, Raspagliesi F, Scambia G. Randomized phase II trial of carboplatin-paclitaxel (CP) compared to carboplatin-paclitaxel-bevacizumab (CP-B) in advanced (stage III-IV) or recurrent endometrial cancer: The MITO END-2 trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5502] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Domenica Lorusso
- MITO and Fondazione IRCCS National Cancer Institute, Milan, Italy
| | | | | | - Sandro Pignata
- Department of Medical Oncology, National Cancer Institute of Naples, Naples, Italy
| | - Vanda Salutari
- Policlinico Gemelli, Gynecologic Oncology Unit, Catholic University of Rome, Rome, Italy
| | | | | | | | | | | | - Roberto Sorio
- MITO and Centro di Riferimento Oncologico-IRCCS, Aviano, Italy
| | | | - Enrico Breda
- Medical Oncology, Ospedale Fatebenefratelli, Roma, Italy
| | | | - Stefano Lepori
- Fondazione IRCCS National Cancer Institute Milan, Milan, Italy
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Lorusso D, Ferrandina G, Pignata S, Sorio R, Amadio G, Mosconi A, Pisano C, Mangili G, Masini C, Artioli G, Narducci F, Di Napoli M, Rigamonti C, Raspagliesi F, Scambia G. Trabectedin in Patients with Brca Mutated and Brcaness Phenotype Advanced Ovarian Cancer (Aoc): Phase Ii Prospective Mito-15 Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu338.12] [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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Giorda G, Gadducci A, Lucia E, Sorio R, Bounous VE, Sopracordevole F, Tinelli A, Baldassarre G, Campagnutta E. Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study. J Ovarian Res 2014; 7:72. [PMID: 25328074 PMCID: PMC4100746 DOI: 10.1186/1757-2215-7-72] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/26/2014] [Indexed: 01/18/2023] Open
Abstract
Background Optimal debulking surgery is postulated to be useful in survival of ovarian cancer patients. Some studies highlighted the possible role of bowel surgery in this topic. We wanted to evaluate the role of bowel involvement in patients with advanced epithelial ovarian cancer who underwent optimal cytoreduction. Methods Between 1997 and 2004, 301 patients with advanced epithelial cancer underwent surgery at Department of Gynecological Oncology of Centro di Riferimento Oncologico (CRO) National Cancer Institute Aviano (PN) Italy. All underwent maximal surgical effort, including bowel and upper abdominal procedure, in order to achieve optimal debulking (R < 0.5 cm). PFS and OS were compared with residual disease, grading and surgical procedures. Results Optimal cytoreduction was achieved in 244 patients (81.0%); R0 in 209 women (69.4.%) and R < 0.5 in 35 (11.6%). Bowel resection was performed in 116 patients (38.5%): recto-sigmoidectomy alone (69.8%), upper bowel resection only (14.7%) and both recto-sigmoidectomy and other bowel resection (15.5%). Pelvic peritonectomy and upper abdomen procedures were carried out in 202 (67.1%) and 82 (27.2%) patients respectively. Among the 284 patients available for follow-up, PFS and OS were significantly better in patients with R < 0.5. Among the 229 patients with optimal debulking (R < 0.5), 137 patients (59.8%) developed recurrent disease or progression. In the 229 R < 0.5 group, bowel involvement was associated with decreased PFS and OS in G1-2 patients whereas in G3 patients OS, but not PFS, was adversely affected. In the 199 patients with R0, PFS and OS were significantly better (p < 0.01) for G1-2 patients without bowel involvement whereas only significant OS (p < 0.05) was observed in G3 patients without bowel involvement versus G3 patients with bowel involvement. Conclusions Optimal cytoreduction (R < 0.5 cm and R0) is the most important prognostic factor for advanced epithelial ovarian cancer. In the optimally cytoreduced (R < 0.5 and R0) patients, bowel involvement is associated with dismal prognosis for OS both in patients with G1-2 grading and in patients with G3 grading. Bowel involvement in G3 patients, carries instead the same risk of recurrence for PFS.
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Affiliation(s)
- Giorgio Giorda
- Department of Gynecological Oncology of Centro di Riferimento Oncologico (CRO) National Cancer Institute, via Gallini 2, I-33019 Aviano, (PN), Italy.
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48
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Lorusso D, Ferrandina G, Pignata S, Sorio R, Pietragalla A, Mosconi AM, Pisano C, Mangili G, Martinelli F, Masini C, Artioli G, Narducci F, DI Napoli M, Raspagliesi F, Scambia G. Phase II prospective study on trabectedin (T) in BRCA-mutated and BRCAness phenotype advanced ovarian cancer (AOC) patients (pts): The MITO 15 trial. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.5530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Gabriella Ferrandina
- Policlinico Gemelli, Gynecologic Oncology Unit, Catholic University of Rome, Rome, Italy
| | | | - Roberto Sorio
- MITO and Centro di Riferimento Oncologico-IRCCS, Aviano, Italy
| | | | | | | | | | | | - Cristina Masini
- A.O. Univ. Policl. di Modena Univ. Studi Modena e R. Emilia, Modena, Italy
| | - Grazia Artioli
- Department of Medical Science - Oncology-Haematology, Mirano, Venice, Italy
| | | | | | | | - Giovanni Scambia
- Universita Cattolica del Sacro Cuore Policlinico Agostino Gemelli, Rome, Italy
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Pujade-Lauraine E, Hilpert F, Weber B, Reuss A, Poveda A, Kristensen G, Sorio R, Vergote I, Witteveen P, Bamias A, Pereira D, Wimberger P, Oaknin A, Mirza MR, Follana P, Bollag D, Ray-Coquard I. Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: The AURELIA open-label randomized phase III trial. J Clin Oncol 2014. [PMID: 24637997 DOI: 10.1200/jco.2013.51.4489] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In platinum-resistant ovarian cancer (OC), single-agent chemotherapy is standard. Bevacizumab is active alone and in combination. AURELIA is the first randomized phase III trial to our knowledge combining bevacizumab with chemotherapy in platinum-resistant OC. PATIENTS AND METHODS Eligible patients had measurable/assessable OC that had progressed < 6 months after completing platinum-based therapy. Patients with refractory disease, history of bowel obstruction, or > two prior anticancer regimens were ineligible. After investigators selected chemotherapy (pegylated liposomal doxorubicin, weekly paclitaxel, or topotecan), patients were randomly assigned to single-agent chemotherapy alone or with bevacizumab (10 mg/kg every 2 weeks or 15 mg/kg every 3 weeks) until progression, unacceptable toxicity, or consent withdrawal. Crossover to single-agent bevacizumab was permitted after progression with chemotherapy alone. The primary end point was progression-free survival (PFS) by RECIST. Secondary end points included objective response rate (ORR), overall survival (OS), safety, and patient-reported outcomes. RESULTS The PFS hazard ratio (HR) after PFS events in 301 of 361 patients was 0.48 (95% CI, 0.38 to 0.60; unstratified log-rank P < .001). Median PFS was 3.4 months with chemotherapy alone versus 6.7 months with bevacizumab-containing therapy. RECIST ORR was 11.8% versus 27.3%, respectively (P = .001). The OS HR was 0.85 (95% CI, 0.66 to 1.08; P < .174; median OS, 13.3 v 16.6 months, respectively). Grade ≥ 2 hypertension and proteinuria were more common with bevacizumab. GI perforation occurred in 2.2% of bevacizumab-treated patients. CONCLUSION Adding bevacizumab to chemotherapy statistically significantly improved PFS and ORR; the OS trend was not significant. No new safety signals were observed.
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Affiliation(s)
- Eric Pujade-Lauraine
- Eric Pujade-Lauraine, Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) and Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Paris; Béatrice Weber, GINECO and Centre Alexis Vautrin, Vandoeuvre-les-Nancy; Philippe Follana, GINECO and Centre Antoine-Lacassagne, Nice; Isabelle Ray-Coquard, GINECO and Centre Léon Bérard, Lyon, France; Felix Hilpert, Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and Klinik für Gynäkologie und Geburtshilfe, Kiel; Alexander Reuss, AGO and Coordinating Center for Clinical Trials, Marburg; Pauline Wimberger, AGO and University of Duisburg-Essen, Essen, Germany; Andres Poveda, Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Instituto Valenciano de Oncologia, Valencia; Ana Oaknin, GEICO and Vall d'Hebron University Hospital, Barcelona, Spain; Gunnar Kristensen, Nordic Society of Gynaecological Oncology (NSGO) and Norwegian Radium Hospital, Oslo, Norway; Roberto Sorio, Multicenter Italian Trials in Ovarian Cancer and Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy; Ignace Vergote, Belgian Gynaecological Oncology Group and University Hospital Leuven, Leuven, Belgium; Petronella Witteveen, Dutch Gynecological Oncology Group and University Medical Center Utrecht, Utrecht, the Netherlands; Aristotelis Bamias, Hellenic Cooperative Oncology Group and University of Athens, Athens, Greece; Deolinda Pereira, GINECO and Instituto Português de Oncologia do Porto, Porto, Portugal; Mansoor Raza Mirza, NSGO and Rigshospitalet, Copenhagen, Denmark; and David Bollag, F. Hoffmann-La Roche, Basel, Switzerland
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50
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Stockler MR, Hilpert F, Friedlander M, King MT, Wenzel L, Lee CK, Joly F, de Gregorio N, Arranz JA, Mirza MR, Sorio R, Freudensprung U, Sneller V, Hales G, Pujade-Lauraine E. Patient-reported outcome results from the open-label phase III AURELIA trial evaluating bevacizumab-containing therapy for platinum-resistant ovarian cancer. J Clin Oncol 2014; 32:1309-16. [PMID: 24687829 DOI: 10.1200/jco.2013.51.4240] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine the effects of bevacizumab on patient-reported outcomes (PROs; secondary end point) in the AURELIA trial. PATIENTS AND METHODS Patients with platinum-resistant ovarian cancer were randomly assigned to chemotherapy alone (CT) or with bevacizumab (BEV-CT). PROs were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Ovarian Cancer Module 28 (EORTC QLQ-OV28) and Functional Assessment of Cancer Therapy-Ovarian Cancer symptom index (FOSI) at baseline and every two or three cycles (8/9 weeks) until disease progression. The primary PRO hypothesis was that more patients receiving BEV-CT than CT would achieve at least a 15% (≥ 15-point) absolute improvement on the QLQ-OV28 abdominal/GI symptom subscale (items 31-36) at week 8/9. Patients with missing week 8/9 questionnaires were included as unimproved. Questionnaires from all assessments until disease progression were analyzed using mixed-model repeated-measures (MMRM) analysis. Sensitivity analyses were used to determine the effects of differing assumptions and methods for missing data. RESULTS Baseline questionnaires were available from 89% of 361 randomly assigned patients. More BEV-CT than CT patients achieved a ≥ 15% improvement in abdominal/GI symptoms at week 8/9 (primary PRO end point, 21.9% v 9.3%; difference, 12.7%; 95% CI, 4.4 to 20.9; P = .002). MMRM analysis covering all time points also favored BEV-CT (difference, 6.4 points; 95% CI, 1.3 to 11.6; P = .015). More BEV-CT than CT patients achieved ≥ 15% improvement in FOSI at week 8/9 (12.2% v 3.1%; difference, 9.0%; 95% CI, 2.9% to 15.2%; P = .003). Sensitivity analyses gave similar results and conclusions. CONCLUSION Bevacizumab increased the proportion of patients achieving a 15% improvement in patient-reported abdominal/GI symptoms during chemotherapy for platinum-resistant ovarian cancer.
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Affiliation(s)
- Martin R Stockler
- Martin R. Stockler, Madeleine T. King, Chee Khoon Lee, The University of Sydney; Michael Friedlander, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia; Felix Hilpert, Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) and Klinik für Gynäkologie und Geburtshilfe, Kiel; Nikolaus de Gregorio, AGO and University of Ulm Medical Center, Ulm, Germany; Lari Wenzel, University of California Irvine, Irvine, CA; Florence Joly, Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) and Centre François Baclesse, Caen; Eric Pujade-Lauraine, GINECO and Centre Hospitalier Universitaire Hotel Dieu, Paris, France; José Angel Arranz, Grupo Español de Investigación en Cáncer de Ovario and Hospital General Universitario Gregorio Marañón, Madrid, Spain; Mansoor Raza Mirza, Nordic Society of Gynaecological Oncology and Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Roberto Sorio, Multicenter Italian Trials in Ovarian Cancer and Centro di Riferimento Oncologico-Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy; and Ulrich Freudensprung, Vesna Sneller, Gill Hales, F. Hoffmann-La Roche, Basel, Switzerland
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