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Li Y, Shah RB, Sarti S, Belcher AL, Lee BJ, Gorbatenko A, Nemati F, Yu H, Stanley Z, Rahman M, Shao Z, Silva JM, Zha S, Sidi S. A noncanonical IRAK4-IRAK1 pathway counters DNA damage-induced apoptosis independently of TLR/IL-1R signaling. Sci Signal 2023; 16:eadh3449. [PMID: 38113335 DOI: 10.1126/scisignal.adh3449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
Interleukin-1 receptor (IL-1R)-associated kinases (IRAKs) are core effectors of Toll-like receptors (TLRs) and IL-1R in innate immunity. Here, we found that IRAK4 and IRAK1 together inhibited DNA damage-induced cell death independently of TLR or IL-1R signaling. In human cancer cells, IRAK4 was activated downstream of ATR kinase in response to double-strand breaks (DSBs) induced by ionizing radiation (IR). Activated IRAK4 then formed a complex with and activated IRAK1. The formation of this complex required the E3 ubiquitin ligase Pellino1, acting structurally but not catalytically, and the activation of IRAK1 occurred independently of extracellular signaling, intracellular TLRs, and the TLR/IL-1R signaling adaptor MyD88. Activated IRAK1 translocated to the nucleus in a Pellino2-dependent manner. In the nucleus, IRAK1 bound to the PIDD1 subunit of the proapoptotic PIDDosome and interfered with platform assembly, thus supporting cell survival. This noncanonical IRAK signaling pathway was also activated in response to other DSB-inducing agents. The loss of IRAK4, of IRAK4 kinase activity, of either Pellino protein, or of the nuclear localization sequence in IRAK1 sensitized p53-mutant zebrafish to radiation. Thus, the findings may lead to strategies for overcoming tumor resistance to conventional cancer treatments.
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Affiliation(s)
- Yuanyuan Li
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Richa B Shah
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Samanta Sarti
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Alicia L Belcher
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Brian J Lee
- Institute for Cancer Genetics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Andrej Gorbatenko
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Francesca Nemati
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Honglin Yu
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Zoe Stanley
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mahbuba Rahman
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Zhengping Shao
- Institute for Cancer Genetics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Jose M Silva
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Shan Zha
- Institute for Cancer Genetics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Division of Pediatric Oncology, Hematology and Stem Cell Transplantation, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Samuel Sidi
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Cell, Developmental and Regenerative Biology, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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De Paolo R, Munagala U, Cucco F, Sarti S, Pitto L, Martignano F, Conticello SG, Poliseno L. Modified Cas9-Guided Oxford Nanopore Technology Sequencing Uncovers Single and Multiple Transgene Insertion Sites in a Zebrafish Melanoma Model. CRISPR J 2023; 6:489-492. [PMID: 38108521 DOI: 10.1089/crispr.2023.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Affiliation(s)
- Raffaella De Paolo
- Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Uday Munagala
- Molecular Mechanisms of Oncogenesis Unit, Core Research Laboratory, ISPRO, Florence, Italy
| | - Francesco Cucco
- Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Samanta Sarti
- Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | | | - Filippo Martignano
- Molecular Mechanisms of Oncogenesis Unit, Core Research Laboratory, ISPRO, Florence, Italy
| | - Silvestro G Conticello
- Institute of Clinical Physiology, CNR, Pisa, Italy
- Molecular Mechanisms of Oncogenesis Unit, Core Research Laboratory, ISPRO, Florence, Italy
| | - Laura Poliseno
- Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy
- Institute of Clinical Physiology, CNR, Pisa, Italy
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3
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Conte P, Bisagni G, Piacentini F, Sarti S, Minichillo S, Anselmi E, Aieta M, Gebbia V, Schirone A, Musolino A, Garrone O, Beano A, Rimanti A, Giotta F, Turletti A, Miglietta F, Dieci MV, Vicini R, Balduzzi S, D'Amico R, Guarneri V. Nine-Week Versus One-Year Trastuzumab for Early Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: 10-Year Update of the ShortHER Phase III Randomized Trial. J Clin Oncol 2023; 41:4976-4981. [PMID: 37748109 PMCID: PMC10642895 DOI: 10.1200/jco.23.00790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/21/2023] [Accepted: 06/29/2023] [Indexed: 09/27/2023] Open
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned coprimary or secondary analyses are not yet available. Clinical trial updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.We present the final analysis of the phase III noninferiority, randomized ShortHER trial comparing 9 weeks versus 1 year of adjuvant trastuzumab with chemotherapy in patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC). Women with HER2+ BC were randomly assigned to anthracycline-taxane combinations plus 1-year trastuzumab (arm A, long) or 9-week trastuzumab (arm B, short). Here, we report the second coprimary end point overall survival (OS), updated disease-free survival (DFS), and outcomes according to hormone receptor status, age, and nodal status. At a median follow-up of 9 years, 10-year DFS is 77% versus 78% in the long versus short arm, respectively. Ten-year OS is 89% versus 88% in the long versus short arm, respectively. 10-year DFS rates in the long versus short arm according to nodal status are N0 81% versus 85%; N1-3 77% versus 79%; and N4+ 63% versus 53%. Ten-year OS rates in long versus short arm according to nodal status are N0 89% versus 95%%; N1-3 92% versus 89%; and N4+ 84% versus 64%. The updated analysis of the ShortHER trial shows that 1-year trastuzumab is the standard treatment for patients with HER2+ early BC as noninferiority cannot be claimed. However, numerically, the differences for the patients at low or intermediate risk (N0/N1-3) is negligible, while patients with N4+ have a clear benefit with 1-year trastuzumab.
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Affiliation(s)
- PierFranco Conte
- S Camillo Hospital, IRCCS, Venezia, Italy
- University of Padova, Padova, Italy
| | - Giancarlo Bisagni
- Department of Oncology and Advanced Technologies, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Federico Piacentini
- Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy
| | - Samanta Sarti
- IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori,” IRST srl, Meldola, Italy
| | | | - Elisa Anselmi
- Department of Oncology and Hematology, ASL Piacenza, Piacenza, Italy
| | - Michele Aieta
- Medical Oncology, IRCCS-CROB, Rionero in Vulture, Italy
| | - Vittorio Gebbia
- Kore University, Enna and La Maddalena Clinic, Palermo, Italy
| | | | | | - Ornella Garrone
- IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Alessandra Beano
- Breast Oncology, Città della Salute e della Scienza, Torino, Italy
| | | | | | - Anna Turletti
- Senology, Ospedale Martini, ASL Città di Torino, Torino, Italy
| | - Federica Miglietta
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Oncology 2, Veneto Oncology Institute, IOV-IRCCS, Padova, Italy
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Oncology 2, Veneto Oncology Institute, IOV-IRCCS, Padova, Italy
| | | | - Sara Balduzzi
- University of Modena and Reggio Emilia, Modena, Italy
| | - Robert D'Amico
- Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Oncology 2, Veneto Oncology Institute, IOV-IRCCS, Padova, Italy
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4
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Trevisan B, Pepe FF, Vallini I, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Baldelli A, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Sarti S, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Clivio L, Torri V, Cazzaniga ME. Final results of the real-life observational VICTOR-6 study on metronomic chemotherapy in elderly metastatic breast cancer (MBC) patients. Sci Rep 2023; 13:12255. [PMID: 37507480 PMCID: PMC10382472 DOI: 10.1038/s41598-023-39386-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
Nowadays, treatment of metastatic breast cancer (MBC) has been enriched with novel therapeutical strategies. Metronomic chemotherapy (mCHT) is a continuous and frequent administration of chemotherapy at a lower dose and so whit less toxicity. Thus, this strategy could be attractive for elderly MBC patients. Aim of this analysis is to provide insights into mCHT's activity in a real-life setting of elderly MBC patients. Data of patients ≥ 75 years old included in VICTOR-6 study were analyzed. VICTOR-6 is a multicentre, Italian, retrospective study, which collected data on mCHT in MBC patients treated between 2011 and 2016. A total of 112 patients were included. At the beginning of mCHT, median age was 81 years (75-98) and in 33% of the patients mCHT was the first line choice. Overall Response Rate (ORR) and Disease Control Rate (DCR) were 27.9% and 79.3%, respectively. Median PFS ranged between 7.6 and 9.1 months, OS between 14.1 and 18.5 months. The most relevant toxicity was the hematological one (24.1%); severe toxicity (grade 3-4) ranged from 0.9% for skin toxicity up to 8% for hematologic one. This is a large study about mCHT in elderly MBC patients, providing insights to be further investigated in this subgroup of frail patients.
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Affiliation(s)
- B Trevisan
- Azienda Ospedaliera San Gerardo, Monza, Italy
| | - F F Pepe
- Azienda Ospedaliera San Gerardo, Monza, Italy
| | - I Vallini
- Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - E Montagna
- European Institute of Oncology, Milan, Italy
| | | | - R Berardi
- Azienda Ospedaliera Universitaria Ospedali Riuniti, Torrette, Italy
| | - A Butera
- Nuovo Ospedale San Giovanni Di Dio, Florence, Italy
| | | | - L Cavanna
- Azienda Ospedaliera Piacenza, Piacenza, Italy
| | | | - S Cinieri
- Ospedale A. Perrino, Brindisi, Italy
| | | | | | - A Febbraro
- Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Ospedale San Vincenzo, Taormina, Italy
| | - A Ferzi
- Azienda Ospedaliera Ospedale Civile Di Legnano, Magenta, Italy
| | | | - A Fontana
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - O Garrone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - V Gebbia
- Ospedale La Maddalena, Palermo, Italy
| | - D Generali
- Istituti Ospitalieri Cremona, Cremona, Italy
| | | | | | | | | | - S Sarti
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | | | - C Putzu
- Azienda Ospedaliera-Universitaria, Sassari, Italy
| | - F Riccardi
- Ospedale Antonio Cardarelli, Naples, Italy
| | - D Santini
- Università Campus Bio-Medico, RomE, Italy
| | | | | | | | - P Spadaro
- Casa di Cura Villa Salus-Messina, Messina, Italy
| | | | | | | | | | | | - M R Valerio
- A.O.U. Policlinico Paolo Giaccone, Palermo, Italy
| | - P Vici
- INT Regina Elena, Rome, Italy
| | - L Clivio
- IRCCS Mario Negri Institute of Pharmacological Research, Milan, Italy
| | - V Torri
- IRCCS Mario Negri Institute of Pharmacological Research, Milan, Italy
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5
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De Paolo R, Sarti S, Bernardi S, Cucco F, Tavosanis A, Pitto L, Poliseno L. Differential impact of BRAFV600E isoforms on tumorigenesis in a zebrafish model of melanoma. Cell Biosci 2023; 13:121. [PMID: 37393328 DOI: 10.1186/s13578-023-01064-w] [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] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/05/2023] [Indexed: 07/03/2023] Open
Abstract
BRAFV600E comes as two main splicing variants. The well-studied ref isoform and the recently discovered X1 isoform are co-expressed in cancer cells and differ in terms of 3'UTR length and sequence, as well as C-term protein sequence. Here, we use a melanoma model in zebrafish to study the role played by each isoform in larval pigmentation, nevi formation, and their progression into melanoma tumours. We show that both BRAFV600E-ref and BRAFV600E-X1 proteins promote larval pigmentation and nevi formation, while melanoma-free survival curves performed in adult fish indicate that BRAFV600E-ref protein is a much stronger melanoma driver that BRAFV600E-X1 protein. Crucially, we also show that the presence of the 3'UTR suppresses the effect of ref protein. Our data highlight the necessity to undertake a systematic study of BRAFV600E isoforms, in order to uncover the full spectrum of their kinase-(in)dependent and coding-(in)dependent functions, hence to develop more informed strategies for therapeutic targeting.
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Affiliation(s)
- Raffaella De Paolo
- Institute of Clinical Physiology, CNR, Pisa, Italy
- Oncogenomics Unit, Core Research Laboratory (CRL), ISPRO, Via Moruzzi 1, 56124, Pisa, Italy
| | - Samanta Sarti
- Institute of Clinical Physiology, CNR, Pisa, Italy
- Oncogenomics Unit, Core Research Laboratory (CRL), ISPRO, Via Moruzzi 1, 56124, Pisa, Italy
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, USA
| | - Sara Bernardi
- Institute of Clinical Physiology, CNR, Pisa, Italy
- Oncogenomics Unit, Core Research Laboratory (CRL), ISPRO, Via Moruzzi 1, 56124, Pisa, Italy
- Department of Molecular Medicine and Neurobiology, IRCCS Fondazione Stella Maris, Pisa, Italy
| | | | - Andrea Tavosanis
- Institute of Clinical Physiology, CNR, Pisa, Italy
- Oncogenomics Unit, Core Research Laboratory (CRL), ISPRO, Via Moruzzi 1, 56124, Pisa, Italy
- San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Laura Poliseno
- Institute of Clinical Physiology, CNR, Pisa, Italy.
- Oncogenomics Unit, Core Research Laboratory (CRL), ISPRO, Via Moruzzi 1, 56124, Pisa, Italy.
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Merloni F, Palleschi M, Rossi A, Iamurri AP, Gianni C, Sarti S, Mannozzi F, Fiori F, Menna GD, Cecconetto L, Sirico M, Casadei C, Bleve S, Gasperoni L, Casadei R, Tontini L, Romeo A, Barone D, De Giorgi U. Abstract P1-05-13: Clinical impact of whole-body magnetic resonance imaging on subsequent management in luminal/HER2-negative breast cancer patients. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p1-05-13] [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: 03/06/2023]
Abstract
Abstract
Background: Routine imaging can be inaccurate, especially in metastatic breast cancer (MBC) with bone-only disease or mainly bone disease. This analysis investigates how the use of whole-body magnetic resonance imaging (WB-MRI), in addition to routine computed tomography (CT) and bone scintigraphy (BS), can influence treatment decisions in patients with known MBC. Methods: In a prospective observational study, in our Institute, we performed WB-MRI as baseline and follow-up examination in addition to routine imaging (CT, BS) in luminal/HER2-negative BC patients with prevalence of bone disease potentially candidate to CDK 4/6 inhibitors. All examinations were interpreted by two experienced radiology specialists. Using the results of the examination, a multidisciplinary oncology committee (MOC) reported on the treatment strategy. A positive impact on clinical management was considered if the examination determined a modification in the treatment strategy compared to the MOC decision before WB-MRI. Results: Thirty consecutive luminal breast cancer patients in a metastatic setting at standard imaging were recruited. All these patients underwent CT and BS followed by WB-MRI study. At standard imaging, fourteen patients (46.7%) presented with bone-only disease, while eight patients (26.6%) did not show bone lesions. In 18 of 30 cases (60%) WB-MRI led to a modification of the therapeutic approach. Due to the detection of new metastatic lesions or progression of known metastatic sites, reported on WB-MRI alone, the therapeutic decision changed in 6 (20%) and 3 (10%) patients, respectively. In one patient (3%) the therapeutic decision changed because of both findings. Nine patients (30%) started a new therapeutic line due to evidence of progressive disease on WB-MRI, while 4 patients (13.3%) underwent radiotherapy and 1 patient received orthopaedic counselling for high risk WB-MRI-assessed bone lesions. In 8 patients (26.6%) the disease was re-classified as early breast cancer based on WB-MRI assessment. Conclusions: WB-MRI could play a role in the clinical assessment of luminal MBC. Further studies are needed to better address the potential use of WB-MRI in the assessment and monitoring of bone only/bone predominant luminal MBC and/or in equivocal cases.
Citation Format: Filippo Merloni, Michela Palleschi, Alice Rossi, Andrea Prochowski Iamurri, Caterina Gianni, Samanta Sarti, Francesca Mannozzi, Federica Fiori, Giandomenico Di Menna, Lorenzo Cecconetto, Marianna Sirico, Chiara Casadei, Sara Bleve, Lorenzo Gasperoni, Roberto Casadei, Luca Tontini, Antonino Romeo, Domenico Barone, Ugo De Giorgi. Clinical impact of whole-body magnetic resonance imaging on subsequent management in luminal/HER2-negative breast cancer patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-13.
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Affiliation(s)
- Filippo Merloni
- 1Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Michela Palleschi
- 2Department of Medical Oncology, IRCCS- Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Alice Rossi
- 3Department of Radiology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | | | - Caterina Gianni
- 5Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Samanta Sarti
- 6Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Francesca Mannozzi
- 7Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Federica Fiori
- 8Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Giandomenico Di Menna
- 9Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Lorenzo Cecconetto
- 10Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Marianna Sirico
- 11Department of Medical Oncology,, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Chiara Casadei
- 12Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Sara Bleve
- 13Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Lorenzo Gasperoni
- 14Oncology Pharmacy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Roberto Casadei
- 15Orthopedic Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy
| | - Luca Tontini
- 16Radiotherapy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Antonino Romeo
- 17Radiotherapy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Domenico Barone
- 18Department of Radiology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Ugo De Giorgi
- 19Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
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7
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Merloni F, Palleschi M, Gianni C, Casadei C, Curcio A, Romeo A, Rocchi M, Cima S, Sirico M, Sarti S, Cecconetto L, Mariotti M, Di Menna G, De Giorgi U. Locoregional treatment of de novo stage IV breast cancer in the era of modern oncology. Front Oncol 2023; 13:1083297. [PMID: 36793604 PMCID: PMC9923000 DOI: 10.3389/fonc.2023.1083297] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023] Open
Abstract
Approximately 6% of metastatic breast cancers arise de novo. While systemic therapy (ST) remains the treatment backbone as for patients with metachronous metastases, locoregional treatment (LRT) of the primary tumor remains a controversial method. The removal of the primary has an established role for palliative purposes, but it is unclear if it could also determine a survival benefit. Retrospective evidence and pre-clinical studies seem to support the removal of the primary as an effective approach to improve survival. On the other hand, most randomized evidence suggests avoiding LRT. Both retrospective and prospective studies suffer several limitations, ranging from selection bias and outdated ST to a small sample of patients. In this review we discuss available data and try to identify subgroups of patients which could benefit the most from LRT of the primary, to facilitate clinical practice decisions, and to hypothesize future studies design on this topic.
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Affiliation(s)
- Filippo Merloni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Michela Palleschi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Chiara Casadei
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Annalisa Curcio
- Breast Surgery Unit, Pierantoni-Morgagni Hospital Forlì and Santa Maria delle Croci Hospital Ravenna, Forli, Italy
| | - Antonino Romeo
- Radiotherapy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Maddalena Rocchi
- Breast Surgery Unit, Pierantoni-Morgagni Hospital Forlì and Santa Maria delle Croci Hospital Ravenna, Forli, Italy
| | - Simona Cima
- Radiotherapy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Samanta Sarti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Marita Mariotti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giandomenico Di Menna
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
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8
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Li Y, Shah RB, Sarti S, Belcher AL, Lee BJ, Gorbatenko A, Nemati F, Yu I, Stanley Z, Shao Z, Silva JM, Zha S, Sidi S. A Non-Canonical IRAK Signaling Pathway Triggered by DNA Damage. bioRxiv 2023:2023.02.08.527716. [PMID: 36798275 PMCID: PMC9934671 DOI: 10.1101/2023.02.08.527716] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Interleukin-1 receptor (IL-1R)-associated kinases (IRAKs) are core effectors of Toll-like receptor (TLR) and IL-1R signaling, with no reported roles outside of innate immunity. We find that vertebrate cells exposed to ionizing radiation (IR) sequentially activate IRAK4 and IRAK1 through a phosphorylation cascade mirroring that induced by TLR/IL-1R, resulting in a potent anti-apoptotic response. However, IR-induced IRAK1 activation does not require the receptors or the IRAK4/1 adaptor protein MyD88, and instead of remaining in the cytoplasm, the activated kinase is immediately transported to the nucleus via a conserved nuclear localization signal. We identify: double-strand DNA breaks (DSBs) as the biologic trigger for this pathway; the E3 ubiquitin ligase Pellino1 as the scaffold enabling IRAK4/1 activation in place of TLR/IL-1R-MyD88; and the pro-apoptotic PIDDosome (PIDD1-RAIDD-caspase-2) as a critical downstream target in the nucleus. The data delineate a non-canonical IRAK signaling pathway derived from, or ancestral to, TLR signaling. This DSB detection pathway, which is also activated by genotoxic chemotherapies, provides multiple actionable targets for overcoming tumor resistance to mainstay cancer treatments.
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9
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Merloni F, Palleschi M, Casadei C, Romeo A, Curcio A, Casadei R, Stella F, Ercolani G, Gianni C, Sirico M, Cima S, Sarti S, Cecconetto L, Di Menna G, De Giorgi U. Oligometastatic breast cancer and metastasis-directed treatment: an aggressive multimodal approach to reach the cure. Ther Adv Med Oncol 2023; 15:17588359231161412. [PMID: 36950272 PMCID: PMC10026139 DOI: 10.1177/17588359231161412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/16/2023] [Indexed: 03/20/2023] Open
Abstract
Metastatic breast cancer (BC) is considered an incurable disease and is usually treated with palliative intent. However, about 50% of metastatic BCs present with only a few metastatic lesions and are characterized by longer overall survival. These patients, defined as oligometastatic, could benefit from a multimodal approach, which combines systemic therapy with metastasis-directed treatment (stereotactic ablative therapy or surgery). The current definition of oligometastatic seems incomplete since it is based only on imaging findings and does not include biological features, and the majority of relevant data supporting this strategy comes from retrospective or non-randomized studies. However, the chance of reaching long-term complete remission or even a cure has led to the development of randomized trials investigating the impact of combined treatment in oligometastatic BC (OMBC). The SABR-COMET trial, the first randomized study to include BC patients, showed promising results from a combination of stereotactic ablative radiotherapy and systemic therapy. Considering the randomized trial's results, multidisciplinary teams should be set up to select OMBC patients who could achieve long-term survival with aggressive multimodal treatment.
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Affiliation(s)
| | - Michela Palleschi
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Chiara Casadei
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Antonino Romeo
- Radiotherapy Unit, IRCCS Istituto Romagnolo per
lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Annalisa Curcio
- Breast Surgery Unit, Pierantoni-Morgagni
Hospital Forlì and Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Roberto Casadei
- Orthopedic Unit, Morgagni-Pierantoni Hospital,
Ausl Romagna, Forlì, Italy
| | - Franco Stella
- Division of Thoracic Surgery, Department of
Experimental, Diagnostic and Specialty Medicine—DIMES of the Alma Mater
Studiorum, University of Bologna, Forlì, Italy
| | - Giorgio Ercolani
- Department of Medical and Surgical
Sciences-DIMEC, Alma Mater Studiorum – University of Bologna, Bologna,
Italy
- General and Oncology Surgery,
Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy
| | - Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Simona Cima
- Radiotherapy Unit, IRCCS Istituto Romagnolo
per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Samanta Sarti
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Giandomenico Di Menna
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
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10
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Gianni C, Palleschi M, Merloni F, Bleve S, Casadei C, Sirico M, Di Menna G, Sarti S, Cecconetto L, Mariotti M, De Giorgi U. Potential Impact of Preoperative Circulating Biomarkers on Individual Escalating/de-Escalating Strategies in Early Breast Cancer. Cancers (Basel) 2022; 15:96. [PMID: 36612091 PMCID: PMC9817806 DOI: 10.3390/cancers15010096] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
The research on non-invasive circulating biomarkers to guide clinical decision is in wide expansion, including the earliest disease settings. Several new intensification/de-intensification strategies are approaching clinical practice, personalizing the treatment for each patient. Moreover, liquid biopsy is revealing its potential with multiple techniques and studies available on circulating biomarkers in the preoperative phase. Inflammatory circulating cells, circulating tumor cells (CTCs), cell-free DNA (cfDNA), circulating tumor DNA (ctDNA), and other biological biomarkers are improving the armamentarium for treatment selection. Defining the escalation and de-escalation of treatments is a mainstay of personalized medicine in early breast cancer. In this review, we delineate the studies investigating the possible application of these non-invasive tools to give a more enlightened approach to escalating/de-escalating strategies in early breast cancer.
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Affiliation(s)
- Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy
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11
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Gianni C, Palleschi M, Schepisi G, Casadei C, Bleve S, Merloni F, Sirico M, Sarti S, Cecconetto L, Di Menna G, Schettini F, De Giorgi U. Circulating inflammatory cells in patients with metastatic breast cancer: Implications for treatment. Front Oncol 2022; 12:882896. [PMID: 36003772 PMCID: PMC9393759 DOI: 10.3389/fonc.2022.882896] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/05/2022] [Indexed: 11/20/2022] Open
Abstract
Adaptive and innate immune cells play a crucial role as regulators of cancer development. Inflammatory cells in blood flow seem to be involved in pro-tumor activities and contribute to breast cancer progression. Circulating lymphocyte ratios such as the platelet-lymphocytes ratio (PLR), the monocyte-lymphocyte ratio (MLR) and the neutrophil-lymphocyte ratio (NLR) are new reproducible, routinely feasible and cheap biomarkers of immune response. These indexes have been correlated to prognosis in many solid tumors and there is growing evidence on their clinical applicability as independent prognostic markers also for breast cancer. In this review we give an overview of the possible value of lymphocytic indexes in advanced breast cancer prognosis and prediction of outcome. Furthermore, targeting the immune system appear to be a promising therapeutic strategy for breast cancer, especially macrophage-targeted therapies. Herein we present an overview of the ongoing clinical trials testing systemic inflammatory cells as therapeutic targets in breast cancer.
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Affiliation(s)
- Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
- *Correspondence: Caterina Gianni,
| | - Michela Palleschi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Giuseppe Schepisi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Chiara Casadei
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Sara Bleve
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Filippo Merloni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Samanta Sarti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Giandomenico Di Menna
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Francesco Schettini
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
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12
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Cazzaniga ME, Vallini I, Montagna E, Amoroso D, Berardi R, Butera A, Cagossi K, Cavanna L, Ciccarese M, Cinieri S, Cretella E, De Conciliis E, Febbraro A, Ferraù F, Ferzi A, Baldelli A, Fontana A, Gambaro AR, Garrone O, Gebbia V, Generali D, Gianni L, Giovanardi F, Grassadonia A, Leonardi V, Marchetti P, Sarti S, Musolino A, Nicolini M, Putzu C, Riccardi F, Santini D, Saracchini S, Sarobba MG, Schintu MG, Scognamiglio G, Spadaro P, Taverniti C, Toniolo D, Tralongo P, Turletti A, Valenza R, Valerio MR, Vici P, Di Mauro P, Cogliati V, Capici S, Clivio L, Torri V. Metronomic chemotherapy (mCHT) in metastatic triple-negative breast cancer (TNBC) patients: results of the VICTOR-6 study. Breast Cancer Res Treat 2021; 190:415-424. [PMID: 34546500 PMCID: PMC8558172 DOI: 10.1007/s10549-021-06375-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 08/13/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Purpose Triple-negative breast cancer (TNBC) represents a subtype of breast cancer which lacks the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2): TNBC accounts for approximately 20% of newly diagnosed breast cancers and is associated with younger age at diagnosis, greater recurrence risk and shorter survival time. Therapeutic options are very scarce. Aim of the present analysis is to provide further insights into the clinical activity of metronomic chemotherapy (mCHT), in a real-life setting. Methods We used data included in the VICTOR-6 study for the present analysis. VICTOR-6 is an Italian multicentre retrospective cohort study, which collected data of metastatic breast cancer (MBC) patients who have received mCHT between 2011 and 2016. Amongst the 584 patients included in the study, 97 were triple negative. In 40.2% of the TNBC patients, mCHT was the first chemotherapy treatment, whereas 32.9% had received 2 or more lines of treatment for the metastatic disease. 45.4% out of 97 TNBC patients received a vinorelbine (VRL)-based regimen, which resulted in the most used type of mCHT, followed by cyclophosphamide (CTX)-based regimens (30.9%) and capecitabine (CAPE)-based combinations (22.7%). Results Overall response rate (ORR) and disease control rate (DCR) were 17.5% and 64.9%, respectively. Median progression free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.9–7.2) and 12.1 months (95% CI: 9.6–16.7). Median PFS was 6.9 months for CAPE-based regimens (95% CI: 5.0–18.4), 6.1 months (95% CI: 4.0–8.9) for CTX-based and 5.3 months (95% CI: 4.1–9.5) for VRL-based ones. Median OS was 18.2 months (95% CI: 9.1-NE) for CAPE-based regimens and 11.8 months for VRL- (95% CI: 9.3–16.7 and CTX-based ones (95%CI: 8.7–52.8). Tumour response, PFS and OS decreased proportionally in later lines. Conclusion This analysis represents the largest series of TNBC patients treated with mCHT in a real-life setting and provides further insights into the advantages of using this strategy even in this poor prognosis subpopulation.
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Affiliation(s)
- M E Cazzaniga
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy.
- Oncology Unit, ASST Monza, Monza, MB, Italy.
| | - I Vallini
- Medical Oncology, ASST Sette Laghi Ospedale Di Circolo E Fondazione Macchi, Varese, VA, Italy
| | - E Montagna
- Medical Senology Division, IEO, Milan, Italy
| | - D Amoroso
- Medical Oncology, Ospedale Versilia, ATNO, Lido Di Camaiore, LU, Italy
| | - R Berardi
- Medical Oncology, Università Politecnica Delle Marche, AOU Ospedali Riuniti, Ancona, Italy
| | - A Butera
- Medical Oncology, Ospedale San Giovanni Di Dio, Agrigento, Italy
| | - K Cagossi
- Medical Oncology, Ospedale Ramazzini, Carpi, Italy
| | - L Cavanna
- Medical Oncology, Azienda Ospedaliera Piacenza, Piacenza, Italy
| | - M Ciccarese
- Medical Oncology, Ospedale Vito Fazzi, Lecce, Italy
| | - S Cinieri
- Medical Oncology, ASL Brindisi, Brindisi, Italy
| | - E Cretella
- Medical Oncology, Ospedale Bolzano, Bolzano, Italy
| | | | - A Febbraro
- Medical Oncology, Ospedale S. Cuore di Gesù Fatebenefratelli, Benevento, Italy
| | - F Ferraù
- Medical Oncology, Osp Taormina, Taormina, Italy
| | - A Ferzi
- Medical Oncology, A.S.S.T. Ovest Milanese Legnano, Legnano, Italy
| | - A Baldelli
- Medical Oncology, Ospedale San Salvatore, Pesaro, Italy
| | - A Fontana
- Medical Oncology 2, Az. Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A R Gambaro
- Medical Oncology, ASST Fatebenefratelli Sacco, Milano, Italy
| | - O Garrone
- Breast Unit Medical Oncology, A.O. S. Croce e Carle, Cuneo, Italy
| | - V Gebbia
- Medical Oncology, Ospedale La Maddalena, Palermo, Italy
| | - D Generali
- Medical Oncology, Istituti Ospitalieri Cremona, Cremona, Italy
| | - L Gianni
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, Italy
| | - F Giovanardi
- AUSL IRCCS Reggio Emilia Provincial Oncology Unit, Reggio Emilia, Italy
| | - A Grassadonia
- Medical Oncology, P.O. SS Annunziata -ASL2 Lanciano-Vasto, Chieti, Italy
| | - V Leonardi
- Medical Oncology, Ospedale Civico, Palermo, Italy
| | - P Marchetti
- Medical Oncology, A.O. Sant'Andrea, Roma, Italy
| | - S Sarti
- IRCCS Istituto Romagnolo per lo studio dei Tumori (IRST) "Dino Amadori", 47014, Meldola, Italy
| | - A Musolino
- Department of Medicine and Surgery, Medical Oncology and Breast Unit, University of Parma and University Hospital of Parma, Parma, Italy
| | - M Nicolini
- Medical Oncology, Azienda USL Romagna, U.O. di Oncologia Rimini, Cattolica, Italy
| | - C Putzu
- Medical Oncology, A. Ospedaliera-Universitaria, Sassari, Italy
| | - F Riccardi
- Medical Oncology, A. Ospedaliera Antonio Cardarelli, Napoli, Italy
| | - D Santini
- Medical Oncology, Università Campus Bio-Medico, Roma, Italy
| | - S Saracchini
- Medical Oncology, Az. Osp. Santa Maria degli Angeli, Pordenone, Italy
| | - M G Sarobba
- Medical Oncology, Ospedale San Francesco, Nuoro, Italy
| | - M G Schintu
- Medical Oncology, Osp Giovanni Paolo II, Olbia, Italy
| | | | - P Spadaro
- Medical Oncology, Casa di Cura Villa Salus-Messina, Messina, Italy
| | - C Taverniti
- Medical Oncology, A.O.U. Città della Salute e della Scienza, Osp. Molinette, Torino, Italy
| | - D Toniolo
- Medical Oncology, ASST Rhodense, Ospedale di Circolo Rho, Rho, Italy
| | - P Tralongo
- Medical Oncology, Osp. Umberto I, Siracusa, Italy
| | - A Turletti
- Medical Oncology, P.O. Martini, Torino, Italy
| | - R Valenza
- Medical Oncology, P.O. Vittorio Emanuele, Gela, Italy
| | - M R Valerio
- Department of Discipline Chirurgiche, Oncologiche e Stomatologiche (DICHIRONS), Medical Oncology, A.O.U. Policlinico Paolo Giaccone, Palermo, Italy
| | - P Vici
- Phase IV trials, IRCCS, INT Regina Elena, Rome, Italy
| | - P Di Mauro
- Oncology Unit, ASST Monza, Monza, MB, Italy
| | - V Cogliati
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - S Capici
- Phase 1 Research Centre and Oncology Unit, Department of Medicine and Surgery, University of Milano-Bicocca, ASST Monza, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - L Clivio
- Oncology Department, IRCCS Mario Negri Institute, Milan, Italy
| | - V Torri
- Oncology Department, IRCCS Mario Negri Institute, Milan, Italy
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13
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Guarneri V, Dieci MV, Griguolo G, Miglietta F, Girardi F, Bisagni G, Generali DG, Cagossi K, Sarti S, Frassoldati A, Gianni L, Cavanna L, Pinotti G, Musolino A, Piacentini F, Cinieri S, Prat A, Conte P. Trastuzumab-lapatinib as neoadjuvant therapy for HER2-positive early breast cancer: Survival analyses of the CHER-Lob trial. Eur J Cancer 2021; 153:133-141. [PMID: 34153715 DOI: 10.1016/j.ejca.2021.05.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 03/22/2021] [Revised: 04/30/2021] [Accepted: 05/08/2021] [Indexed: 11/16/2022]
Abstract
AIM The Cher-LOB randomised phase II study showed that the combination of lapatinib-trastuzumab plus chemotherapy increases pathologic complete response (pCR) rate compared with chemotherapy plus either trastuzumab or lapatinib. Here, we report the post hoc survival analysis as per treatment arm, pCR and biomarkers. METHODS The Cher-LOB study randomised 121 patients with human epidermal growth factor receptor 2-positive, stage II-IIIA breast cancer. A specific protocol to collect recurrence-free survival (RFS) and overall survival (OS) data was designed. Tumour-infiltrating lymphocytes (TILs) and PAM50-intrinsic subtyping were evaluated at baseline. RESULTS At 9-year median follow-up, a trend towards RFS improvement with lapatinib-trastuzumab over trastuzumab was observed (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.18-1.05). Combining treatment arms, pCR was significantly associated with both RFS (HR 0.12, 95% CI 0.03-0.49) and OS (HR 0.12, 95% CI 0.03-0.49). TILs were significantly associated with RFS (HR = 0.978 for each 1% increment). Luminal-A subtype was a significant and independent predictor of improved RFS as compared with other PAM50-based intrinsic subtypes at the multivariate analysis including the most relevant clinicopathologic variables (HR 0.29, 95% CI 0.09-0.94, p = 0.040). CONCLUSIONS Cher-LOB trial survival analysis confirmed the prognostic role of pCR and TILs and showed a signal for a better outcome with lapatinib-trastuzumab over trastuzumab. TRIAL REGISTRATION NCT00429299.
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Affiliation(s)
- Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128 Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy.
| | - Maria V Dieci
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128 Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy
| | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128 Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy
| | - Federica Miglietta
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128 Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy
| | - Fabio Girardi
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy
| | - Giancarlo Bisagni
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy
| | - Daniele G Generali
- Breast Cancer Unit, Azienda Socio Sanitaria Territoriale di Cremona, Cremona, Italy; Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Samanta Sarti
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy
| | - Antonio Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara, Italy
| | - Lorenzo Gianni
- Oncology Unit Rimini, Azienda USL Romagna, Rimini, Italy
| | | | | | - Antonino Musolino
- Department of Medicine and Surgery, University of Parma, Medical Oncology and Breast Unit, University Hospital of Parma, Parma, Italy
| | - Federico Piacentini
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Saverio Cinieri
- Medical Oncology & Breast Unit, Antonio Perrino Hospital, Brindisi, Italy
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - PierFranco Conte
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128 Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy
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Sarti S, De Paolo R, Ippolito C, Pucci A, Pitto L, Poliseno L. Inducible modulation of miR-204 levels in a zebrafish melanoma model. Biol Open 2020; 9:bio053785. [PMID: 33037013 PMCID: PMC7657466 DOI: 10.1242/bio.053785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/22/2020] [Indexed: 11/20/2022] Open
Abstract
Here, we present miniCoopR-I, an inducible upgrade of the constitutive miniCoopR vector. We developed miniCoopR-I-sponge-204 and miniCoopR-I-pre-miR-204 vectors and we successfully tested them for their ability to achieve time- (embryo/juvenile/adult) and space- (melanocytic lineage) restricted inhibition/overexpression of miR-204, a positive modulator of pigmentation previously discovered by us. Furthermore, melanoma-free survival curves performed on induced fish at the adult stage indicate that miR-204 overexpression accelerates the development of BRAFV600E-driven melanoma. miniCoopR-I allows study of the impact that coding and non-coding modulators of pigmentation exert on melanomagenesis in adult zebrafish, uncoupling it from the impact that they exert on melanogenesis during embryonic development.This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Samanta Sarti
- Oncogenomics Unit, CRL-ISPRO, Pisa 56124, Italy
- Institute of Clinical Physiology, CNR, Pisa 56124, Italy
| | - Raffaella De Paolo
- Oncogenomics Unit, CRL-ISPRO, Pisa 56124, Italy
- Institute of Clinical Physiology, CNR, Pisa 56124, Italy
- University of Siena, Siena 53100, Italy
| | - Chiara Ippolito
- Unit of Histology and Human Embryology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56126, Italy
| | - Angela Pucci
- Histopathology Department, Pisa University Hospital, Pisa 56126, Italy
| | - Letizia Pitto
- Institute of Clinical Physiology, CNR, Pisa 56124, Italy
| | - Laura Poliseno
- Oncogenomics Unit, CRL-ISPRO, Pisa 56124, Italy
- Institute of Clinical Physiology, CNR, Pisa 56124, Italy
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Palleschi M, Barzotti E, Melegari E, Manunta S, Mannozzi F, Vagheggini A, Maltoni R, Fedeli A, Sarti S, Cecconetto L, Possanzini P, Ravaioli S, Tumedei M, Amadori D, Bravaccini S, Rocca A. Impact of Ki67 and progesterone receptor on PFS with cyclin-dependent kinase 4/6 inhibitors in HER2-negative advanced breast cancer: A real world mono-institutional experience. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Palleschi M, Maltoni R, Ravaioli S, Vagheggini A, Mannozzi F, Fanini F, Pirini F, Tumedei MM, Barzotti E, Cecconetto L, Sarti S, Manunta S, Possanzini P, Fedeli A, Curcio A, Altini M, De Giorgi U, Rocca A, Bravaccini S. Ki67 and PR in Patients Treated with CDK4/6 Inhibitors: A Real-World Experience. Diagnostics (Basel) 2020; 10:diagnostics10080573. [PMID: 32784518 PMCID: PMC7460222 DOI: 10.3390/diagnostics10080573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 01/20/2023] Open
Abstract
CDK4/6 inhibitors (CDK4/6i) are recommended in patients with estrogen receptor (ER)-positive, HER2-negative advanced breast cancer (ABC). Up to now, no prognostic biomarkers have been identified in this setting. We retrospectively analyzed the expression of progesterone receptor (PR) and Ki67, assessed by immunohistochemistry, in 71 ABC patients treated with CDK4/6i and analyzed the impact of these markers on progression-free survival (PFS). The majority of patients 63/71 (88.7%) received palbociclib, 4 (5.6%) received ribociclib, and 4 (5.6%) received abemaciclib. A higher median value of Ki67 was observed in cases undergoing second-line treatment (p = 0.047), whereas the luminal B subtype was more prevalent (p = 0.005). In the univariate analysis of the first-line setting, luminal A subtype showed a trend towards a correlation with a longer PFS (p = 0.053). A higher continuous Ki67 value led to a significantly shorter PFS. When the interaction between pathological characteristics and line of treatment was considered, luminal B subtype showed a significantly (p = 0.043) worse outcome (Hazard Ratio (HR) 2.84; 1.03–7.82 95% Confidence Interval (CI)). PFS in patients undergoing endocrine therapy plus CDK4/6i was inversely correlated with Ki67 expression but not with PR, suggesting that tumor proliferation has a greater impact on cell cycle inhibitors combined with endocrine therapy than PR expression.
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Affiliation(s)
- Michela Palleschi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Roberta Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Sara Ravaioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
- Correspondence: ; Tel.: +39-054-373-9978; Fax: +39-054-373-9221
| | - Alessandro Vagheggini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Francesca Mannozzi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Francesca Fanini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Francesca Pirini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Maria Maddalena Tumedei
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Eleonora Barzotti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Lorenzo Cecconetto
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Silvia Manunta
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Paola Possanzini
- Pathology Unit, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy;
| | - Anna Fedeli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Annalisa Curcio
- Breast Surgery Unit, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy;
| | - Mattia Altini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Sara Bravaccini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
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Guarneri V, Dieci MV, Bisagni G, Generali DG, Cagossi K, Sarti S, Frassoldati A, Gianni L, Cavanna L, Pinotti G, Musolino A, Piacentini F, Michelotti A, Cinieri S, Griguolo G, Miglietta F, De Salvo GL, Conte PF. Survival analysis of the prospective randomized Cher-Lob study evaluating the dual anti-HER2 treatment with trastuzumab and lapatinib plus chemotherapy as neoadjuvant therapy for HER2-positive breast cancer (BC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
582 Background: The CHER-LOB randomized phase II study showed that the combination of lapatinib and trastuzumab plus chemotherapy increases the pathologic complete response (pCR) rate compared with chemotherapy plus either trastuzumab or lapatinib. Here we report the results of survival analysis according to treatment arm and pCR. Methods: The CherLOB study randomized 121 HER2-positive, stage II-IIIA breast cancer patients to anthracyclines/taxane-based chemotherapy plus trastuzumab, lapatinib, or both. After surgery, patients received adjuvant trastuzumab for up to 1 year. The primary end point of the study was met, with a relative increase of 80% in the pCR rate achieved with chemotherapy plus trastuzumab and lapatinib compared with chemotherapy plus either trastuzumab or lapatinib (Guarneri, J Clin Oncol 2012). Relapse-free survival (RFS) was calculated from randomization to breast cancer recurrence (locoregional or distant) or death from any cause, whichever first. Overall survival (OS) was calculated from randomization to death from any cause. Results: At a median follow up of 8.8 years, RFS rates at 5 years were: 85.8% in the trastuzumab + lapatinib arm, 77.8% in the trastuzumab arm, 78.1% in the lapatinib arm (log-rank p = 0.160). Patients treated with dual HER2 blockade (trastuzumab + lapatinib arm) experienced numerically better RFS as compared to patients treated with single HER2 blockade (trastuzumab arm and lapatinib arm combined): 5-yr RFS 85.8% vs 78.0%, log-rank p = 0.087; HR = 0.51, 95% CI 0.23-1.12, p = 0.093. The achievement of pCR was a strong prognostic factor. 5-yr RFS rate was 97.3% for pCR patients vs 72.9% for non-pCR patients (log-rank p < 0.001, HR = 0.12, 95% CI 0.03-0.49, p = 0.003); similar significant results were observed in both the estrogen receptor-negative and estrogen-receptor positive subgroups. OS was also improved in pCR patients: 8-yr OS rates were 97.2% vs 80.0% for non pCR patients (log-rank p = 0.028, HR = 0.14, 95% CI 0.02-1.08, p = 0.060). Conclusions: In the Cher-LOB study, there was a not statistically significant signal for a better RFS for patients who received dual HER2 blockade with trastuzumab and lapatinib plus chemotherapy as compared to patients treated with single anti-HER2 agent (trastuzumab or lapatinib) plus chemotherapy. Patients achieving a pCR had longer RFS and OS as compared to non-pCR patients. Clinical trial information: NCT00429299 .
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Affiliation(s)
- Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padua and Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Giancarlo Bisagni
- Oncologia Medica Azienda USL/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Katia Cagossi
- Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | | | - Luigi Cavanna
- Oncology-Hematology Department, Hospital of Piacenza, Piacenza, Italy
| | | | - Antonino Musolino
- University Hospital of Parma, Medical Oncology and Breast Unit, Parma, Italy
| | | | | | - Saverio Cinieri
- Department of Oncology, Medical Oncology, "Antonio Perrino" Hospital, Brindisi, Italy
| | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | | | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Pier Franco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova and Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
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Dieci MV, Conte P, Bisagni G, Brandes AA, Frassoldati A, Cavanna L, Musolino A, Giotta F, Rimanti A, Garrone O, Bertone E, Cagossi K, Sarti S, Ferro A, Piacentini F, Maiorana A, Orvieto E, Sanders M, Miglietta F, Balduzzi S, D'Amico R, Guarneri V. Association of tumor-infiltrating lymphocytes with distant disease-free survival in the ShortHER randomized adjuvant trial for patients with early HER2+ breast cancer. Ann Oncol 2020; 30:418-423. [PMID: 30657852 PMCID: PMC6442655 DOI: 10.1093/annonc/mdz007] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [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] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There is the need to identify new prognostic markers to refine risk stratification for HER2-positive early breast cancer patients. The aim of this study was to evaluate the association of tumor-infiltrating lymphocytes (TILs) with distant disease-free survival (DDFS) in patients with HER2-positive early breast cancer enrolled in the ShortHER adjuvant trial which compared 9 weeks versus 1-year trastuzumab in addition to chemotherapy, and to test the interaction between TILs and treatment arm. PATIENTS AND METHODS Stromal TILs were assessed for 866 cases on centralized hematoxylin and eosin-stained tumor slides. The association of TILs as 10% increments with DDFS was assessed with Cox models. Kaplan-Meier curves were estimated for patients with TILs ≥20% and TILs <20%. Median follow-up was 6.1 years. RESULTS Median TILs was 5% (Q1-Q3 1%-15%). Increased TILs were independently associated with better DDFS in multivariable model [hazard ratio (HR) 0.73, 95% confidence interval (CI) 0.59-0.89, P = 0.006, for each 10% TILs increment]. Five years DDFS rates were 91.1% for patients with TILs <20% and 95.7% for patients with TILs ≥20% (P = 0.025). The association between 10% TILs increments and DDFS was significant for patients randomized to 9 weeks of trastuzumab (HR 0.60, 95% CI 0.41-0.88) but not for patients treated with 1 year of trastuzumab (HR 0.89, 95% CI 0.71-1.12; test for interaction P = 0.088). For patients with TILs <20%, the HR for the comparison between the short versus the long arm was 1.75 (95% CI 1.09-2.80, P=0.021); whereas, for patients with TILs ≥20% the HR for the comparison of short versus long arm was 0.23 (95% CI 0.05-1.09, P = 0.064), resulting in a significant interaction (P = 0.015). CONCLUSIONS TILs are an independent prognostic factor for HER2-positive early breast cancer patients treated with adjuvant chemotherapy and trastuzumab and may refine the ability to identify patients at low risk of relapse eligible for de-escalated adjuvant therapy.
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Affiliation(s)
- M V Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova
| | - P Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova.
| | - G Bisagni
- Oncology Unit, Department of Oncology and Advanced Technologies, Azienda USL-IRCCS, Reggio Emilia
| | - A A Brandes
- Medical Oncology, Azienda Unità Sanitaria Locale di Bologna-IRCCS Istituto delle Scienze Neurologiche, Bologna
| | - A Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara
| | - L Cavanna
- Department of Oncology-Hematology, G. da Saliceto Hospital, Piacenza
| | - A Musolino
- Medical Oncology Unit, University Hospital of Parma, Piacenza
| | - F Giotta
- Division of Medical Oncology, IRCCS, Istituto Tumori "Giovanni Paolo II", Bari
| | - A Rimanti
- Medical Oncology, Azienda Ospedaliera di Mantova, Mantova
| | - O Garrone
- Medical Oncology, A.O. S. Croce and Carle Teaching Hospital, Cuneo
| | - E Bertone
- Medical Oncology, S. Anna Hospital, Torino
| | - K Cagossi
- Breast Unit Ausl Modena, Ramazzini Hospital, Carpi
| | - S Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola
| | - A Ferro
- Rete Clinica Senologica - Oncologia Medica S. Chiara, Trento
| | - F Piacentini
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Modena; Azienda Ospedaliero-Universitaria di Modena, Modena
| | - A Maiorana
- Department of Diagnostic, Clinical Medicine and Public Health, University Hospital of Modena, Modena
| | - E Orvieto
- Pathology Unit, Ulss 5 Polesana, Rovigo, Italy
| | - M Sanders
- Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - F Miglietta
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova
| | - S Balduzzi
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Italy
| | - R D'Amico
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Italy
| | - V Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova
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Palleschi M, Maltoni R, Barzotti E, Melegari E, Curcio A, Cecconetto L, Sarti S, Manunta S, Rocca A. Can cyclin-dependent kinase 4/6 inhibitors convert inoperable breast cancer relapse to operability? A case report. World J Clin Cases 2020; 8:517-521. [PMID: 32110660 PMCID: PMC7031833 DOI: 10.12998/wjcc.v8.i3.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pathological complete response (pCR) is rare in hormone receptor-positive (HR+) HER2-negative breast cancer (BC) treated with either endocrine therapy (ET) or chemotherapy. Radical resection of locoregional relapse, although potentially curative in some cases, is challenging when the tumor invades critical structures. The oral cyclin-dependent kinase 4/6 inhibitor palbociclib in combination with ET has obtained a significant increase in objective response rates and progression-free survival in patients with advanced BC and is now being evaluated in the neoadjuvant setting. We present a clinical case of a patient with an inoperable locoregional relapse of HR+ HER2-negative BC who experienced pCR after treatment with palbociclib.
CASE SUMMARY We report the clinical case of a 60-year-old patient who presented with an inoperable locoregional relapse of HR+, HER2-negative BC 10 years after the diagnosis of the primary tumor. During a routine follow-up visit, breast magnetic resonance imaging and positron emission tomography/computed tomography revealed a 4-cm lesion in the right subclavicular region, infiltrating the chest wall and extending to the subclavian vessels, but without bone or visceral involvement. Treatment was begun with palbociclib plus letrozole, converting the disease to operability over a period of 6 mo. Surgery was performed and a pCR achieved. Of note, during treatment the patient experienced a very uncommon toxicity characterized by burning tongue and glossodynia associated with dysgeusia, paresthesia, dysesthesia, and xerostomia. A reduction in the dose of palbociclib did not provide relief and treatment with the inhibitor was thus discontinued, resolving the tongue symptoms. Laboratory exams were unremarkable. Given that this was a late relapse, the tumor was classified as endocrine-sensitive, a condition associated with high sensitivity to palbociclib.
CONCLUSION This case highlights the potential of the cyclin-dependent kinase 4/6 inhibitor plus ET combination to achieve pCR in locoregional relapse of BC, enabling surgical resection of a lesion initially considered inoperable.
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Affiliation(s)
- Michela Palleschi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Roberta Maltoni
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Eleonora Barzotti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Elisabetta Melegari
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Annalisa Curcio
- Breast Surgery Unit, Ospedale Morgagni-Pierantoni, Forlì 47121, Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Samanta Sarti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Silvia Manunta
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Andrea Rocca
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
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Dieci MV, Bisagni G, Brandes AA, Frassoldati A, Cavanna L, Giotta F, Aieta M, Gebbia V, Musolino A, Garrone O, Donadio M, Rimanti A, Beano A, Zamagni C, Soto Parra H, Piacentini F, Danese S, Ferro A, Cagossi K, Sarti S, Gambaro AR, Romito S, Bazan V, Amaducci L, Moretti G, Foschini MP, Balduzzi S, Vicini R, D'Amico R, Griguolo G, Guarneri V, Conte PF. Validation of the AJCC prognostic stage for HER2-positive breast cancer in the ShortHER trial. BMC Med 2019; 17:207. [PMID: 31747948 PMCID: PMC6868696 DOI: 10.1186/s12916-019-1445-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/04/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The 8th edition of the American Joint Committee on Cancer (AJCC) staging has introduced prognostic stage based on anatomic stage combined with biologic factors. We aimed to validate the prognostic stage in HER2-positive breast cancer patients enrolled in the ShortHER trial. METHODS The ShortHER trial randomized 1253 HER2-positive patients to 9 weeks or 1 year of adjuvant trastuzumab combined with chemotherapy. Patients were classified according to the anatomic and the prognostic stage. Distant disease-free survival (DDFS) was calculated from randomization to distant relapse or death. RESULTS A total of 1244 patients were included. Compared to anatomic stage, the prognostic stage downstaged 41.6% (n = 517) of patients to a more favorable stage category. Five-year DDFS based on anatomic stage was as follows: IA 96.6%, IB 94.1%, IIA 92.4%, IIB 87.3%, IIIA 81.3%, IIIC 70.5% (P < 0.001). Five-year DDFS according to prognostic stage was as follows: IA 95.7%, IB 91.4%, IIA 86.9%, IIB 85.0%, IIIA 77.6%, IIIC 67.7% (P < 0.001). The C index was similar (0.69209 and 0.69249, P = 0.975). Within anatomic stage I, the outcome was similar for patients treated with 9 weeks or 1 year trastuzumab (5-year DDFS 96.2% and 96.6%, P = 0.856). Within prognostic stage I, the outcome was numerically worse for patients treated with 9 weeks trastuzumab (5-year DDFS 93.7% and 96.3%, P = 0.080). CONCLUSIONS The prognostic stage downstaged 41.6% of patients, while maintaining a similar prognostic performance as the anatomic stage. The prognostic stage is valuable in counseling patients and may serve as reference for a clinical trial design. Our data do not support prognostic stage as guidance to de-escalate treatment. TRIAL REGISTRATION EUDRACT number: 2007-004326-25; NCI ClinicalTrials.gov number: NCT00629278.
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Affiliation(s)
- Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto - IRCCS, Via Gattamelata 64, 35128, Padova, Italy
| | - Giancarlo Bisagni
- Department of Oncology and Advanced Technologies, Oncology Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Alba A Brandes
- Medical Oncology, Azienda Unità Sanitaria Locale di Bologna-IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Antonio Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara, Italy
| | - Luigi Cavanna
- Department of Oncology-Hematology, G. da Saliceto Hospital, Piacenza, Italy
| | | | - Michele Aieta
- Division of Medical Oncology, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero Vulture, Italy
| | - Vittorio Gebbia
- Medical Oncology, Casa di Cura La Maddalena, University of Palermo, Palermo, Italy
| | | | - Ornella Garrone
- Medical Oncology, A.O. S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Michela Donadio
- Department of Medical Oncology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Anita Rimanti
- Medical Oncology, Azienda Ospedaliera di Mantova, Mantova, Italy
| | - Alessandra Beano
- Department of Medical Oncology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Claudio Zamagni
- Policlinico S.Orsola-Malpighi, SSD Oncologia Medica Addarii, Bologna, Italy
| | - Hector Soto Parra
- Medical Oncology Unit, AOU Policlinico Vittorio Emanuele, Catania, Italy
| | - Federico Piacentini
- Division of Medical Oncology Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Modena, Italy
| | - Saverio Danese
- Department of Gynecology and Obstetrics, Ospedale S. Anna, Turin, Italy
| | - Antonella Ferro
- Rete clinica senologica - Oncologia medica S. Chiara, Trento, Italy
| | - Katia Cagossi
- Breast Unit Ausl Modena, Ramazzini Hospital, Carpi, Italy
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Sante Romito
- Medical Oncology, A.O.U. "Ospedali Riuniti", Foggia, Italy
| | - Viviana Bazan
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Laura Amaducci
- Medical Oncology Unit, Ospedale degli Infermi Faenza, Faenza, Italy
| | - Gabriella Moretti
- Department of Oncology and Advanced Technologies, Oncology Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Maria Pia Foschini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Unit of Anatomic Pathology at Bellaria Hospital, Bologna, Italy
| | - Sara Balduzzi
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena, Modena, Italy
| | - Roberto Vicini
- Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Roberto D'Amico
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena, Modena, Italy.,Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto - IRCCS, Via Gattamelata 64, 35128, Padova, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto - IRCCS, Via Gattamelata 64, 35128, Padova, Italy
| | - Pier Franco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy. .,Medical Oncology 2, Istituto Oncologico Veneto - IRCCS, Via Gattamelata 64, 35128, Padova, Italy.
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21
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Palleschi M, Maltoni R, Sarti S, Melegari E, Bravaccini S, Rocca A. Immunotherapy: The end of the "dark age" for metastatic triple-negative breast cancer? Breast J 2019; 26:739-742. [PMID: 31612573 DOI: 10.1111/tbj.13662] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 01/10/2023]
Abstract
The lack of effective therapies for metastatic triple-negative breast cancer (mTNBC) highlights the need for the development of novel treatment strategies. The cornerstone of treatment has long been represented by chemotherapy. Relevant evidence has recently emerged regarding the efficacy of immune checkpoint inhibitors, with the demonstration of a statistically significant improvement of progression-free survival with the addition of atezolizumab to nab-paclitaxel in the first-line treatment of mTNBC, accompanied by a substantial overall survival benefit in the PD-L1-positive subgroup. Despite this, it is necessary to identify the biomarkers that could allow a better selection of patients and combination regimens.
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Affiliation(s)
- Michela Palleschi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Roberta Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Elisabetta Melegari
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sara Bravaccini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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22
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Vitiello M, Evangelista M, Di Lascio N, Kusmic C, Massa A, Orso F, Sarti S, Marranci A, Rodzik K, Germelli L, Chandra D, Salvetti A, Pucci A, Taverna D, Faita F, Gravekamp C, Poliseno L. Antitumoral effects of attenuated Listeria monocytogenes in a genetically engineered mouse model of melanoma. Oncogene 2019; 38:3756-3762. [PMID: 30664692 PMCID: PMC6756113 DOI: 10.1038/s41388-019-0681-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 07/03/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 12/30/2022]
Abstract
Attenuated Listeria monocytogenes (Lmat-LLO) represents a valuable anticancer vaccine and drug delivery platform. Here we show that in vitro Lmat-LLO causes ROS production and, in turn, apoptotic killing of a wide variety of melanoma cells, irrespectively of their stage, mutational status, sensitivity to BRAF inhibitors or degree of stemness. We also show that, when administered in the therapeutic setting to Braf/Pten genetically engineered mice, Lmat-LLO causes a strong decrease in the size and volume of primary melanoma tumors, as well as a reduction of the metastatic burden. At the molecular level, we confirm that the anti-melanoma activity exerted in vivo by Lmat-LLO depends also on its ability to potentiate the immune response of the organism against the infected tumor. Our data pave the way to the preclinical testing of listeria-based immunotherapeutic strategies against metastatic melanoma, using a genetically engineered mouse rather than xenograft models.
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Affiliation(s)
- Marianna Vitiello
- Institute of Clinical Physiology, CNR, Pisa, Italy. .,Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy.
| | | | | | | | - Annamaria Massa
- Molecular Biotechnology Center (MBC), University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Francesca Orso
- Molecular Biotechnology Center (MBC), University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.,Center for Complex Systems in Molecular Biology and Medicine, University of Torino, Torino, Italy
| | - Samanta Sarti
- Institute of Clinical Physiology, CNR, Pisa, Italy.,Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy
| | - Andrea Marranci
- Institute of Clinical Physiology, CNR, Pisa, Italy.,Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy
| | - Katarzyna Rodzik
- Department of Biochemistry and Molecular Biology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Lorenzo Germelli
- Institute of Clinical Physiology, CNR, Pisa, Italy.,Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy
| | - Dinesh Chandra
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, New York, USA
| | - Alessandra Salvetti
- Unit of Experimental Biology and Genetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Angela Pucci
- Histopathology Department, Pisa University Hospital, Pisa, Italy
| | - Daniela Taverna
- Molecular Biotechnology Center (MBC), University of Torino, Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.,Center for Complex Systems in Molecular Biology and Medicine, University of Torino, Torino, Italy
| | | | - Claudia Gravekamp
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, New York, USA
| | - Laura Poliseno
- Institute of Clinical Physiology, CNR, Pisa, Italy. .,Oncogenomics Unit, Core Research Laboratory, ISPRO, Pisa, Italy.
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23
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Conte P, Guarneri V, Bisagni G, Piacentini F, Brandes A, Cavanna L, Giotta F, Aieta M, Gebbia V, Frassoldati A, Musolino A, Garrone O, Taverniti C, Rimanti A, Sarti S, Rubino D, Bologna A, Vicini R, Balduzzi S, D'Amico R. 9 weeks versus 1 year adjuvant trastuzumab for HER2+ early breast cancer: Subgroup analysis of the ShortHER trial allows to identify patients for whom a shorter trastuzumab administration may have a favourable risk/benefit ratio. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Dieci M, Conte P, Bisagni G, Brandes A, Frassoldati A, Cavanna L, Musolino A, Giotta F, Rimanti A, Garrone O, Bertone E, Cagossi K, Sarti S, Ferro A, Omarini C, Maiorana A, Orvieto E, Sanders M, D'Amico R, Guarneri V. Tumor-infiltrating lymphocytes (TILs) as an independent prognostic factor for early HER2+ breast cancer patients treated with adjuvant chemotherapy and trastuzumab in the randomized shortHER trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.183] [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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25
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Bronte G, Bravaccini S, Ravaioli S, Puccetti M, Scarpi E, Andreis D, Tumedei MM, Sarti S, Cecconetto L, Pietri E, De Simone V, Maltoni R, Bonafè M, Amadori D, Rocca A. Androgen Receptor Expression in Breast Cancer: What Differences Between Primary Tumor and Metastases? Transl Oncol 2018; 11:950-956. [PMID: 29890379 PMCID: PMC6036224 DOI: 10.1016/j.tranon.2018.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 02/22/2018] [Revised: 05/14/2018] [Accepted: 05/23/2018] [Indexed: 01/13/2023] Open
Abstract
Genomic studies have shown that the androgen receptor (AR) pathway plays an important role in some breast cancer subtypes. However few data are present on the concordance between AR expression in primary tumors and metastases. We investigated AR expression by using immunohistochemistry (IHC) in 164 primary tumors and 83 metastases, to explore its distribution in the different tumor subtypes and its concordance between the two sample types and according to sampling time. AR was more highly expressed in luminal A and B than HER2-positive and triple negative primary tumors. A similar distribution was found in metastases, and the concordance of AR expression between primary tumors and metastases was greater than 60%. No association between sampling time and AR expression was observed. We found a good concordance of AR expression between primary tumor and metastasis, but the variability remains high between the two types of specimens, regardless of the variation in sampling time. For this reason, if used for treatment decisions, AR evaluation should be repeated in each patient whenever a new biopsy is performed, as commonly done for the other breast cancer biomarkers.
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Affiliation(s)
- Giuseppe Bronte
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Sara Bravaccini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy.
| | - Sara Ravaioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | | | - Emanuela Scarpi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Daniele Andreis
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Maria Maddalena Tumedei
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Lorenzo Cecconetto
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Elisabetta Pietri
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Valeria De Simone
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Roberta Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Massimiliano Bonafè
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy; Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Dino Amadori
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
| | - Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC, Italy
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26
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Cecconetto L, Gardini AC, Tenti E, Maltoni R, Bravaccini S, Oboldi D, Zoli W, Serra P, Donati C, Sarti S, Amadori D, Rocca A. Long-term Complete Response in a Patient with Liver Metastases from Breast Cancer Treated with Metronomic Chemotherapy. Tumori Journal 2018. [DOI: 10.1177/1578.17238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lorenzo Cecconetto
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Andrea Casadei Gardini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Elena Tenti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Roberta Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sara Bravaccini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Devil Oboldi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Wainer Zoli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Patrizia Serra
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Caterina Donati
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Dino Amadori
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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27
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Vitiello M, Tuccoli A, D'Aurizio R, Sarti S, Giannecchini L, Lubrano S, Marranci A, Evangelista M, Peppicelli S, Ippolito C, Barravecchia I, Guzzolino E, Montagnani V, Gowen M, Mercoledi E, Mercatanti A, Comelli L, Gurrieri S, Wu LW, Ope O, Flaherty K, Boland GM, Hammond MR, Kwong L, Chiariello M, Stecca B, Zhang G, Salvetti A, Angeloni D, Pitto L, Calorini L, Chiorino G, Pellegrini M, Herlyn M, Osman I, Poliseno L. Context-dependent miR-204 and miR-211 affect the biological properties of amelanotic and melanotic melanoma cells. Oncotarget 2018; 8:25395-25417. [PMID: 28445987 PMCID: PMC5421939 DOI: 10.18632/oncotarget.15915] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 02/06/2017] [Indexed: 12/13/2022] Open
Abstract
Despite increasing amounts of experimental evidence depicting the involvement of non-coding RNAs in cancer, the study of BRAFV600E-regulated genes has thus far focused mainly on protein-coding ones. Here, we identify and study the microRNAs that BRAFV600E regulates through the ERK pathway. By performing small RNA sequencing on A375 melanoma cells and a vemurafenib-resistant clone that was taken as negative control, we discover miR-204 and miR-211 as the miRNAs most induced by vemurafenib. We also demonstrate that, although belonging to the same family, these two miRNAs have distinctive features. miR-204 is under the control of STAT3 and its expression is induced in amelanotic melanoma cells, where it acts as an effector of vemurafenib's anti-motility activity by targeting AP1S2. Conversely, miR-211, a known transcriptional target of MITF, is induced in melanotic melanoma cells, where it targets EDEM1 and consequently impairs the degradation of TYROSINASE (TYR) through the ER-associated degradation (ERAD) pathway. In doing so, miR-211 serves as an effector of vemurafenib's pro-pigmentation activity. We also show that such an increase in pigmentation in turn represents an adaptive response that needs to be overcome using appropriate inhibitors in order to increase the efficacy of vemurafenib. In summary, we unveil the distinct and context-dependent activities exerted by miR-204 family members in melanoma cells. Our work challenges the widely accepted “same miRNA family = same function” rule and provides a rationale for a novel treatment strategy for melanotic melanomas that is based on the combination of ERK pathway inhibitors with pigmentation inhibitors.
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Affiliation(s)
- Marianna Vitiello
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy.,Institute of Clinical Physiology (IFC), CNR, Pisa, Italy
| | - Andrea Tuccoli
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy
| | - Romina D'Aurizio
- Laboratory of Integrative Systems Medicine (LISM), Institute of Informatics and Telematics (IIT), CNR, Pisa, Italy
| | - Samanta Sarti
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy.,University of Siena, Italy
| | - Laura Giannecchini
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy
| | - Simone Lubrano
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy.,University of Siena, Italy
| | - Andrea Marranci
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy.,University of Siena, Italy
| | | | - Silvia Peppicelli
- Section of Experimental Pathology and Oncology, Department of Experimental and Clinical Biomedical Sciences, University of Firenze, Italy
| | - Chiara Ippolito
- Unit of Histology, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | | | - Valentina Montagnani
- Tumor Cell Biology Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUC, Firenze, Italy
| | | | - Elisa Mercoledi
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy
| | | | - Laura Comelli
- Institute of Clinical Physiology (IFC), CNR, Pisa, Italy
| | - Salvatore Gurrieri
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy
| | | | | | | | | | | | | | - Mario Chiariello
- Institute of Clinical Physiology (IFC), CNR, Pisa, Italy.,Signal Transduction Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUS, Siena, Italy
| | - Barbara Stecca
- Tumor Cell Biology Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUC, Firenze, Italy
| | - Gao Zhang
- The Wistar Institute, Philadelphia, PA, USA
| | - Alessandra Salvetti
- Unit of Experimental Biology and Genetics, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | - Letizia Pitto
- Institute of Clinical Physiology (IFC), CNR, Pisa, Italy
| | - Lido Calorini
- Section of Experimental Pathology and Oncology, Department of Experimental and Clinical Biomedical Sciences, University of Firenze, Italy
| | | | - Marco Pellegrini
- Laboratory of Integrative Systems Medicine (LISM), Institute of Informatics and Telematics (IIT), CNR, Pisa, Italy
| | | | | | - Laura Poliseno
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, Pisa, Italy.,Institute of Clinical Physiology (IFC), CNR, Pisa, Italy
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28
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Bronte G, Rocca A, Ravaioli S, Puccetti M, Tumedei MM, Scarpi E, Andreis D, Maltoni R, Sarti S, Cecconetto L, Fedeli A, Pietri E, De Simone V, Asioli S, Amadori D, Bravaccini S. Androgen receptor in advanced breast cancer: is it useful to predict the efficacy of anti-estrogen therapy? BMC Cancer 2018; 18:348. [PMID: 29587674 PMCID: PMC5872575 DOI: 10.1186/s12885-018-4239-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/16/2018] [Indexed: 01/20/2023] Open
Abstract
Background Androgen receptor (AR) is widely expressed in breast cancer (BC) but its role in estrogen receptor (ER)-positive tumors is still controversial. The AR/ER ratio has been reported to impact prognosis and response to antiestrogen endocrine therapy (ET). Methods We assessed whether AR in primary tumors and/or matched metastases is a predictor of efficacy of first-line ET in advanced BC. Patients who had received first-line ET (2002–2011) were recruited, while those given concomitant chemotherapy or trastuzumab or pretreated with > 2 lines of chemotherapy were excluded. ER, progesterone receptor (PgR), Ki67 and AR expression were assessed by immunohistochemistry, and HER2 mainly by fluorescent in-situ hybridization. Cut-offs of 1 and 10% immunostained cells were used to categorize AR expression. Results Among 102 evaluable patients, biomarkers were assessed in primary tumors in 70 cases and in metastases in 49, with 17 patients having both determinations. The overall concordance rate between primary tumors and metastases was 64.7% (95% CI 42%-87.4%) for AR status. AR status did not affect TTP significantly, whereas PgR and Ki67 status did. AR/PgR ≥0.96 was associated with a significantly shorter TTP (HR = 1.65, 95% CI 1.05-2.61, p = 0.028). AR status in primary tumors or metastases was not associated with progressive disease (PD) as best response. In contrast, Ki67 ≥ 20% and PgR < 10% showed a statistically significant association with PD as best response. Conclusions AR expression does not appear to be useful to predict the efficacy of ET in advanced BC, whereas Ki67 and PgR exert a greater impact on its efficacy.
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Affiliation(s)
- Giuseppe Bronte
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy.
| | - Sara Ravaioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | | | - Maria Maddalena Tumedei
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Emanuela Scarpi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Daniele Andreis
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Roberta Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Lorenzo Cecconetto
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Anna Fedeli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Elisabetta Pietri
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Valeria De Simone
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Silvia Asioli
- Department of Pathology, Morgagni-Pierantoni Hospital, 47121, Forlì, Italy
| | - Dino Amadori
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy
| | - Sara Bravaccini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, FC, Italy.
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Capobianco E, Valdes C, Sarti S, Jiang Z, Poliseno L, Tsinoremas NF. Ensemble Modeling Approach Targeting Heterogeneous RNA-Seq data: Application to Melanoma Pseudogenes. Sci Rep 2017; 7:17344. [PMID: 29229974 PMCID: PMC5725464 DOI: 10.1038/s41598-017-17337-7] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 11/23/2017] [Indexed: 01/28/2023] Open
Abstract
We studied the transcriptome landscape of skin cutaneous melanoma (SKCM) using 103 primary tumor samples from TCGA, and measured the expression levels of both protein coding genes and non-coding RNAs (ncRNAs). In particular, we emphasized pseudogenes potentially relevant to this cancer. While cataloguing the profiles based on the known biotypes, all the employed RNA-Seq methods generated just a small consensus of significant biotypes. We thus designed an approach to reconcile the profiles from all methods following a simple strategy: we selected genes that were confirmed as differentially expressed by the ensemble predictions obtained in a regression model. The main advantages of this approach are: 1) Selection of a high-confidence gene set identifying relevant pathways; 2) Use of a regression model whose covariates embed all method-driven outcomes to predict an averaged profile; 3) Method-specific assessment of prediction power and significance. Furthermore, the approach can be generalized to any biological system for which noisy RNA-Seq profiles are computed. As our analyses concerned bio-annotations of both high-quality protein coding genes and ncRNAs, we considered the associations between pseudogenes and parental genes (targets). Among the candidate targets that were validated, we identified PINK1, which is studied in patients with Parkinson and cancer (especially melanoma).
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Affiliation(s)
- Enrico Capobianco
- Center for Computational Science, University of Miami, Miami, FL, USA.
| | - Camilo Valdes
- Center for Computational Science, University of Miami, Miami, FL, USA
| | | | - Zhijie Jiang
- Center for Computational Science, University of Miami, Miami, FL, USA
| | - Laura Poliseno
- Istituto Toscano Tumori Oncogenomics Unit, Institute of Clinical Physiology-National Research Council, Pisa, Italy
| | - Nicolas F Tsinoremas
- Center for Computational Science, University of Miami, Miami, FL, USA
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
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Ravaioli S, Rocca A, Bronte G, Puccetti M, Tumedei M, Scarpi E, Maltoni R, Sarti S, Cecconetto L, Andreis D, Pietri E, Calistri D, Amadori D, Bravaccini S. Is Androgen Receptor a predicitive biomarker of response to antiestrogen therapy in advanced breast cancer? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx511.025] [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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31
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Rocca A, Bronte G, Ravaioli S, Puccetti M, Tumedei MM, Scarpi E, Maltoni R, Sarti S, Cecconetto L, Bedei L, Fedeli A, Andreis D, Pietri E, Calistri D, Amadori D, Bravaccini S. Is androgen receptor useful to predict the efficacy of anti-estrogen therapy in advanced breast cancer? J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.1042] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1042 Background: The androgen receptor (AR) is widely expressed in breast cancers but its role in estrogen receptor (ER)-positive tumors is still controversial. However, the AR/ER ratio may impact prognosis and the response to antiestrogen endocrine therapy (ET). Methods: We assessed whether AR in primary tumors and/or matched metastases is a predictor of efficacy of first-line ET in advanced breast cancer (ABC). We evaluated patients treated with first-line ET (2002–2011), excluding those receiving concomitant chemotherapy or trastuzumab or pretreated with > 2 lines of chemotherapy. ER, progesterone receptor (PgR), Her2, Ki67 and AR expression was determined by immunohistochemistry. A cut-off of < 1% immunostained cells was used to categorize AR expression. AR expression was analyzed in relation to the other conventional biomarkers (ER, PgR, Her2 and Ki67), best response (CR, PR, SD, PD), and time to progression (TTP) (months). TTP was estimated using the Kaplan-Meier method and compared with the log-rank test. Hazard ratios and their 95% confidence intervals (95% CI) were estimated using the Cox regression model. The Chi-square test was used to evaluate correlations between categorical variables and best response. p values < 0.05 were considered statistically significant. Results: Of the 102 evaluable patients (93% were treated with an aromatase inhibitor), biomarkers were assessed in primary tumors in 70 cases, in metastases in 49 and in 17 in both). Median TTP was 17 months (95% CI 14-21.5, median follow-up 75 months). The overall concordance rate between primary tumors and metastases was 64.7% (95% CI 42%-87.4%) for AR expression. Differences in TTP according to AR status were not statistically significant. AR/PgR ≥ 0.96 was associated with a significantly shorter TTP (HR = 1.65, 95% CI 1.05-2.61, p = 0.030). AR status in primary tumors or metastases was not associated with PD as best response. In contrast, Ki67 > 20% and PgR < 10% showed a significant association with PD as best response. Using a cut off of ≤10% for AR expression, results did not change. Conclusions: AR expression does not appear to be useful to predict the efficacy of ET in ABC. Ki67 and PgR exert a greater impact on the efficacy of hormone therapy than AR.
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Affiliation(s)
- Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giuseppe Bronte
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sara Ravaioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Maria Maddalena Tumedei
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Emanuela Scarpi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Roberta Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Lorenzo Cecconetto
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Lucia Bedei
- Cancer Prevention Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Anna Fedeli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Daniele Andreis
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Elisabetta Pietri
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Daniele Calistri
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Dino Amadori
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sara Bravaccini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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Marranci A, Jiang Z, Vitiello M, Guzzolino E, Comelli L, Sarti S, Lubrano S, Franchin C, Echevarría-Vargas I, Tuccoli A, Mercatanti A, Evangelista M, Sportoletti P, Cozza G, Luzi E, Capobianco E, Villanueva J, Arrigoni G, Signore G, Rocchiccioli S, Pitto L, Tsinoremas N, Poliseno L. The landscape of BRAF transcript and protein variants in human cancer. Mol Cancer 2017; 16:85. [PMID: 28454577 PMCID: PMC5410044 DOI: 10.1186/s12943-017-0645-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 04/03/2017] [Indexed: 12/20/2022] Open
Abstract
Background The BRAF protein kinase is widely studied as a cancer driver and therapeutic target. However, the regulation of its expression is not completely understood. Results Taking advantage of the RNA-seq data of more than 4800 patients belonging to 9 different cancer types, we show that BRAF mRNA exists as a pool of 3 isoforms (reference BRAF, BRAF-X1, and BRAF-X2) that differ in the last part of their coding sequences, as well as in the length (BRAF-ref: 76 nt; BRAF-X1 and BRAF-X2: up to 7 kb) and in the sequence of their 3’UTRs. The expression levels of BRAF-ref and BRAF-X1/X2 are inversely correlated, while the most prevalent among the three isoforms varies from cancer type to cancer type. In melanoma cells, the X1 isoform is expressed at the highest level in both therapy-naïve cells and cells with acquired resistance to vemurafenib driven by BRAF gene amplification or expression of the Δ[3–10] splicing variant. In addition to the BRAF-ref protein, the BRAF-X1 protein (the full length as well as the Δ[3–10] variant) is also translated. The expression levels of the BRAF-ref and BRAF-X1 proteins are similar, and together they account for BRAF functional activities. In contrast, the endogenous BRAF-X2 protein is hard to detect because the C-terminal domain is selectively recognized by the ubiquitin-proteasome pathway and targeted for degradation. Conclusions By shedding light on the repertoire of BRAF mRNA and protein variants, and on the complex regulation of their expression, our work paves the way to a deeper understanding of a crucially important player in human cancer and to a more informed development of new therapeutic strategies. Electronic supplementary material The online version of this article (doi:10.1186/s12943-017-0645-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea Marranci
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, CNR-IFC, Via Moruzzi 1, 56124, Pisa, Italy.,University of Siena, Siena, Italy
| | - Zhijie Jiang
- Center for Computational Science, University of Miami, Gables One Tower, Room 600 N, 1320 S. Dixie Highway, Coral Gables, FL, 33146-2926, USA
| | - Marianna Vitiello
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, CNR-IFC, Via Moruzzi 1, 56124, Pisa, Italy.,Institute of Clinical Physiology (IFC), CNR, Via Moruzzi 1, 56124, Pisa, Italy
| | | | - Laura Comelli
- Institute of Clinical Physiology (IFC), CNR, Via Moruzzi 1, 56124, Pisa, Italy
| | - Samanta Sarti
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, CNR-IFC, Via Moruzzi 1, 56124, Pisa, Italy.,University of Siena, Siena, Italy
| | - Simone Lubrano
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, CNR-IFC, Via Moruzzi 1, 56124, Pisa, Italy.,University of Siena, Siena, Italy
| | - Cinzia Franchin
- Department of Biomedical Sciences, University of Padova, Padova, Italy.,Proteomics Center, University of Padova and Azienda Ospedaliera di Padova, Padova, Italy
| | - Ileabett Echevarría-Vargas
- Molecular and Cellular Oncogenesis Program & Melanoma Research Center, The Wistar Institute, Philadelphia, USA
| | - Andrea Tuccoli
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, CNR-IFC, Via Moruzzi 1, 56124, Pisa, Italy
| | - Alberto Mercatanti
- Institute of Clinical Physiology (IFC), CNR, Via Moruzzi 1, 56124, Pisa, Italy
| | - Monica Evangelista
- Institute of Clinical Physiology (IFC), CNR, Via Moruzzi 1, 56124, Pisa, Italy
| | | | - Giorgio Cozza
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Ettore Luzi
- Department of Surgery and Translational Medicine, University of Firenze, Firenze, Italy
| | - Enrico Capobianco
- Center for Computational Science, University of Miami, Gables One Tower, Room 600 N, 1320 S. Dixie Highway, Coral Gables, FL, 33146-2926, USA
| | - Jessie Villanueva
- Molecular and Cellular Oncogenesis Program & Melanoma Research Center, The Wistar Institute, Philadelphia, USA
| | - Giorgio Arrigoni
- Department of Biomedical Sciences, University of Padova, Padova, Italy.,Proteomics Center, University of Padova and Azienda Ospedaliera di Padova, Padova, Italy
| | | | - Silvia Rocchiccioli
- Institute of Clinical Physiology (IFC), CNR, Via Moruzzi 1, 56124, Pisa, Italy
| | - Letizia Pitto
- Institute of Clinical Physiology (IFC), CNR, Via Moruzzi 1, 56124, Pisa, Italy
| | - Nicholas Tsinoremas
- Center for Computational Science, University of Miami, Gables One Tower, Room 600 N, 1320 S. Dixie Highway, Coral Gables, FL, 33146-2926, USA.
| | - Laura Poliseno
- Oncogenomics Unit, Core Research Laboratory, Istituto Toscano Tumori (ITT), AOUP, CNR-IFC, Via Moruzzi 1, 56124, Pisa, Italy. .,Institute of Clinical Physiology (IFC), CNR, Via Moruzzi 1, 56124, Pisa, Italy.
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Gennari A, Nanni O, Rocca A, De Censi A, Fieschi A, Bologna A, Gianni L, Rosetti F, Amaducci L, Cavanna L, Foca F, Sarti S, Serra P, Valmorri L, Corradengo D, Antonucci G, Bruzzi P, Amadori D. Phase II randomised clinical study of metformin plus chemotherapy vs chemotherapy alone in HER2 negative metastatic breast cancer: final results of the MYME trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.09] [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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34
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Pietri E, Conteduca V, Andreis D, Massa I, Melegari E, Sarti S, Cecconetto L, Schirone A, Bravaccini S, Serra P, Fedeli A, Maltoni R, Amadori D, De Giorgi U, Rocca A. Androgen receptor signaling pathways as a target for breast cancer treatment. Endocr Relat Cancer 2016; 23:R485-98. [PMID: 27528625 DOI: 10.1530/erc-16-0190] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/12/2016] [Indexed: 12/23/2022]
Abstract
The androgen receptor (AR) is a ligand-dependent transcription factor, and its effects on breast range from physiological pubertal development and age-related modifications to cancer onset and proliferation. The prevalence of AR in early breast cancer is around 60%, and AR is more frequently expressed in ER-positive than in ER-negative tumors. We offer an overview of AR signaling pathways in different breast cancer subtypes, providing evidence that its oncogenic role is likely to be different in distinct biological and clinical scenarios. In particular, in ER-positive breast cancer, AR signaling often antagonizes the growth stimulatory effect of ER signaling; in triple-negative breast cancer (TNBC), AR seems to drive tumor progression (at least in luminal AR subtype of TNBC with a gene expression profile mimicking luminal subtypes despite being negative to ER and enriched in AR expression); in HER2-positive breast cancer, in the absence of ER expression, AR signaling has a proliferative role. These data represent the rationale for AR-targeting treatment as a potentially new target therapy in breast cancer subset using androgen agonists in some AR-positive/ER-positive tumors, AR antagonists in triple-negative/AR-positive tumors and in combination with anti-HER2 agents or with other signaling pathways inhibitors (including PI3K/MYC/ERK) in HER2-positive/AR-positive tumors. Only the ongoing and future prospective clinical trials will allow us to establish which agents are the best option in every specific condition, keeping in mind that there is evidence of opposite androgens and AR agonist/antagonist drug effects on cell proliferation particularly in AR-positive/ER-positive tumors.
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Affiliation(s)
- Elisabetta Pietri
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Vincenza Conteduca
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Daniele Andreis
- Unit of Biostatistics and Clinical TrialsIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Ilaria Massa
- Unit of Biostatistics and Clinical TrialsIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Elisabetta Melegari
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Samanta Sarti
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Lorenzo Cecconetto
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Alessio Schirone
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Sara Bravaccini
- Biosciences LaboratoryIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Patrizia Serra
- Unit of Biostatistics and Clinical TrialsIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Anna Fedeli
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Roberta Maltoni
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Dino Amadori
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Ugo De Giorgi
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Andrea Rocca
- Department of Medical OncologyIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
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Musolino A, Naldi N, Dieci MV, Zanoni D, Rimanti A, Boggiani D, Sgargi P, Generali DG, Piacentini F, Ambroggi M, Cagossi K, Gianni L, Sarti S, Bisagni G, Ardizzoni A, Conte PF, Guarneri V. Immunoglobulin G fragment C receptor polymorphisms and efficacy of preoperative chemotherapy plus trastuzumab and lapatinib in HER2-positive breast cancer. Pharmacogenomics J 2016; 16:472-7. [PMID: 27378608 DOI: 10.1038/tpj.2016.51] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/04/2016] [Accepted: 05/06/2016] [Indexed: 11/09/2022]
Abstract
Lapatinib enhances antibody-dependent cell-mediated cytotoxicity (ADCC) activity of trastuzumab. FcγR polymorphisms have been associated with both ADCC and clinical activity of trastuzumab in HER2+ breast cancer (BC) patients (pts). We analyzed FcγRIIa-H131R and FcγRIIIa-V158F polymorphisms in the CHER-LOB trial population of HER2+ BCs treated with preoperative chemotherapy plus trastuzumab (arm A), lapatinib (arm B) or both (arm C). Genotyping was successfully performed in 73/121 (60%) pts. A significant improvement in pathological complete response (pCR) rate was observed for the combination arm C, but only in FcγRIIIa V allele carriers (C vs A, 67 vs 27%, P=0.043; C vs B, 67 vs 22%, P=0.012). An independent interaction between arm C and FcγRIIIa V allele was found for pCR (odds ratio=9.4; 95% confidence interval, 2.3-39.6; P=0.003). No significant associations were observed between pCR and FcγRIIa polymorphism, and between pre-treatment tumor-infiltrating lymphocytes and FcγR polymorphisms. Our study provides evidence for a FcγRIIIa V allele-restricted pCR benefit from neoadjuvant trastuzumab plus lapatinib in HER2+ BC.
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Affiliation(s)
- A Musolino
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - N Naldi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - M V Dieci
- Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - D Zanoni
- Department of Oncology, Guastalla Hospital, Guastalla, Italy
| | - A Rimanti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - D Boggiani
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - P Sgargi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - D G Generali
- U.O. Multidisciplinare di Patologia Mammaria, A.O. Istituti Ospitalieri di Cremona, Cremona, Italy
| | - F Piacentini
- Medical Oncology Unit, Modena University Hospital, Modena, Italy
| | - M Ambroggi
- Medical Oncology Unit, Hospital of Piacenza, Piacenza, Italy
| | - K Cagossi
- Medical Oncology Unit, Ramazzini Hospital, Carpi, Italy
| | - L Gianni
- Medical Oncology Unit, Ospedale Infermi, Rimini, Italy
| | - S Sarti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - G Bisagni
- Medical Oncology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - A Ardizzoni
- Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - P F Conte
- Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - V Guarneri
- Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
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Rocca A, Cecconetto L, Passardi A, Melegari E, Andreis D, Monti M, Maltoni R, Sarti S, Pietri E, Schirone A, Fedeli A, Donati C, Nanni O, Amadori D. A phase Ib study of lapatinib plus pegylated liposomal doxorubicin in patients with advanced HER2-positive breast cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Lorenzo Cecconetto
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Alessandro Passardi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Elisabetta Melegari
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Daniele Andreis
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Manuela Monti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Roberta Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Elisabetta Pietri
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Alessio Schirone
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Anna Fedeli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Caterina Donati
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Oriana Nanni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Dino Amadori
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
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Serra P, Masalu N, Bucchi L, Kahima J, Kiyesi L, Maltoni R, Nanni O, Sarti S, Botteghi M, Amadori D. Disease prevalence, tumour stage, and results of testing in the pilot phase of a service for cervical cancer screening and diagnosis in northern Tanzania. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.10] [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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Rocca A, Andreis D, Fedeli A, Maltoni R, Sarti S, Cecconetto L, Pietri E, Schirone A, Bravaccini S, Serra P, Farolfi A, Amadori D. Pharmacokinetics, pharmacodynamics and clinical efficacy of pertuzumab in breast cancer therapy. Expert Opin Drug Metab Toxicol 2015; 11:1647-63. [DOI: 10.1517/17425255.2015.1078311] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Guarneri V, Dieci MV, Frassoldati A, Maiorana A, Ficarra G, Bettelli S, Tagliafico E, Bicciato S, Generali DG, Cagossi K, Bisagni G, Sarti S, Musolino A, Ellis C, Crescenzo R, Conte P. Prospective Biomarker Analysis of the Randomized CHER-LOB Study Evaluating the Dual Anti-HER2 Treatment With Trastuzumab and Lapatinib Plus Chemotherapy as Neoadjuvant Therapy for HER2-Positive Breast Cancer. Oncologist 2015; 20:1001-10. [PMID: 26245675 DOI: 10.1634/theoncologist.2015-0138] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/26/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The CHER-LOB randomized phase II study showed that the combination of lapatinib and trastuzumab plus chemotherapy increases the pathologic complete remission (pCR) rate compared with chemotherapy plus either trastuzumab or lapatinib. A biomarker program was prospectively planned to identify potential predictors of sensitivity to different treatments and to evaluate treatment effect on tumor biomarkers. MATERIALS AND METHODS Overall, 121 breast cancer patients positive for human epidermal growth factor 2 (HER2) were randomly assigned to neoadjuvant chemotherapy plus trastuzumab, lapatinib, or both trastuzumab and lapatinib. Pre- and post-treatment samples were centrally evaluated for HER2, p95-HER2, phosphorylated AKT (pAKT), phosphatase and tensin homolog, Ki67, apoptosis, and PIK3CA mutations. Fresh-frozen tissue samples were collected for genomic analyses. RESULTS A mutation in PIK3CA exon 20 or 9 was documented in 20% of cases. Overall, the pCR rates were similar in PIK3CA wild-type and PIK3CA-mutated patients (33.3% vs. 22.7%; p = .323). For patients receiving trastuzumab plus lapatinib, the probability of pCR was higher in PIK3CA wild-type tumors (48.4% vs. 12.5%; p = .06). Ki67, pAKT, and apoptosis measured on the residual disease were significantly reduced from baseline. The degree of Ki67 inhibition was significantly higher in patients receiving the dual anti-HER2 blockade. The integrated analysis of gene expression and copy number data demonstrated that a 50-gene signature specifically predicted the lapatinib-induced pCR. CONCLUSION PIK3CA mutations seem to identify patients who are less likely to benefit from dual anti-HER2 inhibition. p95-HER2 and markers of phosphoinositide 3-kinase pathway deregulation are not confirmed as markers of different sensitivity to trastuzumab or lapatinib. IMPLICATIONS FOR PRACTICE HER2 is currently the only validated marker to select breast cancer patients for anti-HER2 treatment; however, it is becoming evident that HER2-positive breast cancer is a heterogeneous disease. In addition, more and more new anti-HER2 treatments are becoming available. There is a need to identify markers of sensitivity to different treatments to move in the direction of treatment personalization. This study identified PIK3CA mutations as a potential predictive marker of resistance to dual anti-HER2 treatment that should be further studied in breast cancer.
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Affiliation(s)
- Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Antonio Frassoldati
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Antonino Maiorana
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Guido Ficarra
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Stefania Bettelli
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Enrico Tagliafico
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Silvio Bicciato
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Daniele Giulio Generali
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Katia Cagossi
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Giancarlo Bisagni
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Samanta Sarti
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Antonino Musolino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Catherine Ellis
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Rocco Crescenzo
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - PierFranco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Division of Medical Oncology 2, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy; Division of Oncology, University Hospital, Ferrara, Italy; Division of Pathology, Modena University Hospital, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy; Unità Operativa Multidisciplinare di Patologia Mammaria, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy; Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy; Department of Medical Oncology, Azienda Ospedaliera ASMN, IRCCS, Reggio Emilia, Italy; Division of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Division of Medical Oncology, University Hospital, Parma, Italy; GlaxoSmithKline, Collegeville, Pennsylvania, USA
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Rocca A, Farolfi A, Maltoni R, Carretta E, Melegari E, Ferrario C, Cecconetto L, Sarti S, Schirone A, Fedeli A, Andreis D, Pietri E, Ibrahim T, Montalto E, Amadori D. Efficacy of endocrine therapy in relation to progesterone receptor and Ki67 expression in advanced breast cancer. Breast Cancer Res Treat 2015; 152:57-65. [PMID: 26012644 DOI: 10.1007/s10549-015-3423-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/08/2015] [Indexed: 11/30/2022]
Abstract
We assessed whether progesterone receptor (PgR) and Ki67 in primary tumors and/or matched metastases are predictors of clinical benefit from first-line endocrine therapy (ET) in advanced breast cancer. We evaluated patients treated at our institute with first-line ET (2002-2011), excluding those receiving concomitant chemotherapy or trastuzumab or pretreated with >2 lines of chemotherapy. A cut-off of 20 % immunostained cells was used for PgR and Ki67. The main endpoint was time-to-progression (TTP). Groups were compared by the log-rank test and Cox multivariate analysis. In the 135 assessable patients (93 % were receiving an aromatase inhibitor; biomarker assessment had been performed on primary tumors in 77 cases, on metastases in 23 and on both in 35), median TTP was 16 months (median follow-up 43 months). The overall discordance rate between primary tumors and metastases was 23 % for Ki67 and 31 % for PgR. A longer median TTP (24 vs. 12 months, P = 0.012) was seen for PgR >20 % in metastases. Ki67 showed a trend for TTP prediction in the entire case series (P = 0.062). Patients with high Ki67 and low PgR in metastases had a median TTP of only 5 months. High Ki67 in primary tumors (P = 0.026) or metastases (P = 0.01) predicted disease progression at the first evaluation. PgR in metastases remained a significant independent predictor of TTP at multivariate analysis (HR 2.45). In an ER-high population, PgR >20 % in metastases identified patients with a long TTP on endocrine treatment, while Ki67 >20 % was associated with an increased risk of non-response.
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Affiliation(s)
- Andrea Rocca
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Alberto Farolfi
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Roberta Maltoni
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Elisa Carretta
- Unit of Biostatistics and Clinical Trials, IRST IRCCS, Meldola, Italy
| | - Elisabetta Melegari
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Cristiano Ferrario
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Samanta Sarti
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Alessio Schirone
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Anna Fedeli
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Daniele Andreis
- Unit of Biostatistics and Clinical Trials, IRST IRCCS, Meldola, Italy
| | - Elisabetta Pietri
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Toni Ibrahim
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Erika Montalto
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy
| | - Dino Amadori
- Department of Medical Oncology, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, 47014, Meldola, Italy.
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Gennari A, Nanni O, DeCensi A, Sarti S, Freschi A, Bologna A, Gianni L, Amaducci L, Rosetti F, Giovanardi F, Fedeli A, Ambroggi M, Bruzzi P, Amadori D. Abstract P3-13-02: Phase II randomised clinical study of first line chemotherapy plus metformin versus first line chemotherapy alone in HER2 negative, non diabetic, metastatic breast cancer patients: Final results of the MYME study. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p3-13-02] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Epidemiological studies indicated that the presence of insulin resistance is an adverse prognostic factor in MBC. Recently increasing interest has focused on metformin, an oral insulin- sensitizing drug widely prescribed for type 2 diabetes; unexpensive and well tolerated, metformin has also been shown to have direct antiproliferative properties in breast cancer. We present here the final analysis of a phase II comparative multicentric study on the addition of metformin to first line chemotherapy in MBC non diabetic patients.
Methods:
This is a Phase II randomized study of HER-2 negative MBC patients with measurable or non-measurable disease; no prior chemotherapy for MBC was allowed. Patients were allowed to have had prior endocrine therapy for MBC and prior adjuvant chemotherapy if completed at least 1 year prior to study entry. Patients were stratified by HOMA Index (>2,5 vs </= 2,5) and center. Patients were randomly assigned to Arm A, non pegylated liposomal doxorubicin 60 mg/sqm plus cyclophosphamide 600mg/sqm (AC) plus metformin (M) 1,000 mg PO QD or to AC alone. Treatment was administered for 8 3-weekly cycles in both arms, M was administered until disease progression. The primary endpoint was progression free survival (PFS). Secondary objectives included activity, safety and evaluation of metabolic profile. Correlative studies evaluated 1) circulating tumor cells and 2) modulation of insulin-related genes in mRNA isolated from CTCs. Planned sample size was 112 patients (98 events).
Results:
As of June 8th, 2014, 108 patients had been randomised. Median age was 60 yrs (range 36-77); 87% of patients were ER+, 60% had received prior adjuvant CT, with antracyclines in 51% of patients. Prior endocrine therapy for MBC was used in 39% of the patients. Measurable disease was present in 74% of the patients. 48% of the patients were insulin resistant by HOMA Index >2.5 and 60% were overweight (BMI > 25: 16% were obese, BMI >30). At a median follow up of 16 months (range 1 – 48), median PFS (ITT) was 9 months (95% CI 8-14) with AC + M and 11 months (95% CI 7-16) with AC alone, p=.84. No significant interaction was detected between HOMA Index and treatment arm (p = 0.15). Median OS was 30 months (95% CI 14-NE) in Arm A versus 27 (95% CI 17-33) in Arm B, p = .58. The most common toxicities observed were G3/4 neutropenia in 51.5% of patients in arm A vs 69.6% in arm B, with Febrile Neutropenia observed in 2,2% and 5.4% of patients, respectively. As expected G2 diarrhea was reported by 11.1% of patients in Arm A.
Conclusions: The addition of M to AC in MBC patients receiving first line chemotherapy did not improve PFS compared with AC alone. M seems to have a protective effect on hematological toxicity. Final results including translational data will be available at SABCS 2014.
Citation Format: Alessandra Gennari, Oriana Nanni, Andrea DeCensi, Samanta Sarti, Andrea Freschi, Alessandra Bologna, Lorenzo Gianni, Laura Amaducci, Francesco Rosetti, Filippo Giovanardi, Anna Fedeli, Massimo Ambroggi, Paolo Bruzzi, Dino Amadori. Phase II randomised clinical study of first line chemotherapy plus metformin versus first line chemotherapy alone in HER2 negative, non diabetic, metastatic breast cancer patients: Final results of the MYME study [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-13-02.
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Affiliation(s)
| | - Oriana Nanni
- 2IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)
| | | | - Samanta Sarti
- 2IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)
| | | | | | | | | | | | | | | | | | | | - Dino Amadori
- 2IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)
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Musolino A, Guarneri V, Naldi N, Bortesi B, Boggiani D, Sgargi P, Generali DG, Piacentini F, Dieci MV, Ambroggi M, Cagossi K, Gianni L, Sarti S, Bisagni G, Frassoldati A, Conte P, Ardizzoni A. Abstract P3-06-23: Immunoglobulin G fragment C receptor polymorphisms and clinical efficacy of preoperative chemotherapy plus trastuzumab and lapatinib in patients with HER2-positive operable breast cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p3-06-23] [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: 11/16/2022]
Abstract
Abstract
Introduction: In vitro studies have shown that lapatinib enhances the immune-mediated cytotoxicity (ADCC) of trastuzumab. FcγR polymorphisms have been associated with both ADCC and clinical activity of trastuzumab in patients with HER2-positive metastatic breast cancer. There are no data on the relationship between these polymorphisms and the combination of trastuzumab plus lapatinib in the early stage setting. We performed a pharmacogenomics analysis of CHER-LOB, a randomized phase II trial of preoperative chemotherapy plus trastuzumab (arm A), lapatinib (arm B), or both (arm C) in HER2-positive operable breast cancer.
Methods: FcγRIIa-H131R and FcγRIIIa-V158F polymorphisms were analyzed on DNA from peripheral blood samples. Pathologic complete response (pCR) of genotyped cases was evaluated by FcγR polymorphism and treatment arm.
Results: Genotyping was successfully performed in 73/121 (60%) patients. No deviation from the Hardy-Weinberg equilibrium was observed. Similarly to the overall results of the CHER-LOB study, in the subset of patients genotyped in this analysis, a significant improvement in pCR rate was observed in favor of the combination of lapatinib plus trastuzumab (arm C) compared to arm A (OR=3.66, P=0.037), and B (OR=3.03, P=0.049). Such improvement was restricted to carriers of FcγRIIIa V allele (C vs. A, OR=5.33, P=0.043; C vs. B, OR=6.50, P=0.012), while it was not observed in patients with FcγRIIIa F/F genotype (C vs. A, OR=2.14, P=0.642; C vs. B, OR=0.71, P=0.737). Disease free survival (DFS) was not different by treatment arm in all genotyped cases, but a trend toward significance for an interaction between FcγRIIIa V allele and better DFS with the combination of lapatinib plus trastuzumab was detected (P=0.058). No significant associations were observed by FcγRIIa polymorphism.
Conclusions: Host-related immune signatures may mediate lapatinib enhanced trastuzumab-dependent ADCC. FcγRIIIa genotypes may help predict different outcomes to lapatinib plus trastuzumab in HER2-Positive Early Breast Cancer.
Citation Format: Antonino Musolino, Valentina Guarneri, Nadia Naldi, Beatrice Bortesi, Daniela Boggiani, Paolo Sgargi, Daniele G Generali, Federico Piacentini, Maria V Dieci, Massimo Ambroggi, Katia Cagossi, Lorenzo Gianni, Samanta Sarti, Giancarlo Bisagni, Antonio Frassoldati, Pierfranco Conte, Andrea Ardizzoni. Immunoglobulin G fragment C receptor polymorphisms and clinical efficacy of preoperative chemotherapy plus trastuzumab and lapatinib in patients with HER2-positive operable breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-06-23.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Maria V Dieci
- 2Istituto Oncologico Veneto-IRCCS, University of Padova
| | | | | | | | - Samanta Sarti
- 8Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
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Cecconetto L, Casadei Gardini A, Tenti E, Maltoni R, Bravaccini S, Oboldi D, Zoli W, Serra P, Donati C, Sarti S, Amadori D, Rocca A. Long-term complete response in a patient with liver metastases from breast cancer treated with metronomic chemotherapy. Tumori 2014; 100:e79-82. [PMID: 25076256 DOI: 10.1700/1578.17238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Preclinical studies have shown that several chemotherapeutic agents at low doses may affect the vascular system. Here we report the case of a patient with long-term cancer control by metronomic chemotherapy. CASE PRESENTATION A 62-year-old woman with breast cancer underwent a left mastectomy in July 2007. For a liver metastasis she was given first-line chemotherapy with doxorubicin plus paclitaxel every 21 days. A CT scan after the sixth cycle showed a partial response. It was decided to stop the treatment with doxorubicin and paclitaxel, and start metronomic therapy with cyclophosphamide 50 mg daily orally and methotrexate 2.5 mg twice daily, 2 days a week. After 6 months of this maintenance treatment, CT scan showed a complete response. We examined the expression of vascular endothelial growth factor receptor 2 (VEGFR2) in histological sections of the primary tumor of our patient, finding evidence of overexpression of the receptor. The metronomic treatment is still ongoing, and after 60 months the patient maintains a complete response. CONCLUSION This clinical case highlights how suitable metronomic chemotherapy can be used as maintenance therapy, allowing long-term treatment with no significant toxicity. This case suggests that the level of VEGFR2 is predictive of best response to antiangiogenic therapy.
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Farolfi A, Scarpi E, Schirone A, Bravaccini S, Maltoni R, Cecconetto L, Sarti S, Serra P, Amadori D, Rocca A. Time to Initiation of Adjuvant Chemotherapy in Patients with Rapidly Proliferating Early Breast Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Maselli M, Giantin V, Franchin A, Zanatta F, Sarti S, Corradin ML, Tramontano A, Stifani B, Sergi G, Manzato E. Detection of blood pressure increments in active elderly individuals: the role of ambulatory blood pressure monitoring. Nutr Metab Cardiovasc Dis 2014; 24:914-920. [PMID: 24548664 DOI: 10.1016/j.numecd.2014.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 12/04/2013] [Accepted: 01/04/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Physiological aging can lead to an increase in blood pressure (BP) over time even in regularly exercising elders. Office BP measurements (OBPM) might be unable to detect these BP variations. The aim of this study was to analyze BP changes over 3.5 years in active elders using ABPM. METHODS AND RESULTS The study involved 80 active subjects ≥65 years old who exercised regularly. At baseline and again 3.5 years later, all subjects had lab tests, weight, body mass index (BMI), body composition, resting energy expenditure (REE) recorded; they underwent OBPM, ABPM and physical activity assessment. Over 3.5 years, our sample's mean weight, BMI, body composition, REE, albumin, and physical activity levels, did not change significantly. The prevalence of hypertension detected by OBPM dropped from 68.8% to 61.3%. ABPM revealed an increase in mean 24-h BP (Δsystolic: 5.3 ± 13.6 mmHg; p = 0.001; Δdiastolic: 1.8 ± 6.7 mmHg; p = 0.018) and mean daytime BP (Δsystolic: 5.8 ± 13.5 mmHg; p = 0.001; Δdiastolic: 1.9 ± 7.1 mmHg; p = 0.022); the prevalence of hypertension detected by ABPM increased from 50% to 65%, also due to an increase (from 8.8% to 16.3%) in masked hypertension. There was no correlation between BP changes and changes in body composition and REE. CONCLUSION BP tends to increase over time in active elders, regardless of changes in body composition or level of physical activity. ABPM is an appropriate method for detecting these BP variations in active elders and to reveal cases of masked hypertension that might otherwise escape detection by OBPM.
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Affiliation(s)
- M Maselli
- Geriatric Unit, Department of Medicine, University of Padua, Italy.
| | - V Giantin
- Geriatric Unit, Department of Medicine, University of Padua, Italy
| | - A Franchin
- Geriatric Unit, Department of Medicine, University of Padua, Italy
| | | | - S Sarti
- Geriatric Unit, Department of Medicine, University of Padua, Italy
| | - M L Corradin
- Geriatric Unit, Department of Medicine, University of Padua, Italy
| | - A Tramontano
- Geriatric Unit, Department of Medicine, University of Padua, Italy
| | - B Stifani
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - G Sergi
- Geriatric Unit, Department of Medicine, University of Padua, Italy
| | - E Manzato
- Geriatric Unit, Department of Medicine, University of Padua, Italy
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Gennari A, Nanni O, Scarpi E, Cecconetto L, Sarti S, Amadori D. Impact of body mass index (BMI) on the prognosis of women with high-risk early breast cancer (BC) receiving adjuvant chemotherapy (CT). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.552] [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
552 Background: Obesity has been shown to impact the prognosis of early BC; this effect was not consistently observed across the different biological subtypes, and is less clear when aggressive tumor phenotypes are considered. The aim of this study was to evaluate the influence of BMI (kg/m2) on the prognosis of women with high risk early BC enrolled into a phase III clinical trial of adjuvant CT. Methods: The relationship between BMI and Disease Free (DFS) or Overall Survival (OS) was assessed in 1066 early BC patients with rapidly proliferating tumors (Thymidine Labeling Index > 3% or G3 or Ki67 > 20%), randomized to receive adjuvant CT with or without anthracyclines (Epirubicin → CMF vs CMF → Epirubicin vs CMF). BMI was defined as follows: normal < 25 kg/m2, overweight 25-30 kg/m2, obese >30 kg/m2. DFS and OS were calculated by Kaplan-Meier estimation; multivariate Cox analysis was performed according to menopausal status, type of CT, hormonal, HER-2 and nodal status. Results: Information on BMI at baseline, was available on 959 women. Of these, 430/959 (44.8%) were normal, 331 (34.5%) were overweight and 198 (20.7%) were obese. Median age was 52 years (range 26 to 70); 48% was node positive, 62% was ER positive and 33% was HER-2 positive. At a median follow-up of 69 mos (range 1-119), 5-year DFS was 80% (95% CI 78-83) and 5-year OS was 94% (95% CI 90–94). 5-year DFS was 81% (95% CI 77-85), 82% (95% CI 77-86) and 76% (95% CI 70-83), in normal, overweight and obese women, respectively (p 0.6). 5-year OS was 92% (95% CI 89-95), 94% (95% CI 91-96) and 89% (95% CI 84-93), respectively (p 0.4). By multivariate analysis only ER, HER-2 and nodal status were significantly associated with differences in DFS and/or OS. Conclusions: BMI at baseline was not associated with the prognosis of early BC patients with rapidly proliferating tumors, receiving adjuvant CT. These results confirm those achieved in triple negative BC and suggest that neither dietary restriction or medical interventions aimed at reducing BMI and/or underlying insulin resistance nor specific anticancer strategies seem to be appropriate in this subgroup.
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Affiliation(s)
| | - Oriana Nanni
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy
| | - Emanuela Scarpi
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Lorenzo Cecconetto
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Samanta Sarti
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Dino Amadori
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
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Farolfi A, Melegari E, Aquilina M, Scarpi E, Ibrahim T, Maltoni R, Sarti S, Cecconetto L, Pietri E, Ferrario C, Fedeli A, Faedi M, Nanni O, Frassineti GL, Amadori D, Rocca A. Trastuzumab-induced cardiotoxicity in early breast cancer patients: a retrospective study of possible risk and protective factors. Heart 2013; 99:634-9. [PMID: 23349345 DOI: 10.1136/heartjnl-2012-303151] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Although adjuvant trastuzumab improves survival in patients with HER2-positive early breast cancer, there is growing concern about the long-term effect of trastuzumab-induced cardiotoxicity (TIC). We retrospectively assessed the incidence of TIC and heart failure (HF) to identify possible risk and protective factors. DESIGN Retrospective study. SETTING Institute for Cancer Research and Treatment, Medical Oncology Department. PATIENTS Consecutive patients who started adjuvant trastuzumab between 2007 and 2010. MAIN OUTCOME Measures TIC was defined as an absolute left ventricular ejection fraction (LVEF) decrease ≥ 15 points from baseline or a LVEF<50%. Logistic regression was used to estimate OR and their 95% CI in order to evaluate the risk of TIC, considering potential cardiac risk factors (hypertension, hypercholesterolaemia, diabetes mellitus, smoke, cardiac ischaemia and previous chest radiotherapy) and protective factors (β-blockers, ACE inhibitors and/or angiotensin receptor blockers). RESULTS Among 179 patients, 78 cases of TIC (44%, 95% CI 37% to 51%) and four cases of HF (2%, 95% CI 0% to 4%) were reported. 14 patients stopped trastuzumab as a result of TIC. None of the cardiac risk factors or concomitant cardiovascular medications altered the risk of TIC. A previous cumulative dose >240 mg/m(2) of doxorubicin or >500 mg/m(2) of epirubicin increased the risk of TIC compared with lower doses (OR 3.07; 95% CI 1.29 to 7.27, p=0.0011). CONCLUSIONS TIC is a frequent, albeit generally mild, adverse event in clinical practice. Further studies are warranted to better define the risk of and protective factors for TIC.
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Affiliation(s)
- Alberto Farolfi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST-IRCCS), via Piero Maroncelli 40, Meldola 47014, Italy
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Marini E, Sergi G, Succa V, Saragat B, Sarti S, Coin A, Manzato E, Buffa R. Efficacy of specific bioelectrical impedance vector analysis (BIVA) for assessing body composition in the elderly. J Nutr Health Aging 2013; 17:515-21. [PMID: 23732547 DOI: 10.1007/s12603-012-0411-7] [Citation(s) in RCA: 38] [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: 02/08/2023]
Abstract
OBJECTIVES This study aimed to ascertain the efficacy of bioelectrical impedance vector analysis (BIVA) in assessing body composition in the elderly by comparing findings with the results of dual-energy X-ray absorptiometry (DXA), and to test an analytical variant of the method (specific BIVA). DESIGN Cross-sectional study. PARTICIPANTS The sample comprised 207 free-living elderly individuals (75 men and 132 women) aged 65 to 93 years. MEASUREMENTS Anthropometric and bioelectrical measurements were taken according to standard criteria. BIVA was applied using the 'classic' procedure and correcting bioelectrical values for body geometry to obtain an estimate of the whole-body impedivity. DXA was used as a reference body composition assessment method. BIVA (classic and specific values) and DXA findings were compared using Student's t and Hotelling's T2 tests, and Pearson's correlation coefficient. RESULTS In both sexes, BIVA distinguished between individuals with different amounts of fat and fat-free mass (lean mass including bone mineral content), according to DXA, but not between those with different proportions of fat mass (FM%). Specific bioelectrical values detected changes in body composition. CONCLUSION BIVA should be used with caution for evaluating body composition in the elderly. Specific bioelectrical values proved effective, showing promise as a methodological variant of BIVA, suitable for identifying age-related changes in body fatness.
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Affiliation(s)
- E Marini
- Department of Environmental and Life Sciences, Anthropological Science Section, University of Cagliari, Cittadella Universitaria, 09042 Monserrato (Cagliari), Italy.
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Sarti S, Truzzolillo D, Bordi F. Hydrogen bond network relaxation in aqueous polyelectrolyte solutions: the effect of temperature. J Phys Condens Matter 2012; 24:284102. [PMID: 22740600 DOI: 10.1088/0953-8984/24/28/284102] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Dielectric spectroscopy data over the range 100 MHz–40 GHz allow for a reliable analysis of two of the major relaxation phenomena for polyelectrolytes (PE) in water. Within this range, the dielectric relaxation of pure water is dominated by a near-Debye process at ν = 18.5 GHz corresponding to a relaxation time of τ = 8.4 ps at 25 °C. This mode is commonly attributed to the cooperative relaxation specific to liquids forming a hydrogen bond network (HBN) and arising from long range H-bond-mediated dipole–dipole interactions. The presence of charged polymers in water partially modifies the dielectric characteristics of the orientational water molecule relaxation due to a change of the dielectric constant of water surrounding the charges on the polyion chain. We report experimental results on the effect of the presence of a standard flexible polyelectrolyte (sodium polyacrylate) on the HBN relaxation in water for different temperatures, showing that the HBN relaxation time does not change by increasing the polyelectrolyte density in water, even if relatively high concentrations are reached (0.02 monomol l(−1) ≤ C ≤ 0.4 monomol l(−1)). We also find that the effect of PE addition on the HBN relaxation is not even a broadening of its distribution, rather a decrease of the spectral weight that goes beyond the pure volume fraction effect. This extra decrease is larger at low T and less evident at high T, supporting the idea that the correlation length of the water is less affected by the presence of charged flexible chains at high temperatures.
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Affiliation(s)
- S Sarti
- Dipartimento di Fisica, Sapienza Università di Roma, Piazzale Aldo Moro 5, I-00185, Roma, Italy.
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Guarneri V, Frassoldati A, Bottini A, Cagossi K, Bisagni G, Sarti S, Ravaioli A, Cavanna L, Giardina G, Musolino A, Untch M, Orlando L, Artioli F, Boni C, Generali DG, Serra P, Bagnalasta M, Marini L, Piacentini F, D'Amico R, Conte P. Preoperative Chemotherapy Plus Trastuzumab, Lapatinib, or Both in Human Epidermal Growth Factor Receptor 2–Positive Operable Breast Cancer: Results of the Randomized Phase II CHER-LOB Study. J Clin Oncol 2012; 30:1989-95. [DOI: 10.1200/jco.2011.39.0823] [Citation(s) in RCA: 285] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose This is a noncomparative, randomized, phase II trial of preoperative taxane-anthracycline in combination with trastuzumab, lapatinib, or combined trastuzumab plus lapatinib in patients with human epidermal growth factor receptor 2 (HER2) –positive, stage II to IIIA operable breast cancer. The primary aim was to estimate the percentage of pathologic complete response (pCR; no invasive tumor in breast and axillary nodes). Patients and Methods In the three arms, chemotherapy consisted of weekly paclitaxel (80 mg/m2) for 12 weeks followed by fluorouracil, epirubicin, and cyclophosphamide for four courses every 3 weeks. The patients randomly assigned to arm A received a 4-mg loading dose of trastuzumab followed by 2 mg weekly; in arm B patients received lapatinib 1,500 mg orally (PO) daily; and in arm C, patients received trastuzumab and lapatinib 1,000 mg PO daily. Results A total of 121 patients were randomly assigned. Diarrhea and dermatologic and hepatic toxicities were observed more frequently in patients receiving lapatinib. No episodes of congestive heart failure were observed. The rates of breast-conserving surgery were 66.7%, 57.9%, and 68.9% in arms A, B and C, respectively. The pCR rates were 25% (90% CI, 13.1% to 36.9%) in arm A, 26.3% (90% CI, 14.5% to 38.1%) in arm B, and 46.7% (90% CI, 34.4% to 58.9%) in arm C (exploratory P = .019). Conclusion The primary end point of the study was met, with a relative increase of 80% in the pCR rate achieved with chemotherapy plus trastuzumab and lapatinib compared with chemotherapy plus either trastuzumab or lapatinib. These data add further evidence supporting the superiority of a dual-HER2 inhibition for the treatment of HER2-positive breast cancer.
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Affiliation(s)
- Valentina Guarneri
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Antonio Frassoldati
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Alberto Bottini
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Katia Cagossi
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Giancarlo Bisagni
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Samanta Sarti
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Alberto Ravaioli
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Luigi Cavanna
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Giovanni Giardina
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Antonino Musolino
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Michael Untch
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Laura Orlando
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Fabrizio Artioli
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Corrado Boni
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Daniele Giulio Generali
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Patrizia Serra
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Michela Bagnalasta
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Luca Marini
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Federico Piacentini
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - Roberto D'Amico
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
| | - PierFranco Conte
- Valentina Guarneri, Antonio Frassoldati, Federico Piacentini, Roberto D'Amico, and PierFranco, Modena University Hospital, Modena; Alberto Bottini and Daniele Giulio Generali, AO Istituti Ospitalieri di Cremona, Cremona; Katia Cagossi and Fabrizio Artioli, Ramazzini Hospital, Carpi; Giancarlo Bisagni and Corrado Boni, Arcispedale Santa Maria Nuova, Reggio Emilia; Samanta Sarti and Patrizia Serra, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola; Alberto Ravaioli, Ospedale
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