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Gatti F, Caruso G, Potenza C, Santini D, Petrozza V, Annetta A, Ceddia S, Cosimati A, Brandi M, Sorrentino V, Proietti I, Rossi L. Psoriasis induced by first‑line pembrolizumab in metastatic non‑small cell lung cancer: A case report. Oncol Lett 2023; 26:311. [PMID: 37332334 PMCID: PMC10272958 DOI: 10.3892/ol.2023.13897] [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: 01/04/2023] [Accepted: 03/15/2023] [Indexed: 06/20/2023] Open
Abstract
Therapeutic options for non-small cell lung cancer (NSCLC) have changed with the introduction of immune checkpoint inhibitors. Immunotherapy is generally well tolerated, but can also be associated with severe adverse events, such as the development of new autoimmune diseases. In patients without a history of autoimmune diseases, psoriasis caused by immunotherapy treatment is rarely described in the literature. The present study describes the case of a 68-year-old man with metastatic NSCLC that started chemoimmunotherapy with carboplatin plus pemetrexed plus pembrolizumab. After two cycles of therapy, the patient developed a G3 maculopapular rash. Biopsy confirmed psoriasis and pembrolizumab treatment was discontinued. At the last follow up, the patient was still on maintenance therapy with pemetrexed alone, which is well tolerated. Psoriasis has rarely been reported as an immune-related adverse event. Although the patient had to stop the immunotherapy treatment, the patient is still exhibiting a response to it. Notably, it has previously been described how skin toxicities are associated with a better outcome. Other studies need to be conducted to identify the risk and predictive factors associated with severe immune adverse events and objective response.
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Affiliation(s)
- Federica Gatti
- Department of Clinical and Molecular Medicine, ‘Sapienza’ University of Rome, I-00185 Rome, Italy
| | - Gianluca Caruso
- Department of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, ‘Sapienza’ University of Rome, I-04100 Latina, Italy
| | - Concetta Potenza
- Dermatology Unit ‘Daniele Innocenzi’, Department of Medical-Surgical Sciences and Bio-Technologies, ‘Sapienza’ University of Rome, Fiorini Hospital, I-04019 Terracina, Italy
| | - Daniele Santini
- Multispeciality Department of Oncology, ASL Latina, ‘Sapienza’ University of Rome, I-04011 Aprilia, Italy
| | - Vincenzo Petrozza
- Department of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, ‘Sapienza’ University of Rome, I-04100 Latina, Italy
| | - Alessandro Annetta
- Dermatology Unit ‘Daniele Innocenzi’, Department of Medical-Surgical Sciences and Bio-Technologies, ‘Sapienza’ University of Rome, Fiorini Hospital, I-04019 Terracina, Italy
| | - Serena Ceddia
- Department of Clinical and Molecular Medicine, ‘Sapienza’ University of Rome, I-00185 Rome, Italy
| | - Antonella Cosimati
- Department of Clinical and Molecular Medicine, ‘Sapienza’ University of Rome, I-00185 Rome, Italy
| | - Martina Brandi
- Department of Clinical and Molecular Medicine, ‘Sapienza’ University of Rome, I-00185 Rome, Italy
| | - Veronica Sorrentino
- Department of Medico-Surgical Sciences and Biotechnologies, Pathology Unit, ICOT Hospital, ‘Sapienza’ University of Rome, I-04100 Latina, Italy
| | - Ilaria Proietti
- Dermatology Unit ‘Daniele Innocenzi’, Department of Medical-Surgical Sciences and Bio-Technologies, ‘Sapienza’ University of Rome, Fiorini Hospital, I-04019 Terracina, Italy
| | - Luigi Rossi
- Department of Oncology, Hospital Dono Svizzero of Formia, I-04023 Formia, Italy
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Chiavassa A, Riva F, Vari S, Onesti C, Ceddia S, Veroli M, Salvatori F, Maggi G, Torchia A, Sperati F, Ferraresi V. 79P Ifosfamide neurotoxicity in sarcoma patients: A real-life analysis from a sarcoma referral centre. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Veroli M, Vari S, Onesti C, Ceddia S, Salvatori F, Chiavassa A, Cosimati A, Torchia A, Riva F, Petrongari M, Ferraresi V. 84P Post-radiation sarcomas: A real-life analysis from a referral centre. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Orciuolo C, Sorrentino R, Colarusso C, Ceddia S, Minuti G, Conti L, Mandoj C, Carpano S, Canali L, Fucci C, Brandi M, Fusco F, Giammaruco M, Resuli B, Landi L, Cappuzzo F. PP01.54 ImmunoBlood: A Prospective Study Evaluating the Development of Anti-Checkpoint Inhibitor Antibodies in Patients with Advanced Non-Small Cell Lung Cancer Treated with Immunotherapy. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.080] [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: 01/30/2023]
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Buccilli D, Onesti C, Vari S, Maggi G, Faltyn W, Cenci C, Ceddia S, Biagini R, Ferraresi V, Cercato M. 62P Digital narrative diary: The role in daily clinical practice of soft tissue and bone sarcomas patients. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Ceddia S, Vari S, Torchia A, Onesti C, Cosimati A, Veroli M, Chiavassa A, Riva F, Salvatori F, Benvenuti G, Anelli V, Sperduti I, Ferraresi V. 83P Radiological evaluation of response in patients with soft tissue sarcoma treated with trabectedin. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Gallina F, Marinelli D, Forcella D, Tajè R, Ceddia S, Fusco F, Melis E, Buglioni S, Visca P, Cappuzzo F, Facciolo F. 56P The prognostic role of KRAS mutations in patients with early-stage lung adenocarcinoma after robotic lobectomy and systematic lymphadenectomy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Gallina FT, Bertolaccini L, Forcella D, Mohamed S, Ceddia S, Melis E, Fusco F, Bardoni C, Marinelli D, Buglioni S, Visca P, Cappuzzo F, Spaggiari L, Facciolo F. Analysis of Molecular Biomarkers in Resected Early-Stage Non-Small Cells Lung Cancer: A Narrative Review. Cancers (Basel) 2022; 14:cancers14081949. [PMID: 35454856 PMCID: PMC9024905 DOI: 10.3390/cancers14081949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/07/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary In the last few years, the treatment of advanced NSCLC has radically changed after the development of new drugs against specific molecular targets. Moreover, multiple tumour biopsies have become mandatory in order to better select the appropriate targeted therapy. Molecular analysis using NGS in the early stage of NSCLC is still relatively widespread. The recent clinical trials that use targeted therapies in neoadjuvant and adjuvant settings also require molecular characterisation for early-stage patients. Due to the widespread use of molecular analysis in patients with early-stage NSCLC, the prognostic role of molecular biomarkers needs to be fully understood. This paper aimed to review the most recent studies associating the molecular expressions of early-stage NSCLC with survival. Abstract Next-generation sequencing has become a cornerstone in clinical oncology practice and is recommended for the appropriate use of tailored therapies in NSCLC. While NGS has already been standardised in advanced-stage NSCLC, its use is still uncommon in the early stages. The recent approval of Osimertinib for resected EGFR-mutated NSCLC in an adjuvant setting has launched the hypothesis that other targeted therapies used in metastatic patients can also lead to improved early-stage outcomes of NSCLC. The impact of molecular biomarkers on the prognosis of patients undergoing radical surgery for NSCLC is still unclear. Notably, the heterogeneous populations included in the studies that analysed surgical patients could be the main reason for these results. In this review, we report the most important studies that analysed the impact of principal molecular biomarkers on the survival outcomes of patients who underwent radical surgery for NSCLC.
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Affiliation(s)
- Filippo Tommaso Gallina
- Thoracic Surgery Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (D.F.); (E.M.); (F.F.)
- Correspondence: ; Tel.: +39-06-5266-5832; Fax: +39-06-5266-6993
| | - Luca Bertolaccini
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20100 Milan, Italy; (L.B.); (S.M.); (C.B.); (L.S.)
| | - Daniele Forcella
- Thoracic Surgery Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (D.F.); (E.M.); (F.F.)
| | - Shehab Mohamed
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20100 Milan, Italy; (L.B.); (S.M.); (C.B.); (L.S.)
| | - Serena Ceddia
- Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.C.); (F.F.); (F.C.)
| | - Enrico Melis
- Thoracic Surgery Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (D.F.); (E.M.); (F.F.)
| | - Francesca Fusco
- Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.C.); (F.F.); (F.C.)
| | - Claudia Bardoni
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20100 Milan, Italy; (L.B.); (S.M.); (C.B.); (L.S.)
| | - Daniele Marinelli
- Medical Oncology Unit B, Policlinico Umberto I, Sapienza University, 00185 Rome, Italy;
| | - Simonetta Buglioni
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.B.); (P.V.)
| | - Paolo Visca
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.B.); (P.V.)
| | - Federico Cappuzzo
- Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.C.); (F.F.); (F.C.)
| | - Lorenzo Spaggiari
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20100 Milan, Italy; (L.B.); (S.M.); (C.B.); (L.S.)
| | - Francesco Facciolo
- Thoracic Surgery Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (D.F.); (E.M.); (F.F.)
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Gallina FT, Melis E, Forcella D, Mercadante E, Marinelli D, Ceddia S, Cappuzzo F, Vari S, Cecere FL, Caterino M, Vidiri A, Visca P, Buglioni S, Sperduti I, Marino M, Facciolo F. Nodal Upstaging Evaluation After Robotic-Assisted Lobectomy for Early-Stage Non-small Cell Lung Cancer Compared to Video-Assisted Thoracic Surgery and Thoracotomy: A Retrospective Single Center Analysis. Front Surg 2021; 8:666158. [PMID: 34277693 PMCID: PMC8280310 DOI: 10.3389/fsurg.2021.666158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/18/2021] [Indexed: 12/25/2022] Open
Abstract
Introduction: The standard surgical procedures for patients with early-stage NSCLC is lobectomy-associated radical lymphadenectomy performed by using the thoracotomy approach. In the last few years, minimally invasive techniques have increasingly strengthened their role in lung cancer treatment, especially in the early stage of the disease. Although the lobectomy technique has been accepted, controversy still surrounds lymph node dissection. In our study, we analyze the rate of upstaging early non-small cell lung cancer patients who underwent radical surgical treatment using the robotic and the VATS techniques compared to the standard thoracotomy approach. Methods and Materials: We retrospectively reviewed patients who underwent a lobectomy and radical lymphadenectomy at our Institute between 2010 and 2019. We selected 505 patients who met the inclusion criteria of the study: 237 patients underwent robotic surgery, 158 patients had thoracotomy, and 110 patients were treated with VATS. We analyzed the demographic features between the groups as well as the nodal upstaging rate after pathological examination, the number of dissected lymph nodes and the ratio of dissected lymph nodes to metastatic lymph nodes of the three groups. Results: The patients of the three groups were homogenous with respect to age, sex, and histology. The postoperative major morbidity rate was significantly higher in the thoracotomy group, and hospital stay was significantly longer. The percentage of the mediastinal nodal upstaging rate and the number of dissected lymph nodes was significantly higher in the robotic group compared with the VATS group. The ratio of dissected lymph nodes to metastatic lymph nodes was significantly lower compared with the VATS group and the thoracotomy group. Discussion: The prognostic impact of the R(un) status is still highly debated. A surgical approach that allows better results in terms of resection has still not been defined. Our results show that robotic surgery is a safe and feasible approach especially regarding the accuracy of mediastinal lymphadenectomy. These findings can lead to defining a more precise pathological stage of the disease and, if necessary, to more accurate postoperative treatment.
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Affiliation(s)
| | - Enrico Melis
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Daniele Forcella
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Edoardo Mercadante
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Daniele Marinelli
- Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Serena Ceddia
- Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Federico Cappuzzo
- Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Sabrina Vari
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Mauro Caterino
- Radiology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonello Vidiri
- Radiology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Visca
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Simonetta Buglioni
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Isabella Sperduti
- Department of Biostatistics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mirella Marino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Facciolo
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Ceddia S, Codacci-Pisanelli G. Treatment of brain metastases in ALK-positive non-small cell lung cancer. Crit Rev Oncol Hematol 2021; 165:103400. [PMID: 34147645 DOI: 10.1016/j.critrevonc.2021.103400] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 11/17/2022] Open
Abstract
Brain metastases are quite frequent in patients with ALK-translocated non-small cell lung cancer (NSCLC): they are often not amenable to surgical resection and are generally treated with radiotherapy (RT). This however causes severe late toxic side effects that may become invalidating considering the relatively long survival provided by recent medical treatment with target therapies. Several clinical trials have demonstrated that ALK-inhibitors (crizotinib, alectinib, brigatinib) show excellent activity also against brain metastases. It is therefore reasonable, in asymptomatic patients, to start treatment with specific inhibitors: RT will be used at the time of tumor progression or when symptoms appear. This sequence provides the best quality of life for patients.
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Affiliation(s)
- Serena Ceddia
- Department of Medical and Surgical Sciences and Biotechnology, University of Rome "la Sapienza", Corso della Repubblica, 79, 04100, Latina, Italy.
| | - Giovanni Codacci-Pisanelli
- Department of Medical and Surgical Sciences and Biotechnology, University of Rome "la Sapienza", Corso della Repubblica, 79, 04100, Latina, Italy.
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Rossi L, Cimino G, Gozzi E, Sinjari M, Brandi M, Ceddia S, Cosimati A, Raimondi L, Fontana A, Filippi L, Bagni O, Spinelli GP. Stunning Response with Low-Dose Enzalutamide after Abiraterone Acetate Failure in a Patient Diagnosed with Metastatic Castration-Resistant Prostate Cancer: A Case Report. Case Rep Oncol 2021; 14:634-640. [PMID: 33976646 PMCID: PMC8077606 DOI: 10.1159/000514979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 11/19/2022] Open
Abstract
We report a case of an elderly patient with metastatic castration-resistant prostate cancer, initially treated with abiraterone acetate (1,000 mg/day) combined with LH-RH antagonist, prednisone (10 mg/day), and zoledronic acid to manage bone metastases. In consideration of his poor performance status, radiological and biochemical progression of the disease, we decided to switch abiraterone to enzalutamide (160 mg/day). Due to adverse events, we reduced enzalutamide to a dose of 80 mg/day. Currently, the disease is under control despite the use of a low dose of enzalutamide.
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Affiliation(s)
- Luigi Rossi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Giuseppe Cimino
- Department of Cellular Biotechnology and Hematology, University of Rome "Sapienza", Rome, Italy
| | - Elisa Gozzi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Marsela Sinjari
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Martina Brandi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Serena Ceddia
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Antonella Cosimati
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Lucrezia Raimondi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Antonella Fontana
- Department of Radiotherapy, Santa Maria Goretti Hospital, Latina, Italy
| | - Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Oreste Bagni
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Gian Paolo Spinelli
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
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Megaro G, Rossi L, Ceddia S, Sinjari M, Mannino A, Gozzi E, Cosimati A, Brandi M, Bitca V, Toscani I, Cimino G, Tomao S. Synchronous and Metachronous Metastatic Breast Cancer, with Different Histology and Opposite Immunophenotype, Treated with Combination of Chemotherapy, Anti-Her2, and Endocrine Therapy: A Case Report. Case Rep Oncol 2020; 13:544-549. [PMID: 32547382 PMCID: PMC7275194 DOI: 10.1159/000507433] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 11/19/2022] Open
Abstract
In the case of our patient, the synergic action of endocrine therapy and chemotherapy plus dual anti-HER2 combination allowed a complete disease control. Therapy should be scheduled by considering the two cancers as individual entities. The approach to breast cancer is changing from being considered a singular disease to a multiform one, according to current research focused on biological markers such as HER2, ERs, and PRs, with important implications in clinical, prognostic, and therapeutic features.
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Affiliation(s)
- Giacomina Megaro
- Department of Paediatric Haematology and Oncology, Ospedale Bambin Gesù, Rome, Italy
| | - Luigi Rossi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Serena Ceddia
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Marsela Sinjari
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Adele Mannino
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Elisa Gozzi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Antonella Cosimati
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Martina Brandi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Victoria Bitca
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Ilaria Toscani
- Medical Oncology Ospedale G. da Saliceto, Piacenza, Italy
| | - Giuseppe Cimino
- Department of Cellular Biotechnology and Haematology, University of Rome "Sapienza", Rome, Italy
| | - Silverio Tomao
- Medical Oncology Unit A Policlinico Umberto I, University of Rome "Sapienza", Rome, Italy
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