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Vagnini D, Natalucci V, Moi S, Vallorani L, Pietrelli A, Panico AR, Ferri Marini C, Lucertini F, Annibalini G, Sisti D, Rocchi MBL, Catalano V, Saita E, Emili R, Barbieri E. Home-based lifestyle intervention for breast cancer survivors: A surprising improvement in the quality of life during the first year of COVID-19 pandemic. PLoS One 2024; 19:e0296163. [PMID: 38165970 PMCID: PMC10760703 DOI: 10.1371/journal.pone.0296163] [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: 11/07/2022] [Accepted: 11/28/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic induced an extraordinary impact on public mental health to a degree not completely understood, especially in vulnerable populations such as breast cancer (BC) survivors. In this study, we described the short- (after 3-month) and long- (after 12-month) term effects of a multidisciplinary home-based lifestyle intervention in Italian women BC survivors during the first year of COVID-19 pandemic. MATERIALS AND METHODS In total, 30 Italian BC survivors with risk factors for recurrence took part in the ongoing MoviS trial (protocol: NCT04818359). Between January 2020 and January 2021, a 3-month lifestyle intervention based on psychological counseling, nutrition, and exercise was carried out. Participants were asked to fill out psychological questionnaires for the assessment of quality of life (QoL) indicators (European Organization for Research and Treatment of Cancer QoL, EORTC-QLQ-C30) and psychological health measures such as fatigue (Brief Fatigue Inventory, BFI), distress (Distress Thermometer, DT and Psychological Distress Inventory, PDI), cancer-related fatigue (Verbal Rating Scale, VRS), and mood states (Profile of Mood States Questionnaire, POMS). IBM SPSS Statistical Software version 27.0 and R Project for Statistical Computing version 4.2.1 were used to process data. All participants were assessed at four time points: T0 (baseline), T1 (3-month), and follow-up at T2 and T3 (6- and 12-month, respectively) to measure primary (quality of life indicators) and secondary (psychological health) outcomes. Friedman non parametric test and Wilcoxon signed rank test (with Bonferroni correction) were conducted to investigate the statistically significant differences in psychometric scores and between assessment times. RESULTS Compared to baseline (T0), at T1 most of the QoL indicators (i.e., symptoms of fatigue and general health) were improved (p < 0.017) with the exception of a worsening in participants' social functioning ability. Also, perception of severity of fatigue, distress, cancer-related fatigue, depression, and anger enhanced. Compared to baseline (T0), at T3 we mainly observed a stable condition with T0-T1 pairwise comparison, however other secondary outcomes (i.e., fatigue mood state, confusion, and anxiety) significantly improved. DISCUSSION Our preliminary findings support the proposal of this lifestyle intervention for BC survivors. Despite the home-confinement due to the COVID-19 pandemic, the intervention surprisingly improved QoL indicators and psychological health of the participants.
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Affiliation(s)
- Denise Vagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Valentina Natalucci
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Sara Moi
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Alice Pietrelli
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Andrea Rocco Panico
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Marco Bruno Luigi Rocchi
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Vincenzo Catalano
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Rita Emili
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
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Chiari R, Palladino S, Emili R, De Lisa M, Sarti D, Catalano V, Magnani M, Graziano F, Ruzzo A. KRAS4A and KRAS4B in liquid biopsy of metastatic lung adenocarcinoma patients treated with Pembrolizumab or chemotherapy plus Pembrolizumab. Sci Rep 2023; 13:21036. [PMID: 38030703 PMCID: PMC10687227 DOI: 10.1038/s41598-023-48304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023] Open
Abstract
KRAS is involved in the stability and expression of PD-L1. We investigated the expression of circulating mRNA (cmRNA) of KRAS4A and KRAS4B and the possible impact on progression-free survival (PFS) of patients with metastatic lung adenocarcinoma treated with immunotherapy. Patients without driver mutations undergoing Pembrolizumab (P) or P plus chemotherapy (PC) were prospectively accrued for liquid biopsy analysis of KRAS4A, KRAS4B, and PD-L1 cmRNA. Both KRAS isoforms were also studied for association with PD-L1 cmRNA. Of 56 patients, 28 received P and 28 PC. Patients with high levels of both KRAS isoforms showed significantly better PFS. The median PFS for KRAS4A was 29 months (95% CI 22-29 months) and KRAS4B 24 months (95% CI 13-29 months), respectively. The median PFS of patients with low levels of both isoforms was 12 months (95% CI 6-15 months for KRAS4A and 95% CI 5-20 months for KRAS4B). High KRAS4A retained a significant positive association with PFS in the multivariate model. An exploratory analysis in treatment subgroups found a positive association between high KRAS4A and KRAS4B with PFS in patients treated with P. PD-L1 cmRNA was significantly higher in patients with high KRAS isoforms levels and this effect was pronounced for high KRAS4A carriers. KRAS4A deserves further investigation as a potential marker for defining patients who may benefit the most from immune checkpoint inhibitors therapy and improving personalized cancer immunotherapeutic strategies.
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Affiliation(s)
- Rita Chiari
- Oncology Unit, AST1 Pesaro e Urbino, Stabilimento di Muraglia - Via Lombroso 1, 61122, Pesaro, Italy
- Oncology Unit, AST1 Pesaro e Urbino, Fano, Italy
| | - Silvia Palladino
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Via Arco d'Augusto, 2, 61032, Fano, Italy
| | - Rita Emili
- Oncology Unit, AST1 Pesaro e Urbino, Urbino, Italy
| | | | | | | | - Mauro Magnani
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Via Arco d'Augusto, 2, 61032, Fano, Italy
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
| | - Francesco Graziano
- Oncology Unit, AST1 Pesaro e Urbino, Stabilimento di Muraglia - Via Lombroso 1, 61122, Pesaro, Italy.
| | - Annamaria Ruzzo
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Via Arco d'Augusto, 2, 61032, Fano, Italy.
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Natalucci V, Ferri Marini C, Lucertini F, Annibalini G, Sisti D, Vallorani L, Saltarelli R, Panico AR, Imperio M, Flori M, Busacca P, Villarini A, Donati Zeppa S, Agostini D, Monaldi S, Barocci S, Catalano V, Rocchi MBL, Benelli P, Stocchi V, Barbieri E, Emili R. Effect of a lifestyle intervention program's on breast cancer survivors' cardiometabolic health: Two-year follow-up. Heliyon 2023; 9:e21761. [PMID: 38027927 PMCID: PMC10651516 DOI: 10.1016/j.heliyon.2023.e21761] [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: 07/07/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
The purpose of this study is to assess the cardiometabolic responses of a lifestyle intervention (LI) conducted at home among breast cancer (BC) survivors during the two years of COVID-19 pandemic. A 3-month LI focused on diet and exercise was performed on thirty BC survivors (women; stages 0-II; non-metastatic; aged 53.6 ± 7.6 years; non-physically active) with a risk factor related to metabolic/endocrine diseases. Anthropometrics, cardiorespiratory fitness (V ˙ O2max), physical activity level (PAL), adherence to the Mediterranean diet (MeDiet modified questionnaire), and several biomarkers (i.e., glycemia, insulin, insulin resistance [HOMA-IR] index, triglycerides, high- [HDL] and low- [LDL] density lipoproteins, total cholesterol, progesterone, testosterone, and hs-troponin) were evaluated before and 3-, 6-, 12-, and 24-month after the LI. Beneficial effects of the LI were observed on several variables (i.e., body mass index, waist circumference, MeDiet, PAL, V ˙ O2max, glycemia, insulin, HOMA-IR index, LDL, total cholesterol, triglycerides, testosterone) after 3-month. The significant effect on Mediterranean diet adherence and V ˙ O2max persisted up to the 24-month follow-up. Decreases in HOMA-IR index and triglycerides were observed up to 12-month, however did not persist afterward. This study provides evidence on the positive association between LI and cardiometabolic health in BC survivors.
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Affiliation(s)
- Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Roberta Saltarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Andrea Rocco Panico
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marta Imperio
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marco Flori
- U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Paolo Busacca
- U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Anna Villarini
- Department of Medicine and Surgery, University of Perugia, Piazzale Settimio Gambuli, 06132, Perugia, Italy
| | - Sabrina Donati Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Silvia Monaldi
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Simone Barocci
- U.O.C. Patologia Clinica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Vincenzo Catalano
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | | | - Piero Benelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132, Roma, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Rita Emili
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
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Donati Zeppa S, Natalucci V, Agostini D, Vallorani L, Amatori S, Sisti D, Rocchi MBL, Pazienza V, Perri F, Villani A, Binda E, Panebianco C, Mencarelli G, Ciuffreda L, Ferri Marini C, Annibalini G, Lucertini F, Bartolacci A, Imperio M, Virgili E, Catalano V, Piccoli G, Stocchi V, Emili R, Barbieri E. Changes in gut microbiota composition after 12 weeks of a home-based lifestyle intervention in breast cancer survivors during the COVID-19 lockdown. Front Oncol 2023; 13:1225645. [PMID: 37727203 PMCID: PMC10505708 DOI: 10.3389/fonc.2023.1225645] [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: 05/19/2023] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
Background Breast cancer (BC) is the second-leading cause of cancer-related death worldwide. This study aimed to investigate the effects of a 12-week home-based lifestyle intervention (based on nutrition and exercise) on gut microbial composition in twenty BC survivors of the MoviS clinical trial (protocol: NCT04818359). Methods Gut microbiota analysis through 16S rRNA gene sequencing, anthropometrics, Mediterranean Diet (MD) adherence, and cardiometabolic parameters were evaluated before (Pre) and after (Post) the lifestyle intervention (LI). Results Beneficial effects of the LI were observed on MD adherence, and cardiometabolic parameters (pre vs post). A robust reduction of Proteobacteria was observed after LI, which is able to reshape the gut microbiota by modulating microorganisms capable of decreasing inflammation and others involved in improving the lipid and glycemic assets of the host. A significant negative correlation between fasting glucose and Clostridia_vadinBB60 (r = -0.62), insulin and homeostatic model assessment (HOMA) index and Butyricicoccus genera (r = -0.72 and -0.66, respectively), and HDL cholesterol and Escherichia/Shigella (r = -0.59) have been reported. Moreover, positive correlations were found between MD adherence and Lachnospiraceae_ND3007 (r = 0.50), Faecalibacterium (r = 0.38) and Butyricimonas (r = 0.39). Conclusion These data suggest that adopting a healthy lifestyle, may contribute to ameliorate several biological parameters that could be involved in the prevention of cancer relapses through the modulation of gut microbiota.
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Affiliation(s)
- Sabrina Donati Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Stefano Amatori
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Marco B. L. Rocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Valerio Pazienza
- Division of Gastroenterology, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Francesco Perri
- Division of Gastroenterology, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Annacandida Villani
- Division of Gastroenterology, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Elena Binda
- Cancer Stem Cells Unit, Institute for Stem Cell Biology, Regenerative Medicine and Innovative Therapeutics (ISBReMIT), IRCSS Casa Sollievo della Sofferenza, Opera di San Pio da Pietrelcina, San Giovanni Rotondo, Italy
| | - Concetta Panebianco
- Division of Gastroenterology, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Italy
| | - Gandino Mencarelli
- Cancer Stem Cells Unit, Institute for Stem Cell Biology, Regenerative Medicine and Innovative Therapeutics (ISBReMIT), IRCSS Casa Sollievo della Sofferenza, Opera di San Pio da Pietrelcina, San Giovanni Rotondo, Italy
| | - Luigi Ciuffreda
- Breast Surgery Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giosué Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Alessia Bartolacci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Marta Imperio
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Edy Virgili
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Vincenzo Catalano
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, Urbino, Italy
| | - Giovanni Piccoli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | | | - Rita Emili
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, Urbino, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
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Giampieri R, Baleani MG, Bittoni A, Rastelli F, Catalano V, Del Prete M, Chiorrini S, Pinterpe G, Graziano F, Giorgi FC, Bisonni R, Silva R, Alessandroni P, Mencarini L, Berardi R. Impact of Signet-Ring Cell Histology in the Management of Patients with Non-Metastatic Gastric Cancer: Results from a Retrospective Multicenter Analysis Comparing FLOT Perioperative Chemotherapy vs. Surgery Followed by Adjuvant Chemotherapy. Cancers (Basel) 2023; 15:3342. [PMID: 37444451 DOI: 10.3390/cancers15133342] [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: 05/11/2023] [Revised: 06/14/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND FLOT perioperative chemotherapy represents the standard of care in non-metastatic gastric cancer patients. Signet-ring cell positivity is associated with a worse prognosis in patients with gastric cancer treated with chemotherapy. Comparison between FLOT perioperative chemotherapy vs. surgery followed by adjuvant chemotherapy based on signet-ring cell positivity is lacking. The aim of the analysis was to compare perioperative FLOT with adjuvant chemotherapy in gastric cancer patients stratified by signet-ring cell positivity. METHODS We conducted a retrospective multicenter analysis based on disease-free survival (DFS) and overall survival (OS) in patients with gastric cancer who received perioperative chemotherapy with a FLOT regimen and compared their survival with a historical cohort of patients treated with adjuvant chemotherapy, matched by cT and cN stage and by tumor histological features. RESULTS Seventy-six patients were enrolled and 24 (32%) were signet-ring cell positive. At a median follow-up time of 39 months, the median DFS was 26.3 months and the median OS was 37.3 months. Signet-ring cell positivity was associated with a shorter OS (median OS: 20.4 vs. 46.9 months, HR: 3.30, 95%CI: 1.56-6.99, p = 0.0018) and DFS (mDFS: 15.2 vs. 38.6 months, HR: 3.18, 95%CI: 1.55-6.54, p = 0.0016). This was confirmed by multivariate analysis for DFS (Exp(B): 2.55) and OS (Exp(B): 2.68). After propensity score matching, statistically significant shorter DFS (HR: 3.30, 95%CI: 1.50-7.35, p = 0.003) and OS (HR: 5.25, 95%CI: 2.18-12-68, p = 0.0002) were observed for patients with signet-ring cell positivity who received perioperative treatment vs. those who received surgery followed by adjuvant chemotherapy. CONCLUSIONS Signet-ring positivity was associated with shorter DFS and OS in patients who received perioperative treatment with FLOT compared with surgery followed by adjuvant therapy. These data suggest that for patients with signet-ring cell histology, FLOT perioperative treatment might not always be the best choice of treatment, and further research should be focused on this group of patients.
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Affiliation(s)
- Riccardo Giampieri
- Medical Oncology Unit, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti delle Marche, 60126 Ancona, Italy
| | | | - Alessandro Bittoni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy
| | - Francesca Rastelli
- Department of Oncology, Ospedale "C.e G. Mazzoni" Ascoli Piceno, 63100 Ascoli Piceno, Italy
| | - Vincenzo Catalano
- Department of Oncology, Ospedale Santa Maria della Misericordia, AV1, 61029 Urbino, Italy
| | - Michela Del Prete
- Department of Oncology, Ospedale Augusto Murri di Fermo, 63900 Fermo, Italy
| | - Silvia Chiorrini
- Department of Oncology, Ospedale E. Profili, 60044 Fabriano, Italy
| | - Giada Pinterpe
- Medical Oncology Unit, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti delle Marche, 60126 Ancona, Italy
| | - Francesco Graziano
- Department of Oncology, Azienda Ospedaliera Marche Nord, AV1, 61121 Pesaro, Italy
| | - Francesca Chiara Giorgi
- Department of Oncology, Ospedale Madonna del Soccorso, 63074 San Benedetto del Tronto, Italy
| | - Renato Bisonni
- Department of Oncology, Ospedale Augusto Murri di Fermo, 63900 Fermo, Italy
| | - Rosarita Silva
- Department of Oncology, Ospedale E. Profili, 60044 Fabriano, Italy
| | - Paolo Alessandroni
- Department of Oncology, Azienda Ospedaliera Marche Nord, AV1, 61121 Pesaro, Italy
| | - Lara Mencarini
- Medical Oncology Unit, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti delle Marche, 60126 Ancona, Italy
| | - Rossana Berardi
- Medical Oncology Unit, Dipartimento Scienze Cliniche e Molecolari, Università Politecnica delle Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti delle Marche, 60126 Ancona, Italy
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Mesolella M, Allosso S, D’aniello R, Pappalardo E, Catalano V, Quaremba G, Motta G, Salerno G. Subjective Perception and Psychoacoustic Aspects of the Laryngectomee Voice: The Impact on Quality of Life. J Pers Med 2023; 13:jpm13030570. [PMID: 36983751 PMCID: PMC10057772 DOI: 10.3390/jpm13030570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/17/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Purpose: A retrospective study is presented to correlate the inter-judge consistency for the different psycho-perceptual parameters of the recently proposed Impression Noise Fluency Voicing (INFVo) perceptual rating scale for substitution voices, and the vocal function as perceived by the patient. Methods: The scale Voice-Related Quality of Life (V-RQoL) and the Self Evaluation of Communication Experiences After Laryngectomy scale (SECEL)—a self-evaluation questionnaire of communicative experience after laryngectomy surgery—were administered to 89 total laryngectomees, subdivided in four groups depending on their type of alaryngeal voice (i.e., tracheoesophageal and esophageal speakers, electro larynx users, voiceless patients), in order to evaluate the impact of the impairment of the phonatory function on the quality of life. Results: No significant differences exist among the various groups on their perception of QoL using subjective questionnaires, whereas the INFVo scale has proven to be a useful tool for the description and analysis of the psychoacoustic characteristics of the vocal signal and a reliable instrument to correctly classify the patients. It is also notable that the judgement of the patients on their own voice and those of the referees are highly significant. Conclusion: Although speech rehabilitation for the acquisition of a substitution voice offers a new way of communication for the laryngectomized patients, nonetheless, their QoL is not significantly related to the type of substitution voice. Therefore, improving the patient’s adaptation to the new phonatory condition is mandatory.
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Salerno G, Villari P, Catalano V, Sivero L, Maldonato MN, Bottone M, Sivero S. Voice rehabilitation and quality of life in laryngectomized patients. Ann Ital Chir 2023; 94:7-10. [PMID: 36810488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND Total laryngectomy represents the surgical procedure necessary for the treatment of some advanced neoplasms of the hypopharyngeal-laryngeal district and involves strong functional, physical and emotional repercussions. This research investigated the way in which the rehabilitation methods, used to improve the communicative needs of laryngectomized patients, influence their perceived quality of life. METHOD The questionnaires "V-RQoL" and "SECEL" were administered to 45 patients divided into four groups on the basis of the type of vicarious voice: group TE (27 patients), group E (7 patients), group EL (2 patients), group NV (9 patients). RESULTS Patients using electrical or tracheo-esophageal prostheses reported a better quality of life than patients with an erythromophonic voice. Regarding postoperative satisfaction, the group with esophageal voice was the most satisfied. CONCLUSIONS The results lead us to emphasize the importance of preoperative counseling to make the patient as aware as possible of his future condition. KEY WORDS Cancer, Laryngectomy, Vicarious Voice, Voice Rehabilitation, Quality of Life.
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Natalucci V, Ferri Marini C, De Santi M, Annibalini G, Lucertini F, Vallorani L, Panico AR, Sisti D, Saltarelli R, Donati Zeppa S, Agostini D, Gervasi M, Baldelli G, Grassi E, Nart A, Rossato M, Biancalana V, Piccoli G, Benelli P, Villarini A, Somaini M, Catalano V, Guarino S, Pietrelli A, Monaldi S, Sarti D, Barocci S, Flori M, Rocchi MBL, Brandi G, Stocchi V, Emili R, Barbieri E. Movement and health beyond care, MoviS: study protocol for a randomized clinical trial on nutrition and exercise educational programs for breast cancer survivors. Trials 2023; 24:134. [PMID: 36814313 PMCID: PMC9946288 DOI: 10.1186/s13063-023-07153-y] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common invasive cancer in women, and exercise can significantly improve the outcomes of BC survivors. MoviS (Movement and Health Beyond Care) is a randomized controlled trial aimed to evaluate the potential health benefits of exercise and proper nutritional habits. This study aims to assess the efficacy of aerobic exercise training in improving quality of life (QoL) and health-related factors in high-risk BC. METHODS One hundred seventy-two BC survivor women, aged 30-70 years, non-metastatic, stage 0-III, non-physically active, 6-12 months post-surgery, and post chemo- or radiotherapy, will be recruited in this study. Women will be randomly allocated to the intervention arm (lifestyle recommendations and MoviS Training) or control arm (lifestyle recommendations). The MoviS training consists of 12 weeks of aerobic exercise training (2 days/week of supervised and 1 day/week of unsupervised exercise) with a progressive increase in exercise intensity (40-70% of heart rate reserve) and duration (20-60 min). Both arms will receive counseling on healthy lifestyle habits (nutrition and exercise) based on the World Cancer Research Fund International (WCRF) 2018 guidelines. The primary outcome is the improvement of the QoL. The secondary outcomes are improvement of health-related parameters such as Mediterranean diet adherence, physical activity level, flexibility, muscular fitness, fatigue, cardiorespiratory fitness (estimated maximal oxygen uptake), echocardiographic parameters, heart rate variability (average of the standard deviations of all 5 min normal to normal intervals (ASDNN/5 min) and 24 h very low and low frequency), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein). DISCUSSION This trial aims to evaluate if supervised exercise may improve QoL and health-related factors of BC survivors with a high risk of recurrence. Findings from this project could provide knowledge improvement in the field of exercise oncology through the participation of a multidisciplinary team that will provide a coordinated program of cancer care to improve healthcare quality, improve prognosis, increase survival times and QoL, and reduce the risk of BC recurrence. TRIAL REGISTRATION ClinicalTrials.gov NCT04818359 . Retrospectively registered on March 26, 2021.
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Affiliation(s)
- Valentina Natalucci
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Carlo Ferri Marini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Mauro De Santi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy.
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy.
| | - Francesco Lucertini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Luciana Vallorani
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Andrea Rocco Panico
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Davide Sisti
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Roberta Saltarelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Sabrina Donati Zeppa
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Deborah Agostini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marco Gervasi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giulia Baldelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Eugenio Grassi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Alessandra Nart
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Massimo Rossato
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vincenzo Biancalana
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giovanni Piccoli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Piero Benelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Anna Villarini
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Matteo Somaini
- grid.4708.b0000 0004 1757 2822School of Specialization in Nutrition Science, University of Milano, Milan, Italy
| | - Vincenzo Catalano
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Stefania Guarino
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Alice Pietrelli
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Silvia Monaldi
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Donatella Sarti
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Simone Barocci
- Clinical Pathology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Marco Flori
- Cardiology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Marco Bruno Luigi Rocchi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giorgio Brandi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132 Rome, Italy
| | - Rita Emili
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Elena Barbieri
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
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Bocconcelli M, Natalucci V, Ferri Marini C, Annibalini G, Sisti D, Lucertini F, Vallorani L, De Santi M, Rocchi M, Barocci S, Flori M, Brandi G, Catalano V, Villarini A, Barbieri E, Emili R. 181P A randomized controlled trial on the efficacy of supervised exercise training in reducing IGF-1 levels in breast cancer survivors of the Movis’ cohort. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.216] [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: 11/30/2022] Open
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10
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Natalucci V, Marini CF, Flori M, Pietropaolo F, Lucertini F, Annibalini G, Vallorani L, Sisti D, Saltarelli R, Villarini A, Monaldi S, Barocci S, Catalano V, Rocchi MBL, Benelli P, Stocchi V, Barbieri E, Emili R. Effects of a Home-Based Lifestyle Intervention Program on Cardiometabolic Health in Breast Cancer Survivors during the COVID-19 Lockdown. J Clin Med 2021; 10:2678. [PMID: 34204528 PMCID: PMC8235209 DOI: 10.3390/jcm10122678] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 05/19/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 12/16/2022] Open
Abstract
This study aimed to evaluate the cardiometabolic effects of a home-based lifestyle intervention (LI) in breast cancer survivors (BCSs) during the COVID-19 lockdown. In total, 30 BCSs (women; stages 0-II; non-metastatic; aged 53.5 ± 7.6 years; non-physically active; normal left ventricular systolic function) with a risk factor for recurrence underwent a 3-month LI based on nutrition and exercise. Anthropometrics, Mediterranean diet adherence, physical activity level (PAL), cardiorespiratory fitness (VO2max), echocardiographic parameters, heart rate variability (average standard deviation of NN intervals (ASDNN/5 min) and 24 h very- (24 hVLF) and low-frequency (24 hLF)), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein (hs-CRP)) were evaluated before (T0) and after (T1) the LI. After the LI, there were improvements in: body mass index (kg/m2: T0 = 26.0 ± 5.0, T1 = 25.5 ± 4.7; p = 0.035); diet (Mediet score: T0 = 6.9 ± 2.3, T1 = 8.8 ± 2.2; p < 0.001); PAL (MET-min/week: T0 = 647 ± 547, T1 = 1043 ± 564; p < 0.001); VO2max (mL·min-1·kg-1: T0 = 30.5 ± 5.8, T1 = 33.4 ± 6.8; p < 0.001); signs of diastolic dysfunction (participants: T0 = 15, T1 = 10; p = 0.007); AS-DNN/5 min (ms: T0 = 50.6 ± 14.4, T1 = 55.3 ± 16.7; p = 0.032); 24 hLF (ms2: T0 = 589 ± 391, T1 = 732 ± 542; p = 0.014); glycemia (mg/dL: T0 = 100.8 ± 11.4, T1 = 91.7 ± 11.0; p < 0.001); insulin resistance (HOMA-IR score: T0 = 2.07 ± 1.54, T1 = 1.53 ± 1.11; p = 0.005); testosterone (ng/mL: T0 = 0.34 ± 0.27, T1 = 0.24 ± 0.20; p = 0.003); hs-CRP (mg/L: T0 = 2.18 ± 2.14, T1 = 1.75 ± 1.74; p = 0.027). The other parameters did not change. Despite the home-confinement, LI based on exercise and nutrition improved cardiometabolic health in BCSs.
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Affiliation(s)
- Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Marco Flori
- U.O.C. Cardiologia/UTIC, Ospedale Santa Maria della Misericordia, Area Vasta n.1, 61029 Urbino, Italy; (M.F.); (F.P.)
| | - Francesca Pietropaolo
- U.O.C. Cardiologia/UTIC, Ospedale Santa Maria della Misericordia, Area Vasta n.1, 61029 Urbino, Italy; (M.F.); (F.P.)
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Roberta Saltarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Anna Villarini
- Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy;
| | - Silvia Monaldi
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
| | - Simone Barocci
- U.O.C. Patologia Clinica, Ospedale Santa Maria della Misericordia, Area Vasta n. 1, 61029 Urbino, Italy;
| | - Vincenzo Catalano
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
| | - Marco Bruno Luigi Rocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Piero Benelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132 Roma, Italy;
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (V.N.); (C.F.M.); (F.L.); (G.A.); (L.V.); (D.S.); (R.S.); (M.B.L.R.); (P.B.)
| | - Rita Emili
- U.O.C. Oncologia Medica, ASUR Area Vasta 1, Ospedale Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy; (S.M.); (V.C.); (R.E.)
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11
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Ruzzo A, Graziano F, Bagaloni I, Di Bartolomeo M, Prisciandaro M, Aprile G, Ongaro E, Vincenzi B, Perrone G, Santini D, Fornaro L, Vivaldi C, Tomasello G, Loupakis F, Lonardi S, Fassan M, Valmasoni M, Sarti D, Lorenzini P, Catalano V, Bisonni R, Del Prete M, Collina G, Magnani M. Glycolytic competence in gastric adenocarcinomas negatively impacts survival outcomes of patients treated with salvage paclitaxel-ramucirumab. Gastric Cancer 2020; 23:1064-1074. [PMID: 32372141 PMCID: PMC7567716 DOI: 10.1007/s10120-020-01078-0] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/23/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION For energy production, cancer cells maintain a high rate of glycolysis instead of oxidative phosphorylation converting glucose into lactic acid. This metabolic shift is useful to survive in unfavorable microenvironments. We investigated whether a positive glycolytic profile (PGP) in gastric adenocarcinomas may be associated with unfavorable outcomes under an anticancer systemic therapy, including the anti-angiogenic ramucirumab. MATERIALS AND METHODS Normal mucosa (NM) and primary tumor (PT) of 40 metastatic gastric adenocarcinomas patients who received second-line paclitaxel-ramucirumab (PR) were analyzed for mRNA expression of the following genes: HK-1, HK-2, PKM-2, LDH-A, and GLUT-1. Patients were categorized with PGP when at least a doubling of mRNA expression (PT vs. NM) in all glycolytic core enzymes (HK-1 or HK-2, PKM-2, LDH-A) was observed. PGP was also related to TP53 mutational status. RESULTS Mean LDH-A, HK-2, PKM-2 mRNA expression levels were significantly higher in PT compared with NM. 18 patients were classified as PGP, which was associated with significantly worse progression-free and overall survival times. No significant association was observed between PGP and clinical-pathologic features, including TP53 positive mutational status, in 28 samples. CONCLUSIONS Glycolytic proficiency may negatively affect survival outcomes of metastatic gastric cancer patients treated with PR systemic therapy. TP53 mutational status alone does not seem to explain such a metabolic shift.
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Affiliation(s)
- Annamaria Ruzzo
- Department of Biomolecular Sciences (DiSB), University of Urbino "Carlo Bo", Via Arco d'Augusto, 2, 61032, Fano, PU, Italy.
| | - Francesco Graziano
- Department of Onco-Hematology, Division of Oncology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", 61122, Pesaro, Italy.
| | - Irene Bagaloni
- Department of Biomolecular Sciences (DiSB), University of Urbino "Carlo Bo", Via Arco d'Augusto, 2, 61032, Fano, PU, Italy
| | | | | | - Giuseppe Aprile
- Department of Medical Oncology, San Bortolo General Hospital, AULSS8 Berica, Vicenza, Italy
| | - Elena Ongaro
- Department of Oncology, University and General Hospital, Udine, Italy
| | | | | | | | | | | | | | - Fotios Loupakis
- Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Sara Lonardi
- Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Matteo Fassan
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Michele Valmasoni
- Clinica Chirurgica 3, Department of Surgical, Oncological and Gastroenterological Sciences (DISCOG), University of Padua, Padua, Italy
| | - Donatella Sarti
- Department of Onco-Hematology, Division of Oncology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", 61122, Pesaro, Italy
| | - Paola Lorenzini
- Department of Onco-Hematology, Division of Oncology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", 61122, Pesaro, Italy
| | - Vincenzo Catalano
- Department of Onco-Hematology, Division of Oncology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", 61122, Pesaro, Italy
| | | | | | - Guido Collina
- Area vasta 5, Ospedale "C. e G. Mazzoni" Ascoli Piceno, Ascoli Piceno, Italy
| | - Mauro Magnani
- Department of Biomolecular Sciences (DiSB), University of Urbino "Carlo Bo", Via Arco d'Augusto, 2, 61032, Fano, PU, Italy
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Rossi D, Lippe P, Rocchi MBL, Sarti D, Catalano V, Graziano F, Giordani P, Baldelli A, Fedeli SL, Imperatori L, Laici G, Cappelletti C, Tamburrano T, Bracci R, Alessandroni P. Metronomic Oral Vinorelbine: An Alternative Schedule in Elderly and Patients PS2 With Local/Advanced and Metastatic NSCLC Not Oncogene-addicted. In Vivo 2020; 34:2687-2691. [PMID: 32871800 DOI: 10.21873/invivo.12088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND The MILES and ELVIS studies showed that vinorelbine is one of the best options for elderly patients with advanced non-small-cell-lung cancer (NSCLC). Oral vinorelbine at standard schedule (60-80 mg/m2/weekly) has good activity in terms of response rates and progression-free survival. In recent years, a metronomic schedule of oral vinorelbine (40-50 mg/m2 three times a week, continuously) has been studied in phase II trials, especially in unfit and elderly patients. In the MOVE trial metronomic oral vinorelbine had a clinical benefit [partial response (PR)+stable disease (SD) >12 weeks] in 58.1% of patients with mild toxicity. On this basis, in 2017 we started a phase II study with metronomic oral vinorelbine in elderly (over 70 years) or unfit [Eastern Cooperative Oncology Group performance score (ECOG-PS) of 2] patients with locally/advanced and metastatic NSCLC. Primary aims were clinical benefit (PR+SD ≥6 months) and toxicity; secondary aims were progression-free survival and overall survival. PATIENTS AND METHODS A total of 25 patients entered the study: 11 with local/advanced and 14 with metastatic NSCLC (five squamous and 20 adenocarcinoma). None of the patients had epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) translocation, or programmed death ligand 1 (PDL1) expression; those with squamous carcinoma did not have PDL1 expression. The median age was 79 (range=44-90) years. The PS was 0 in 12 patients (48%), 1 in four patients (16%) and 2 in nine patients (36%). Oral vinorelbine was administered at 40 mg three times a week continuously. RESULTS Clinical benefit was achieved in eight patients (32%). Objective responses were partial response in two patients (8%), stable disease in seven (28%), progressive disease in nine (36%); seven patients were not evaluable for response (28%). Median progression-free survival was 2 months; median overall survival was 4 months but four out of eight patients with clinical benefit were still alive at 18 months. Overall survival at 1 year was 32%. Toxicity was mild: only one patient experienced grade 4 neutropenia, one grade 3 peripheral neuropathy, four grade 2 asthenia, one grade 2 mucositis, and one grade 2 diarrhoea. The dose needed to be reduced to 30 mg/m2/three times a week in three patients. CONCLUSION Our study confirmed the activity and safety of metronomic oral vinorelbine in patients with wild-type local/advanced and metastatic NSCLC unsuitable for treatment with standard i.v. chemotherapy, allowing patients a comfortable home-based therapy, thereby avoiding frequent hospital visits.
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Affiliation(s)
- David Rossi
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Paolo Lippe
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Donatella Sarti
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Vincenzo Catalano
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Francesco Graziano
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Paolo Giordani
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Annamaria Baldelli
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Stefano Luzi Fedeli
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Luca Imperatori
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Gianluca Laici
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Claudia Cappelletti
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Tiziana Tamburrano
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Raffaella Bracci
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Paolo Alessandroni
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
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Emili R, Natalucci V, Marini C, Lucertini F, Vallorani L, Annibalini G, De Santi M, Donati Zeppa S, Agostini D, Gervasi M, Panico A, Sisti D, Rocchi M, Barocci S, Flori M, Brandi G, Stocchi V, Catalano V, Villarini A, Barbieri E. 238P Beneficial effects of exercise in oncology - MoviS: ‘Movement and Health Beyond Care’. Ann Oncol 2020. [PMCID: PMC7506414 DOI: 10.1016/j.annonc.2020.08.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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14
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Fischer NW, Graziano F, Bagaloni I, Di Bartolomeo M, Lonardi S, Vincenzi B, Fornaro L, Ongaro E, Aprile G, Bisonni R, Prisciandaro M, Gariépy J, Loupakis F, Sarti D, Del Prete M, Catalano V, Magnani M, Ruzzo A. TP53 mutation analysis in gastric cancer and clinical outcomes of patients with metastatic disease treated with anti-angiogenic or standard chemotherapy regimens. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e16571] [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
e16571 Background: Current data support the angiogenic potential of cancer cells with mutant p53 and VEGF-A up-regulation in solid tumors. These findings have renewed interest in the p53 role as a predictive/prognostic factor in cancer therapy. We investigated TP53 mutations in gastric adenocarcinoma (GA) samples of metastatic patients (pts) who underwent anti-angiogenic Paclitaxel-Ramucirumab (PR) therapy. The analysis was also performed in a control group of pts who received first-line chemotherapy (CT) with platinum derivates and fluoropyrimidines. Methods: TP53 mutations were identified by next-generation sequencing in 110 GA primary tumors of two retrospective metastatic series including 48 pts who were treated with second-line PR and 62 pts who received first-line CT with Cisplatin or Oxaliplatin plus 5-Fluorouracil or Capecitabine. Detected TP53 mutations were classified for TP53 mutant-specific residual transcriptional activity scores ( TP53 RTAS) (Fischer NW et al JCI Insight 2018). TP53 RTAS results were used for stratifying pts in survival analyses. Primary end-point was overall survival (OS). Results: In the PR group, TP53 mutations were detected in 29 out of 48 tumor samples (60.4%) with 10 having TP53 RTAS 0%-to-<1%. In the CT group, TP53 mutations were found in 40 out of 62 tumor samples (64.5%) with 11 having TP53 RTAS 0%-to-<1%. In the PR group, the 10 cases with a TP53 mutation causing no residual or minimal activity ( TP53 RTAS 0%-to-<1%) showed better OS in comparison with pts in the remaining groups (wild-type and TP53 RTAS > 1%). This effect was retained in the multivariate model analysis (Hazard Ratio = 0.29, 95% confidence interval 0.17-0.85, p = 0.02). An opposite effect was seen in the CT group with the worst OS in carriers of TP53 RTAS 0%-to-<1% mutations (Hazard Ratio = 2.64, 95% confidence interval 1.17-5.95, p = 0.02). Notably, in the whole group of 110 pts, TP53 mutations (any type) occurred more frequently in the intestinal-type GA group (p = 0.02). Conclusions: Additional studies are warranted to explore the favorable role of TP53 mutations in cancer pts undergoing anti-angiogenic therapies. TP53 mutations frequently occur in GA and these findings would lead to novel tailored therapy strategies in this lethal disease.
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Affiliation(s)
| | - Francesco Graziano
- Department od Onco-Hematology, Azienda Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Irene Bagaloni
- Department of Biomolecular Sciences - University of Urbino, Fano, Italy
| | | | - Sara Lonardi
- Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy
| | - Bruno Vincenzi
- Policlinico Universitario Campus, Bio-Medico, Rome, Italy
| | | | - Elena Ongaro
- Department of Oncology, Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico (CRO) di Aviano, IRCCS, Aviano, Italy
| | - Giuseppe Aprile
- Department of Oncology, San Bortolo General Hospital, ULSS8 Berica-East District, Vicenza, Italy
| | | | - Michele Prisciandaro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Fotios Loupakis
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Donatella Sarti
- Medical Oncology Unit, Azienda Ospedaliera Marche Nord, Pesaro, Italy
| | - Michela Del Prete
- Department of Medical Oncology, A.O. Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | | | - Mauro Magnani
- Department of Biomolecular Sciences - University of Urbino, Urbino, Italy
| | - Annamaria Ruzzo
- Department of Biomolecular Sciences - University of Urbino, Fano, Italy
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15
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Tonioni F, Mazza M, Autullo G, Pellicano GR, Aceto P, Catalano V, Marano G, Corvino S, Martinelli D, Fiumana V, Janiri L, Lai C. Socio-emotional ability, temperament and coping strategies associated with different use of Internet in Internet addiction. Eur Rev Med Pharmacol Sci 2019; 22:3461-3466. [PMID: 29917199 DOI: 10.26355/eurrev_201806_15171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of the present study was to compare socio-emotional patterns, temperamental traits, and coping strategies, between a group of Internet addiction (IA) patients and a control group. PATIENTS AND METHODS Twenty-five IA patients and twenty-six healthy matched subjects were tested on IA, temperament, coping strategies, alexithymia and attachment dimensions. Participants reported their prevalent Internet use (online pornography, social networks, online games). RESULTS The IA patients using Internet for gaming online showed a greater attitude to novelty seeking and a lower tendency to use socio-emotional support and self-distraction compared to patients using Internet for social networking. Moreover, they showed a lower level of acceptance than patients using Internet for pornography. In the control group, the participants using Internet for online gaming showed higher levels of IA, emotional impairments and social alienation compared to social-networks and pornography users. CONCLUSIONS Findings showed a higher psychological impairment in gaming online users compared to social networking and online pornography users.
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Affiliation(s)
- F Tonioni
- Psychiatry and Psychology Institute, A. Gemelli Foundation Hospital, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy.
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16
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Di Bartolomeo M, Niger M, Morano F, Corallo S, Antista M, Tamberi S, Lonardi S, Di Donato S, Berardi R, Scartozzi M, Cardellino GG, Di Costanzo F, Rimassa L, Luporini AG, Longarini R, Zaniboni A, Bertolini A, Tomasello G, Pinotti G, Scagliotti G, Tortora G, Bonetti A, Spallanzani A, Frassineti GL, Tassinari D, Giuliani F, Cinieri S, Maiello E, Verusio C, Bracarda S, Catalano V, Basso M, Ciuffreda L, De Vita F, Parra HS, Fornaro L, Caporale M, de Braud F, Pietrantonio F. Assessment of Ramucirumab plus paclitaxel as switch maintenance versus continuation of first-line chemotherapy in patients with advanced HER-2 negative gastric or gastroesophageal junction cancers: the ARMANI phase III trial. BMC Cancer 2019; 19:283. [PMID: 30922323 PMCID: PMC6440108 DOI: 10.1186/s12885-019-5498-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 09/24/2018] [Accepted: 03/20/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Platinum/fluoropyrimidine regimens are the backbone of first-line chemotherapy for advanced gastric cancer (AGC). However response rates to first line chemotherapy range from 30 to 50% and disease progression occurs after 4-6 cycles. The optimal duration of first-line therapy is still unknown and its continuation until disease progression represents the standard. However this strategy is often associated with cumulative toxicity and rapid development of drug resistance. Moreover, only about 40% of AGC pts. are eligible for second-line treatment. METHODS This is a randomized, open-label, multicenter phase III trial. It aims at assessing whether switch maintenance to ramucirumab plus paclitaxel will extend the progression-free survival (PFS) of subjects with HER-2 negative AGC who have not progressed after 3 months of a first-line with a platinum/fluoropyrimidine regimen (either FOLFOX4, mFOLFOX6 or XELOX). The primary endpoint is to compare Progression-Free Survival (PFS) of patients in ARM A (switch maintenance to ramucirumab and placlitaxel) versus ARM B (continuation of the same first-line therapy with oxaliplatin/fluoropyrimidine). Secondary endpoints are: overall survival, time-to-treatment failure, overall response rate, duration of response, percentage of patients that will receive a second line therapy according to arm treatment, safety, quality of life. Exploratory studies including Next-Generation Sequencing (NGS) in archival tumor tissues are planned in order to identify potential biomarkers of primary resistance and prognosis. DISCUSSION The ARMANI study estimates if patients treated with early swich with ramucirumab plus paclitaxel received benefit when compared to those treated with continuation of first line therapy. The hypothesis is that the early administration of an active, non-cross resistant second-line regimen such as ramucirumab plus paclitaxel may prolong the time in which patients are progression-free, and consequently have a better quality of life. Moreover, this strategy may rescue all those subjects that become ineligible for second-line therapy due to the rapid deterioration of health status after the first disease progression. TRIAL REGISTRATION ARMANI is registered at ClinicalTrials.gov ( NCT02934464 , October 17, 2016) and EudraCT(2016-001783-12, April 202,016).
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Affiliation(s)
- Maria Di Bartolomeo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian, 1, 20133 Milan, Italy
| | - Monica Niger
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian, 1, 20133 Milan, Italy
| | - Federica Morano
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian, 1, 20133 Milan, Italy
| | - Salvatore Corallo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian, 1, 20133 Milan, Italy
| | - Maria Antista
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian, 1, 20133 Milan, Italy
| | - Stefano Tamberi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Ravenna Viale Randi, 5, 48121 Ravenna, Italy
| | - Sara Lonardi
- Department of Medical Oncology, IOV Istituto Oncologico Veneto, Via Gattamelata, 64, 35128 Padova, PD Italy
| | - Samantha Di Donato
- Sandro Pitigliani Medical Oncology Department, Nuovo Ospedale di Prato, Via Suor Niccolina Infermiera, 20, 59100 Prato, Italy
| | - Rossana Berardi
- Department of Medical Oncology, AOU Ospedali Riuniti Di Ancona, via Corridoni, 11, 60123 Ancona, Italy
| | - Mario Scartozzi
- Department of Medical Oncology, AOU Cagliari, Via Ospedale, 54, 09124 Cagliari, Italy
| | - Giovanni Gerardo Cardellino
- Department of Medical Oncology, Azienda Sanitaria Universitaria Integrata di Udine, Via Pozzuolo, 330 – 33100, piazzale Santa Maria della misericordia 15, 33100 Udine, Udine Italy
| | - Francesco Di Costanzo
- Department of Medical Oncology, AOU Careggi di Firenze, Largo Brambilla, 3, 50134 Florence, Italy
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano, Milan Italy
| | - Alberto Gianluigi Luporini
- Department of Medical Oncology, IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, 20097 San Donato Milanese, MI Italy
| | - Raffaella Longarini
- Department of Medical Oncology, Ospedale San Gerardo, Via G. B. Pergolesi, 33, 20900 Monza, Italy
| | - Alberto Zaniboni
- Department of Medical Oncology, Fondazione Poliambulanza, Via Leonida Bissolati, 57, 25124 Brescia, Italy
| | - Alessandro Bertolini
- Department of Medical Oncology, ASST della Valtellina e dell’Alto Lario, Via Stelvio, 25, 23100 Sondrio, Italy
| | - Gianluca Tomasello
- Department of Medical Oncology, Ospedale di Cremona, Viale Concordia, 1, 26100 Cremona, Italy
| | - Graziella Pinotti
- Department of Medical Oncology, Ospedale di Circolo e Fondazione Macchi, Viale Luigi Borri, 57, 21100 Varese, Italy
| | - Giorgio Scagliotti
- Department of Medical Oncology, AOU San Luigi Gonzaga, Regione Gonzole, 10, 10043 Orbassano, Torino Italy
| | - Giampaolo Tortora
- Department of Medical Oncology, AOUI Verona Ospedale Policlinico ‘Giambattista Rossi’ di Borgo Roma, Piazzale L.A. Scuro, 10, 37134 Verona, VR Italy
| | - Andrea Bonetti
- Department of Medical Oncology, Ospedale Mater Salutis, Via Carlo Gianella, 1, 37045 Legnago, Verona, Italy
| | - Andrea Spallanzani
- Department of Medical Oncology, AOU di Modena, Via Emilia Est, 583-585, 41122 Modena, MO Italy
| | - Giovanni Luca Frassineti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli, 40, 47014 Meldola, Italy
| | - Davide Tassinari
- Department of Medical Oncology, Ospedale degli infermi di Rimini, Viale L. Settembrini, 2, 47923 Rimini, Italy
| | - Francesco Giuliani
- Department of Medical Oncology, I.R.C.C.S. Istituto Tumori Bari, Viale Orazio Flacco, 65, 70124 Bari, Italy
| | - Saverio Cinieri
- Department of Medical Oncology, Ospedale A. Perrino di Brindisi, Strada Statale 7 per Mesagne, 72100 Brindisi, Italy
| | - Evaristo Maiello
- Department of Medical Oncology, Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013 San Giovanni Rotondo, FG Italy
| | - Claudio Verusio
- Department of Medical Oncology, ASST Valle Olona, PO Saronno Piazzale Borella 1, 21047 Saronno, Varese Italy
| | - Sergio Bracarda
- Department of Medical Oncology, Ospedale San Donato, Azienda USL Toscana Sudest Via Pietro Nenni, 20/22, 52100 Arezzo, Italy
| | - Vincenzo Catalano
- Department of Medical Oncology, Azienda Ospedaliera “Ospedali Riuniti Marche Nord”, Piazzale Cinelli, 4, 61121 Pesaro, Italy
| | - Michele Basso
- Department of Medical Oncology, Fondazione Policlinico Universitario “A. Gemelli” - IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy
| | - Libero Ciuffreda
- Department of Medical Oncology, A.O.U. Citta della Salute e della Scienza di Torino, H Molinette, corso Bramante, 88, 10126 Torino, Italy
| | - Ferdinando De Vita
- Division of Medical Oncology, Department of Precision Medicine, University of Campania ‘Luigi Vanvitelli’ - School of Medicine, Via S.Pansini, 5, 80131 Naples, Italy
| | - Hector Soto Parra
- Department of Medical Oncology, P.O. G. Rodolico, Via Plebiscito, 628 Catania, Italy
| | - Lorenzo Fornaro
- Department of Medical Oncology, AOU Pisana, Polo Oncologico - Osp. S. Chiara, via Roma 67, 56100 Pisa, Italy
| | - Marta Caporale
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian, 1, 20133 Milan, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian, 1, 20133 Milan, Italy
- Department of Hematology-Oncology, University Milan, Milan, Italy
| | - Filippo Pietrantonio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian, 1, 20133 Milan, Italy
- Department of Hematology-Oncology, University Milan, Milan, Italy
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Catalano V, Bergamo F, Cremolini C, Vincenzi B, Negri F, Giordani P, Santini D, Sarti D, Torresi U, Bisonni R, Silva R, Rocchi M, Lonardi S, Falcone A, Mattioli R, Graziano F. Optimizing the use of first-line chemotherapy in metastatic colorectal cancer patients with mucinous histology. A multicenter, retrospective, combined analysis on 897 patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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18
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Rossi D, Graziano F, Ugolini M, Dennetta D, Alessandroni P, Catalano V, Giordani P, Fedeli SL, Fedeli A, Catalano G. Weekly Docetaxel as Second-Line Therapy in Non-Small Cell Lung Cancer: A Phase II Study. Tumori 2018; 90:50-3. [PMID: 15143972 DOI: 10.1177/030089160409000112] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Single-agent docetaxel is active as second-line chemotherapy in non-small cell lung cancer (NSCLC) pretreated patients; seven phase II studies have shown response rates of about 20% and 9 months of median survival. Two phase III studies documented a survival benefit at 1 year compared to BSC and vinorelbine or ifosfamide. Recent trials indicate acceptable activity and a good safety profile of weekly docetaxel with doses of 25–43 mg/m2. The aim of our study was to confirm this evidence and to evaluate activity and toxicity of weekly docetaxel at the dose of 40 mg/m2. Patients and methods Twenty-one patients with NSCLC entered the study (7 stage NIB and 14 stage IV): 13 males and 8 females. Median age was 66 years (range, 53–75). ECOG was O in 6, 1 in 9 and 2 in 6 patients. All patients were pretreated with a first-line chemotherapy (13 patients progressed soon after the first line); 6 of them received palliative radiotherapy on the chest. The treatment consisted of weekly docetaxel, 40 mg/m2 in 1 hr for six weeks with two weeks of rest (1 cycle). A total of 87 administrations was delivered (median, 4; range, 1–12). Responses All patients were assessable for response (according to the “intent-to-treat principle”) and for toxicity. No complete or partial remission was observed; 2 minor responses (9.5%), 1 stable disease (5%), 8 progressive diseases (38%) were documented. Seven patients dropped out the study due to severe toxicity (33.5%) and 3 due to early death (14%). Median survival was 3 months (range, 1–17), and 1-year survival was 9.5%. Toxicity was as follows: grade 4 diarrhea in 1; grade 3 asthenia in 8 (38%), grade 3 stomatitis in 2; grade 3 neutropenia in 1; allergic reactions in 2. No treatment-related death was recorded. Conclusions The trial showed only very modest activity of weekly docetaxel, with severe side effects that induced us to stop the accrual in order to prevent other worse toxicities. We therefore concluded that a dose of 40 mg/m2 of weekly docetaxel is not manageable and does not seem to provide a real benefit in terms of response and quality of life.
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Affiliation(s)
- David Rossi
- Oncology-Hematology Department, S Salvatore Hospital, Pesaro, Italy.
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Mosconi S, Cascinu S, Zaniboni A, Catalano V, Giordani P, Beretta GD, Martignoni G, Pancera G, Baldelli AM, Poletti P, Curti C, Labianca R. The Value of Oxaliplatin in Combination with Continuous infusion ± Bolus 5-Fluorouracil and Levo-Folinic Acid in Metastatic Colorectal Cancer Progressing after 5FU-Based Chemotherapy: A Giscad (Italian Group for the Study of Digestive Tract) Cancer Phase II Trial. Tumori 2018; 86:465-9. [PMID: 11218187 DOI: 10.1177/030089160008600606] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background The phase II trial was designed to evaluate the activity of combined oxaliplatin (L-OHP), continuous infusion (CI) ± bolus 5-fluorouracil (5FU) and levo-folinic acid (IFA) in patients with metastatic colorectal cancer progressing after one or more lines of 5FU-based chemotherapy. Patients and methods We designed two contemporary studies: in the former we enrolled patients previously treated with 1 line of chemotherapy, and in the latter, patients previously treated with 2, 3 and 4 lines. Seventy-six consecutive patients were enrolled: 45 received L-OHP (85 mg/m2 iv 2 h on day 1) + I-FA (100 mg/m2 iv 2 h on days 1 and 2) + 5FU iv bolus (400 mg/m2 days 1 and 2) + 5FU (600 mg/m2 CI 22 h days 1 and 2 (FOLFOX 4); 31 received L-OHP (100 mg/m2 iv 2 h on day 1) + I-FA (250 mg/m2 iv 2 h on days 1 and 2), followed by 5FU (1500 mg/m2 CI 24 h days 1 and 2 (FOLFOX 2). The treatment was recycled every 2 weeks and continued until progression and/or unacceptable toxicity or patient preference. The primary end point was activity (tumor growth control [TGC]: partial response [PR] + stable disease [SD]); the secondary end points were time to progression (TTP), overall survival (OS) and toxicity. Results Forty-five patients in 2nd line (22 FOLFOX 4, 23 FOLFOX 2), 23 (17 FOLFOX 4, 6 FOLFOX 2) in 3rd, 4 in 4th and 1 in 5th line were assessable; 3 were lost to follow-up. In 15 patients (11 FOLFOX 4, 4 FOLFOX 2), disease involved the liver only. A total of 533 courses were administered with a range of 1-14 in FOLFOX4 and 1-12 in FOLFOX2; dose intensity was 92.85%, and the total dose of the administered L-OHP was 98.29%. As a 2nd line treatment, FOLFOX 4 achieved TGC in 72.8% of the patients (PR, 18.2%; SD, 54.6%), with a median TTP of 6 months and a median OS of 7 months, whereas in the FOLFOX 2 group these figures were 78.3% (PR 21.8%, SD 56.5%), and 5 and 9 months. As a 3rd line treatment, FOLFOX 4 produced TGC in 41.1% of patients (PR 23.5%, SD 17.6%), with a median TTP of 5 months and median OS of 7+ months, whereas FOLFOX 2 obtained respective values of 50% (PR 16.7%, SD 33.3%), 7 and 9 months. As a 4th line of treatment, TGC was achieved in 2 patients (1 PR, 1 SD); the patient in 5th line therapy obtained a SD. With “de Gramont” as the first-line regimen, patients assessable were 24 in FOLFOX 4 and 18 in FOLFOX 2. In the former population, TGC was 70.8% (PR 37.5%, SD 33.3%), with a TTP of 6 months and OS of 10 months, whereas with FOLFOX2 these values were 61.1% (PR 5.6%, SD 55.5), 5 and 7 months. In patients with liver involvement only, FOLFOX 4 obtained TGC in 63.6% of cases (with a TTP of 7 months and OS of 6+ months), FOLFOX 2 in 100% (with a TTP of 9.5 months and OS of 13.5+ months). Both schedules exhibited an acceptable toxicity: neurologic, hematologic and hepatic grade 3 side effects occurred in a limited number of patients, with a higher frequency in the FOLFOX 2 group. Conclusions Treatment with L-OHP, CI ± bolus 5FU and I-FA was well tolerated. The activity in terms of TGC was interesting and comparable with results reported in the literature for the standard treatment for 2nd line, i.e. irinotecan alone. Treatment was effective in 2nd line and in patients previously treated with more than two chemotherapy lines; in particular, treatment was active in patients with hepatic disease only. Although the two schedules seemed to achieve the same benefit with the same tolerance, we could not define from the study the better regime.
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Affiliation(s)
- S Mosconi
- Medical Oncology Units of Ospedali Riuniti di Bergamo, Italy.
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20
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Catalano V, Bergamo F, Cremolini C, Vincenzi B, Negri F, Graziano F, Giordani P, Alessandroni P, Intini R, Rumanò L, Rossini D, Borelli B, Santini D, Sarti D, Rocchi M, Lonardi S, Falcone A, Zagonel V, Mattioli R. Does bevacizumab plus chemotherapy matter in metastatic colorectal cancer patients with mucinous histology? A multicenter, retrospective analysis on 685 patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422] [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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21
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Meraviglia S, Lo Presti E, Tosolini M, La Mendola C, Orlando V, Todaro M, Catalano V, Stassi G, Cicero G, Vieni S, Fourniè JJ, Dieli F. Distinctive features of tumor-infiltrating γδ T lymphocytes in human colorectal cancer. Oncoimmunology 2017; 6:e1347742. [PMID: 29123962 DOI: 10.1080/2162402x.2017.1347742] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [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: 03/31/2017] [Revised: 06/14/2017] [Accepted: 06/22/2017] [Indexed: 12/31/2022] Open
Abstract
γδ T cells usually infiltrate many different types of cancer, but it is unclear whether they inhibit or promote tumor progression. Moreover, properties of tumor-infiltrating γδ T cells and those in the corresponding normal tissue remain largely unknown. Here we have studied features of γδ T cells in colorectal cancer, normal colon tissue and peripheral blood, and correlated their levels with clinicopathologic hallmarks. Flow cytometry and transcriptome analyses showed that the tumor comprised a highly variable rate of TILs (5-90%) and 4% γδ T cells on average, with the majority expressing Vδ1. Most Vδ1 and Vδ2 T cells showed a predominant effector memory phenotype and had reduced production of IFN- γ which was likely due to yet unidentified inhibitory molecules present in cancer stem cell secretome. Transcriptome analyses revealed that patients containing abundant γδ T cells had significantly longer 5-year disease free survival rate, suggesting their efficacy in controlling tumor at very early stage.
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Affiliation(s)
- S Meraviglia
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - E Lo Presti
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - M Tosolini
- Centre de Recherches en Cancérologie de Toulouse (CRCT), Toulouse, France
| | - C La Mendola
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - V Orlando
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - M Todaro
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Medicine, University of Palermo, Palermo, Italy
| | - V Catalano
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy
| | - G Stassi
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - G Cicero
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - S Vieni
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - J J Fourniè
- Centre de Recherches en Cancérologie de Toulouse (CRCT), Toulouse, France
| | - F Dieli
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
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Mazza M, Marano G, Traversi G, Di Nicola M, Catalano V, Janiri L. The complex interplay of Depression, Inflammation and Omega-3: state of the art and progresses in research. Clin Ter 2016; 166:e242-7. [PMID: 26152637 DOI: 10.7417/ct.2015.1859] [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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Many epidemiological and preclinical studies have proven the potential benefit and critical role of omega-3 PUFAs in the development and management of depressive disorders. Depression may be the consequence of a complex interplay between cell-mediated-immune activation and inflammation evolving in neuroprogression. Associations between n-3 PUFAs, inflammation, oxidative stress and the risk of depression have been demonstrated and clinical and animal supplementation studies have shown the potential of PUFAs to decrease neurodegeneration and inflammation. Future research should focus on the dynamic interactions between the different cell signaling networks and oxidative and nitrosative stress pathways that cause depression.
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Affiliation(s)
- M Mazza
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Marano
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Traversi
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Di Nicola
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - V Catalano
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Janiri
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
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Fiorentini G, Carrandina R, Sarti D, Mulazzani L, Felicioli A, Coschiera P, Catalano V, Aliberti C. Hepatic arterial infusion of Polythylene Glycol drug-eluting beads for Primary liver cancer therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aliberti C, Carandina R, Sarti D, Giordani P, Catalano V, Mulazzani L, Fiorentini G. Transarterial Chemoembolization using Polythylene Glycol drug-eluting beads pre-charged with irinotecan (LIFIRI®) for the treatment of Metastatic liver cancer: preliminary results. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.33] [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: 11/15/2022] Open
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Aliberti C, Carandina R, Sarti D, Mulazzani L, Catalano V, Felicioli A, Coschiera P, Fiorentini G. Hepatic Arterial Infusion of Polyethylene Glycol Drug-eluting Beads for Primary and Metastatic Liver Cancer Therapy. Anticancer Res 2016; 36:3515-3521. [PMID: 27354617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/10/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND/AIM Recently, there has been the launch of the new Polyethylene glycol (PEG) drug-eluting beads (LifePearl®) for transarterial chemoembolization. Their innovation is that PEG guarantees more compressibility, elasticity and maximizes beads' suspension time. We applied these beads for hepatic intra-arterial infusion of irinotecan or doxorubicin for the therapy of primary and metastatic liver cancer. PATIENTS AND METHODS We treated 20 consecutive patients, affected by unresectable primary liver cancer (PLC) or hepatic metastases (refractory to chemotherapy) using chemoembolization with doxorubicin or irinotecan pre-loaded Lifepearls. RESULTS Tumor response rate was >80% in most patients with 63% of complete and 37% of partial response. We observed no complications during the chemoembolization and no severe general drug-related side-effects. CONCLUSION Our data suggest that chemoembolization with LifePearl® is efficacious and safe for the treatment of liver cancer as indicated by good tolerability, quality of life and high tumor response.
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Affiliation(s)
- Camillo Aliberti
- Oncology Radiodiagnostics, Oncology Institute of Veneto, Institute for the Research and Treatment of Cancer (IRCCS), Padua, Italy
| | - Riccardo Carandina
- Oncology Radiodiagnostics, Oncology Institute of Veneto, Institute for the Research and Treatment of Cancer (IRCCS), Padua, Italy
| | - Donatella Sarti
- Oncology Unit, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Pesaro, Italy
| | - Luca Mulazzani
- Diagnostics for Images Unit and Interventional Radiology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Pesaro, Italy
| | - Vincenzo Catalano
- Oncology Unit, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Pesaro, Italy
| | - Alessandro Felicioli
- Diagnostics for Images Unit and Interventional Radiology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Pesaro, Italy
| | - Paolo Coschiera
- Diagnostics for Images Unit and Interventional Radiology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Pesaro, Italy
| | - Giammaria Fiorentini
- Oncology Unit, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Pesaro, Italy
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Graziano F, Ruzzo A, Giacomini E, Ricciardi T, Aprile G, Loupakis F, Lorenzini P, Ongaro E, Zoratto F, Catalano V, Sarti D, Rulli E, Cremolini C, De Nictolis M, De Maglio G, Falcone A, Fiorentini G, Magnani M. Glycolysis gene expression analysis and selective metabolic advantage in the clinical progression of colorectal cancer. Pharmacogenomics J 2016; 17:258-264. [DOI: 10.1038/tpj.2016.13] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 01/16/2023]
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Graziano F, Rulli E, Biagioli E, Catalano V. Number needed to treat for pricing costly anticancer drugs: the example of regorafenib in metastatic colorectal cancer. Ann Oncol 2016; 27:747-8. [PMID: 26787235 DOI: 10.1093/annonc/mdw024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Graziano
- Department of Onco-Hematology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Pesaro
| | - E Rulli
- Clinical Research Laboratory, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - E Biagioli
- Clinical Research Laboratory, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - V Catalano
- Department of Onco-Hematology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Pesaro
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Fiorentini G, Aliberti C, Sarti D, Coschiera P, Tilli M, Mulazzani L, Giordani P, Graziano F, Marqués Gonzalez A, García Marcos R, Gómez Mugnoz F, Cantore M, Ricci S, Catalano V, Mambrini A. DEBIRI and cetuximab (DEBIRITUX) as a secondline treatment for unresectable colorectal liver metastases (UCLM): results of a phase II trial exploring a new sequence. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ongaro E, Ruzzo A, Giacomini E, Ricciardi T, Aprile G, Loupakis F, Lorenzini P, Zoratto F, Cremolini C, Catalano V, Sarti D, Rullia E, De Nictolis M, DeMaglio G, Falcone A, Fiorentini G, Magnani M, Graziano F. Glucose metabolism enzymes gene expression analysis and selective metabolic advantage in the clinical progression of colorectal cancer (CRC). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.49] [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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Fiorentini G, Aliberti C, Sarti D, Coschiera P, Tilli M, Mulazzani L, Giordani P, Graziano F, Gonzalez AM, Marcos RG, Mugnoz FG, Cantore M, Ricci S, Catalano V, Mambrini A. Locoregional therapy and systemic cetuximab to treat colorectal liver metastases. World J Gastrointest Oncol 2015; 7:47-54. [PMID: 26090075 PMCID: PMC4468842 DOI: 10.4251/wjgo.v7.i6.47] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/10/2015] [Accepted: 05/06/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To investigate efficacy and safety of second-line treatment with irinotecan-loaded drug-eluting beads (DEBIRI) and cetuximab (DEBIRITUX) of unresectable colorectal liver metastases.
METHODS: Patients with the following characteristics were included in the study: unresectable hepatic metastases from colorectal carcinoma (CRC-LM), progression after first line chemotherapy (any type of chemotherapeutic drug and combination was allowed), second line treatment (mandatory), which included for each patient (unregarding the KRas status) two cycles of DEBIRI (using 100-300 μm beads loaded with irinotecan at a total dose 200 mg) followed by 12 cycles of cetuximab that was administered weekly at a first dose of 400 mg/m2 and then 250 mg/m2; good performance status (0-2) and liver functionality (alanine aminotransferase and gamma-glutamyl transferase not exceeding three times the upper limit of normal, total bilirubin not exceeding 2.5 mg/mL). Data were collected retrospectively and included: tumor response (evaluated monthly for 6 mo then every 3 mo), overall response rate (ORR), KRas status, type and intensity of adverse events (G according to the Common Terminology Criteria for Adverse Events v3.0, CTCAE), overall survival (OS) and progression free survival (PFS).
RESULTS: Forty consecutive cases of CRC hepatic metastases were included in the study. Median duration of DEBIRITUX was 4.4 mo (range, 4.0-6.5). Sixteen patients (40%) received the planned 2 cycles of DEBIRI and an average of 10 cetuximab cycles. ORR of the whole sample was 50%, in particular 4 patients were complete responders (10%) and 16 (40%) partial responders. The most observed side effects (G2) were: post-embolization syndrome (30%), diarrhea (25%), skin rushes (38%) and asthenia (35%). The retrospective evaluation of KRas status (24 wild type, 16 mutated) showed that the group of patients with wild type KRas had ORR significantly higher than mutant KRas. Median follow-up was 29 mo (8-48 range); median PFS was 9.8 mo and OS was 20.4 mo. Future randomized trials are required in this setting to establish a role for DEBIRITUX compared with systemic chemotherapy.
CONCLUSION: DEBIRITUX seems to be efficacious after first line chemotherapy for the treatment of unresectable CRC-LM.
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Graziano F, Ruzzo A, Giacomini E, Ricciardi T, Aprile G, Loupakis F, Lorenzini P, Ongaro E, Zoratto F, Catalano V, Cremolini C, Sarti D, Rulli E, De Nictolis M, De Maglio G, Falcone A, Fiorentini G, Magnani M. Glucose metabolism enzymes gene expression analysis and selective metabolic advantage in the progression of colorectal cancer (CRC). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e14519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Francesco Graziano
- Dept. of Onco-Hematology, Azienda Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Annamaria Ruzzo
- Dipartimento di Scienze Biomolecolari, Università di Urbino, Urbino, Italy
| | - Elisa Giacomini
- Dipartimento di Scienze Biomolecolari, Università di Urbino, Urbino, Italy
| | - Teresa Ricciardi
- Dipartimento di Scienze Biomolecolari, Università di Urbino, Urbino, Italy
| | | | - Fotios Loupakis
- Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - Paola Lorenzini
- Institute of Histopathology, Azienda Ospedali Marche Nord, Pesaro, Italy
| | | | - Federica Zoratto
- U.O. Oncologia Medica II, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Chiara Cremolini
- Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - Donatella Sarti
- Medical Oncology Unit, Azienda Ospedaliera Marche Nord, Pesaro, Italy
| | | | - Michele De Nictolis
- Institute of Histopathology, Azienda Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Alfredo Falcone
- Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | | | - Mauro Magnani
- Department of Biomolecular Sciences Section of Biochemistry and Molecular Biology, University of Urbino, Urbino, Italy
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Zane M, Scavo E, Catalano V, Bonanno M, Todaro M, De Maria R, Stassi G. Normal vs cancer thyroid stem cells: the road to transformation. Oncogene 2015; 35:805-15. [PMID: 25961919 DOI: 10.1038/onc.2015.138] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 03/24/2015] [Accepted: 03/30/2015] [Indexed: 01/06/2023]
Abstract
Recent investigations in thyroid carcinogenesis have led to the isolation and characterisation of a subpopulation of stem-like cells, responsible for tumour initiation, progression and metastasis. Nevertheless, the cellular origin of thyroid cancer stem cells (SCs) remains unknown and it is still necessary to define the process and the target population that sustain malignant transformation of tissue-resident SCs or the reprogramming of a more differentiated cell. Here, we will critically discuss new insights into thyroid SCs as a potential source of cancer formation in light of the available information on the oncogenic role of genetic modifications that occur during thyroid cancer development. Understanding the fine mechanisms that regulate tumour transformation may provide new ground for clinical intervention in terms of prevention, diagnosis and therapy.
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Affiliation(s)
- M Zane
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy.,Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - E Scavo
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - V Catalano
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - M Bonanno
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - M Todaro
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - R De Maria
- Regina Elena National Cancer Institute, Rome, Italy
| | - G Stassi
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
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Ruzzo A, Catalano V, Canestrari E, Giacomini E, Santini D, Tonini G, Vincenzi B, Fiorentini G, Magnani M, Graziano F. Genetic modulation of the interleukin 6 (IL-6) system in patients with advanced gastric cancer: a background for an alternative target therapy. BMC Cancer 2014; 14:357. [PMID: 24886605 PMCID: PMC4046495 DOI: 10.1186/1471-2407-14-357] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 09/16/2013] [Accepted: 05/12/2014] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND IL-6 triggers oncogenic/angiogenic signals and the cytokine-dependent pro-cachexia cascade. The prognostic role of the functional IL-6 (promoter) rs1800795 and the IL-6R (receptor) rs8192284 single nucleotide polymorphisms (SNP) was studied in patients with advanced gastric cancer treated with palliative chemotherapy. METHODS One-hundred-sixty-one patients were genotyped for rs1800795 and rs8192284 SNPs using polymerase chain reaction based restriction fragment length polymorphism (PCR-RFLP) analysis assay. These results were studied for association with overall survival (OS). RESULTS In 161 assessable patients, frequencies of rs1800795 G/G, G/C and C/C genotypes were 46%, 42% and 12%, respectively. Frequencies of rs8192284 A/A, A/C and C/C genotypes were 36%, 45% and 19%, respectively. Carriers of the rs1800795 G/G and rs8192284 C/C genotypes showed the worst OS. In the multivariate model, rs1800795 G/G (1.69 hazard ratio; 95% confidence interval 1.18-2.42), and rs8192284 C/C (1.78 hazard ratio; 95% confidence interval 1.12-2.83) confirmed an adverse prognostic impact. CONCLUSIONS In this population, genetic variants that up-regulate the IL-6 system showed impact on OS. This findings sustain the hypothesis that anti-IL-6 compounds deserve clinical studies as novel therapeutics in the palliative treatment of cancer patients.
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Affiliation(s)
- Annamaria Ruzzo
- Department of Biomolecular Sciences, University of Urbino, Urbino, Italy.
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Fiorentini G, Aliberti C, Mulazzani L, Coschiera P, Catalano V, Rossi D, Giordani P, Ricci S. Chemoembolization in colorectal liver metastases: the rebirth. Anticancer Res 2014; 34:575-584. [PMID: 24510986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Currently image-guided trans-arterial chemoembolization (TACE) has a significant role in the therapy of patients with hepatocellular carcinoma and liver metastases. This endovascular hepatic-directed therapy offers the dual benefit of true local neoplastic control and reduction of side-effects. As a result, it has been included in the guidelines for primary liver cancer and is often considered as salvage therapy for patients liver metastases from neuroendocrine and chemorefractory colorectal tumors. The development of new embolizing agents, such as DC beads loaded with doxorubicin and irinotecan, permits better standardization and definition of protocols, making the procedures less linked to criteria of different hospitals and personal experiences of interventional radiologists. The understanding that hypoxia induces vessel re-growth will open a new avenue for clinical research and a rebirth for TACE. Chemoembolization followed by target therapy (bevacizumab, aflibercept and regorafenib) could increase quality, duration of responses and better quality of life.
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Affiliation(s)
- Giammaria Fiorentini
- Oncology Unit, Department of Oncology-Hematology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, via Cesare Lombroso 1, 61121 Pesaro (PU), Italy.
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Ghannoum M, Isham N, Catalano V. A second look at efficacy criteria for onychomycosis: clinical and mycological cure. Br J Dermatol 2014; 170:182-7. [DOI: 10.1111/bjd.12594] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2013] [Indexed: 11/27/2022]
Affiliation(s)
- M. Ghannoum
- Center for Medical Mycology; Department of Dermatology; University Hospitals Case Medical Center; Cleveland OH U.S.A
| | - N. Isham
- Center for Medical Mycology; Department of Dermatology; University Hospitals Case Medical Center; Cleveland OH U.S.A
| | - V. Catalano
- Center for Medical Mycology; Department of Dermatology; University Hospitals Case Medical Center; Cleveland OH U.S.A
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Pantano F, Berti P, Guida FM, Perrone G, Vincenzi B, Amato MMC, Righi D, Dell'aquila E, Graziano F, Catalano V, Caricato M, Rizzo S, Muda AO, Russo A, Tonini G, Santini D. The role of macrophages polarization in predicting prognosis of radically resected gastric cancer patients. J Cell Mol Med 2013; 17:1415-21. [PMID: 24283947 PMCID: PMC4117554 DOI: 10.1111/jcmm.12109] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 06/25/2013] [Indexed: 01/24/2023] Open
Abstract
Tumour-associated Macrophages (TAM) present two different polarizations: classical (M1) characterized by immunostimulation activity and tumour suppression; alternative (M2) characterized by tumour promotion and immune suppression. In this retrospective study, we evaluated the correlation between the two forms of TAM with survival time in radically resected gastric cancer patients. A total of 52 chemo- and radio-naive patients were included. Two slides were prepared for each patient and double-stained for CD68/NOS2 (M1) or CD68/CD163 (M2) and five representative high-power fields per slide were evaluated for TAM count. The median value of the two macrophage populations density and the median value of M1/M2 ratio were used as cut-off. Twenty-seven patients with M1 density above-the-median had a significantly higher survival compared to those below the median. Twenty-six patients with M1/M2 ratio above the median showed median OS of 27.2 months compared to 15.5 months of the patients below the median. No association between M2 macrophage density and patient's outcome was found. In multivariate analysis, M1/M2 was a positive independent predictor of survival. The M1 macrophage density and M1/M2 ratio, as confirmed in multivariate analysis, are factors that can help in predicting patients survival time after radical surgery for gastric cancer.
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Affiliation(s)
- Francesco Pantano
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy
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Di Nicola M, Sala L, Romo L, Catalano V, Dubertret C, Martinotti G, Mazza M, Guelfi JD, Rouillon F, Janiri L, Gorwood P. Trouble déficit d’attention avec ou sans hyperactivité chez des adultes souffrant d’un trouble de l’humeur : le rôle des dimensions de la personnalité. Eur Psychiatry 2013. [DOI: 10.1016/j.eurpsy.2013.09.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IntroductionDans les cas des troubles bipolaires, les taux de comorbidité avec un TDAH peut varier entre 9,5 % et 27 % [1]. Ces patients présentent un début de trouble plus précoce, avec plus d’épisodes dépressifs et des épisodes mixtes. Il existe peu d’étude sur le lien entre ces deux pathologies et les différentes dimensions de personnalité selon le modèle de Big Five.
MethodsNotre étude comporte 106 patients souffrant de dépression, 102 patients bipolaires et 120 témoins, tous homogènes vis-à-vis de leurs caractéristiques démographiques. Le diagnostic de TDAH se basait sur les critères DSM-IV-TR. Les traits de TDAH étaient autoévalués avec la Wender Utah Rating Scale (WURS), la Adult ADHD Self-rating Scale (ASRS) et la Brown Attention Déficit Disorder Scale (ADD). L’Inventaire de Personnalité-Révisé, le NEO PI-R, servait également à évaluer les dimensions de la personnalité au sein des groupes cliniques.
Résultats15,7 % des adultes souffrant d’un trouble bipolaire et 7,5 % souffrant d’une dépression sévère manifestaient une comorbidité d’un TDAH en comparaison avec seulement 3,3 % des témoins. Il existe des corrélations significatives entre des traits de personnalité et la présence d’un TDAH. Une analyse de régression logistique de l’ensemble des 208 sujets cliniques a montré que ceux avec des faibles niveaux de névrosisme manifestaient un taux moins important de comorbidité avec un TDAH.
DiscussionNotre étude souligne le lien entre des troubles de l’humeur, notamment les troubles bipolaires, et la présence d’un TDAH chez des adultes. Nos résultats soutiennent la nécessité d’évaluer les sujets souffrant des troubles d’humeur sur une éventuelle comorbidité de TDAH en milieu clinique. Il faudra étudier d’une façon plus approfondie ces traits de personnalité et les liens entre des troubles de l’humeur et un TDAH afin de pouvoir adapter la prise en charge.
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Silvestris N, Pantano F, Ibrahim T, Gamucci T, De Vita F, Di Palma T, Pedrazzoli P, Barni S, Bernardo A, Febbraro A, Satolli MA, Bertocchi P, Catalano V, Giommoni E, Comandone A, Maiello E, Riccardi F, Ferrara R, Trogu A, Berardi R, Leo S, Bertolini A, Angelini F, Cinieri S, Russo A, Pisconti S, Brunetti AE, Azzariti A, Santini D. Natural history of malignant bone disease in gastric cancer: final results of a multicenter bone metastasis survey. PLoS One 2013; 8:e74402. [PMID: 24204569 PMCID: PMC3810275 DOI: 10.1371/journal.pone.0074402] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [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: 02/13/2013] [Accepted: 08/01/2013] [Indexed: 02/06/2023] Open
Abstract
Background Bone metastasis represents an increasing clinical problem in advanced gastric cancer (GC) as disease-related survival improves. In literature, few data on the natural history of bone disease in GC are available. Patients and Methods Data on clinicopathology, skeletal outcomes, skeletal-related events (SREs), and bone-directed therapies for 208 deceased GC patients with evidence of bone metastasis were statistically analyzed. Results Median time to bone metastasis was 8 months (CI 95%, 6.125–9.875 months) considering all included patients. Median number of SREs/patient was one. Less than half of the patients (31%) experienced at least one and only 4 and 2% experienced at least two and three events, respectively. Median times to first and second SRE were 2 and 4 months, respectively. Median survival was 6 months after bone metastasis diagnosis and 3 months after first SRE. Median survival in patients who did not experience SREs was 5 months. Among patients who received zoledronic acid before the first SRE, the median time to appearance of first SRE was significantly prolonged compared to control (7 months vs 4 months for control; P: 0.0005). Conclusions To our knowledge, this retrospective analysis is the largest multicenter study to demonstrate that bone metastases from GC are not so rare, are commonly aggressive and result in relatively early onset of SREs in the majority of patients. Indeed, our large study, which included 90 patients treated with ZOL, showed, for the first time in literature, a significant extension of time to first SRE and increase in the median survival time after diagnosis of bone metastasis. Taken together, these data may support the beneficial effects of ZOL in GC patients.
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Affiliation(s)
- Nicola Silvestris
- Medical Oncology Unit, National Cancer Research Centre Istituto Tumori “Giovanni Paolo II”, Bari, Italy
- * E-mail:
| | | | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, IRCCS -Romagnolo Scientific Institute for the Study and Treatment of Cancer, Meldola, Italy
| | - Teresa Gamucci
- Medical Oncology Unit, Hospital of Frosinone, Frosinone, Italy
| | | | | | - Paolo Pedrazzoli
- Department of Oncology-Hematology, Hospital of Pavia, Pavia, Italy
| | - Sandro Barni
- Division of Medical Oncology, Treviglio-Caravaggio Hospital, Treviglio, Italy
| | - Antonio Bernardo
- Operative Unit of Oncology - IRCCS Fondazione Maugeri, Pavia, Italy
| | | | | | - Paola Bertocchi
- Department of Medical Oncology, Fondazione Poliambulanza of Brescia, Brescia, Italy
| | | | - Elisa Giommoni
- Medical Oncology Unit, Hospital Careggi, Florence, Italy
| | - Alessandro Comandone
- Department of Oncology, Gradenigo Hospital and Gruppo Piemontese Sarcomi, Turin, Italy
| | - Evaristo Maiello
- Medical Oncology Unit, Hospital “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Italy
| | | | | | - Antonio Trogu
- Medical Oncology Unit, Hospital of Aosta, Aosta, Italy
| | | | - Silvana Leo
- Medical Oncology Unit, Hospital of Lecce, Lecce, Italy
| | | | - Francesco Angelini
- Medical Oncology Unit, Hospital Regina Apostolorum, Albano Laziale, Italy
| | - Saverio Cinieri
- Medical Oncology Department & Breast Unit – Hospital of Brindisi and Medical Oncology Department – European Institute of Oncology, Milan, Italy
| | - Antonio Russo
- Medical Oncology Unit, University of Palermo, Palermo, Italy
| | | | - Anna Elisabetta Brunetti
- Medical Oncology Unit, National Cancer Research Centre Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Amalia Azzariti
- Clinical and Preclinical Pharmacology Laboratory, National Cancer Research Centre Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Daniele Santini
- Medical Oncology Unit, University Campus Bio-Medico, Roma, Italy
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Catalano V, Bisonni R, Graziano F, Giordani P, Alessandroni P, Baldelli AM, Casadei V, Rossi D, Fedeli SL, D'Emidio S, Giustini L, Fiorentini G. A phase II study of modified FOLFOX as first-line chemotherapy for metastatic gastric cancer in elderly patients with associated diseases. Gastric Cancer 2013; 16:411-9. [PMID: 23065042 DOI: 10.1007/s10120-012-0204-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 09/23/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Elderly patients are generally underrepresented in the study populations of combination chemotherapy trials. This study evaluates the efficacy and safety of a modified FOLFOX regimen in elderly patients with metastatic gastric cancer and presenting associated disease(s). METHODS A total of 43 patients aged ≥70 years received oxaliplatin 85 mg/m(2) together with 6S-leucovorin 200 mg/m(2) on day 1, followed by a 46-h infusion of 5-fluorouracil 2,400 mg/m(2), every 2 weeks. Assessment of response was performed every four cycles according to RECIST criteria. RESULTS Median patient age was 74 years (range, 70-83 years). Overall response rate was 34.9% [95% confidence interval (CI), 20.6-49.1, with 3 complete responses and 12 partial responses. Grade 3 neutropenia occurred in 4 patients (9.3%), fatigue in 3 patients (7.0%), and vomiting in 2 patients (4.6%). Grade 2 and 3 peripheral neuropathy was observed in 5 patients (11.6%) and 1 patient (2.3%), respectively. No treatment-related death was observed. Median progression-free and overall survival were 6.8 and 10.5 months, respectively. CONCLUSIONS This modified FOLFOX regimen is an active and well-tolerated treatment for elderly patients with metastatic gastric cancer and also represents a good therapeutic option in patients with associated disease(s).
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Affiliation(s)
- Vincenzo Catalano
- U.O.C. Oncologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio San Salvatore, Via Lombroso, 61122, Pesaro, Italy.
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Silvestris N, Pantano F, Ibrahim T, Gamucci T, De Vita F, Pedrazzoli P, Barni S, Maiello E, Numico G, Catalano V, Berardi R, Di Costanzo F, Cinieri S, Russo A, Brunetti AE, Santini D. Natural history of malignant bone disease in gastric cancer: Final results of a multicenter bone metastasis survey. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.4091] [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
4091 Background: Bone metastasis represents an increasing clinical problem in advanced gastric cancer (GC) as disease-related survival improves. In literature few data on the natural history of bone disease in this malignancy are available. Methods: A retrospective, observational multicenter study aimed to define the natural history of GC patients with bone metastasis was conducted in 22 Italian hospital centres in which these patients received diagnosis and treatment of disease from 1998 to 2011. Data on clinicopathology, skeletal outcomes, skeletal-related events (SREs), and bone-directed therapies for 208 deceased GC patients with evidence of bone metastasis were statistically analyzed. Results: Median time to bone metastasis was 8 months (CI 95%, 6.125–9.875 months) considering all included patients. Median number of SREs/patient was one; less than half of the patients (31%) experienced at least one event and only 4 and 2% experienced at least two and three events, respectively. Median times to first and second SRE were 2 and 4 months, respectively. Median survival was 6 months after bone metastasis diagnosis and 3 months after first SRE. Median survival in patients who did not experience SREs was 5 months. Among patients who received zoledronic acid (ZOL) before the first SRE, median time to its appearance was significantly prolonged compared to control (7 months vs 4 months for control; P:0.0005). Conclusions: To our knowledge, this retrospective analysis is the largest multicenter study to demonstrate that bone metastases from GC are not so rare, are commonly aggressive and result in relatively early onset of SREs in the majority of patients. Furthermore, our large study, which included 90 patients treated with ZOL, showed, for the first time in literature, a significant extension of time to first SRE and increase in the median survival time after diagnosis of bone metastasis.
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Affiliation(s)
| | - Francesco Pantano
- Department of Medical Oncology, Università Campus Bio-Medico, Rome, Roma, Italy
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | - Fernando De Vita
- Medical Oncology Division, Second University of Naples, Naples, Italy
| | - Paolo Pedrazzoli
- Department of Oncology-Hematology – Hospital of Pavia, Pavia, Italy
| | - Sandro Barni
- Department of Medical Oncology, Treviglio and Caravaggio Hospital, Treviglio, Italy
| | - Evaristo Maiello
- IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | | | - Rossana Berardi
- Clinica di Oncologia Medica, A.O. Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy
| | | | - Saverio Cinieri
- Medical Oncology & Breast Unit, Senatore Antonio Perrino Hospital, Brindisi, Italy
| | - Antonio Russo
- Laboratorio Oncologia Molecolare, Dip. Oncologico, Policlinico, Palermo, Italy
| | | | - Daniele Santini
- Department of Medical Oncology, Università Campus Bio-Medico, Rome, Rome, Italy
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Di Nicola M, Sala L, Romo L, Catalano V, Tedeschi D, Even C, Dubertret C, Mazza M, Martinotti G, Callea A, Guelfi J, Rouillon F, Janiri L, Gorwood P. 2846 – A multicentre study on adult attention-deficit/hyperactivity disorder in subjects with affective disorders: role of personality traits and clinical implications. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)77427-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Vincenzi B, Frezza AM, Schiavon G, Spoto C, Addeo R, Catalano V, Graziano F, Santini D, Tonini G. Identification of clinical predictive factors of oxaliplatin-induced chronic peripheral neuropathy in colorectal cancer patients treated with adjuvant Folfox IV. Support Care Cancer 2012. [DOI: 10.1007/s00520-012-1667-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Santini D, Tampellini M, Vincenzi B, Ibrahim T, Ortega C, Virzi V, Silvestris N, Berardi R, Masini C, Calipari N, Ottaviani D, Catalano V, Badalamenti G, Giannicola R, Fabbri F, Venditti O, Fratto ME, Mazzara C, Latiano TP, Bertolini F, Petrelli F, Ottone A, Caroti C, Salvatore L, Falcone A, Giordani P, Addeo R, Aglietta M, Cascinu S, Barni S, Maiello E, Tonini G. Natural history of bone metastasis in colorectal cancer: final results of a large Italian bone metastases study. Ann Oncol 2012; 23:2072-2077. [PMID: 22219016 DOI: 10.1093/annonc/mdr572] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Data are limited regarding bone metastases from colorectal cancer (CRC). The objective of this study was to survey the natural history of bone metastasis in CRC. PATIENTS AND METHODS This retrospective, multicenter, observational study of 264 patients with CRC involving bone examined cancer treatments, bone metastases characteristics, skeletal-related event (SRE) type and frequency, zoledronic acid therapy, and disease outcomes. RESULTS Most patients with bone metastases had pathologic T3/4 disease at CRC diagnosis. The spine was the most common site involved (65%), followed by hip/pelvis (34%), long bones (26%), and other sites (17%). Median time from CRC diagnosis to bone metastases was 11.00 months; median time to first SRE thereafter was 2.00 months. Radiation and pathologic fractures affected 45% and 10% of patients, respectively; 32% of patients had no reported SREs. Patients survived for a median of 7.00 months after bone metastases diagnosis; SREs did not significantly affect survival. Subgroup analyses revealed that zoledronic acid significantly prolonged median time to first SRE (2.00 months versus 1.00 month, respectively, P=0.009) and produced a trend toward improved overall survival versus no zoledronic acid. CONCLUSION This study illustrates the burden of bone metastases from CRC and supports the use of zoledronic acid in this setting.
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Affiliation(s)
- D Santini
- Department of Medical Oncology, University Campus Bio-Medico, Rome.
| | - M Tampellini
- Department of Medical Oncology, University of Torino, San Luigi Hospital, Orbassano, Torino
| | - B Vincenzi
- Department of Medical Oncology, University Campus Bio-Medico, Rome
| | - T Ibrahim
- Osteo-oncology Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Forlì-Cesena
| | - C Ortega
- Oncological Department, Medical Oncology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Torino
| | - V Virzi
- Department of Medical Oncology, University Campus Bio-Medico, Rome
| | - N Silvestris
- Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari
| | - R Berardi
- Department of Medical Oncology, Universita Politecnica delle Marche, Ancona
| | - C Masini
- Department of Medical Oncology, University Hospital, Modena
| | - N Calipari
- Department of Radiotherapy, Ospedali Riuniti, Reggio Calabria
| | - D Ottaviani
- Department of Medical Oncology, Presidio Sanitario Gradenigo, Turin
| | - V Catalano
- Department of Medical Oncology, A.O. Ospedali Riuniti Marche Nord, Pesaro
| | - G Badalamenti
- Department of Surgery and Oncology, Policlinico Universitario 'P. Giaccone', Palermo
| | - R Giannicola
- Department of Medical Oncology, Ospedali Riuniti, Reggio Calabria
| | - F Fabbri
- Osteo-oncology Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Forlì-Cesena
| | - O Venditti
- Department of Medical Oncology, University Campus Bio-Medico, Rome
| | - M E Fratto
- Department of Medical Oncology, University Campus Bio-Medico, Rome
| | - C Mazzara
- Department of Medical Oncology, University Campus Bio-Medico, Rome
| | - T P Latiano
- Department of Onco-Hematology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo
| | - F Bertolini
- Department of Medical Oncology, University Hospital, Modena
| | - F Petrelli
- Department of Medical Oncology, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, Bergamo
| | - A Ottone
- Department of Medical Oncology, University of Torino, San Luigi Hospital, Orbassano, Torino
| | - C Caroti
- S.C. Medical Oncology, Galliera Hospital, Genoa
| | - L Salvatore
- Division of Medical Oncology, Department of Oncology, University Hospital S. Chiara, Pisa
| | - A Falcone
- Division of Medical Oncology, Department of Oncology, University Hospital S. Chiara, Pisa
| | - P Giordani
- Department of Medical Oncology, A.O. Ospedali Riuniti Marche Nord, Pesaro
| | - R Addeo
- Department of Medical Oncology, Ospedale San Giovanni di Dio di Frattamaggiore, Naples
| | - M Aglietta
- Oncological Department, Medical Oncology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Torino; Department of Clinical Oncology, University of Torino Medical School - Institute for Cancer Research and Treatment, Candiolo, Torino, Italy
| | - S Cascinu
- Department of Medical Oncology, Universita Politecnica delle Marche, Ancona
| | - S Barni
- Department of Medical Oncology, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, Bergamo
| | - E Maiello
- Department of Onco-Hematology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo
| | - G Tonini
- Department of Medical Oncology, University Campus Bio-Medico, Rome
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Catalano V, Sisti V, Spada D, Graziano F, Giordani P, Alessandroni P, Baldelli A, Casadei V, Rossi D, D'Emidio S, Fedeli SL, De Nictolis M, Testa E, Fiorentini G, Zingaretti C. P-0068 The 7th Edition of the TNM Classification for Gastric Cancer and a Proposal of a New Classification for D2 Gastrectomy. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)30275-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Frezza AM, Schiavon G, Vincenzi B, Addeo R, Catalano V, Graziano F, Santini D, Tonini G. Identification of clinical predictive factors of oxaliplatin-induced chronic peripheral neuropathy in colorectal cancer patients treated with adjuvant FOLFOX IV. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e14135] [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
e14135 Background: Oxaliplatin-induced neuropathy is a dose-related side effect which occurs in almost 40% of patients treated with oxaliplatin. Aim of the present study was to identify reliable clinical factors predicting its development and duration. Methods: 169 completely resected CRC patients treated with adjuvant Folfox IV regimen were retrospectively included. The following pre-treatment clinical parameters were collected: hypocalcemia, hypomagnesaemia, hypoalbuminemia, anaemia, diabetes, chronic renal failure (CRF), folate deficiency, B12 deficiency, number of cycles received and habit to alcohol consumption. Incidence, grade (NCI-CTCAE v.3) and duration of neuropathy were recorded. Results: Incidence of neuropathy was found to be higher in patients with pretreatment anaemia (p=0.001), hypoalbuminemia (p=0.01) and hypomagnesemia (p=0.001) as well in those with habit to alcohol consumption (p=0.003). Neuropathy durations was conversely associated with age, being longer in younger patients (p=0.03), and again with hypoalbuminemia (p=0.04) and hypomagnesemia (p=0.002). No correlation was found with gender, hypocalcemia, diabetes and CRF. The correlation between vitamin B12 and folate levels and the development of neurotoxicity was not analysed because of the high number of missing data in the population. Conclusions: Age, anaemia, hypoalbuminemia, hypomagnesemia and alcohol consumption are reliable and easily assessable clinical factors predicting incidence and length of oxaliplatin induced neuropathy.
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Affiliation(s)
| | - Gaia Schiavon
- Department of Medical Oncology, Erasmus University Medical Center - Daniel den Hoed Cancer Center, Rotterdam, Netherlands
| | | | | | | | | | - Daniele Santini
- Dipartimento di Medicina Oncologica, Università Campus Bio-Medico di Roma, Rome, Italy
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Catalano V, Sisti V, Spada D, Graziano F, Cicetti M, Giordani P, Alessandroni P, Baldelli AM, Casadei V, Luzi Fedeli S, Rossi D, D'Emidio S, De Nictolis M, Testa E, Fiorentini G, Zingaretti C. Assessment of the 7th edition of the AJCC classification and a proposal of a new classification in patients with gastric cancer undergoing D2 gastrectomy. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.4084] [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
4084 Background: Studies on Asian, US, and German patients have moved some criticisms on the validity of the 7th edition of the AJCC classification to discriminate outcome of gastric cancer stages. We investigated the effect of this AJCC classification in a high-quality surgical populations of patients receiving D2 lymphadenectomy. Methods: From the prospective database at San Salvatore Hospital, Pesaro, we identified 515 patientswith gastroesophageal junction (Siewert II and III) or stomach adenocarcinoma who underwent gastrectomy with curative intent from 1998 to 2010. Lymphadenectomy extended to the 3rd level 12p/b nodes (D2/D3) was performed in all patients. Overall survival (OS) probabilities, calculated from the date of surgery to the date of death, from any cause, were estimated using the Kaplan-Meier method and compared using the log-rank test. Results: 58% of patients were male,median age was 73 years (range 36-96). Median number of examined lymph nodes was 32 (range, 1-89), and only 8.9% of patients had less than 15 examined lymph nodes; 96 patients received adjuvant chemo- or chemoradiotherapy. As shown in the table, we proposed a revised staging system (Pesaro Staging System, PSS), which performs better than the 7th edition of AJCC classification in terms of survival differences between stages. Conclusions: This study confirms once again that the 7th edition of the AJCC classification does not discriminate adequately the outcome from stage to stage. In a European population of patients undergoing gastrectomy plus at least D2 lymphadenectomy, the revised staging system, PSS, better defines patient prognosis. [Table: see text]
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Enrica Testa
- UOC Oncologia, Ospedale di Urbino, Urbino, Italy
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Ruzzo A, Graziano F, Vincenzi B, Canestrari E, Perrone G, Galluccio N, Catalano V, Loupakis F, Rabitti C, Santini D, Tonini G, Fiorentini G, Rossi D, Falcone A, Magnani M. High let-7a microRNA levels in KRAS-mutated colorectal carcinomas may rescue anti-EGFR therapy effects in patients with chemotherapy-refractory metastatic disease. Oncologist 2012; 17:823-9. [PMID: 22584434 DOI: 10.1634/theoncologist.2012-0081] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [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: 01/12/2023] Open
Abstract
Preclinical and experimental data in vivo indicate that Lethal-7 (Let-7) microRNA downregulates KRAS with antitumor effects in the presence of activating KRAS mutations. We quantified the Let-7a isoform in KRAS-mutated colorectal carcinomas from patients who received salvage cetuximab plus irinotecan. The study population was retrospectively identified among metastatic colorectal cancer patients who underwent third-line therapy with cetuximab plus irinotecan in a period when only epidermal growth factor receptor (EGFR) expression was required for anti-EGFR therapy. In 59 patients harboring KRAS mutations, Let-7a levels were analyzed for association with overall survival (OS) and progression-free survival (PFS) times. An exploratory subgroup analysis was performed using the rs61764370 (LCS6 T>G) polymorphism that experimentally impairs Let-7 binding to KRAS mRNA. In the whole group, higher Let-7a levels were significantly associated with better survival outcomes. For the primary OS endpoint, the multivariate hazard ratio was 0.82 (95% confidence interval, 0.73-0.91; p = .01). The same findings with an accentuated positive effect of high Let-7a levels on both OS and PFS times were observed in an exploratory analysis of the 45 wild-type LCS6 patients (excluding 14 carriers of the LCS6 G allele variant). All survival associations were confirmed after excluding patients with KRAS codon 13 mutations. Among the clinicopathologic features, high Let-7a levels were associated with grade 2-3 skin toxicity (p = .002). In patients with KRAS mutations, Let-7a analysis may serve to identify subgroups of patients who may still benefit from EGFR inhibition and this may open up new perspectives for alternative treatment strategies.
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Affiliation(s)
- Annamaria Ruzzo
- Department of Biomolecular Sciences, University of Urbino, Urbino, Italy
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Zaniboni A, Aitini E, Barni S, Ferrari D, Cascinu S, Catalano V, Valmadre G, Ferrara D, Veltri E, Codignola C, Labianca R. FOLFIRI as second-line chemotherapy for advanced pancreatic cancer: a GISCAD multicenter phase II study. Cancer Chemother Pharmacol 2012; 69:1641-5. [PMID: 22576338 DOI: 10.1007/s00280-012-1875-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Accepted: 04/24/2012] [Indexed: 12/14/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate the activity and the tolerability of the FOLFIRI regimen, administered as second-line chemotherapy in patients with locally advanced or metastatic pancreatic cancer after the failure of a gemcitabine-based regimen. METHODS Patients with locally advanced/metastatic disease who received a first-line chemotherapy (one line only) with gemcitabine ± platinoid (cisplatin, oxaliplatin) and who had measurable disease conform with the RECIST criteria were eligible for the study. FOLFIRI consists of irinotecan 180 mg/m(2) i.v. on day 1, leucovorin (l-form) 200 mg/m(2) i.v. on day 1 and 2, 5-FU 400 mg/m(2) i.v. bolus on days 1 and 2, and 5-FU 600 mg/m(2) i.v. by ci for 22 h on days 1 and 2, repeated every 2 weeks. The primary end point was the response rate. RESULTS Among the 50 enrolled patients, 4 partial responses (PR) (8%) and 14 stable diseases were observed, for a disease control rate of 18/50 (36%). Forty-one patients (82%) have been pretreated with cisplatin/oxaliplatin+gemcitabine as first-line chemotherapy. The median progression-free and overall survivals were 3.2 and 5 months, respectively. The 6-month survival rate was 32%. Grade 3-4 neutropenia and diarrhea occurred in 10 (20%) and 6 (12%) patients, respectively. CONCLUSION The FOLFIRI regimen showed a modest clinical activity in this quite heavily pretreated patients' population with locally advanced or metastatic pancreatic cancer with a manageable toxicity profile.
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Affiliation(s)
- Alberto Zaniboni
- Medical Oncology Unit, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy.
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Fiorentini G, Aliberti C, Tilli M, Mulazzani L, Graziano F, Giordani P, Mambrini A, Montagnani F, Alessandroni P, Catalano V, Coschiera P. Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer: final results of a phase III study. Anticancer Res 2012; 32:1387-1395. [PMID: 22493375] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Metastases to the liver receive most of their blood supply from the arterial route, therefore for patients with hepatic metastases from large bowel cancer, hepatic arterial infusion adopting drug-eluting beads preloaded with irinotecan (DEBIRI) may offer a chance of cure. PATIENTS AND METHODS In a multi-institutional study, 74 patients were randomly assigned to receive DEBIRI (36) versus systemic irinotecan, fluorouracil and leucovorin (FOLFIRI, 38). The primary end-point was survival; secondary end points were response, recurrence, toxicity, quality of life, cost and influence of molecular markers. RESULTS At 50 months, overall survival was significantly longer for patients treated with DEBIRI than for those treated with FOLFIRI (p=0.031, log-rank). Median survival was 22 (95% Confidence Interval CI=21-23) months, for DEBIRI and 15 (95% CI=12-18) months for FOLFIRI. Progression-free survival was 7 (95% CI=3-11) months in the DEBIRI group compared to 4 (95% CI=3-5) months in the FOLFIRI group and the difference between groups was statistically significant (p=0.006, log-rank). Extrahepatic progression had occurred in all patients by the end of the study, at a median time of 13 (95% CI=10-16) months in the DEBIRI group compared to 9 (95% CI 5-13) months in the FOLFIRI group. A statistically significant difference between groups was not observed (p=0.064, log-rank).The median time for duration of improvement to quality of life was 8 (95% CI=3-13) months in the DEBIRI group and 3 (95% CI=2-4) months in the FOLFIRI group. The difference in duration of improvement was statistically significant (p=0.00002, log-rank). CONCLUSION This study showed a statistically significant difference between DEBIRI and FOLFIRI for overall survival (7 months), progression-free survival (3 months) and quality of life (5 months). In addition, a clinically significant improvement in time to extrahepatic progression (4 months) was observed for DEBIRI, a reversal of the expectation for a regional treatment. This suggests a benefit of DEBIRI treatment over standard chemotherapy and serves to establish the expected difference between these two treatment options for planning future large randomized studies.
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Affiliation(s)
- Giammaria Fiorentini
- Department of Oncology-Hematology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
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Catalano V, Loupakis F, Graziano F, Bisonni R, Torresi U, Vincenzi B, Mari D, Giordani P, Alessandroni P, Salvatore L, Fornaro L, Santini D, Baldelli AM, Rossi D, Giustini L, Silva RR, Falcone A, D'Emidio S, Rocchi M, Luzi Fedeli S. Prognosis of mucinous histology for patients with radically resected stage II and III colon cancer. Ann Oncol 2012; 23:135-141. [PMID: 21531784 DOI: 10.1093/annonc/mdr062] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [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: 12/13/2022] Open
Abstract
BACKGROUND Previous studies investigating the prognostic role of mucinous histology of colorectal cancer produced conflicting results. This retrospective analysis was carried out in order to explore whether mucinous adenocarcinoma (MC) is associated with a comparatively worse prognosis than that of nonmucinous adenocarcinoma (NMC) for patients undergoing curative resection for stage II and III colon cancer. PATIENTS AND METHODS This study involved 1025 unselected patients who underwent curative surgery for sporadic colon cancer and follow-up procedures at six different oncology departments. RESULTS MCs accounted for 17.4% (n=178) of tumours. Patients with MC had 5- and 8-year overall survival rates of 78.6% and 68.8%, respectively, compared with 72.3% and 63.8%, respectively, for patients with nonmucinous tumours. Multivariate analysis using the Cox proportional hazards model showed that the clinically significant prognostic factors were stage of disease and adjuvant chemotherapy. No statistically significant interaction between mucinous histology and adjuvant chemotherapy was found. CONCLUSIONS For patients with stage II and III colon cancer who underwent curative surgery, mucinous histology has no significant correlation with prognosis compared with NMC. This retrospective analysis suggests a comparable benefit from adjuvant chemotherapy for MC compared with NMC.
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Affiliation(s)
- V Catalano
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro.
| | - F Loupakis
- Department of Medical Oncology, 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - F Graziano
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - R Bisonni
- Department of Oncology, Ospedale 'A. Murri', Fermo
| | - U Torresi
- Department of Oncology, Ospedale di Macerata, Macerata
| | - B Vincenzi
- Department of Oncology, Università Campus BioMedico, Rome
| | - D Mari
- Department of Oncology, Ospedale 'E. Profili', Fabriano
| | - P Giordani
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - P Alessandroni
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - L Salvatore
- Department of Medical Oncology, 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - L Fornaro
- Department of Medical Oncology, 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - D Santini
- Department of Oncology, Università Campus BioMedico, Rome
| | - A M Baldelli
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - D Rossi
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - L Giustini
- Department of Oncology, Ospedale 'A. Murri', Fermo
| | - R R Silva
- Department of Oncology, Ospedale 'E. Profili', Fabriano
| | - A Falcone
- Department of Medical Oncology, 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - S D'Emidio
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
| | - M Rocchi
- Istituto di Biomatematica, Università degli Studi di Urbino, Urbino, Italy
| | - S Luzi Fedeli
- Department of Oncology, Azienda Ospedaliera 'Ospedali Riuniti Marche Nord', Presidio San Salvatore, Pesaro
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