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Leone AG, Miceli R, Trapani D, Massagrande M, Morano F, Marsoni S, La Verde N, Berardi R, Casolino R, Lambertini M, Dalu D, Di Maio M, Beretta GD, Perrone F, Cinieri S, Pietrantonio F. Cancer care in transgender and gender-diverse persons: results from two national surveys among providers and health service users by the Italian Association of Medical Oncology. ESMO Open 2023; 8:101578. [PMID: 37270870 DOI: 10.1016/j.esmoop.2023.101578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/23/2023] [Accepted: 04/29/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Transgender and gender-diverse (TGD) population represents an underserved group across the cancer care continuum. To assess the perspective of both oncology health care providers (OHPs) and TGD individuals in Italy, we conducted two national surveys: one among 2407 OHPs about their attitudes, knowledge and behavior toward TGD patients, and one among TGD persons about their health needs, experiences and barriers encountered in the use of health services across the cancer continuum. MATERIALS AND METHODS The surveys were self-compiled web-based computer-aided web interview, conducted in Italy within the 'OncoGender-Promoting Inclusion in Oncology' project, led by the Italian national cancer society [Associazione Italiana di Oncologia Medica (AIOM)]-associated researchers. All members of AIOM were invited by e-mail to participate in the OHP survey. TGD persons were reached through advocacy groups and consumers' panel. The recruitment was completed on a voluntary basis. Survey data were collected and managed using an online platform managed by ELMA Research, an independent pharmaceutical marketing agency. RESULTS A total of 305 OHPs (13% of AIOM members) and 190 TGD individuals participated in the surveys. Only 19% of OHPs felt competent in providing care to TGD patients and 21% declared not to feel comfortable in treating TGD patients. Seventy-one percent of TGD persons reported that they had never joined any cancer screening program; 32% reported one or more acts of discrimination by health care providers. Seventy-two percent of OHPs recognized the lack of specific education on cancer care for TGD patients and deemed it necessary to receive adequate training. CONCLUSIONS A general lack of knowledge among OHPs about TGD health issues seems to be the main driver of difficulties in providing assistance and of discriminatory attitudes against TGD individuals. Ultimately, this whole issue generates access barriers and contributes to lack of trust in health care services. Educational interventions and an implementation of person-centric cancer policies are urgently needed.
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Affiliation(s)
- A G Leone
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Miceli
- Department of Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - D Trapani
- European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy; Department of Oncology and Hematology (DIPO), University of Milan, Milan, Italy
| | | | - F Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Marsoni
- IFOM-The FIRC Institute of Molecular Oncology, Milan, Italy
| | - N La Verde
- Department of Oncology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - R Berardi
- Oncology Clinic, Università Politecnica delle Marche, AOU delle Marche, Ancona, Italy
| | - R Casolino
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - D Dalu
- Department of Oncology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M Di Maio
- Department of Oncology, University of Turin, A.O. Ordine Mauriziano, Turin, Italy
| | - G D Beretta
- UOC Oncologia Medica, ASL Pescara P.O., Pescara, Italy
| | - F Perrone
- Clinical Trial Unit, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - S Cinieri
- Medical Oncology Unit, Ospedale di Summa A. Perrino, Brindisi, Italy
| | - F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Del Mastro L, Poggio F, Blondeaux E, De Placido S, Giuliano M, Forestieri V, De Laurentiis M, Gravina A, Bisagni G, Rimanti A, Turletti A, Nisticò C, Vaccaro A, Cognetti F, Fabi A, Gasparro S, Garrone O, Alicicco MG, Urracci Y, Mansutti M, Poletti P, Correale P, Bighin C, Puglisi F, Montemurro F, Colantuoni G, Lambertini M, Boni L, Venturini M, Abate A, Pastorino S, Canavese G, Vecchio C, Guenzi M, Lambertini M, Levaggi A, Giraudi S, Accortanzo V, Floris C, Aitini E, Fornari G, Miraglia S, Buonfanti G, Cherchi M, Petrelli F, Vaccaro A, Magnolfi E, Contu A, Labianca R, Parisi A, Basurto C, Cappuzzo F, Merlano M, Russo S, Mansutti M, Poletto E, Nardi M, Grasso D, Fontana A, Isa L, Comandè M, Cavanna L, Iacobelli S, Milani S, Mustacchi G, Venturini S, Scinto A, Sarobba M, Pugliese P, Bernardo A, Pavese I, Coccaro M, Massidda B, Ionta M, Nuzzo A, Laudadio L, Chiantera V, Dottori R, Barduagni M, Castiglione F, Ciardiello F, Tinessa V, Ficorella A, Moscetti L, Vallini I, Giardina G, Silva R, Montedoro M, Seles E, Morano F, Cruciani G, Adamo V, Pancotti A, Palmisani V, Ruggeri A, Cammilluzzi E, Carrozza F, D'Aprile M, Brunetti M, Gallotti P, Chiesa E, Testore F, D'Arco A, Ferro A, Jirillo A, Pezzoli M, Scambia G, Iacono C, Masullo P, Tomasello G, Gandini G, Zoboli A, Bottero C, Cazzaniga M, Genua G, Palazzo S, D'Amico M, Perrone D. Fluorouracil and dose-dense adjuvant chemotherapy in patients with early-stage breast cancer (GIM2): end-of-study results from a randomised, phase 3 trial. Lancet Oncol 2022; 23:1571-1582. [DOI: 10.1016/s1470-2045(22)00632-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
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Pietrantonio F, Berrino E, Manca P, S.E. Bellomo, Raimondi A, Corso S, Morano F, Migliore C, Niger M, Marchiò C, Di Bartolomeo M, Restuccia E, Lambertini C, Tabernero J, Giordano S. 1206P HER2 copy number variation (CNV), HER2 expression and primary resistance mechanisms in patients (pts) with HER2-positive metastatic gastric or gastroesophageal junction cancer (mGC/GEJC) receiving first-line chemotherapy (CT) + trastuzumab (T) +/- pertuzumab (P) in the JACOB trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Raimondi A, Morano F, Trarbach T, Karthaus M, Lonardi S, Fruehauf S, Cremolini C, Graeven U, Bittoni A, Mueller L, Sartore Bianchi A, Aranda E, Boige V, Stintzing S, Di Bartolomeo M, Koenig A, Pietrantonio F, Modest D. SO-21 Optimal maintenance treatment strategy following an anti-EGFR-based first-line induction therapy in patients with RAS wild type metastatic colorectal cancer: An individual patient data pooled analysis of clinical trials. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.420] [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: 11/01/2022] Open
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Raimondi A, Fucà G, Leone AG, Lonardi S, Antoniotti C, Smiroldo V, Amatu A, Tampellini M, Ritorto G, Murialdo R, Clavarezza M, Zaniboni A, Berenato R, Ratti M, Corallo S, Morano F, Di Bartolomeo M, Di Maio M, Pietrantonio F. Impact of age and gender on the efficacy and safety of upfront therapy with panitumumab plus FOLFOX followed by panitumumab-based maintenance: a pre-specified subgroup analysis of the Valentino study. ESMO Open 2021; 6:100246. [PMID: 34416469 PMCID: PMC8379288 DOI: 10.1016/j.esmoop.2021.100246] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The safety and efficacy outcome of elderly metastatic colorectal cancer (mCRC) patients fit enough to receive combination chemotherapy plus biological agents is an issue of growing interest. Also, gender-specific differential toxicity and efficacy of anti-epidermal growth factor receptor (EGFR)-based upfront treatments need to be explored. PATIENTS AND METHODS Valentino was a multicenter, randomized, phase II trial, investigating two panitumumab-based maintenance strategies following first-line panitumumab plus FOLFOX in RAS wild-type mCRC patients. We carried out a subgroup analysis, aimed at assessing the differences in efficacy, safety and quality of life (QoL) according to age (<70 versus ≥70 years) and gender (male versus female). Efficacy endpoints were progression-free survival (PFS), overall survival (OS) and overall response rate (ORR); safety endpoints were rates of any grade and grade 3/4 adverse events (AEs). RESULTS No significant differences in terms of PFS, OS and ORR were observed between patients aged <70 or ≥70 years and the effect of the maintenance treatment arm on survival outcomes was similar in the two subgroups. The safety profile of both induction and maintenance treatment and the impact on QoL were similar in elderly and younger patients. No significant differences in PFS, OS, ORR or clinical benefit rate were observed according to gender. A significantly higher rate of overall grade 3/4 AEs (P = 0.008) and of grade 3/4 thrombocytopenia (P = 0.017), any grade and grade 3/4 neutropenia (P < 0.0001) and any grade conjunctivitis (P = 0.033) was reported in female as compared to male patients. Conversely, we reported a significantly higher incidence of any grade skin rash (P = 0.0007) and hypomagnesemia (P = 0.029) in male patients. CONCLUSIONS The upfront choice of an anti-EGFR-based doublet chemotherapy followed by a maintenance strategy represents a valuable option in RAS wild-type mCRC irrespective of gender and age, though a careful evaluation of patients to maximize the risk/benefit ratio is warranted.
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Affiliation(s)
- A Raimondi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Fucà
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A G Leone
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Lonardi
- Medical Oncology Unit 3, Department of Oncology, Istituto Oncologico Veneto-IRCCS, Padua, Italy
| | - C Antoniotti
- Unit of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - V Smiroldo
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - A Amatu
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - M Tampellini
- Department of Oncology, AOU San Luigi di Orbassano, University of Torino, Orbassano, Italy
| | - G Ritorto
- SSD ColoRectal Cancer Unit, Oncology Department, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - R Murialdo
- Department of Internal Medicine, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - M Clavarezza
- Medical Oncology Unit, Ente Ospedaliero Ospedali Galliera, Genoa, Italy
| | - A Zaniboni
- Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy
| | - R Berenato
- Medical Oncology Unit, A.O. Papardo, Messina, Italy
| | - M Ratti
- Medical Oncology Unit, ASST Ospedale di Cremona, Cremona, Italy
| | - S Corallo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Morano
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Di Bartolomeo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Di Maio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - F Pietrantonio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Pietrantonio F, Morano F, Lonardi S, Raimondi A, Salvatore L, Marmorino F, Murgioni S, Pella N, Antonuzzo L, Ritorto G, Zaniboni A, Ratti M, Palermo F, Pagani F, Prisciandaro M, Cagnazzo C, Capone I, Milione M, Di Bartolomeo M, de Braud F. 383O MAYA trial: Temozolomide (TMZ) priming followed by combination with low-dose ipilimumab and nivolumab in patients with microsatellite stable (MSS), MGMT silenced metastatic colorectal cancer (mCRC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Maron S, Moya S, Morano F, Emmett M, Disel U, Chalasani S, Ku G, Kasi P, Uboha N, Kato S, Shitara K, Nakamura Y, Chao J, Lee J, Wainberg Z, Petty R, Pietrantonio F, Klempner S, Catenacci D. 1421P EGFR inhibition in EGFR-amplified esophagogastric cancer (EGC): Retrospective global experience. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Borelli B, Fontana E, Giordano M, Antoniotti C, Bergamo F, Murgioni S, Pietrantonio F, Morano F, Tamburini E, Boccaccino A, Santini D, Conca V, Pella N, Maiello E, Ugolini C, Fontanini G, Falcone A, Nyamundanda G, Sadanandam A, Cremolini C. SO-20 Consensus molecular subtypes and CRCAssigner classifications in metastatic colorectal cancer (mCRC): Prognostic and predictive impact in the TRIBE2 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.035] [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: 11/26/2022] Open
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Morano F, Corallo S, Niger M, Barault L, Milione M, Berenato R, Moretto R, Randon G, Antista M, Belfiore A, Raimondi A, Nichetti F, Martinetti A, Battaglia L, Perrone F, Pruneri G, Falcone A, Di Bartolomeo M, de Braud F, Di Nicolantonio F, Cremolini C, Pietrantonio F. Temozolomide and irinotecan (TEMIRI regimen) as salvage treatment of irinotecan-sensitive advanced colorectal cancer patients bearing MGMT methylation. Ann Oncol 2019; 29:1800-1806. [PMID: 29860358 DOI: 10.1093/annonc/mdy197] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Non-randomized studies showed that temozolomide (TMZ) achieves an average 10% response rate in heavily pretreated metastatic colorectal cancer (mCRC) patients with promoter methylation of the DNA repair gene O6-methylguanine-DNA methyltransferase (MGMT). In this phase II trial, irinotecan and temozolomide (TEMIRI) combination regimen was assessed in irinotecan-sensitive, MGMT methylated/microsatellite stable (MSS) pretreated mCRC patients. Patients and methods Key inclusion criteria were centrally confirmed MGMT methylation by methylation-specific PCR, MSS mCRC, progression after at least two prior chemotherapy regimens for advanced disease and irinotecan-free interval >3 months. TEMIRI (TMZ 150 mg/m2 on days 1-5 plus irinotecan 100 mg/m2 on days 1, 15 q28 days) was administered for six cycles, followed by maintenance with TMZ. The primary end point was overall response rate (ORR). Exploratory translational analyses included MGMT immunohistochemistry (IHC) and methyl-BEAMing (MB). Results Between December 2014 and June 2017, 25 patients were enrolled. The primary end point was met, since six patients achieved a partial response [ORR 24%, 95% confidence interval (CI) 11% to 43%]. At a median follow-up of 15.6 months, median progression-free survival (mPFS) and overall survival (mOS) were 4.4 and 13.8 months, respectively. Only four (16%) patients had ≥ grade 3 (CTCAE 4.0) adverse events. All patients whose cancer was MGMT-positive IHC were non-responders. Consistently, patients with MGMT-negative/low tumors had a significantly longer mPFS than others (6.9 versus 2.0 months; hazard ratio = 0.29, 95% CI 0.02-0.41; P = 0.003) and a non-significant trend for longer mOS. MB testing showed similar accuracy. Conclusions TEMIRI regimen is a safe and active option in pre-treated, irinotecan-sensitive mCRC patients with MGMT methylation.
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Affiliation(s)
- F Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Corallo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Niger
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Barault
- Department of Oncology, University of Turin, Candiolo, Turin, Italy; Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Turin, Italy
| | - M Milione
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Berenato
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Moretto
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - G Randon
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Antista
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Belfiore
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Raimondi
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Nichetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Martinetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Battaglia
- Colorectal Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Perrone
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Pruneri
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - A Falcone
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - M Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy
| | - F Di Nicolantonio
- Department of Oncology, University of Turin, Candiolo, Turin, Italy; Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Turin, Italy
| | - C Cremolini
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy.
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Pietrantonio F, Di Nicolantonio F, Schrock AB, Lee J, Morano F, Fucà G, Nikolinakos P, Drilon A, Hechtman JF, Christiansen J, Gowen K, Frampton GM, Gasparini P, Rossini D, Gigliotti C, Kim ST, Prisciandaro M, Hodgson J, Zaniboni A, Chiu VK, Milione M, Patel R, Miller V, Bardelli A, Novara L, Wang L, Pupa SM, Sozzi G, Ross J, Di Bartolomeo M, Bertotti A, Ali S, Trusolino L, Falcone A, de Braud F, Cremolini C. RET fusions in a small subset of advanced colorectal cancers at risk of being neglected. Ann Oncol 2019. [PMID: 29538669 DOI: 10.1093/annonc/mdy090] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Recognition of rare molecular subgroups is a challenge for precision oncology and may lead to tissue-agnostic approval of targeted agents. Here we aimed to comprehensively characterize the clinical, pathological and molecular landscape of RET rearranged metastatic colorectal cancer (mCRC). Patients and methods In this case series, we compared clinical, pathological and molecular characteristics of 24 RET rearranged mCRC patients with those of a control group of 291 patients with RET negative tumors. RET rearranged and RET negative mCRCs were retrieved by systematic literature review and by taking advantage of three screening sources: (i) Ignyta's phase 1/1b study on RXDX-105 (NCT01877811), (ii) cohorts screened at two Italian and one South Korean Institutions and (iii) Foundation Medicine Inc. database. Next-generation sequencing data were analyzed for RET rearranged cases. Results RET fusions were more frequent in older patients (median age of 66 versus 60 years, P = 0.052), with ECOG PS 1-2 (90% versus 50%, P = 0.02), right-sided (55% versus 32%, P = 0.013), previously unresected primary tumors (58% versus 21%, P < 0.001), RAS and BRAF wild-type (100% versus 40%, P < 0.001) and MSI-high (48% versus 7%, P < 0.001). Notably, 11 (26%) out of 43 patients with right-sided, RAS and BRAF wild-type tumors harbored a RET rearrangement. At a median follow-up of 45.8 months, patients with RET fusion-positive tumors showed a significantly worse OS when compared with RET-negative ones (median OS 14.0 versus 38.0 months, HR: 4.59; 95% CI, 3.64-32.66; P < 0.001). In the multivariable model, RET rearrangements were still associated with shorter OS (HR: 2.97; 95% CI, 1.25-7.07; P = 0.014), while primary tumor location, RAS and BRAF mutations and MSI status were not. Conclusions Though very rare, RET rearrangements define a new subtype of mCRC that shows poor prognosis with conventional treatments and is therefore worth of a specific management.
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Affiliation(s)
- F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
| | - F Di Nicolantonio
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - A B Schrock
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - J Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - F Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Fucà
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Nikolinakos
- Medical Oncology, University Cancer & Blood Center, Athens
| | - A Drilon
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J F Hechtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - K Gowen
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - G M Frampton
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - P Gasparini
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - D Rossini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - C Gigliotti
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - S T Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Prisciandaro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - J Hodgson
- Medical Oncology, University Cancer & Blood Center, Athens
| | - A Zaniboni
- Department of Medical Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - V K Chiu
- Department of Internal Medicine, University of New Mexico, Albuquerque, USA
| | - M Milione
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Patel
- Department of Diagnostics, Ignyta, Inc., San Diego, USA
| | - V Miller
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - A Bardelli
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - L Novara
- ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - L Wang
- Department of Pathology, St Jude Children's Research Hospital, Memphis, USA
| | - S M Pupa
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Sozzi
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - J Ross
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - M Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Bertotti
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - S Ali
- Clinical Development, Foundation Medicine, Inc., Cambridge, USA
| | - L Trusolino
- Department of Oncology, University of Torino, Candiolo, Italy; ECMO, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - A Falcone
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - F de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - C Cremolini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Dell’Aquila E, Rossini D, Stellato M, Bergamo F, Aprile G, Morano F, Intini R, Fea E, Ronzoni M, Libertini M, Buonadonna A, Fanchini L, Marcucci L, Maiello E, Marmorino F, Boccaccino A, Cordio S, Masi G, Falcone A, Santini D. Prognostic and predictive role of body mass index (BMI) in metastatic colorectal cancer (mCRC): A pooled analisys of TRIBE and TRIBE-2 studies by GONO. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.055] [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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12
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Niger M, Morano F, Manglaviti S, Nichetti F, Tamborini E, Perrone F, Marcuzzo M, Peverelli G, Brambilla M, Pagani F, Torchio M, Ottini A, Antista M, Pietrantonio F, Pusceddu S, Pruneri G, Di Bartolomeo M, De Braud F. Is MGMT methylation a new therapeutic target for biliary tract cancer? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.059] [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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13
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Niger M, Morano F, Manglaviti S, Nichetti F, Perrone F, Tamborini E, Marcuzzo M, Raimondi A, Peverelli G, Brambilla M, Pagani F, Torchio M, Prisciandaro M, Antista M, Pietrantonio F, Pusceddu S, Pruneri G, De Braud F, Di Bartolomeo M. MGMT methylation in metastatic pancreatic cancer (mPAC): A single center experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.039] [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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14
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Pietrantonio F, Antista M, Lobefaro R, Morano F, Lonardi S, Raimondi A, Murgioni S, Rimassa L, Farina G, Longarini R, Mosconi S, Sartore-Bianchi A, Tomasello G, Perrone F, Barault L, Milione M, Di Maio M, Di Nicolantonio F, Di Bartolomeo M, De Braud F. Randomized phase II study of CAPTEM versus FOLFIRI in RAS mutated, MGMT methylated metastatic colorectal cancer (mCRC): Final analysis, tumour biomarkers and methylated ctDNA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Cremolini C, Antoniotti C, Lonardi S, Rossini D, Morano F, Cordio S, Bergamo F, Marmorino F, Maiello E, Passardi A, Masi G, Tamburini E, Santini D, Grande R, Zaniboni A, Granetto C, Murgioni S, Aprile G, Delliponti L, Boni L, Falcone A. Updated results of TRIBE2, a phase III, randomized strategy study by GONO in the 1st- and 2nd-line treatment of unresectable mCRC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz183.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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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16
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Raimondi A, Di Maio M, Peverelli G, Morano F, Corallo S, Bergamo F, Cremolini C, Smiroldo V, Amatu A, Tampellini M, Fanchini L, Murialdo R, Clavarezza M, Noventa S, Adamo V, Ratti M, Petrelli F, Antonuzzo L, Palermo M, de Braud F, Di Bartolomeo M, Pietrantonio F. Health-related quality of life in RAS wild-type metastatic colorectal cancer patients treated with panitumumab plus FOLFOX followed by panitumumab or panitumumab plus 5-FU/LV maintenance: the secondary endpoint of the Valentino study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.015] [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: 11/13/2022] Open
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17
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Morano F, Corallo S, Di Bartolomeo M, Lonardi S, Cremolini C, Rimassa L, Sartore Bianchi A, Murialdo R, Zaniboni A, Adamo V, Tomasello G, Tampellini M, Fanchini L, Schirripa M, Clavarezza M, Petrelli F, Longarini R, Cinieri S, de Braud F, Pietrantonio F. Negative hyper-selection of RAS wild-type (wt) metastatic colorectal cancer (mCRC) patients randomized to first-line FOLFOX plus panitumumab (Pan) followed by maintenance therapy with either 5FU/LV plus pan or single-agent pan: Translational analyses of the VALENTINO study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.023] [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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Raimondi A, Corallo S, Niger M, Antista M, Randon G, Morano F, Cremolini C, Di Bartolomeo M, de Braud F, Pietrantonio F. Metronomic capecitabine plus cyclophosphamide in unresectable or relapsed pseudomyxoma peritonei. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Ongaro E, Rossini D, Pietrantonio F, Morano F, de Braud F, Mazzaferro V, Corti F, Randon G, Raimondi A, Battaglia L, Morelli L, Urbani L, Masi G, Moretto R, Antoniotti C, Marmorino F, Borelli B, Zucchelli G, Boccaccino A, Cremolini C, Falcone A. Clinical and molecular determinants of extrahepatic disease progression (ePD) in initially unresectable, liver-limited metastatic colorectal cancer (mCRC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.016] [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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20
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Giordano M, Moretto R, Giannini R, Zucchelli G, Pietrantonio F, Antoniotti C, Ugolini C, Morano F, Marmorino F, Sensi E, Belfiore A, Rossini D, Lupi C, Masi G, Borelli B, Ongaro E, Boccaccino A, Falcone A, Cremolini C, Fontanini G. Molecular characterization of immune microenvironment in colorectal cancers with microsatellite instability by digital RNA counting. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Pietrantonio F, Morano F, Corallo S, Raimondi A, Loupakis F, Cremolini C, Smiroldo V, Berenato R, Bianchi AS, Tampellini M, Bustreo S, Clavarezza M, Murialdo R, Zaniboni A, Tomasello G, Peverelli G, Antoniotti C, Procaccio L, Cinieri S, Antonuzzo L, Di Bartolomeo M, de Braud F. First-line FOLFOX plus panitumumab followed by 5-FU/LV plus panitumumab or single-agent panitumumab as maintenance therapy in patients with RAS wild-type metastatic colorectal cancer (mCRC): The VALENTINO study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Cremolini C, Morano F, Moretto R, Berenato R, Tamborini E, Perrone F, Rossini D, Gloghini A, Busico A, Zucchelli G, Baratelli C, Tamburini E, Tampellini M, Sensi E, Fucà G, Volpi C, Milione M, Di Maio M, Fontanini G, De Braud F, Falcone A, Pietrantonio F. Negative hyper-selection of metastatic colorectal cancer patients for anti-EGFR monoclonal antibodies: the PRESSING case-control study. Ann Oncol 2018; 28:3009-3014. [PMID: 29045518 DOI: 10.1093/annonc/mdx546] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Refining the selection of metastatic colorectal cancer patients candidates for anti-epidermal growth factor receptor (EGFR) monoclonal antibodies beyond RAS and BRAF testing is a challenge of precision oncology. Several uncommon genomic mechanisms of primary resistance, leading to activation of tyrosine kinase receptors other than EGFR or downstream signalling pathways, have been suggested by preclinical and retrospective studies. Patients and methods We conducted this multicentre, prospective, case-control study to demonstrate the negative predictive impact of a panel of rare genomic alterations [PRESSING (PRimary rESiStance IN RAS and BRAF wild-type metastatic colorectal cancer patients treated with anti-eGfr monoclonal antibodies) panel], including HER2/MET amplifications, ALK/ROS1/NTRK1-3/RET fusions and PIK3CA mutations. Hypothesizing a prevalence of candidate alterations of 15% and 0% in resistant and sensitive RAS and BRAF wild-type patients, respectively, with two-sided α and β errors of 0.05 and 0.20, 47 patients per group were needed. Results Forty-seven patients per group were included. PRESSING panel alterations were significantly more frequent in resistant (24 out of 47, 51.1%) than in sensitive (1 out of 47, 2.1%) patients (P < 0.001) and in right- (12 out of 29, 41.4%) than left-sided (13 out of 65, 20.0%) tumours (P = 0.03). The predictive accuracy of PRESSING panel and sidedness was 75.3% and 70.2%, respectively. Among hyper-selected patients, right-sidedness was still associated with resistance (P = 0.002). The predictive accuracy of the combined evaluation of PRESSING panel and sidedness was 80.4%. As a secondary analysis, 8 (17.0%) resistant and 0 sensitive patients showed microsatellite instability (P < 0.001). Conclusion The investigated panel of genomic alterations allows refining the selection of RAS and BRAF wild-type metastatic colorectal cancer patients candidates for anti-EGFRs, partially explaining and further corroborating the predictive ability of primary tumour sidedness.
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Affiliation(s)
- C Cremolini
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa
| | - F Morano
- Medical Oncology Department, IRCCS Istituto Nazionale dei Tumori, Milan
| | - R Moretto
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa
| | - R Berenato
- Medical Oncology Department, IRCCS Istituto Nazionale dei Tumori, Milan
| | - E Tamborini
- Laboratory of Experimental Molecular Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - F Perrone
- Laboratory of Experimental Molecular Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - D Rossini
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa
| | - A Gloghini
- Laboratory of Experimental Molecular Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - A Busico
- Laboratory of Experimental Molecular Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - G Zucchelli
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa
| | - C Baratelli
- Department of Oncology, University of Turin - Ordine Mauriziano Hospital, Turin
| | - E Tamburini
- Department of Oncology, Ospedale Infermi, Rimini
| | - M Tampellini
- Department of Oncology, Ospedale San Luigi, Orbassano
| | - E Sensi
- Department of Surgical, Medical, Molecular Pathology and Critical Care, Università di Pisa, Pisa
| | - G Fucà
- Medical Oncology Department, IRCCS Istituto Nazionale dei Tumori, Milan
| | - C Volpi
- Laboratory of Experimental Molecular Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - M Milione
- Laboratory of Experimental Molecular Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - M Di Maio
- Department of Oncology, University of Turin - Ordine Mauriziano Hospital, Turin
| | - G Fontanini
- Department of Surgical, Medical, Molecular Pathology and Critical Care, Università di Pisa, Pisa
| | - F De Braud
- Medical Oncology Department, IRCCS Istituto Nazionale dei Tumori, Milan.,Department of Oncology and Hematoncology, University Of Milan, Milan, IRCCS Fondazione Istituto Nazionale dei Tumori, Milan, Italy
| | - A Falcone
- Unit of Medical Oncology 2, Department of Translational Research and New Technologies in Medicine and Surgery, Azienda Ospedaliera-Universitaria Pisana, University of Pisa, Pisa
| | - F Pietrantonio
- Medical Oncology Department, IRCCS Istituto Nazionale dei Tumori, Milan
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23
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Pietrantonio F, Miceli R, Rimassa L, Lonardi S, Aprile G, Mennitto A, Marmorino F, Bozzarelli S, Antonuzzo L, Tamburini E, Morano F, Rossini D, Battaglin F, Baretti M, Berenato R, Formica V, Mosconi S, Petrelli F, Ghidini M, Loupakis F, Spada D, Cinieri S, Beretta G, Falcone A, de Braud F, Cremolini C. Estimating 12-week death probability in patients with refractory metastatic colorectal cancer: the Colon Life nomogram. Ann Oncol 2017; 28:555-561. [PMID: 27864220 DOI: 10.1093/annonc/mdw627] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Regorafenib and TAS-102 have recently demonstrated statistically significant survival gains in patients with refractory metastatic colorectal cancer (mCRC). Life expectancy ≥12 weeks was an inclusion criterion in registrative trials, and the identification of proper clinical selection tools for the daily use of these drugs in heavily pre-treated patients is needed to improve the cost-benefit ratio. We aimed at building a nomogram able to predict death probability within 12 weeks from the date of assessment of refractory mCRC. Patients and methods Four hundred eleven refractory mCRC patients with ECOG performance status (PS) ≤2 receiving regorafenib, TAS-102 or other treatments were used as developing set. Putative prognostic variables were selected using a random forest model and included in a binary logistic model from which the nomogram was developed. The nomogram was externally validated and its performance was evaluated by examining calibration (how close predictions were to the actual outcome) and discriminative ability (Harrell C index) both on developing (internal validation) and validating (external validation) sets. Results Four variables were selected and included in the nomogram: PS (P < 0.0001), primary tumor resection (P = 0.027), LDH value (P = 0.0001) and peritoneal involvement (P = 0.081). In the developing set, the nomogram discriminative ability was high (C = 0.778), and was confirmed in the validating set (C = 0.778), where the overall outcome was better as a consequence of the enrichment in patients receiving regorafenib or TAS-102 (46% versus 34%; P < 0.0001). Conclusions Our nomogram may be a useful tool to predict the probability of death within 12 weeks in patients with refractory mCRC. Based on four easy-to-collect variables, the 'Colon Life' nomogram and free app for smartphones may improve mCRC patients' selection for later-line therapies and assist researchers for the enrollment in clinical trials in this setting.
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Affiliation(s)
- F Pietrantonio
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy
| | - R Miceli
- Trial Office and Biomedical Statistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - L Rimassa
- Medical Oncology and Hematology Unit, Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan
| | - S Lonardi
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Istituto Oncologico Veneto - IRCCS, Padova
| | - G Aprile
- Department of Oncology, University and General Hospital, Udine
| | - A Mennitto
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy
| | - F Marmorino
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - S Bozzarelli
- Medical Oncology and Hematology Unit, Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan
| | - L Antonuzzo
- S.C. Oncologia Medica 1, Azienda Ospedaliero Universitaria Careggi, Firenze.,Department of Medical Biotechnologies, University of Siena, Siena
| | - E Tamburini
- Medical Oncology Unit, Rimini Hospital, Rimini
| | - F Morano
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy
| | - D Rossini
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - F Battaglin
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Istituto Oncologico Veneto - IRCCS, Padova
| | - M Baretti
- Medical Oncology and Hematology Unit, Cancer Center, Humanitas Clinical and Research Center, Rozzano, Milan
| | - R Berenato
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy
| | - V Formica
- Medical Oncology Unit, Policlinico Tor Vergata University Hospital, Roma
| | - S Mosconi
- Unit of Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo
| | - F Petrelli
- Department of Oncology, ASST Bergamo Ovest, Treviglio, Bergamo
| | - M Ghidini
- Division of Medicine and Medical Oncology, Azienda Istituti Ospitalieri, Cremona
| | - F Loupakis
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Istituto Oncologico Veneto - IRCCS, Padova
| | - D Spada
- ASL Lecce-Presidio Ospedaliero Vito Fazzi, UOC Oncologia Medica, Lecce
| | - S Cinieri
- Medical Oncology, Hospital A. Perrino, Brindisi
| | - G Beretta
- Medical Oncology Unit, Humanitas Gavazzeni, Bergamo
| | - A Falcone
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa
| | - F de Braud
- Department of Medical Oncology, Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1,Milan, Italy.,Oncology and Hemato-Oncology Department, University of Milan, Italy
| | - C Cremolini
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa
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Bogani G, Maltese G, Morano F, Lorusso D, Ditto A, Signorelli M, Raspagliesi F. Assessing the risk of pelvic and para-aortic nodal involvement in apparent early-stage ovarian cancer: a predictors- and nomogram-based analyses. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx429] [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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Marmorino F, Cremolini C, Pietrantonio F, Pellegrinelli A, Zucchelli G, Loupakis F, Lonardi S, Aprile G, Morano F, Prisciandaro M, Masi G, Mennitto A, Bergamo F, Cardellino G, Fassan M, Casagrande M, Milione M, Fontanini G, de Braud F, Falcone A. Histopathologic response and growth patterns of colorectal cancer liver metastases (CRCLM) in patients treated with triplets plus bevacizumab (bev) or anti-EGFRs. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.008] [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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26
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Signorelli M, Bogani G, Morano F, Maltese G, Ditto A, Raspagliesi F, Lorusso D. The impact of chemotherapy-related leukopenia on survival outcomes in locally advanced cervical cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx429.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Morano F, Pietrantonio F, Barretta F, Fanotto V, Niger M, Nichetti F, Bergamo F, Silvestris N, Fornaro L, Bordonaro R, Baretti M, Santini D, Tomasello G, Antonuzzo L, Noventa S, Avallone A, Di Donato S, Maiello E, De Vita F, Aprile G. Estimation of 12-weeks life expectancy in patients (pts) with metastatic gastric cancer (mGC) candidated for second-line treatment: the “Gastric Life” nomogram. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx425.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Pietrantonio F, Schrock A, Lee J, Drilon A, Christiansen J, Chiu V, Zaniboni A, Fucà G, Morano F, Borelli B, Rossini D, Milione M, Corallo S, Prisciandaro M, Cagnazzo C, Bardelli A, Trusolino L, Di Nicolantonio F, Falcone A, de Braud F, Cremolini C. RET rearrangements define an uncommon molecular subtype of metastatic colorectal cancer (mCRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.011] [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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29
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Rossini D, Cremolini C, Morano F, Berenato R, Tamborini E, Perrone F, Moretto R, Gloghini A, Busico A, Zucchelli G, Baratelli C, Tamburini E, Fucà G, Volpi C, Milione M, Di Maio M, Fontanini G, de Braud F, Falcone A, Pietrantonio F. Dissecting primary resistance to anti-EGFRs in RAS and BRAF wt metastatic colorectal cancer (mCRC): A case-control study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.003] [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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30
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Pietrantonio F, Barretta F, Fanotto V, Niger M, Morano F, Bergamo F, Silvestris N, Fornaro L, Bordonaro R, Baretti M, Santini D, Tomasello G, Antonuzzo L, Noventa S, Avallone A, Di Donato S, Maiello E, De Vita F, Miceli R, Aprile G. Estimating 12-weeks life expectancy in metastatic gastric cancer (mGC) patients (pts) candidates for second-line treatment: The “Gastric Life” nomogram. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Schwartz S, Cecchi F, Tian Y, Scott K, Di Bartolomeo M, Morano F, Fucà G, Martinetti A, De Braud F, Dominoni F, Milione M, Calegari M, Orlandi A, Barone C, Pietrantonio F, Hembrough T. Selecting patients with metastatic colorectal cancer for treatment with temozolomide using proteomic analysis of MGMT. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.061] [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: 11/12/2022] Open
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32
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Pietrantonio F, Perrone F, Mennitto A, Gleeson E, Milione M, Tamborini E, Busico A, Settanni G, Berenato R, Caporale M, Morano F, Bossi I, Pellegrinelli A, Di Bartolomeo M, de Braud F, Baratti D, Bowne W, Kusamura S, Deraco M. Toward the molecular dissection of peritoneal pseudomyxoma. Ann Oncol 2016; 27:2097-2103. [DOI: 10.1093/annonc/mdw314] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 07/28/2016] [Indexed: 11/14/2022] Open
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Agustoni F, Fucà G, Corrao G, Vernieri C, Cavalieri S, Raimondi A, Peverelli G, Prisciandaro M, Indelicato P, Dotti K, Morano F, Russo G, Signorelli D, Proto C, Vitali M, Imbimbo M, Zilembo N, Garassino M, De Braud F, Platania M. Impact of hyponatremia in a tertiary cancer center: a one-year-survey at National Cancer Institute of Milan. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sclafani F, Morano F, Baratelli C, Kalaitzaki E, Watkins D, Starling N, Chau I, Cunningham D, Rao S. Platinum-fluoropyrimidine (PF) and paclitaxel (PTX)-based chemotherapy (CT) in advanced anal cancer (AC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Di Bartolomeo M, Niger M, Laterza M, Vivaldi C, Giommoni E, Zaniboni A, Bozzarelli S, Tomasello G, Sava T, Spada M, Bittoni A, Galdy S, Spallanzani A, Bassan F, Scagnoli S, Morano F, Berenato R, Caporale M, Filippo P, De Vita F. Safety and efficacy profile of ramucirumab alone or combined with paclitaxel in metastatic gastric cancer (MGC): A real-life overview of compassionate-use named patients (pts) (RAMoss study). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.28] [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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Pietrantonio F, Caporale M, Morano F, Scartozzi M, Gloghini A, De Vita F, Giommoni E, Fornaro L, Aprile G, Melisi D, Berenato R, Mennitto A, Volpi CC, Laterza MM, Pusceddu V, Antonuzzo L, Vasile E, Ongaro E, Simionato F, de Braud F, Torri V, Di Bartolomeo M. HER2 loss in HER2-positive gastric or gastroesophageal cancer after trastuzumab therapy: Implication for further clinical research. Int J Cancer 2016; 139:2859-2864. [PMID: 27578417 DOI: 10.1002/ijc.30408] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/18/2016] [Accepted: 08/17/2016] [Indexed: 12/21/2022]
Abstract
Mechanisms of acquired resistance to trastuzumab-based treatment in gastric cancer are largely unknown. In this study, we analyzed 22 pairs of tumor samples taken at baseline and post-progression in patients receiving chemotherapy and trastuzumab for advanced HER2-positive [immunohistochemistry (IHC) 3+ or 2+ with in-situ hybridization (ISH) amplification] gastric or gastroesophageal cancers. Strict clinical criteria for defining acquired trastuzumab resistance were adopted. Loss of HER2 positivity and loss of HER2 over-expression were defined as post-trastuzumab IHC score <3+ and absence of ISH amplification, and IHC "downscoring" from 2+/3+ to 0/1+, respectively. HER2 IHC was always performed, while ISH was missing in 3 post-progression samples. Patients with initial HER2 IHC score 3+ and 2+ were 14 (64%) and 8 (36%), respectively. Loss of HER2 positivity and HER2 over-expression was observed in 32 and 32% samples, respectively. The chance of HER2 loss was not associated with any of the baseline clinicopathological variables. The only exception was in patients with initial IHC score 2+ versus 3+, for both endpoints of HER2 positivity (80 vs. 14%; p = 0.008) and HER2 over-expression (63 vs. 14%; p = 0.025). As already shown in breast cancer, loss of HER2 may be observed also in gastric cancers patients treated with trastuzumab-based chemotherapy in the clinical practice. This phenomenon may be one of the biological reasons explaining the failure of anti-HER2 second-line strategies in initially HER2-positive disease.
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Affiliation(s)
- F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - M Caporale
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Scartozzi
- Medical Oncology Department, Azienda Ospedaliera Universitaria Cagliari, Presidio Policlinico Universitario "Duilio Casula", Cagliari, Italy
| | - A Gloghini
- Diagnostic pathology and laboratory medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F De Vita
- Medical Oncology Department, Seconda Università degli studi di Napoli, Naples, Italy
| | - E Giommoni
- Medical Oncology 1, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - L Fornaro
- U.O. Oncologia Medica 2 Universitaria, Ospedale S. Chiara - Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano, Tumori, Italy
| | - G Aprile
- Medical Oncology Department, University and General Hospital, Udine, Italy
| | - D Melisi
- Medical Oncology, Università degli studi di Verona, Italy
| | - R Berenato
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Mennitto
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - C C Volpi
- Diagnostic pathology and laboratory medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M M Laterza
- Medical Oncology Department, Seconda Università degli studi di Napoli, Naples, Italy
| | - V Pusceddu
- Medical Oncology Department, Azienda Ospedaliera Universitaria Cagliari, Presidio Policlinico Universitario "Duilio Casula", Cagliari, Italy
| | - L Antonuzzo
- Medical Oncology 1, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - E Vasile
- U.O. Oncologia Medica 2 Universitaria, Ospedale S. Chiara - Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano, Tumori, Italy
| | - E Ongaro
- Medical Oncology Department, University and General Hospital, Udine, Italy
| | - F Simionato
- Medical Oncology, Università degli studi di Verona, Italy
| | - F de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Oncology Department, University of Milan, Italy
| | - V Torri
- Oncology Department, IRCCS-Mario Negri Institute for Pharmacological Rresearch, Milan, Italy
| | - M Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Morano F, Krause T. Auswirkungen der derzeitigen Behandlung und Betreuung Drogenabhängiger im Strafvollzug: dargestellt am Beispiel Haftentlassener der JVA-Regensburg. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586700] [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: 10/21/2022]
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Nichetti F, Infante G, Miceli R, Berenato R, Caporale M, Morano F, Falvella F, Niger M, Bossi I, Fucà G, Mennitto A, Di Bartolomeo M, Prof de Braud F, Pietrantonio F. Pharmacogenomic evaluation of single nucleotide polymorphisms associated with oxaliplatin-induced peripheral neuropathy: a preliminary study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pietrantonio F, Cremolini C, Rimassa L, Lonardi S, Mennitto A, Morano F, Iacono D, Berenato R, Caporale M, Niger M, Marmorino F, Bozzarelli S, Bergamo F, Rossini D, Baretti M, Battaglin F, Bonotto M, Loupakis F, de Braud F, Miceli R. O-013 A new nomogram for estimating 12-weeks survival in patients (pts) with chemorefractory metastatic colorectal cancer (mCRC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw198.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fontana E, Smyth E, Cunningham D, Morano F, Rao S, Watkins D, Allum W, Thompson J, Waddell T, Moorcraft S, Peckitt C, Starling N, Chau I. P-079 Impact of disease biology and stage on outcomes for oesophageal and gastric adenocarcinoma (OGA) treated with neoadjuvant chemotherapy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Grande R, Pavese I, Natoli C, Ciancola F, Gemma D, Pellegrino A, Garufi C, Di Lauro L, Corsi D, Signorelli D, Sperduti I, Cortese G, Risi E, Morano F, Sergi D, Signorelli C, Ruggeri E, Zampa G, Russano M, Gamucci T. Treatment (T) of Metastatic Colorectal Cancer (Mcrc) Patients (Pts) ≥75 Years (Y) Old in Clinical Practice: a Multicenter Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.102] [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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Passaro A, Palazzo A, Trenta P, Mancini ML, Morano F, Cortesi E. Molecular and clinical analysis of predictive biomarkers in non-small-cell lung cancer. Curr Med Chem 2012; 19:3689-700. [PMID: 22680928 DOI: 10.2174/092986712801661149] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 01/19/2012] [Accepted: 01/27/2012] [Indexed: 11/22/2022]
Abstract
Non-small-cell lung cancer (NSCLC) is the leading cause of cancer-specific death in the USA and Europe. Over the last two decades, the pathogenetic mechanisms and the molecular alterations of NSCLC have been investigated more intensively, a number of potential therapeutic targets have been identified and new agents against specific molecular targets have been introduced in the treatment of NSCLC. Acquired abnormalities in the genes encoding RAS, p53, KRAS, EGFR and ALK, are particularly important in this field. Whenever targetable mutations are not found, the research of other genetic abnormalities can be useful to personalize chemotherapy. The attention has been focused, in particular, on the endonuclease excision repair cross-complementing1 and BRCA1 status. The use of antimetabolite drugs and the level of expression of their cellular targets seem to be correlated and influence the clinical efficacy of those agents. This review will focus on the role of predictive biomarkers for the treatment of non-small cell lung cancer.
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Affiliation(s)
- A Passaro
- Division of Medical Oncology, Sapienza - University of Rome, Viale Regina Elena, 324 - 00161, Rome, Italy.
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Risi E, Iacovelli R, Palazzo A, Passaro A, Campennì G, Morano F, Truscelli K, Trenta P, Mezi S, Cortesi E. Chemotherapy is Effective in Primitive Neuroectodermal Tumor (PNET) / Ewing Sarcoma (EWS) of The Kidney. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34056-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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