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De Sanctis R, Tiberio P, Jacobs F, Gaudio M, Benvenuti C, Giordano L, Torrisi R, Zambelli A, Pozzi C, Penna G, Santoro A, Rescigno M. Optimizing abemaciclib-induced diarrhea management in patients with breast cancer: a pragmatic 2-group study using a postbiotic microbiota stabilizer. Oncologist 2024:oyae101. [PMID: 38767987 DOI: 10.1093/oncolo/oyae101] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Abemaciclib-induced diarrhea is a relevant concern in clinical practice. Postbiotics have emerged as a promising option for managing it. MATERIALS AND METHODS We conducted a retrospective-prospective, 2-group, observational study to assess the impact of the postbiotic PostbiotiX-Restore, derived by Lactobacillus paracasei CNCM I-5220, on abemaciclib-induced diarrhea in patients with hormone receptor-positive HER2-negative breast cancer. The prospective population (Postbio group) received postbiotic during the first cycle of abemaciclib, while the retrospective one received standard care (Standard group). Diarrhea grading was defined according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. RESULTS During the first cycle, diarrhea occurred in 78.9% of patients in the Standard cohort and 97.1% in the Postbio one, with most cases being G1-G2. Severe (G3) diarrhea was significantly less frequent in the Postbio group (0%) compared to the Standard one (7.9%; P = .029). Over the entire study period, while the grading difference was not statistically significant, G3 events were less frequent in the Postbio population (5.9%) than the Standard one (15.4%). Moreover, Postbio patients required fewer dose reductions due to diarrhea compared to the Standard group (P = .002). Notably, in the Postbio population, G1 and G2 events had short median durations (3 and 1 days, respectively) and, for the 2 patients experiencing G3 events during the second abemaciclib cycle (off postbiotic), diarrhea lasted only 1 day. CONCLUSIONS Our study demonstrates the effect of PostbiotiX-Restore in mitigating abemaciclib-induced diarrhea, resulting in reduced severity, fewer dose reductions, and shorter duration. Further exploration and validation in larger cohorts are needed.
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Affiliation(s)
- Rita De Sanctis
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Paola Tiberio
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Flavia Jacobs
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Mariangela Gaudio
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Chiara Benvenuti
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Laura Giordano
- Biostatistic Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Rosalba Torrisi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Chiara Pozzi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Giuseppe Penna
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Maria Rescigno
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
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Molinelli C, Jacobs F, Nader-Marta G, Borea R, Scavone G, Ottonello S, Fregatti P, Villarreal-Garza C, Bajpai J, Kim HJ, Puglisi S, de Azambuja E, Lambertini M. Ovarian Suppression: Early Menopause and Late Effects. Curr Treat Options Oncol 2024; 25:523-542. [PMID: 38478329 PMCID: PMC10997548 DOI: 10.1007/s11864-024-01190-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 04/06/2024]
Abstract
OPINION STATEMENT Around 90% of breast tumours are diagnosed in the early stage, with approximately 70% being hormone receptor-positive. The cornerstone of adjuvant therapy for early-stage hormone receptor-positive breast cancer is endocrine therapy, tailored according to disease stage, biological characteristics of the tumour, patient's comorbidities, preferences and age. In premenopausal patients with hormone receptor-positive breast cancer, ovarian function suppression is a key component of the adjuvant endocrine treatment in combination with an aromatase inhibitor or tamoxifen. Moreover, it can be used during chemotherapy as a standard strategy for ovarian function preservation in all breast cancer subtypes. In the metastatic setting, ovarian function suppression should be used in all premenopausal patients with hormone receptor-positive breast cancer to achieve a post-menopausal status. Despite its efficacy, ovarian function suppression may lead to several side effects that can have a major negative impact on patients' quality of life if not properly managed (e.g. hot flashes, depression, cognitive impairment, osteoporosis, sexual dysfunction, weight gain). A deep knowledge of the side effects of ovarian function suppression is necessary for clinicians. A correct counselling in this regard and proactive management should be considered a fundamental part of survivorship care to improve treatment adherence and patients' quality of life.
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Affiliation(s)
- Chiara Molinelli
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Flavia Jacobs
- Humanitas Clinical and Research Center - IRCCS, Humanitas Cancer Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Guilherme Nader-Marta
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B), 90, Rue Meylemeersch, 1070, Anderlecht, Brussels, Belgium
| | - Roberto Borea
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Graziana Scavone
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Silvia Ottonello
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Piero Fregatti
- Department of Surgery, U.O. Senologia Chirurgica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostic (DISC), School of Medicine, University of Genoa, 16132, Genoa, Italy
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion - TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
| | - Jyoti Bajpai
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Ernest Borges Rd, Parel East, Parel, Mumbai, Maharashtra, 400012, India
| | - Hee Jeong Kim
- Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, South Korea
| | - Silvia Puglisi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Evandro de Azambuja
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B), 90, Rue Meylemeersch, 1070, Anderlecht, Brussels, Belgium
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy.
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
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Gerosa R, De Sanctis R, Jacobs F, Benvenuti C, Gaudio M, Saltalamacchia G, Torrisi R, Masci G, Miggiano C, Agustoni F, Pedrazzoli P, Santoro A, Zambelli A. Cyclin-dependent kinase 2 (CDK2) inhibitors and others novel CDK inhibitors (CDKi) in breast cancer: clinical trials, current impact, and future directions. Crit Rev Oncol Hematol 2024; 196:104324. [PMID: 38462150 DOI: 10.1016/j.critrevonc.2024.104324] [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: 11/01/2023] [Revised: 01/31/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024] Open
Abstract
Aberrant cyclin-dependent kinase 2 (CDK2) activation has been identified as a main resistance mechanism to CDK4/6 inhibition in hormone-receptor positive (HR+) breast cancer. Additionally, consistent preclinical evidence states its crucial role in MYC and CCNE1 overexpressed cancer survival, such as triple-negative breast cancers (TNBC), thus representing an appealing and relatively unexplored target treatment opportunity. Despite emerging initial results of novel CDK2 inhibitors (CDK2i) activity, a comprehensive outcomes collection is currently absent from the scientific literature. We aim to provide an overview of ongoing clinical trials involving CDK2i in the context of metastatic breast cancer (mBC), either as monotherapy or in combination with other agents. The review extends beyond CDK2i to encompass novel emerging CDK4 inhibitors, combined CDK2/4/6 inhibitors, and the well-known pan-CDK inhibitors including those specifically directed at CDK2. Delving into the results, we critically appraise the observed clinical efficacy and offer valuable insights into their potential impact and future applications.
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Affiliation(s)
- Riccardo Gerosa
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy; Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Via Manzoni 56, Milan, Rozzano 20089, Italy
| | - Rita De Sanctis
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy; Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Via Manzoni 56, Milan, Rozzano 20089, Italy.
| | - Flavia Jacobs
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy; Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Via Manzoni 56, Milan, Rozzano 20089, Italy
| | - Chiara Benvenuti
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy; Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Via Manzoni 56, Milan, Rozzano 20089, Italy
| | - Mariangela Gaudio
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy; Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Via Manzoni 56, Milan, Rozzano 20089, Italy
| | - Giuseppe Saltalamacchia
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy
| | - Rosalba Torrisi
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy
| | - Giovanna Masci
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy
| | - Chiara Miggiano
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy; Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Via Manzoni 56, Milan, Rozzano 20089, Italy
| | - Francesco Agustoni
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Armando Santoro
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy; Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Via Manzoni 56, Milan, Rozzano 20089, Italy
| | - Alberto Zambelli
- Humanitas University, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele 20090, Italy; Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Via Manzoni 56, Milan, Rozzano 20089, Italy
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Debien V, Agostinetto E, Bruzzone M, Ceppi M, Martins-Branco D, Molinelli C, Jacobs F, Nader-Marta G, Lambertini M, de Azambuja E. The Impact of Initial Tumor Response on Survival Outcomes of Patients With HER2-Positive Advanced Breast Cancer Treated With Docetaxel, Trastuzumab, and Pertuzumab: An Exploratory Analysis of the CLEOPATRA Trial. Clin Breast Cancer 2024:S1526-8209(24)00050-8. [PMID: 38514306 DOI: 10.1016/j.clbc.2024.02.012] [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: 10/03/2023] [Revised: 02/08/2024] [Accepted: 02/18/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The CLEOPATRA trial (NCT00567190) established a dual anti-HER2 blockade in combination with docetaxel as the first-line standard of care for patients with metastatic HER2-positive breast cancer. While this treatment is overall associated with significant improvement in progression-free survival (PFS) and overall survival (OS), not all patients respond equally. We hypothesized that a radiological complete response (CR) at week 9 (i.e., first disease re-evaluation) is associated with prolonged OS and PFS compared to radiological partial response (PR) or stable disease (SD). METHODS We performed an exploratory analysis of the CLEOPATRA study to address this question. RESULTS Out of 362 patients treated with docetaxel, trastuzumab, and pertuzumab eligible for our analysis, 46 (12.7%) had radiological CR at week 9, 243 (67.1%) PR, and 73 (20.2%) SD per central RECIST v1.0. Radiological CR at first tumor re-evaluation was associated with a 60% risk reduction for death compared to SD (adjusted HR = 0.40 95% confidence interval (CI) 0.23-0.70), whereas no significant impact on survival was observed for PR (adjusted HR = 0.85 95% CI 0.60-1.20). The same was observed for PFS with adjusted HR = 0.30 (95% CI 0.18-0.48) for the CR subgroup and adjusted HR = 0.81 (95% CI 0.60-1.09) for the PR subgroup. In multivariate analysis, no variables were associated with radiological CR. CONCLUSIONS Our findings suggest that radiological CR at first disease re-evaluation is associated with more prolonged survival; this might result from stronger dependence on HER2 pathway addiction, supporting the need for further translational research.
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Affiliation(s)
- Veronique Debien
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium Brussels, Belgium.
| | - Elisa Agostinetto
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium Brussels, Belgium
| | - Marco Bruzzone
- Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Marcello Ceppi
- Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Diogo Martins-Branco
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium Brussels, Belgium
| | - Chiara Molinelli
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium Brussels, Belgium; Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Flavia Jacobs
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium Brussels, Belgium; Humanitas Clinical and Research Center - IRCCS, Humanitas Cancer Center, Rozzano, Milan, Italy
| | - Guilherme Nader-Marta
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium Brussels, Belgium
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Evandro de Azambuja
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium Brussels, Belgium
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Gaudio M, Jacobs F, Benvenuti C, Saltalamacchia G, Gerosa R, De Sanctis R, Santoro A, Zambelli A. Unveiling the HER2-low phenomenon: exploring immunohistochemistry and gene expression to characterise HR-positive HER2-negative early breast cancer. Breast Cancer Res Treat 2024; 203:487-495. [PMID: 37923964 DOI: 10.1007/s10549-023-07151-3] [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: 07/18/2023] [Accepted: 09/29/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE HER2-low breast cancer (BC) is a novel entity with relevant therapeutic implications, especially in hormone receptor (HR) positive BC. This study examines whether HER2 mRNA through the 21-gene assay, Oncotype DX (ODX), can refine the diagnosis of HER2-low and HER2-zero, obtained by immunohistochemistry (IHC). METHODS Between Jan 2021 and Jan 2023, 229 consecutive HR-positive HER2-negative early BC (T1-3 N0-1) have been characterised by IHC and ODX. HER2 status by IHC was either zero (IHC-0) or low (IHC-1 + and IHC-2 + /ISH-negative) while HER2-zero was further divided into HER2-null (IHC-0) and HER2-ultralow (IHC-1-10%). HER2 gene expression by ODX was negative if lower 10.7. RESULTS The distribution of HER2 IHC was as follows: 53.3% HER2-0, 29.25% HER2-1 + , and 17.5% HER2-2 + . The clinicopathological characteristics were similar in the three groups, with higher PgR-negative rate in HER2-zero (13.9% vs 3% vs 5%). The distribution of RS was homogeneous in the three groups with the median HER2 gene expression of 9.20 [IQR: 8.70-9.60]. HER2 gene expression gradually increased as the IHC score, with substantial overlap. After adjusting for confounders, HER2-1 + and HER2 2 + had a significant positive correlation between HER2 gene expression and IHC [OR 1.42, 95% CI 1.21 to 1.68, p < 0.001; OR 1.96, 95% CI 1.61 to 2.37, p < 0.001] compared to the HER2-zero group. HER2 gene expression did not differ between HER2-null and HER2-ultralow subgroups. CONCLUSION Due to the substantial overlap, the HER2 gene expression is unable to properly distinguish HER2-low and HER2-zero IHC whose accurate identification is critical in the context of HER2-negative BC.
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Affiliation(s)
- M Gaudio
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, MI, Italy
| | - F Jacobs
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, MI, Italy
| | - C Benvenuti
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, MI, Italy
| | - G Saltalamacchia
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy
| | - R Gerosa
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, MI, Italy
| | - R De Sanctis
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy.
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, MI, Italy.
| | - A Santoro
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, MI, Italy
| | - A Zambelli
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, MI, Italy
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Borroni RG, Bartolini M, Gaudio M, Jacobs F, Benvenuti C, Gerosa R, Tiberio P, Manara SAAM, Solferino A, Santoro A, De Sanctis R. Ribociclib-Induced Cutaneous Adverse Events in Metastatic HR+/HER2- Breast Cancer: Incidence, Multidisciplinary Management, and Prognostic Implication. Oncologist 2024:oyae004. [PMID: 38242689 DOI: 10.1093/oncolo/oyae004] [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: 08/04/2023] [Accepted: 12/04/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Ribociclib is approved for hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer (ABC) treatment, in combination with endocrine therapy. Hematological, hepatic, and cardiac adverse events (AEs) emerged from pivotal trials, but little is known about cutaneous adverse events (CAEs). PATIENTS AND METHODS We report data from a retrospective cohort study of all patients with HR+/HER2- ABC treated with ribociclib at Humanitas Cancer Center between June 2017 and December 2022. We recorded clinical-pathological data, the incidence, and treatment of ribociclib-related CAEs. These were evaluated according to the NCI-CTCAE v5.0 classification. Progression-free survival (PFS) was estimated by Kaplan-Meier method and the log-rank test was used to analyze differences between groups. RESULTS Thirteen of 91 patients (14.3%) experienced treatment-related CAEs (mean time to the occurrence: 3.9 months). The most frequent CAEs were eczematous dermatitis (53.8%) and maculo-papular reaction (15.4%). Itch was reported by all 13 patients. The grade was G3 in 8 cases, G2 in 4, and G1 in 1. An integrated approach based on ribociclib dose modulation and dermatological interventions (oral antihistamine, moisturized cream, topical, and/or systemic steroids) could prevent ribociclib discontinuation in most patients. At a median follow-up of 20 months, the median PFS was 13 months (range, 1-66) with a better PFS curves for patients experiencing CAEs (P = .04). CONCLUSION We mapped frequency and types of ribociclib-induced CAEs. An interdisciplinary management of CAEs incorporated into routine care may reduce the rate of drug discontinuation thus potentially contributing to better long-term outcomes.
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Affiliation(s)
- Riccardo Giovanni Borroni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Michela Bartolini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Mariangela Gaudio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Flavia Jacobs
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Chiara Benvenuti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Riccardo Gerosa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Paola Tiberio
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | | | - Alessandra Solferino
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Rita De Sanctis
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
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Tinterri C, Fernandes B, Zambelli A, Sagona A, Barbieri E, Di Maria Grimaldi S, Darwish SS, Jacobs F, De Carlo C, Iuzzolino M, Gentile D. The Impact of Different Patterns of Residual Disease on Long-Term Oncological Outcomes in Breast Cancer Patients Treated with Neo-Adjuvant Chemotherapy. Cancers (Basel) 2024; 16:376. [PMID: 38254865 PMCID: PMC10814808 DOI: 10.3390/cancers16020376] [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: 12/19/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUNDS The majority of breast cancer (BC) patients treated with neo-adjuvant chemotherapy (NAC) achieves a pathologic partial response with different patterns of residual disease. No clear correlation between these patterns and oncological results was described. Our aims were to define the predictive factors for different patterns of residual disease and compare the outcomes between the scattered versus the circumscribed pattern. METHODS We reviewed 219 postoperative surgical specimens. Patients were divided into two groups: scattered versus circumscribed. Disease-free survival (DFS), distant DFS (DDFS), and overall survival (OS) were analyzed. RESULTS The scattered and circumscribed patterns were assessed in 111 (50.7%) and 108 (49.3%) patients. Two independent predictive factors for the circumscribed pattern were identified: discontinuation of NAC cycles (p = 0.011), and tumor size post-NAC >18 mm (p = 0.022). No difference was observed in terms of DFS and DDFS. Patients with the scattered pattern exhibited a statistically significant better OS. Discontinuation of NAC cycles, tumor size >18 mm, triple-negative BC, and ypN+ were associated with increased recurrence and poorer survival. CONCLUSIONS Discontinuation of NAC cycles and tumor size are independent factors associated with patterns of residual disease. The scattered pattern presents better survival. Understanding the relationship between NAC, the residual pattern, and differences in survival outcomes offers the potential to optimize the therapeutic approaches.
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Affiliation(s)
- Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; (A.Z.); (M.I.)
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (B.F.); (C.D.C.)
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; (A.Z.); (M.I.)
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy;
| | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
| | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
| | - Simone Di Maria Grimaldi
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
| | - Shadya Sara Darwish
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
| | - Flavia Jacobs
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy;
| | - Camilla De Carlo
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (B.F.); (C.D.C.)
| | - Martina Iuzzolino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; (A.Z.); (M.I.)
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (B.F.); (C.D.C.)
| | - Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy; (C.T.); (A.S.); (E.B.); (S.D.M.G.); (S.S.D.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; (A.Z.); (M.I.)
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Jacobs F, Molinelli C, Martins-Branco D, Marta GN, Salmon M, Ameye L, Piccart M, Lambertini M, Agostinetto E, de Azambuja E. Progression-free survival assessment by local investigators versus blinded independent central review in randomized clinical trials in metastatic breast cancer: A systematic review and meta-analysis. Eur J Cancer 2024; 197:113478. [PMID: 38103328 DOI: 10.1016/j.ejca.2023.113478] [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: 09/20/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION In randomized clinical trials (RCTs), blinded independent central review (BICR) is used to minimize heterogeneity and bias associated with radiological response evaluation by local investigators. However, BICR adds costs and complexity to the trial management. We assessed the discrepancy index between progression-free survival (PFS) assessment by local investigators and by BICR in RCTs conducted in patients with metastatic breast cancer (MBC). METHODS A systematic search of PubMed, Embase, Cochrane databases and conference proceedings (ASCO, SABCS, ESMO) was performed up to January 4, 2023 (PROSPERO: CRD42021229865). All RCTs published from 2000 to 2022, including MBC patients treated in first- or second-line, and reporting PFS assessed by local investigators and BICR were included. A discrepancy index between BICR-assessed and investigator-assessed HR was calculated for each trial and an overall combined DI was obtained using a fixed-effects model. The agreement between hazard ratios (HR) of PFS assessed by local investigators and BICR was measured using intraclass correlation coefficient (ICC). RESULTS We analyzed 24 studies including 13,168 patients. Among them, 19 (79%) were in first-line, 18 (75%) were phase III trials and 23 (96%) had PFS as primary endpoint. The overall combined discrepancy index was 0.97 (95%CI 0.85-1.10; ICC 0.831, p < 0.001) suggesting no statistically significant difference in PFS assessment between local investigators and BICR. This result was consistent across all analyzed subgroups. CONCLUSIONS The good concordance between local investigator and BICR assessments supports the reliability of local investigator-assessed PFS as primary endpoint for RCTs in MBC and questions the practical utility of implementing BICR in all RCTs.
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Affiliation(s)
- Flavia Jacobs
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium; Humanitas Clinical and Research Center - IRCCS, Humanitas Cancer Center, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Chiara Molinelli
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
| | - Diogo Martins-Branco
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium
| | - Guilherme Nader Marta
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium
| | - Maurine Salmon
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Data Center, Brussels, Belgium
| | - Lieveke Ameye
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Data Center, Brussels, Belgium
| | - Martine Piccart
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Medical Oncology Department, Brussels, Belgium
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elisa Agostinetto
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium.
| | - Evandro de Azambuja
- Université Libre de Bruxelles (U.L.B), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Academic Trials Promoting Team (ATPT), Brussels, Belgium.
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9
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Zattarin E, Mariani L, Menichetti A, Leporati R, Provenzano L, Ligorio F, Fucà G, Lobefaro R, Lalli L, Vingiani A, Nichetti F, Griguolo G, Sirico M, Bernocchi O, Marra A, Corti C, Zagami P, Agostinetto E, Jacobs F, Di Mauro P, Presti D, Sposetti C, Giorgi CA, Guarneri V, Pedersini R, Losurdo A, Generali D, Curigliano G, Pruneri G, de Braud F, Dieci MV, Vernieri C. Peripheral blood lymphocytes predict clinical outcomes in hormone receptor-positive HER2-negative advanced breast cancer patients treated with CDK4/6 inhibitors. Ther Adv Med Oncol 2023; 15:17588359231204857. [PMID: 38130467 PMCID: PMC10734364 DOI: 10.1177/17588359231204857] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/14/2023] [Indexed: 12/23/2023] Open
Abstract
Background Cyclin-Dependent Kinase 4/6 inhibitors (CDK4/6i) combined with Endocrine Therapy (ET) are the standard treatment for patients with Hormone Receptor-positive/HER2-negative advanced breast cancer (HR+/HER2- aBC). Objectives While CDK4/6i are known to reduce several peripheral blood cells, such as neutrophils, lymphocytes and platelets, the impact of these modulations on clinical outcomes is unknown. Design A multicenter, retrospective-prospective Italian study. Methods We investigated the association between baseline peripheral blood cells, or their early modifications (i.e. 2 weeks after treatment initiation), and the progression-free survival (PFS) of HR+/HER2- aBC patients treated with ETs plus CDK4/6i. Random Forest models were used to select covariates associated with patient PFS among a large list of patient- and tumor-related variables. Results We evaluated 638 HR+/HER2- aBC patients treated with ET plus CDK4/6i at six Italian Institutions between January 2017 and May 2021. High baseline lymphocyte counts were independently associated with longer PFS [median PFS (mPFS) 20.1 versus 13.2 months in high versus low lymphocyte patients, respectively; adjusted Hazard Ratio (aHR): 0.78; 95% confidence interval (CI): 0.66-0.92; p = 0.0144]. Moreover, patients experiencing a lower early reduction of lymphocyte counts had significantly longer PFS when compared to patients undergoing higher lymphocyte decrease (mPFS 18.1 versus 14.5 months; aHR: 0.82; 95% CI: 0.73-0.93; p = 0.0037). Patients with high baseline lymphocytes and undergoing a lower reduction, or even an increase, of lymphocyte counts during CDK4/6i therapy experienced the longest PFS, while patients with lower baseline lymphocytes and undergoing a higher decrease of lymphocytes had the lowest PFS (mPFS 21.4 versus 11 months, respectively). Conclusion Baseline and on-treatment modifications of peripheral blood lymphocytes have independent prognostic value in HR+/HER2- aBC patients. This study supports the implementation of clinical strategies to boost antitumor immunity in patients with HR+/HER2- aBC treated with ETs plus CDK4/6i.
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Affiliation(s)
- Emma Zattarin
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigi Mariani
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alice Menichetti
- Oncology 2, Istituto Oncologico Veneto IOV – IRCCS, Padova, Italy
| | - Rita Leporati
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Leonardo Provenzano
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesca Ligorio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- IFOM ETS, the AIRC Institute of Molecular Oncology, Milan, Italy
| | - Giovanni Fucà
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Riccardo Lobefaro
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luca Lalli
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Vingiani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Federico Nichetti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Computational Oncology, Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gaia Griguolo
- Oncology 2, Istituto Oncologico Veneto IOV – IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | | | - Antonio Marra
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chiara Corti
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paola Zagami
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elisa Agostinetto
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Institut Jules Bordet and l’Université Libre de Bruxelles, Bruxelles, Belgium
| | - Flavia Jacobs
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Daniele Presti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Caterina Sposetti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Valentina Guarneri
- Oncology 2, Istituto Oncologico Veneto IOV – IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | | | - Agnese Losurdo
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Daniele Generali
- Breast Cancer Unit & Translational Research Unit, ASST Cremona, Cremona, Italy
- Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giancarlo Pruneri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Maria Vittoria Dieci
- Oncology 2, Istituto Oncologico Veneto IOV – IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | - Claudio Vernieri
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milan 20133, Italy IFOM ETS, the AIRC Institute of Molecular Oncology, Milan, Italy
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Debien V, Marta GN, Agostinetto E, Sirico M, Jacobs F, Molinelli C, Moreau M, Paesmans M, De Giorgi U, Santoro A, Taylor D, Duhoux FP, Botticelli A, Barchiesi G, Speranza I, Lambertini M, Wildiers H, Azambuja ED, Piccart M. Real-world clinical outcomes of patients with stage I HER2-positive breast cancer treated with adjuvant paclitaxel and trastuzumab. Crit Rev Oncol Hematol 2023; 190:104089. [PMID: 37562696 DOI: 10.1016/j.critrevonc.2023.104089] [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: 03/03/2023] [Revised: 07/06/2023] [Accepted: 08/07/2023] [Indexed: 08/12/2023] Open
Abstract
Up to 20% of breast cancer overexpress HER2 protein, making it a reliable target for antibody-based treatments. In early HER2-positive breast cancer avoiding anthracycline-based chemotherapy is a challenge. Based on the single-arm phase II APT trial results, adjuvant paclitaxel/trastuzumab is an accepted regimen for patients with stage I HER2-positive disease. In our retrospective study of 240 patients, the median tumor size was 12.0 mm (IQR 9 -15), and 204 (85%) had estrogen receptor-positive disease. After a median follow-up of 4.6 years, 3-year real-world disease-free survival, distant DFS, and overall survival were 98.8% (95% confidence interval (CI), 96.2-99.6), 99.2% (95% CI, 96.7-99.8), and 98.3% (95% CI, 96.2-99.6), respectively. In a real-world setting, an adjuvant paclitaxel/trastuzumab regimen was associated with low recurrence rates among women with stage I, HER2-positive breast cancer. Additionally, we reviewed other treatment optimization strategies attempted or ongoing in HER2-positive breast cancer.
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Affiliation(s)
- Veronique Debien
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Brussels, Belgium.
| | - Guilherme Nader Marta
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Brussels, Belgium
| | - Elisa Agostinetto
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Brussels, Belgium
| | - Marianna Sirico
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Flavia Jacobs
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Chiara Molinelli
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Michel Moreau
- Unité de Gestion de l'Information, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Marianne Paesmans
- Unité de Gestion de l'Information, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Ugo De Giorgi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | | | | | - Andrea Botticelli
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomopatologiche, Università di Roma Sapienza, Rome, Italy
| | - Giacomo Barchiesi
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomopatologiche, Università di Roma Sapienza, Rome, Italy
| | - Iolanda Speranza
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomopatologiche, Università di Roma Sapienza, Rome, Italy
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium
| | - Evandro de Azambuja
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Brussels, Belgium
| | - Martine Piccart
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Brussels, Belgium
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Jacobs F, D'Amico S, Benvenuti C, Gaudio M, Saltalamacchia G, Miggiano C, De Sanctis R, Della Porta MG, Santoro A, Zambelli A. Opportunities and Challenges of Synthetic Data Generation in Oncology. JCO Clin Cancer Inform 2023; 7:e2300045. [PMID: 37535875 DOI: 10.1200/cci.23.00045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/05/2023] [Accepted: 05/25/2023] [Indexed: 08/05/2023] Open
Abstract
Widespread interest in artificial intelligence (AI) in health care has focused mainly on deductive systems that analyze available real-world data to discover patterns not otherwise visible. Generative adversarial network, a new type of inductive AI, has recently evolved to generate high-fidelity virtual synthetic data (SD) trained on relatively limited real-world information. The AI system is fed with a collection of real data, and it learns to generate new augmented data while maintaining the general characteristics of the original data set. The use of SD to enhance clinical research and protect patient privacy has drawn a lot of interest in medicine and in the complex field of oncology. This article summarizes the main characteristics of this innovative technology and critically discusses how it can be used to accelerate data access for secondary purposes, providing an overview of the opportunities and challenges of SD generation for clinical cancer research and health care.
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Affiliation(s)
- Flavia Jacobs
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Istituto Clinico Humanitas, Milan, Italy
| | | | - Chiara Benvenuti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Mariangela Gaudio
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Istituto Clinico Humanitas, Milan, Italy
| | | | - Chiara Miggiano
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Rita De Sanctis
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Matteo Giovanni Della Porta
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Istituto Clinico Humanitas, Milan, Italy
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12
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Molinelli C, Jacobs F, Agostinetto E, Nader-Marta G, Ceppi M, Bruzzone M, Blondeaux E, Schettini F, Prat A, Viale G, Del Mastro L, Lambertini M, de Azambuja E. Prognostic value of HER2-low status in breast cancer: a systematic review and meta-analysis. ESMO Open 2023; 8:101592. [PMID: 37413762 PMCID: PMC10485402 DOI: 10.1016/j.esmoop.2023.101592] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 04/24/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Human epidermal growth factor receptor 2 (HER2)-low expression in breast cancer has been recently identified as a new therapeutic target. However, it is unclear if HER2-low status has an independent impact on prognosis. MATERIALS AND METHODS A systematic literature research was carried out to identify studies comparing survival outcomes of patients affected by HER2-low versus HER2-zero breast cancer. Using random-effects models, pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for progression-free survival (PFS) and overall survival (OS) in the metastatic setting as well as disease-free survival (DFS), OS and pathological complete response (pCR) in the early setting. Subgroup analyses by hormone receptor (HoR) status were carried out. The study protocol is registered on PROSPERO (n.CRD42023390777). RESULTS Among 1916 identified records, 42 studies including 1 797 175 patients were eligible. In the early setting, HER2-low status was associated with significant improved DFS (HR 0.86, 95% CI 0.79-0.92, P < 0.001) and OS (HR 0.90, 95% CI 0.85-0.95, P < 0.001) when compared to HER2-zero status. Improved OS was observed for both HoR-positive and HoR-negative HER2-low populations, while DFS improvement was observed only in the HoR-positive subgroup. HER2-low status was significantly associated with a lower rate of pCR as compared to HER2-zero status both in the overall population (OR 0.74, 95% CI 0.62-0.88, P = 0.001) and in the HoR-positive subgroup (OR 0.77, 95% CI 0.65-0.90, P = 0.001). In the metastatic setting, patients with HER2-low breast cancers showed better OS when compared with those with HER2-zero tumours in the overall population (HR 0.94, 95% CI 0.89-0.98, P = 0.008), regardless of HoR status. No significant PFS differences were found. CONCLUSIONS Compared with HER2-zero status, HER2-low status appears to be associated with a slightly increased OS both in the advanced and early settings, regardless of HoR expression. In the early setting, HER2-low tumours seem to be associated to lower pCR rates, especially if HoR-positive.
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Affiliation(s)
- C Molinelli
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa. https://twitter.com/ChiaraMolinelli
| | - F Jacobs
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of Biomedical Sciences, Humanitas University, Milan. https://twitter.com/FlaviaJacobs_
| | - E Agostinetto
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium. https://twitter.com/ElisaAgostinett
| | - G Nader-Marta
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium. https://twitter.com/Nader_Guilherme
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - E Blondeaux
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://twitter.com/BlondeauxEva
| | - F Schettini
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona; Department of Medical Oncology, Hospital Clínic of Barcelona, Barcelona; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona. https://twitter.com/FrancescoSche20
| | - A Prat
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona; Reveal Genomics, Barcelona, Spain. https://twitter.com/prat_aleix
| | - G Viale
- Department of Pathology, IEO European Institute of Oncology IRCCS, Milan
| | - L Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://twitter.com/delmastro_lucia
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://twitter.com/matteolambe
| | - E de Azambuja
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium; Medical Oncology Department, Institut Jules Bordet and l'Université Libre de Bruxelles (ULB), Brussels, Belgium.
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13
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Tiberio P, Gaudio M, Belloni S, Pindilli S, Benvenuti C, Jacobs F, Saltalamacchia G, Zambelli A, Santoro A, De Sanctis R. Unlocking the Potential of Circulating miRNAs in the Breast Cancer Neoadjuvant Setting: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:3424. [PMID: 37444533 DOI: 10.3390/cancers15133424] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
The potential role of circulating microRNAs (miRNAs) as biomarkers in breast cancer (BC) management has been widely reported. However, the numerous discrepancies between studies in this regard hinders the implementation of circulating miRNAs in routine clinical practice. In the context of BC patients undergoing neoadjuvant chemotherapy (NAC), the possibility of predicting NAC response may lead to prognostic improvements by individualizing post-neoadjuvant therapy. In this context, the present meta-analysis aims to clarify circulating miRNAs' predictive role with respect to NAC response among BC patients. We conducted a comprehensive literature search on five medical databases until 16 February 2023. We pooled the effect sizes of each study by applying a random-effects model. Cochran's Q test (p-level of significance set at 0.05) scores and I2 values were assessed to determine between-study heterogeneity. The PROBAST (Prediction Model Risk of Bias Assessment Tool) tool was used to evaluate the selected studies' risk of bias. Overall, our findings support the hypothesis that circulating miRNAs, specifically miR-21-5p and miR-155-5p, may act as predictive biomarkers in the neoadjuvant setting among BC patients. However, due to the limited number of studies included in this meta-analysis and the high degrees of clinical and statistical heterogeneity, further research is required to confirm the predictive power of circulating miR-21-5p and miR-155-5p.
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Affiliation(s)
- Paola Tiberio
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Mariangela Gaudio
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Silvia Belloni
- Educational and Research Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Sebastiano Pindilli
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Chiara Benvenuti
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Flavia Jacobs
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Giuseppe Saltalamacchia
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Alberto Zambelli
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Armando Santoro
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Rita De Sanctis
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
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14
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Gentile D, Sagona A, De Carlo C, Fernandes B, Barbieri E, Di Maria Grimaldi S, Jacobs F, Vatteroni G, Scardina L, Biondi E, Vinci V, Trimboli RM, Bernardi D, Tinterri C. Pathologic response and residual tumor cellularity after neo-adjuvant chemotherapy predict prognosis in breast cancer patients. Breast 2023; 69:323-329. [PMID: 37001289 PMCID: PMC10070173 DOI: 10.1016/j.breast.2023.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Residual tumor cellularity (RTC) and pathologic complete response (pCR) after neo-adjuvant chemotherapy (NAC) are prognostic factors associated with improved outcomes in breast cancer (BC). However, the majority of patients achieve partial pathologic response (pPR) and no clear correlation between RTC patterns and outcomes was described. Our aims were to define predictive factors for pCR and compare different outcomes of patients with pCR or pPR and with different RTC patterns. MATERIALS AND METHODS Baseline and post-NAC demographics, clinicopathological characteristics, post-operative data, survival and recurrence status were recorded from our institutional database. A multivariable analysis was performed using a logistic regression model to identify independent predictors of pCR. Disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS) analyses were performed using the Kaplan-Meier method. RESULTS Overall, of the 495 patients analyzed, 148 (29.9%) achieved pCR, 347 (70.1%) had pPR, and the median RTC was 40%. Multivariable analysis identified 3 independent factors predictive of pCR: tumor stage before NAC (cT1-2 84.5% versus cT3-4 15.5%), BC sub-type (HER2-positive 54.7% versus triple-negative 29.8% versus luminal-like 15.5%), and vascular invasion (absence 98.0% versus presence 2.0%). We found statistically significant longer DFS, DDFS, and OS in patients with pCR and with RTC <40%; no difference was observed in terms of OS between RTC <40% and RTC ≥40% groups. CONCLUSIONS Tumor stage before NAC, BC sub-type, and vascular invasion are significant and independent factors associated with pCR. Patients with pCR and with RTC <40% have longer DFS, DDFS, and OS compared with patients with pPR.
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Affiliation(s)
- Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Camilla De Carlo
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | | | - Flavia Jacobs
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy; Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Giulia Vatteroni
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Lorenzo Scardina
- Division of Breast Surgery, Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Ersilia Biondi
- Division of Breast Surgery, Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Valeriano Vinci
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Rubina Manuela Trimboli
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Daniela Bernardi
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Corrado Tinterri
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
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15
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Jacobs F, Agostinetto E, Miggiano C, De Sanctis R, Zambelli A, Santoro A. Hope and Hype around Immunotherapy in Triple-Negative Breast Cancer. Cancers (Basel) 2023; 15:cancers15112933. [PMID: 37296893 DOI: 10.3390/cancers15112933] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 04/26/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Triple-negative breast cancer (TNBC) holds a poor prognosis compared to other breast cancer subtypes, and the development of new effective treatment strategies is an unmet medical need. TNBC has traditionally been considered not amenable to treatment with targeted agents due to a lack of actionable targets. Therefore, chemotherapy has remained the mainstay of systemic treatment for many decades. The advent of immunotherapy raised very hopeful expectations in TNBC, possibly due to higher levels of tumor-infiltrating lymphocytes, PD-L1 expression and tumor mutational burden compared to other breast cancer subtypes, that predict an effective anti-tumor immune-engagement. The results of clinical trials testing immunotherapy in TNBC led to the approval of the combination of immune checkpoint inhibitors and chemotherapy in both early and advanced settings. However, some open questions about the use of immunotherapy in TNBC still exist. These include a deeper understanding of the heterogeneity of the disease, identification of reliable predictive biomarkers of response, determination of the most appropriate chemotherapy backbone and appropriate management of potential long-term immune-related adverse events. In this review we aim to examine the available evidence on the use of immunotherapy strategies in both early and advanced TNBC, to critically discuss some of the limitations encountered in clinical research and to summarize data on novel promising immunotherapeutic strategies beyond PD-(L)1 blockade that have been investigated in the most recent trials.
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Affiliation(s)
- Flavia Jacobs
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
- Academic Trials Promoting Team, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B.), 1070 Brussels, Belgium
| | - Elisa Agostinetto
- Academic Trials Promoting Team, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B.), 1070 Brussels, Belgium
| | - Chiara Miggiano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20090 Pieve Emanuele, MI, Italy
| | - Rita De Sanctis
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20090 Pieve Emanuele, MI, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20090 Pieve Emanuele, MI, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20090 Pieve Emanuele, MI, Italy
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16
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Zattarin E, Presti D, Mariani L, Sposetti C, Leporati R, Menichetti A, Corti C, Benvenuti C, Fucà G, Lobefaro R, Ligorio F, Provenzano L, Vingiani A, Del Vecchio M, Griguolo G, Sirico M, Bernocchi O, Marra A, Zagami P, Agostinetto E, Jacobs F, Di Mauro P, Esposito A, Giorgi CA, Lalli L, Boldrini L, Giacchetti PPB, Schianca AC, Guarneri V, Pedersini R, Losurdo A, Zambelli A, Generali D, Criscitiello C, Curigliano G, Pruneri G, de Braud F, Dieci MV, Vernieri C. Prognostic significance of HER2-low status in HR-positive/HER2-negative advanced breast cancer treated with CDK4/6 inhibitors. NPJ Breast Cancer 2023; 9:27. [PMID: 37069173 PMCID: PMC10110597 DOI: 10.1038/s41523-023-00534-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/04/2023] [Indexed: 04/19/2023] Open
Abstract
Whether Human Epidermal growth factor Receptor 2 (HER2)-low status has prognostic significance in HR + /HER2- advanced Breast Cancer (aBC) patients treated with first-line Endocrine Therapy plus CDK 4/6 inhibitors remains unclear. In 428 patients evaluated, HER2-low status was independently associated with significantly worse PFS and OS when compared with HER2-0 status. Based on our findings, HER2-low status could become a new prognostic biomarker in this clinical setting.
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Affiliation(s)
- Emma Zattarin
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniele Presti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigi Mariani
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Caterina Sposetti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rita Leporati
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alice Menichetti
- Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Chiara Corti
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Benvenuti
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
| | - Giovanni Fucà
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Riccardo Lobefaro
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesca Ligorio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- IFOM ETS, the AIRC Institute of Molecular Oncology, Milan, Italy
| | - Leonardo Provenzano
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Vingiani
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Marta Del Vecchio
- Division of Pharmacy, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy
| | - Gaia Griguolo
- Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014, Meldola, Italy
| | - Ottavia Bernocchi
- Farmacia Ospedaliera ASST Cremona, Viale Concordia 1, Cremona, Italy
| | - Antonio Marra
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Paola Zagami
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elisa Agostinetto
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
- Institut Jules Bordet and l'Université Libre de Bruxelles, Bruxelles, Belgium
| | - Flavia Jacobs
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
| | | | | | | | - Luca Lalli
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Boldrini
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Pier Paolo Berton Giacchetti
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ambra Carnevale Schianca
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Valentina Guarneri
- Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | | | - Agnese Losurdo
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
| | - Alberto Zambelli
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
| | - Daniele Generali
- Breast Cancer Unit & Translational Research Unit, ASST Cremona, Cremona, Italy
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34147, Trieste, Italy
| | - Carmen Criscitiello
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giuseppe Curigliano
- Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giancarlo Pruneri
- Pathology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Filippo de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Maria Vittoria Dieci
- Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | - Claudio Vernieri
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
- IFOM ETS, the AIRC Institute of Molecular Oncology, Milan, Italy.
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Benvenuti C, Gaudio M, Jacobs F, Saltalamacchia G, De Sanctis R, Torrisi R, Santoro A, Zambelli A. Clinical Review on the Management of Breast Cancer Visceral Crisis. Biomedicines 2023; 11:biomedicines11041083. [PMID: 37189701 DOI: 10.3390/biomedicines11041083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 05/17/2023] Open
Abstract
Visceral crisis is a life-threatening clinical condition requiring urgent treatment and accounts for 10-15% of new advanced breast cancer diagnoses, mainly hormone receptor-positive/human epidermal growth factor 2 negative. As its clinical definition is an open topic with nebulous criteria and much room for subjective interpretation, it poses a challenge for daily clinical practice. International guidelines recommend combined chemotherapy as first-line treatment for patients with visceral crisis, but with modest results and a very poor prognosis. Visceral crisis has always been a common exclusion criterion in breast cancer trials, and the available evidence mainly comes from limited retrospective studies which are not sufficient to draw solid conclusions. The outstanding efficacy of innovative drugs, such as CDK4/6 inhibitors, questions the role of chemotherapy in this setting. In the lack of clinical reviews, we aim to critically discuss the management of visceral crisis, advocating future treatment perspectives for this challenging condition.
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Affiliation(s)
- Chiara Benvenuti
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
| | - Mariangela Gaudio
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
| | - Flavia Jacobs
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
- Academic Trials Promoting Team, Institut Jules Bordet, L'Univeristé Libre de Bruxelles (U.L.B.), 1070 Bruxelles, Belgium
| | - Giuseppe Saltalamacchia
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
| | - Rita De Sanctis
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
| | - Rosalba Torrisi
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
| | - Armando Santoro
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
| | - Alberto Zambelli
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, MI, Italy
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18
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Tinterri C, Sagona A, Barbieri E, Di Maria Grimaldi S, Caraceni G, Ambrogi G, Jacobs F, Biondi E, Scardina L, Gentile D. Sentinel Lymph Node Biopsy in Breast Cancer Patients Undergoing Neo-Adjuvant Chemotherapy: Clinical Experience with Node-Negative and Node-Positive Disease Prior to Systemic Therapy. Cancers (Basel) 2023; 15:cancers15061719. [PMID: 36980605 PMCID: PMC10046076 DOI: 10.3390/cancers15061719] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Background: Sentinel lymph node biopsy (SLNB) has emerged as the standard procedure to replace axillary lymph node dissection (ALND) in breast cancer (BC) patients undergoing neo-adjuvant chemotherapy (NAC). SLNB is accepted in clinically node-negative (cN0) patients; however, its role in clinically node-positive (cN+) patients is debatable. Methods: We performed a retrospective analysis of BC patients undergoing NAC and SLNB. Our aim was to evaluate the clinical significance of SLNB in the setting of NAC. This was accomplished by comparing the characteristics and oncological outcomes between cN0 and cN+ patients prior to NAC and type of axillary surgery. Results: A total of 291 patients were included in the analysis: 131 were cN0 and 160 were cN+ who became ycN0 after NAC. At a median follow-up of 43 months, axillary recurrence occurred in three cN0 (2.3%) and two cN+ (1.3%) patients. However, there were no statistically significant differences in oncological outcomes (disease-free survival, distant disease-free survival, overall survival, and breast-cancer-specific survival) between cN0 and cN+ patients nor between patients treated with SLNB only or ALND. Conclusions: SLNB in the setting of NAC is an acceptable procedure with a general good prognosis and low axillary failure rates for both cN0 and cN+ patients.
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Affiliation(s)
- Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
| | - Andrea Sagona
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Erika Barbieri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | | | - Giulia Caraceni
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Giacomo Ambrogi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
| | - Flavia Jacobs
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
| | - Ersilia Biondi
- Division of Breast Surgery, Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, 00168 Rome, Italy
| | - Lorenzo Scardina
- Division of Breast Surgery, Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, 00168 Rome, Italy
| | - Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy
- Correspondence: ; Tel.: +39-0282243060
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Gentile D, Sagona A, De Carlo C, Fernandes B, Grimaldi SDM, Barbieri E, Gatzemeier W, Scardina L, Biondi E, Jacobs F, Vatteroni G, Tinterri C. Abstract P6-01-32: Evaluation of pathologic response and residual tumor cellularity following neo-adjuvant chemotherapy predict prognosis in breast cancer patients. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p6-01-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Introduction: Treatment of early-stage beast cancer (BC) has changed since recent evidence showed that neoadjuvant chemotherapy (NAC) can reduce residual tumor cellularity (RTC) and improve patient outcomes. Achieving a pathologic complete response (pCR) has been associated with significantly improved disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS). However, among patients treated with NAC, few experience pCR, while approximately 60-80% of them achieve a pathologic partial response (pPR). In previous studies, BC patients with different grades of pPR have been usually grouped and analyzed together, with inconsistent results and unclear prognostic significance. Objectives: The primary aims of this study were to describe the clinical and treatment characteristics of BC patients treated with NAC, to identify independent predictive factors of pCR, and to compare the oncologic outcomes between patients achieving pCR or pPR. The secondary aim of this study was to measure the RTC of BC patients with pPR and to compare the outcomes of patients with different RTC in order to improve prognostic information. Methods: All the consecutive BC patients undergoing NAC at the Breast Unit of IRCCS Humanitas Research Hospital (Milan, Italy) between October 2006 and April 2020 and their corresponding post-operative pathology slides were reviewed. The following exclusion criteria were used: excisional biopsy or debulking surgery as first BC operation, patients with a previous BC diagnosis or other prior or synchronous malignancies, male patients, unknown NAC regimen, disease progression during NAC, and follow-up ≤12 months. Results: A total of 495 BC patients received NAC. Overall, 148 (29.9%) patients achieved pCR, while 347 (70.1%) had pPR, and median RTC was 40%. At multivariable analysis, 3 independent factors predicting pCR were identified. Tumor stage pre-NAC (cT1-2 84.5% versus cT3-4 15.5%, odds ratio (OR)=0.119, 95% confidence interval (95%CI)=0.048-0.189, p=0.001), BC sub-type (HER2-enriched 54.7% versus triple-negative 29.8% versus luminal-like 15.5%, OR=2.178, 95%CI=2.055-2.301, p=0.001), and vascular invasion (absence 98.0% versus presence 2.0%, OR=0.022, 95%CI=0.004-0.090, p=0.001). Patients with BC undergoing NAC and achieving pCR presented statistically significant longer DFS, DDFS, and OS (p = < 0.001). Patients with RTC < 40% presented statistically significant better DFS and DDFS (p = 0.033, p = 0.015, respectively). However, no statistically significant difference in terms of OS was observed between RTC < 40% and RTC ≥40% groups (p = 0.148). Conclusions: Tumor stage pre-NAC, BC sub-type, and vascular invasion are significantly and independently associated with pCR. Patients with pCR present a better prognosis compared to patients with pPR in terms of DFS, DDFS, and OS. Measurement of RTC in BC patients with pPR improves the prognostic information that can be obtained from the assessment of the pathologic response. Different patterns of residual disease play an important role in predicting the risk of subsequent loco-regional and distant recurrence, and patients with RTC < 40% present significantly better DFS and DDFS.
Citation Format: Damiano Gentile, Andrea Sagona, Camilla De Carlo, Bethania Fernandes, Simone Di Maria Grimaldi, Erika Barbieri, Wolfgang Gatzemeier, Lorenzo Scardina, Ersilia Biondi, Flavia Jacobs, Giulia Vatteroni, Corrado Tinterri. Evaluation of pathologic response and residual tumor cellularity following neo-adjuvant chemotherapy predict prognosis in breast cancer patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-01-32.
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Debien V, Agostinetto E, Sirico M, Jacobs F, Molinelli C, Moreau M, Paesmans M, De Giorgi U, Santoro A, Taylor D, Duhoux FP, Botticelli A, Barchiesi G, Lambertini M, de Azambuja E, Piccart M. Abstract P2-01-04: Real-world clinical outcomes of patients with stage I HER2-positive breast cancer treated with adjuvant paclitaxel and trastuzumab. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p2-01-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: One year of adjuvant trastuzumab with 12 cycles of weekly paclitaxel represents the standard of care for patients with pathological tumor size ≤2cm, node-negative, HER2-positive early breast cancer. Data supporting this indication derive from a single-arm, phase II trial that enrolled 410 patients in the United States only, where the 3 years invasive disease-free survival (DFS) rate was 98.7% (95% CI 97.6-99.8). Therefore, real-world data regarding the clinical outcomes of these patients are needed to confirm the efficacy and safety of this adjuvant anthracycline-free regimen in this population. Methods: We conducted a retrospective, observational, multicentric study to investigate survival outcomes of patients with stage I HER2-positive early breast cancer treated with adjuvant paclitaxel and trastuzumab in seven selected sites in two countries (Belgium and Italy). Eligible patients were men and women with early breast cancer of pathological tumor size between 5 and 20 mm, node-negative (N0 or N1mic), and treated with weekly adjuvant paclitaxel for 12 weeks and trastuzumab (6 mg/kg every 3 weeks administration for 1 year). Patients with a history of previous cancers were not included. The primary endpoint was disease-free survival (DFS) at 3 years from diagnosis. Thus, an optimal follow-up of 3 years from surgery was required. Baseline clinico-pathological characteristics, treatment data, disease recurrences and survival status were extracted from medical records. Survival analysis was performed using log-rank regression test. Results: Overall, 240 patients who received their adjuvant treatment between January 2014 and December 2018 were included in the analysis. The median age was 59.5 years (IQR 50.0-66.9), and 69.6% of patients were post-menopausal at the time of diagnosis. Seventy (31.8%) patients had hypertension and 20 (8.3%) had other cardiac comorbidities. Ductal carcinoma was the most represented histological type (86.3%). The median tumor size was 12mm (IQR 9-15), only seven (2.9%) patients had N1miC, and the majority of tumors (85.0%) were ER-positive. Breast-conserving surgery was performed in 80.8% of patients and 78.2% of patients had adjuvant radiotherapy. The median number of administrated cycles of weekly paclitaxel was 12 (range 1-12) and for trastuzumab 18 (range 1-19). Only one patient stopped trastuzumab prematurely because of safety reason. Aromatase inhibitors were the most frequently administered endocrine therapy (75.7% of patients with ER-positive disease). With a median follow-up of 4.7 (IQR 3.6-5.6) years, we observed a 3-year DFS rate of 98.8% (95% CI 96.2-99.6), with only three disease recurrences (one local and two distant) and four deaths (none of which was breast cancer related) during the duration of the follow-up. Conclusions: In this real-world clinical outcome of patients with stage I HER2-positive breast cancer treated with adjuvant trastuzumab and paclitaxel appeared excellent, with a 1.2% rate of recurrence at 3 years. Our data support the efficacy of an anthracycline-free regimen in this population. A longer follow-up will provide more mature data on overall survival and late relapses, especially in the ER-positive subgroup of patients.
Citation Format: Veronique Debien, Elisa Agostinetto, Marianna Sirico, Flavia Jacobs, Chiara Molinelli, Michel Moreau, Marianne Paesmans, Ugo De Giorgi, Armando Santoro, Donatienne Taylor, François P. Duhoux, Andrea Botticelli, Giacomo Barchiesi, Matteo Lambertini, Evandro de Azambuja, Martine Piccart. Real-world clinical outcomes of patients with stage I HER2-positive breast cancer treated with adjuvant paclitaxel and trastuzumab [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-01-04.
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Affiliation(s)
| | | | - Marianna Sirico
- 3Department of Medical Oncology,, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Flavia Jacobs
- 4Humanitas University, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano
| | - Chiara Molinelli
- 5Academic Trials Promoting Team, Institut Jules Bordet and l’Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Michel Moreau
- 6Institut Jules Bordet, Université Libre de Bruxelles (U.L.B)
| | - Marianne Paesmans
- 7Data Center, Institut Jules Bordet and l’Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Ugo De Giorgi
- 8Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”
| | - Armando Santoro
- 9Humanitas University, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano
| | - Donatienne Taylor
- 10Universite catholique de Louvain, CHU UCL Namur—Site Sainte-Elisabeth, Namur, Belgium
| | | | | | - Giacomo Barchiesi
- 13Dipartimento di Scienze Radiologiche, Oncologiche e Anatomopatologiche, Università di Roma Sapienza
| | | | - Evandro de Azambuja
- 15Academic Trials Promoting Team and Medical Oncology Department, Institut Jules Bordet and l’Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Martine Piccart
- 16Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Anderlecht, Brussels Hoofdstedelijk Gewest, Belgium
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Zattarin E, Sposetti C, Leporati R, Mariani L, Menichetti A, Corti C, Benvenuti C, Fucà G, Lobefaro R, Ligorio F, Presti D, Provenzano L, Vingiani A, Griguolo G, Sirico M, Bernocchi O, Marra A, Zagami P, Agostinetto E, Jacobs F, Mauro PD, Esposito A, Giorgi CA, Lalli L, Boldrini L, Giachetti PPMB, Schianca AC, Guarneri V, Pedersini R, Losurdo A, Zambelli A, Generali DG, Curigliano G, Pruneri G, de Braud F, Dieci MV, Vernieri C. Abstract HER2-02: HER2-02 HER2-Low Status is Associated with Worse Clinical Outcomes in Hormone Receptor-Positive, HER2-Negative Advanced Breast Cancer Patients Treated With First-Line Cyclin-Dependent Kinase 4/6 Inhibitors Plus Endocrine Therapy. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-her2-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Introduction: Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in combination with endocrine therapy (ET) are the standard first-line treatment for patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (HR+/HER2- aBC). HER2-low BC, which is defined by an IHC score for HER2 of 1+ or 2+ with negative ISH assay, accounts for more than half of all HR+/HER2- aBC cases, and it is associated with remarkable clinical benefit from the novel anti-HER2 antibody drug conjugate (ADC) trastuzumab-deruxtecan. Evidence on the prognostic impact of HER2-low status is controversial in both limited-stage and advanced BC. Here, we sought to investigate the possible prognostic relevance of HER2-low status in a population of aBC patients treated with CDK4/6i plus ET. Methods: We conducted a retrospective-prospective study in six Italian Cancer Centers to investigate the impact of HER2 status (low vs. 0) on the progression-free survival (PFS) and overall survival (OS) of consecutive HR+/HER2- aBC patients treated with CDK4/6i plus ET (aromatase inhibitors or fulvestrant) as a first-line therapy. In the main study analysis, we considered HER2 status in the last tumor assessment (i.e., primary tumor, or, when available, a metastatic lesion). We also performed a subgroup analysis including only patients with HER2 status evaluation in a metastatic lesion collected before CDK4/6i plus ET therapy initiation. The association between HER2 status (low vs. 0) and PFS or OS was evaluated using log-rank test and Cox regression modeling. Results: We evaluated 767 consecutive HR+/HER2- aBC patients treated with CDK4/6i plus ET between January 2017 and January 2022. Of these, 436 patients (56.8%) received CDK4/6i plus ET as a first-line therapy, and they were included in this analysis. Median age was 63 years (range 27-87), and 362 patients (83.0%) were postmenopausal. The majority of patients were treated with palbociclib (68.3%), while 91 (20.9%) and 47 (10.8%) patients received ribociclib and abemaciclib, respectively. Regarding HER2 status, 269 (62.9%) patients had HER2-low tumors, while 159 (37.1%) patients had HER2-0 neoplasms. HER2-low status was associated with significantly lower PFS when compared to HER2-0 status [median PFS (mPFS) 23.6 vs. 32.3 months, respectively; p=0.014]. HER2-low status was also associated with significantly worse OS (mOS 48.7 vs 58.3 months, respectively; p=0.025). These results were confirmed in multivariable models adjusting the impact of HER2 status for clinically-relevant covariates, namely estrogen receptor status, Ki-67, age, number of metastatic sites, presence of liver metastases, disease free interval, ECOG Performance Status. In this analysis, HER2-low status, compared with HER2-0 status, was independently associated with worse PFS [adjusted Hazard Ratio (aHR): 1.62; 95% confidence interval (CI): 1.17-2.24; p< 0.01] and OS (aHR: 1.74; 95% CI: 1.09-2.76; p=0.019). Subgroup analysis conducted in the subset of 256 patients with available metastatic tumor samples collected before CDK4/6i plus ET initiation confirmed that HER2-low status (n=157), when compared to HER2-0 status (n=99), was independently associated with worse PFS (mPFS 24.5 vs 35.2 months, p=0.01; aHR 2.07; 95% CI: 1.28-3.34, p< 0.01) and worse OS (mPFS 48.7 vs 72.3 months, p=0.027; aHR 3.12; 95% CI 1.44-6.77, p< 0.01). Conclusions: This multicenter Italian study revealed that HER2-low status has independent, negative prognostic value in patients with HR+/HER2- aBC treated with CDK4/6i plus ET in the first-line setting. Our results suggest that HER2-low status might be associated with different clinical benefit from standard anticancer therapies in specific clinical settings. The definition of treatment algorithms also taking into account HER2 status is a clinical priority in patients with HR+/HER2- aBC.
Citation Format: Emma Zattarin, Caterina Sposetti, Rita Leporati, Luigi Mariani, Alice Menichetti, Chiara Corti, Chiara Benvenuti, Giovanni Fucà, Riccardo Lobefaro, Francesca Ligorio, Daniele Presti, Leonardo Provenzano, Andrea Vingiani, Gaia Griguolo, Marianna Sirico, Ottavia Bernocchi, Antonio Marra, Paola Zagami, Elisa Agostinetto, Flavia Jacobs, Pierluigi Di Mauro, Andrea Esposito, Carlo Alberto Giorgi, Luca Lalli, Laura Boldrini, Pier Paolo Maria Berton Giachetti, Ambra Carnevale Schianca, Valentina Guarneri, Rebecca Pedersini, Agnese Losurdo, Alberto Zambelli, Daniele Giulio Generali, Giuseppe Curigliano, Giancarlo Pruneri, Filippo de Braud, Maria Vittoria Dieci, Claudio Vernieri. HER2-02 HER2-Low Status is Associated with Worse Clinical Outcomes in Hormone Receptor-Positive, HER2-Negative Advanced Breast Cancer Patients Treated With First-Line Cyclin-Dependent Kinase 4/6 Inhibitors Plus Endocrine Therapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr HER2-02.
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Affiliation(s)
- Emma Zattarin
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Rita Leporati
- 3Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigi Mariani
- 4Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alice Menichetti
- 5Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Chiara Corti
- 6European Institute of Oncology, IRCCS, University of Milano, Milan, Italy, Pusiano (CO), Lombardia, Italy
| | - Chiara Benvenuti
- 7IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Giovanni Fucà
- 8Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Daniele Presti
- 11Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Gaia Griguolo
- 14Department of Surgery, Oncology and Gastroenterology, University of Padua; Division of Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Marianna Sirico
- 15Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy
| | | | | | - Paola Zagami
- 18European Institute of Oncology, IRCCS, University of Milano, Milan, Italy
| | | | - Flavia Jacobs
- 20Humanitas University, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano
| | | | - Andrea Esposito
- 22Medical Oncology Unit, ASST Spedali Civili, Brescia, Italy
| | - Carlo Alberto Giorgi
- 23Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Veneto, Italy
| | - Luca Lalli
- 24Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Boldrini
- 25European Institute of Oncology, IRCCS, University of Milano, Milan, Italy, Milano, Lombardia, Italy
| | | | - Ambra Carnevale Schianca
- 27Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Valentina Guarneri
- 28Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | | | - Agnese Losurdo
- 30IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Alberto Zambelli
- 31IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
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Torrisi R, Jacobs F, Miggiano C, De Sanctis R, Santoro A. HR +/HER2 - de novo metastatic breast cancer: a true peculiar entity? Drugs Context 2023; 12:dic-2022-12-2. [PMID: 36926051 PMCID: PMC10012832 DOI: 10.7573/dic.2022-12-2] [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: 12/13/2022] [Accepted: 01/18/2023] [Indexed: 03/08/2023] Open
Abstract
De novo metastatic breast cancer (dnMBC) accounts for ~6-10% of all breast cancers and for ~30% of MBC with increasing incidence over time. Hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) tumours are the most frequent subtype with a similar incidence to that observed amongst recurrent MBC (rMBC). Higher frequency of PI3KCA and ARID2 mutations and a lower frequency of ESR1 mutations and of genes involved in DNA damage, as compared with rMBC, have been reported in HR+/HER2- dnMBC; however, these are not correlating with prognosis, whilst tumour mutational burden is inversely correlated with outcome. Bone represents the most frequent metastatic site, being the single site in up to 60% of patients with dnMBC. HR+/HER2- dnMBC has been generally reported to have better outcomes than rMBC, with a median overall survival ranging from 26 months to nearly 5 years in patients with favourable features such as age <40 years and bone-only disease, but not when compared with patients with late recurring disease (≥2-5 years). Analyses of the de novo cohorts within randomized clinical trials and large real-world series report a better outcome after treatment with CDK4/6 inhibitors and endocrine agents as compared to rMBC. Despite the limitations of retrospective studies and controversial results of the randomized trials, locoregional treatment of the primary tumour after response to systemic therapy appears to confer a survival benefit, particularly in patients with favourable prognostic factors. Altogether genomic, biological and clinical findings highlight HR+/HER2- dnMBC as a peculiar entity as compared with rMBC and deserve a dedicated treatment algorithm. This article is part of the Tackling clinical complexity in breast cancer Special Issue: https://www.drugsincontext.com/special_issues/tackling-clinical-complexity-in-breast-cancer/.
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Affiliation(s)
- Rosalba Torrisi
- IRCCS Humanitas Research Hospital, Department of Medical Oncology and Hematology, Milan, Italy
| | - Flavia Jacobs
- IRCCS Humanitas Research Hospital, Department of Medical Oncology and Hematology, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Chiara Miggiano
- IRCCS Humanitas Research Hospital, Department of Medical Oncology and Hematology, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Rita De Sanctis
- IRCCS Humanitas Research Hospital, Department of Medical Oncology and Hematology, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Armando Santoro
- IRCCS Humanitas Research Hospital, Department of Medical Oncology and Hematology, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Molinelli C, Jacobs F, Marchiò C, Pitto F, Cosso M, Spinaci S, de Azambuja E, Schettini F, Agostinetto E, Lambertini M. HER2-Low Breast Cancer: Where Are We? Breast Care (Basel) 2022; 17:533-545. [PMID: 36590146 PMCID: PMC9801403 DOI: 10.1159/000527391] [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: 09/16/2022] [Accepted: 10/05/2022] [Indexed: 01/04/2023] Open
Abstract
Background Breast cancer is traditionally classified into three clinical subtypes based on hormone receptor and HER2 status (i.e., luminal-like, HER2-positive, and triple negative). Each subtype has distinct clinical-pathological and molecular characteristics and requires tailored treatments. Recent research efforts have been focusing on a new classification, identifying the so-called "HER2-low" category, including tumors characterized by a low level of HER2 expression (immunohistochemistry score 1+ or 2+ without in situ hybridization amplification). Emerging evidence shows that patients with HER2-low tumors can derive benefit from selected anti-HER2 therapies. This represents a major advancement in the field of breast oncology, where a broader proportion of patients with breast cancer can ultimately benefit from new effective targeted treatment strategies. Summary The antibody-drug conjugate trastuzumab deruxtecan has proven impressive efficacy in patients with HER2-low breast cancer, and several other drugs are currently under investigation in this subset of patients. Additional investigation is needed to address open issues that exist in this field, including appropriate pathological assessment of HER2-low status, clarification of its prognostic implications, and global access to newly approved drugs. Key Message Our review aims to summarize the available evidence regarding HER2-low breast cancer, illustrating the current challenges that are being addressed and the future perspectives in this exciting new field.
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Affiliation(s)
- Chiara Molinelli
- Academic Trials Promoting Team, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy
| | - Flavia Jacobs
- Academic Trials Promoting Team, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, Milan, Italy
| | - Caterina Marchiò
- Department of Medical Sciences, University of Turin, Turin, Italy
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Torino, Italy
| | - Francesca Pitto
- Department of Pathology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Maurizio Cosso
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Evandro de Azambuja
- Academic Trials Promoting Team, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Francesco Schettini
- Medical Oncology Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
- Department of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Elisa Agostinetto
- Academic Trials Promoting Team, Institut Jules Bordet, L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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Agostinetto E, Jacobs F, Debien V, De Caluwé A, Pop CF, Catteau X, Aftimos P, de Azambuja E, Buisseret L. Post-Neoadjuvant Treatment Strategies for Patients with Early Breast Cancer. Cancers (Basel) 2022; 14:cancers14215467. [PMID: 36358886 PMCID: PMC9654353 DOI: 10.3390/cancers14215467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 09/19/2022] [Revised: 10/14/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
Simple Summary Treatment strategies for early breast cancer have significantly improved in the last decades. Several new effective agents have proved clinical benefit and have entered the clinics, changing the treatment landscape for this disease and inducing significant prolongation of patient survival. Alongside, there has been an evolution in the design of clinical trials for early breast cancer, with an increasing interest in the pre-surgical treatment approach, which allows a direct evaluation of treatment effect on tumor size and a post-therapy risk stratification. Consequently, the post-neoadjuvant setting has been gaining increasing attention, thanks to the possibility to provide additional treatment for selected patients at higher risk of relapse, namely those who did not respond to neoadjuvant therapy and had residual disease at surgery. Abstract Pre-surgical treatments in patients with early breast cancer allows a direct estimation of treatment efficacy, by comparing the tumor and the treatment. Patients who achieve a pathological complete response at surgery have a better prognosis, with lower risk of disease recurrence and death. Hence, clinical research efforts have been focusing on high-risk patients with residual disease at surgery, who may be “salvaged” through additional treatments administered in the post-neoadjuvant setting. In the present review, we aim to illustrate the development and advantages of the post-neoadjuvant setting, and to discuss the available strategies for patients with early breast cancer, either approved or under investigation. This review was written after literature search on main scientific databases (e.g., PubMed) and conference proceedings from major oncology conferences up to 1 August 2022. T-DM1 and capecitabine are currently approved as post-neoadjuvant treatments for patients with HER2-positive and triple-negative breast cancer, respectively, with residual disease at surgery. More recently, other treatment strategies have been approved for patients with high-risk early breast cancer, including the immune checkpoint inhibitor pembrolizumab, the PARP inhibitor olaparib and the CDK 4/6 inhibitor abemaciclib. Novel agents and treatment combinations are currently under investigation as promising post-neoadjuvant treatment strategies.
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Affiliation(s)
- Elisa Agostinetto
- Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.),1070 Bruxelles, Belgium
| | - Flavia Jacobs
- Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.),1070 Bruxelles, Belgium
| | - Véronique Debien
- Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.),1070 Bruxelles, Belgium
| | - Alex De Caluwé
- Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.),1070 Bruxelles, Belgium
| | - Catalin-Florin Pop
- Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.),1070 Bruxelles, Belgium
| | - Xavier Catteau
- Curepath Laboratory (CHU Tivoli, CHIREC), Rue de Borfilet 12A, 6040 Jumet, Belgium
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles, route de Lennik 808, 1070 Brussels, Belgium
| | - Philippe Aftimos
- Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.),1070 Bruxelles, Belgium
| | - Evandro de Azambuja
- Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.),1070 Bruxelles, Belgium
| | - Laurence Buisseret
- Institut Jules Bordet, L’Université Libre de Bruxelles (U.L.B.),1070 Bruxelles, Belgium
- Correspondence:
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Tiberio P, Antunovic L, Gaudio M, Viganò A, Pastore M, Miggiano C, Jacobs F, Benvenuti C, Farina E, Chiti A, Santoro A, De Sanctis R. The relationship among bowel FDG-PET uptake, pathological complete response, and eating habits in breast cancer patients undergoing neoadjuvant chemotherapy. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01520-9] [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: 11/19/2022]
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Tiberio P, Antunovic L, Gaudio M, Viganò A, Pastore M, Miggiano C, Jacobs F, Benvenuti C, Farina E, Chiti A, Santoro A, De Sanctis R. 48P The relationship among bowel FDG-PET uptake, pathological complete response, and the influence of eating and exercise habits in breast cancer patients undergoing neoadjuvant chemotherapy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.049] [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: 11/29/2022] Open
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De Sanctis R, Jacobs F, Benvenuti C, Gaudio M, Franceschini R, Tancredi R, Pedrazzoli P, Santoro A, Zambelli A. From seaside to bedside: Current evidence and future perspectives in the treatment of breast cancer using marine compounds. Front Pharmacol 2022; 13:909566. [PMID: 36160422 PMCID: PMC9495264 DOI: 10.3389/fphar.2022.909566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/31/2022] [Accepted: 08/08/2022] [Indexed: 12/02/2022] Open
Abstract
To date, only few marine natural compounds have been proved to be active in breast cancer (BC). The main marine-derived drugs that have been studied for the treatment of BC are tubulin-binding agents (eribulin and plocabulin), DNA-targeting agents (cytarabine and minor groove binders—trabectedin and lurbinectedin) and Antibody-Drug Conjugates (ADCs). Notably, eribulin is the only approved cytotoxic drug for the treatment of advanced BC (ABC), while cytarabine has a limited indication in case of leptomeningeal diffusion of the disease. Also plocabulin showed limited activity in ABC but further research is needed to define its ultimate potential role. The available clinical data for both trabectedin and lurbinectedin are of particular interest in the treatment of BRCA-mutated tumours and HR deficient disease, probably due to a possible immune-mediated mechanism of action. One of the most innovative therapeutic options for the treatment of BC, particularly in TNBC and HER2-positive BC, are ADCs. Some of the ADCs were developed using a specific marine-derived cytotoxic molecule as payload called auristatin. Among these, clinical data are available on ladiratuzumab vedotin and glembatumumab vedotin in TNBC, and on disitamab vedotin and ALT-P7 in HER2-positive patients. A deeper knowledge of the mechanism of action and of the potential predictive factors for response to marine-derived drugs is important for their rational and effective use, alone or in combination. In this narrative review, we discuss the role of marine-derived drugs for the treatment of BC, although most of them are not approved, and the opportunities that could arise from the potential treasure trove of the sea for novel BC therapeutics.
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Affiliation(s)
- Rita De Sanctis
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Flavia Jacobs
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Chiara Benvenuti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Mariangela Gaudio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Raul Franceschini
- Department of Chemistry, Università degli studi di Milano Statale, Milan, Italy
| | - Richard Tancredi
- Medical Oncology Unit, ASST Melegnano Martesana, Ospedale A. Uboldo, Milan, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- *Correspondence: Alberto Zambelli,
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Vernieri C, Zattarin E, Mariani L, Menichetti A, Leporati R, Ligorio F, Fuca G, Lobefaro R, Griguolo G, Sirico M, Bernocchi O, Marra A, Agostinetto E, Jacobs F, di Mauro P, Curigliano G, Pedersini R, Losurdo A, Generali D, Dieci M. 227P Peripheral blood lymphocyte counts predict clinical outcomes in patients with hormone receptor-positive HER2-negative advanced breast cancer treated with CDK4/6 inhibitors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.266] [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: 11/29/2022] Open
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Landi L, Tiseo M, Heukamp L, Menon R, de Marinis F, Minuti G, Cortinovis D, Delmonte A, Galetta D, Bertrand M, Zacher A, Gridelli C, Jacobs F, Chiari R, Verusio C, Giannarelli D, Crinò L, Cappuzzo F. P2.14-02 TP53 Mutations Affect Sensitivity to Lorlatinib in ROS1 Positive NSCLC: Final Results of the PFROST Trial. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.258] [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: 10/14/2022]
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De Sanctis R, Antunovic L, Benvenuti C, Jacobs F, Gaudio M, Ilieva M, Viganò A, Chiti A, Santoro A. Brain 18-FDG-PET patterns in early breast cancer subtypes: Relationship with headache. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e12560] [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
e12560 Background: Brain metabolic response on 18F-fuorodeoxiglucose(FDG)-PET in breast cancer (BC) patients is not routinely investigated, although several bidirectional relationships have been described between BC (and BC therapies) and brain functions. For example, common forms of headaches, as migraine (Mi) and tension-type headache (TTH), seem to be oddly distributed among BC subtypes and possibly influence the outcome. Methods: We recruited patients with early BC referring to IRCCS Humanitas Research Hospital who received neoadjuvant chemotherapy. Demographic data, BC characteristics and headache diagnosis were recorded, through detailed interview and instrumental investigation. Ki67 was considered high if above 20%. All patients underwent dedicated 18F-FDG PET scan for the evaluation of brain metabolism. Semiquantitative image analysis was performed using Cortex ID software (GE), comparing patient’s scan with a control group by the means of Z-score. The difference between patients’ subgroups were assessed using One-way ANOVA model. Results: Twenty-three patients were recruited. The median age was 52.5±10.8 years; 65.2% were postmenopausal, 30% premenopausal, and one patient perimenopausal. Ten patients were diagnosed as triple-negative BC, 6 as HER2-positive and 7 as Luminal B/HER2+. Nearly 70% (16/23) of patients had high Ki67 values. All patients had ECOG PS 0. Ten patients were diagnosed with TTH, 9 with migraine of whom two with aura, and four patients had no headache. Eleven patients had active headache at the moment of the study. At the whole brain level, we found a significant increase of brain metabolism in the left hemisphere of BC patients with high Ki-67 (p=0.007). Moreover, the same result was found in parietal cortex and in general associative areas bilaterally. Instead, HER-2 positive BC patient showed a reduced metabolism in right temporal cortex compared to HER-2 negative (p=0.04). Grading and other tumor characteristics did not influence FDG-PET uptake. BC patients with TTH had a reduced activity in right medial frontal lobe compared with migraine patients (p=0.01). Those with an active headache had increased activity in posterior cingulate and reduced activity in visual networks (p=0.03). Conclusions: Although exploratory, this study suggests that BC subtypes could present different metabolic pattern of cerebral activity, particularly in dominant hemisphere and associative areas. The high prevalence of headache in our sample does not affect the above pattern, but it is associated with an altered activation in other networks, mainly cingulate and visual cortex, which are well-known areas involved in primary headache.
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Affiliation(s)
- Rita De Sanctis
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano (Milan), Italy
| | - Lidija Antunovic
- IRCCS Humanitas Research Hospital, Department of Nuclear Medicine, Rozzano (Milan), Italy
| | - Chiara Benvenuti
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano (Milan), Italy
| | - Flavia Jacobs
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano (Milan), Italy
| | - Mariangela Gaudio
- IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano (Milan), Italy
| | - Mariya Ilieva
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele (Milan), Italy
| | | | - Arturo Chiti
- Humanitas University, Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Department of Nuclear Medicine, Pieve Emanuele (Milan), Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy
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De Sanctis R, Antunovic L, Benvenuti C, Jacobs F, Gaudio M, Ilieva M, Viganò A, Chiti A, Santoro A. 50P Brain 18-FDG-PET patterns in early breast cancer subtypes: Relationship with headache. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.065] [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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Teekema S, Stroo A, Uiterwijk M, van de Vossenberg B, Jacobs F, Ibáñez‑Justicia A. First finding of Aedes koreicus (Diptera: Culicidae) in the Netherlands. Journal of the European Mosquito Control Association 2022. [DOI: 10.52004/jemca2021.0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Since 2010, the Centre for Monitoring of Vectors (CMV) of the Netherlands Food and Consumer Product Safety Authority (NVWA), has a surveillance programme in place to detect and control invasive mosquito species (IMS) at locations with increased risk of importation. At the premises of companies that import used tyres from risk areas, the CMV implements surveillance using adult mosquito traps. In case of an IMS finding at a used tyre company location, the monitoring is intensified here (weekly sampling, additional BG-Sentinel traps and larval sampling), as well as within a predefined area with a radius of 500 m from the limits of the used tyre company location. On September 6th, 2021, eight Aedes larvae were found in a sample taken from a water-containing bucket. These larvae were both morphologically and molecularly (Illumina sequencing) identified as Aedes koreicus. Additional sampling at this first finding site of Ae. koreicus in the Netherlands, which was followed by mosquito control using larvicides, did not lead to further findings of the species.
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Affiliation(s)
- S. Teekema
- Centre for Monitoring of Vectors (CMV), Netherlands Food and Consumer Product Safety Authority (NVWA), Geertjesweg 15, 6706 EA Wageningen, the Netherlands
| | - A. Stroo
- Centre for Monitoring of Vectors (CMV), Netherlands Food and Consumer Product Safety Authority (NVWA), Geertjesweg 15, 6706 EA Wageningen, the Netherlands
| | - M. Uiterwijk
- Centre for Monitoring of Vectors (CMV), Netherlands Food and Consumer Product Safety Authority (NVWA), Geertjesweg 15, 6706 EA Wageningen, the Netherlands
| | - B. van de Vossenberg
- National Plant Protection Organization (NPPO-NL), Netherlands Food and Consumer Product Safety Authority (NVWA), Geertjesweg 15, 6706 EA Wageningen, the Netherlands
| | - F. Jacobs
- Centre for Monitoring of Vectors (CMV), Netherlands Food and Consumer Product Safety Authority (NVWA), Geertjesweg 15, 6706 EA Wageningen, the Netherlands
| | - A. Ibáñez‑Justicia
- Centre for Monitoring of Vectors (CMV), Netherlands Food and Consumer Product Safety Authority (NVWA), Geertjesweg 15, 6706 EA Wageningen, the Netherlands
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Bironzo P, Jacobs F, Cani M, Reale M, Tabbò F, Olmetto E, Capelletto E, Napoli V, Passiglia F, Listì A, Righi L, Di Maio M, Novello S, Scagliotti G. P59.20 Natural History of KRAS Mutant Non-Small-Cell Lung Cancer in the Immunotherapy Era: A Single-Centre Retrospective Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.609] [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]
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Derksen M, Kourula S, Jacobs F, Lee Roos J, Van Heerden M, Frazer-Mendelewska E, Ramos E, Lai K, Jonkers S, Theuns V, Verboven P, Huybrechts T, van Asten S, Kunze A, Jardi F, Monshouwer M, Vries R, Boj S, Snoeys J, Pourfarzad F. HUB Organoids™ improve pre-clinical toxicology, metabolism, and pharmacokinetic studies for drug discovery and development. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00534-8] [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: 11/29/2022]
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Angioni D, Hites M, Jacobs F, De Breucker S. Predictive Factors of In-Hospital Mortality in Older Adults with Community-Acquired Bloodstream Infection. J Frailty Aging 2020; 9:232-237. [PMID: 32996560 DOI: 10.14283/jfa.2019.45] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/11/2022]
Abstract
OBJECTIVES To assess the prevalence of intra-hospital mortality and associated risk factors in older people aged 75+, admitted with blood stream infections (BSI). DESIGN Single center retrospective study performed in an 850-bed of the academic hospital of the Université Libre de Bruxelles. SETTING AND PARTICIPANTS From January 2015 to December 2017, all inpatients over 75 years old admitted with BSI were included. MEASURES Demographical, clinical and microbiological data were collected. RESULTS 212 patients were included: median age was 82 [79-85] years and 60 % were female. The in-hospital mortality rate was 19%. The majority of microorganisms were Gram-negative strains, of which Escherichia coli was the most common, and urinary tract infection was the most common origin of BSI. Compared to patients who survived, the non-survivor group had a higher SOFA score (6 versus 3, p<0.0001), a higher comorbidity score (5 versus 4, p<0.0001), more respiratory tract infections (28 vs 6 %, p < 0.0001) and fungal infections (5 vs 1 %, p = 0.033), bedridden status (60 vs 25 %, p < 0.0001), and healthcare related infections (60 vs 40 %, p = 0.019). Using Cox multivariable regression analysis, only SOFA score was independently associated with mortality (HR 1.75 [95%IC 1.52-2.03], p<0.0001). CONCLUSIONS AND IMPLICATIONS BSI in older people are severe infections associated with a significant in-hospital mortality. Severity of clinical presentation at onset remains the most important predictor of mortality for BSI in older people. BSI originating from respiratory source and bedridden patients are at greater risk of intra-hospital mortality. Further prospective studies are needed to confirm these results.
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Affiliation(s)
- D Angioni
- Davide Angioni, Hopital Erasme, Gériatrie, Belgium,
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Brosseau C, Danger R, Durand M, Durand E, Foureau A, Lacoste P, Tissot A, Roux A, Reynaud-Gaubert M, Kessler R, Mussot S, Dromer C, Brugière O, Mornex JF, Guillemain R, Claustre J, Magnan A, Brouard S, Velly J, Rozé H, Blanchard E, Antoine M, Cappello M, Ruiz M, Sokolow Y, Vanden Eynden F, Van Nooten G, Barvais L, Berré J, Brimioulle S, De Backer D, Créteur J, Engelman E, Huybrechts I, Ickx B, Preiser T, Tuna T, Van Obberghe L, Vancutsem N, Vincent J, De Vuyst P, Etienne I, Féry F, Jacobs F, Knoop C, Vachiéry J, Van den Borne P, Wellemans I, Amand G, Collignon L, Giroux M, Angelescu D, Chavanon O, Hacini R, Martin C, Pirvu A, Porcu P, Albaladejo P, Allègre C, Bataillard A, Bedague D, Briot E, Casez‐Brasseur M, Colas D, Dessertaine G, Francony G, Hebrard A, Marino M, Protar D, Rehm D, Robin S, Rossi‐Blancher M, Augier C, Bedouch P, Boignard A, Bouvaist H, Briault A, Camara B, Chanoine S, Dubuc M, Quétant S, Maurizi J, Pavèse P, Pison C, Saint‐Raymond C, Wion N, Chérion C, Grima R, Jegaden O, Maury J, Tronc F, Flamens C, Paulus S, Philit F, Senechal A, Glérant J, Turquier S, Gamondes D, Chalabresse L, Thivolet‐Bejui F, Barnel C, Dubois C, Tiberghien A, Pimpec‐Barthes F, Bel A, Mordant P, Achouh P, Boussaud V, Méléard D, Bricourt M, Cholley B, Pezella V, Brioude G, D'Journo X, Doddoli C, Thomas P, Trousse D, Dizier S, Leone M, Papazian L, Bregeon F, Coltey B, Dufeu N, Dutau H, Garcia S, Gaubert J, Gomez C, Laroumagne S, Mouton G, Nieves A, Picard C, Rolain J, Sampol E, Secq V, Perigaud C, Roussel J, Senage T, Mugniot A, Danner I, Haloun A, Abbes S, Bry C, Blanc F, Lepoivre T, Botturi‐Cavaillès K, Loy J, Bernard M, Godard E, Royer P, Henrio K, Dartevelle P, Fabre D, Fadel E, Mercier O, Stephan F, Viard P, Cerrina J, Dorfmuller P, Feuillet S, Ghigna M, Hervén P, Le Roy Ladurie F, Le Pavec J, Thomas de Montpreville V, Lamrani L, Castier Y, Mordant P, Cerceau P, Augustin P, Jean‐Baptiste S, Boudinet S, Montravers P, Dauriat G, Jébrak G, Mal H, Marceau A, Métivier A, Thabut G, Lhuillier E, Dupin C, Bunel V, Falcoz P, Massard G, Santelmo N, Ajob G, Collange O, Helms O, Hentz J, Roche A, Bakouboula B, Degot T, Dory A, Hirschi S, Ohlmann‐Caillard S, Kessler L, Schuller A, Bennedif K, Vargas S, Bonnette P, Chapelier A, Puyo P, Sage E, Bresson J, Caille V, Cerf C, Devaquet J, Dumans‐Nizard V, Felten M, Fischler M, Si Larbi A, Leguen M, Ley L, Liu N, Trebbia G, De Miranda S, Douvry B, Gonin F, Grenet D, Hamid A, Neveu H, Parquin F, Picard C, Stern M, Bouillioud F, Cahen P, Colombat M, Dautricourt C, Delahousse M, D'Urso B, Gravisse J, Guth A, Hillaire S, Honderlick P, Lequintrec M, Longchampt E, Mellot F, Scherrer A, Temagoult L, Tricot L, Vasse M, Veyrie C, Zemoura L, Dahan M, Murris M, Benahoua H, Berjaud J, Le Borgne Krams A, Crognier L, Brouchet L, Mathe O, Didier A, Krueger T, Ris H, Gonzalez M, Aubert J, Nicod L, Marsland B, Berutto T, Rochat T, Soccal P, Jolliet P, Koutsokera A, Marcucci C, Manuel O, Bernasconi E, Chollet M, Gronchi F, Courbon C, Hillinger S, Inci I, Kestenholz P, Weder W, Schuepbach R, Zalunardo M, Benden C, Buergi U, Huber L, Isenring B, Schuurmans M, Gaspert A, Holzmann D, Müller N, Schmid C, Vrugt B, Rechsteiner T, Fritz A, Maier D, Deplanche K, Koubi D, Ernst F, Paprotka T, Schmitt M, Wahl B, Boissel J, Olivera‐Botello G, Trocmé C, Toussaint B, Bourgoin‐Voillard S, Séve M, Benmerad M, Siroux V, Slama R, Auffray C, Charron D, Lefaudeux D, Pellet J. Blood CD9 + B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant 2019; 19:3162-3175. [PMID: 31305014 DOI: 10.1111/ajt.15532] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 01/25/2023]
Abstract
Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24hi CD38hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24hi CD38hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9+ B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24hi CD38hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome-free survival.
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Affiliation(s)
- Carole Brosseau
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Richard Danger
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Maxim Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Eugénie Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Aurore Foureau
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Philippe Lacoste
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Adrien Tissot
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Antoine Roux
- Hôpital Foch, Suresnes, France.,Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Versailles, France
| | | | | | - Sacha Mussot
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | | | - Olivier Brugière
- Hôpital Bichat, Service de Pneumologie et Transplantation Pulmonaire, Paris, France
| | | | | | - Johanna Claustre
- Clinique Universitaire Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U1055, Grenoble, France
| | - Antoine Magnan
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Sophie Brouard
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Centre d'Investigation Clinique (CIC) Biothérapie, CHU Nantes, Nantes, France
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Kumar M, Chesnais F, Boon R, Krebs A, Curtiss C, Toprakhisar B, Jacobs F, Schmidt B, Leist M, Verfaillie C. Creation of a stable and highly functional pluripotent stem cell derived hepatocyte model for drug metabolisation and toxicity screening. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.06.542] [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: 10/28/2022]
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Ibañez-Justicia A, Teekema S, den Hartog W, Jacobs F, Dik M, Stroo A. The Effectiveness of Asian Bush Mosquito (Aedes japonicus japonicus) Control Actions in Colonised Peri-urban Areas in the Netherlands. J Med Entomol 2018; 55:673-680. [PMID: 29452383 PMCID: PMC5946817 DOI: 10.1093/jme/tjy002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Indexed: 05/11/2023]
Abstract
The Asian bush mosquito (Aedes japonicus japonicus (Theobald)) is an invasive mosquito species in Europe. In 2012, it was for the first time detected in the Netherlands, in the municipality of Lelystad. After further research, thousands of specimens were found in the surrounding peri-urban areas of the city. A targeted mosquito control campaign began in 2015 with the objective of reducing populations in locations with the highest concentrations of Ae. japonicus breeding sites: allotment garden complexes. Mosquito control consisted of source reduction combined with application of the larvicide Vectomax in breeding sites. At eight complexes, mosquito control effectiveness has been systematically measured by sampling larvae from breeding sites. Six measurements were performed between 2015 and 2016. Results show that the effectiveness of mosquito control actions was similar in all treated allotment gardens and resulted in a significant reduction in Ae. japonicus larval abundance. Rain barrels at the allotments represent the most frequent breeding site in Lelystad, but every water filled artificial container is a potential breeding site for the species. Ae. japonicus was not found in the samples taken in other allotment gardens in the province of Flevoland; however, the collection methodology used proven to be effective in detecting this species when it has newly colonized surrounding areas. Targeted mosquito control actions at the breeding sites are crucial for successful reduction of populations of an invasive mosquito species, and systematic measurements of the effectiveness, is in this case, the base to understand the dynamics of Ae. japonicus populations after mosquito control.
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Affiliation(s)
- A Ibañez-Justicia
- Centre for Monitoring of Vectors, Netherlands Food and Consumer Product Safety Authority (NVWA), National Reference Centre (NRC), Ministry of Economic Affairs, Wageningen, The Netherlands
- Corresponding author, e-mail:
| | - S Teekema
- Centre for Monitoring of Vectors, Netherlands Food and Consumer Product Safety Authority (NVWA), National Reference Centre (NRC), Ministry of Economic Affairs, Wageningen, The Netherlands
| | - W den Hartog
- Centre for Monitoring of Vectors, Netherlands Food and Consumer Product Safety Authority (NVWA), National Reference Centre (NRC), Ministry of Economic Affairs, Wageningen, The Netherlands
| | - F Jacobs
- Centre for Monitoring of Vectors, Netherlands Food and Consumer Product Safety Authority (NVWA), National Reference Centre (NRC), Ministry of Economic Affairs, Wageningen, The Netherlands
| | - M Dik
- Centre for Monitoring of Vectors, Netherlands Food and Consumer Product Safety Authority (NVWA), National Reference Centre (NRC), Ministry of Economic Affairs, Wageningen, The Netherlands
| | - A Stroo
- Centre for Monitoring of Vectors, Netherlands Food and Consumer Product Safety Authority (NVWA), National Reference Centre (NRC), Ministry of Economic Affairs, Wageningen, The Netherlands
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Ibañez-Justicia A, Gloria-Soria A, den Hartog W, Dik M, Jacobs F, Stroo A. The first detected airline introductions of yellow fever mosquitoes (Aedes aegypti) to Europe, at Schiphol International airport, the Netherlands. Parasit Vectors 2017; 10:603. [PMID: 29221490 PMCID: PMC5723084 DOI: 10.1186/s13071-017-2555-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [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: 07/20/2017] [Accepted: 11/26/2017] [Indexed: 11/21/2022] Open
Abstract
Background Air-borne introduction of exotic mosquitoes to Schiphol airport in the Netherlands has been considered plausible based upon findings of mosquitoes in aircraft cabins during 2008, 2010 and 2011. Beginning in 2013, surveillance efforts at Schiphol had focused on promptly detecting accidental introductions at the airport facilities in order to quickly react and avoid temporary proliferation or establishment of mosquito populations, identify the origin of the introductions, and avoid potential transmission of vector-borne diseases. Methods BG-Mosquitaire mosquito traps were set at the most likely locations for arrival of the invasive Aedes mosquitoes as part of the mosquito monitoring program at Schiphol airport. Samples were collected bi-weekly. Upon detection of exotic specimens, information about the origin of the flights arriving to the particular location at the airport where specimens were captured was requested from airport authorities. The GIS tool Intersect was then used to identify airports of origin common to positive trapping locations during the specific trapping period. Captured Aedes aegypti mosquitoes were subsequently genotyped at 12 highly polymorphic microsatellite markers and compared to a reference database of 79 populations around the world to further narrow down their location of origin. Results In 2016, six adult yellow fever mosquitoes were captured indoors and outdoors at the airport of Schiphol in the Netherlands confirming, for the first time, air-borne transport of this mosquito vector species into Europe. Mosquitoes were captured during three time periods: June, September and October. Containers carried by aircrafts are considered the most likely pathway for this introduction. GIS analysis and genetic assignment tests on these mosquitoes point to North America or the Middle East as possible origins, but the small sample size prevents us from reliably identifying the geographic origin of this introduction. Conclusions The arrival of Ae. aegypti mosquitoes to Schiphol airport from flights arriving from overseas, demonstrates the potential risk of international flights to public health as carriers of arthropod vectors of disease. The results strongly suggest that disinsection of containers and their storage compartments inside the aircrafts could contribute to preventing future introductions of mosquito vectors. Invasive mosquito species introduced by aircrafts from overseas could become seasonally established during the warmer months in Europe, or permanently in certain climatically suitable areas for the species, with major consequences for human health. Electronic supplementary material The online version of this article (10.1186/s13071-017-2555-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A Ibañez-Justicia
- Centre for Monitoring of Vectors, Food and Consumer Product Safety Authority, P.O. Box 9102, 6700 HC, Wageningen, The Netherlands.
| | - A Gloria-Soria
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, 06511, USA
| | - W den Hartog
- Centre for Monitoring of Vectors, Food and Consumer Product Safety Authority, P.O. Box 9102, 6700 HC, Wageningen, The Netherlands
| | - M Dik
- Centre for Monitoring of Vectors, Food and Consumer Product Safety Authority, P.O. Box 9102, 6700 HC, Wageningen, The Netherlands
| | - F Jacobs
- Centre for Monitoring of Vectors, Food and Consumer Product Safety Authority, P.O. Box 9102, 6700 HC, Wageningen, The Netherlands
| | - A Stroo
- Centre for Monitoring of Vectors, Food and Consumer Product Safety Authority, P.O. Box 9102, 6700 HC, Wageningen, The Netherlands
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Jacobs F. [Lower respiratory tract infections in immunocompetent adult]. Rev Med Brux 2017; 38:313-319. [PMID: 28981235] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Lower respiratory tract infections represent one of the main causes of mortality in the world. They essentially consist of bronchitis, acute exacerbations of chronic obstructive bronchopulmonary diseases (COPD) and acute pneumonia. If acute bronchitis is mainly of viral origin, acute exacerbations of COPD and pneumonia are mainly due to a trio of bacteria (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis). Other pathogens as many viruses and atypical bacteria such as Mycoplasma pneumoniae, Legionella, some Enterobacteriaceae and very rarely Pseudomonas aeruginosa are also implicated. S. pneumoniae is the pathogen associated with the greatest morbidity and mortality and empirical antibiotic treatment should always be active on this germ. According to the type of infection and factors of comorbidity, empirical antibiotic treatment should cover a number of other pathogens. Beta-lactams, associated or not with macrolides/azalides are the first line treatment. Fluoroquinolones, although highly active against all pathogens, must be used only in restricted situations in order to avoid emergence of resistance to these antibiotics.
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Affiliation(s)
- F Jacobs
- Clinique des Maladies infectieuses, Hôpital Erasme, ULB
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Steensels D, Reynders M, Descheemaeker P, Curran M, Jacobs F, Denis O, Delforge ML, Montesinos I. Direct fluorescent antibody, focus diagnostics Simplexa™ Flu A/B & RSV and multi-parameter customized respiratory Taqman® Array Card testing in immunocompromised patients. J Clin Virol 2016. [DOI: 10.1016/j.jcv.2016.08.041] [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: 10/21/2022]
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Lebeaux D, Coussement J, van Delden C, Guillot H, Freund R, Marbus S, Melica G, Rodriguez-Nava V, Jacobs F, Lortholary O. COL 8-02 - Facteurs de risque de nocardiose après transplantation d’organe : première étude rétrospective cas-témoin européenne. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30292-x] [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: 11/26/2022]
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Lheureux O, Trepo E, Hites M, Cotton F, Wolff F, Surin R, Creteur J, Vincent JL, Gustot T, Jacobs F, Taccone FS. B-lactams serum concentrations in critically ill cirrhotic patients: a matched-control study. Intensive Care Med Exp 2015. [PMCID: PMC4797602 DOI: 10.1186/2197-425x-3-s1-a401] [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: 11/17/2022] Open
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Brasseur A, Hites M, Roisin S, Cotton F, Vincent JL, De Backer D, Jacobs F, Taccone FS. A high aminoglycoside regimen associated with renal replacement therapy for the treatment of multi-drug resistant pathogens. Intensive Care Med Exp 2015. [PMCID: PMC4797808 DOI: 10.1186/2197-425x-3-s1-a404] [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: 12/02/2022] Open
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Hamzaoui O, Jozwiak M, Geffriaud T, Sztrymf B, Prat D, Jacobs F, Monnet X, Trouiller P, Richard C, Teboul JL. Norepinephrine exerts an inotropic effect at the early phase of human septic shock. Intensive Care Med Exp 2015. [PMCID: PMC4798414 DOI: 10.1186/2197-425x-3-s1-a798] [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: 11/16/2022] Open
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Beumier M, Casu GS, Hites M, Wolff F, Cotton F, Vincent JL, Jacobs F, Taccone FS. Elevated β-lactam concentrations associated with neurological deterioration in ICU septic patients. Minerva Anestesiol 2015; 81:497-506. [PMID: 25220556] [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: 06/03/2023]
Abstract
BACKGROUND Although β-lactams are considered to have a safe therapeutic profile, neurotoxicity has been reported. The aim of this study was to assess the association between β-lactam concentrations and neurological alterations in septic ICU patients. METHODS Retrospective study on all ICU patients who were treated with meropenem (MEM), piperacillin-tazobactam (TZP) or ceftazidime/cefepime (CEF) and in whom at least one β-lactam trough concentration (C min) was determined. Drug levels were measured using high-performance liquid chromatography; C min was normalized to the clinical breakpoint of Pseudomonas aeruginosa (as determined by EUCAST) for each drug (C min/MIC). Changes in neurological status were evaluated using changes in the neurological sequential organ failure assessment score (ΔnSOFA) using the formula: ΔnSOFA = nSOFA(day of TDM) - nSOFA(ICU admission). Worsening neurological status (NWS) was defined as a ΔnSOFA ≥ 1 for an nSOFA on admission of 0-2. RESULTS We collected 262 C min in 199 patients (130 MEM, 85 TZP, 47 CEF). Median APACHE II score and GCS on admission were 17 and 15, respectively. Overall ICU mortality was 27 %. There were no differences in the occurrence of NWS between antibiotics (39% for MEM, 32% for TZP and 35% for CEF). The occurrence of NWS increased with increasing C min/MIC ranges (P = 0.008); this correlation was found for TZP (P = 0.05) and MEM (P = 0.01), but not for CEF. C min/MIC was an independent predictive factor for NWS (OR 1.12 [1.04-1.20]). CONCLUSION We found a correlation between high β-lactam trough concentrations and increased occurrence of neurological deterioration in septic ICU patients. Although our data cannot determine causality, monitoring of β-lactam levels should be considered when deterioration of neurological status occurs during critical illness.
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Affiliation(s)
- M Beumier
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium -
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Dodémont M, Hites M, Bailly B, Trepant AL, De Mendonça R, Denis O, Jacobs F, Montesinos I. When you can't see the wood for the trees. Mucor circinelloides: A rare case of primary cutaneous zygomycosis. J Mycol Med 2015; 25:151-4. [PMID: 25840851 DOI: 10.1016/j.mycmed.2015.02.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/13/2015] [Accepted: 02/19/2015] [Indexed: 12/28/2022]
Abstract
A patient with refractory diffuse lymphoma treated for pulmonary invasive aspergillosis developed a concomitant primary cutaneous mucormycosis. The mucormycete was identified by sequencing as Mucor circinelloides. This case confirms the importance of a rapid pathogen diagnosis in immunocompromised patients and the usefulness of molecular methods for identification of rare fungal species.
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Affiliation(s)
- M Dodémont
- Laboratory of Bacteriology, Department of Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
| | - M Hites
- Department of Infectious Diseases, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - B Bailly
- Department of Haematology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - A-L Trepant
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - R De Mendonça
- Laboratory of Bacteriology, Department of Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - O Denis
- Laboratory of Bacteriology, Department of Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - F Jacobs
- Department of Infectious Diseases, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - I Montesinos
- Laboratory of Bacteriology, Department of Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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Pacilly FCA, Benning ME, Jacobs F, Leidekker J, Sprong H, Van Wieren SE, Takken W. Blood feeding on large grazers affects the transmission of Borrelia burgdorferi sensu lato by Ixodes ricinus. Ticks Tick Borne Dis 2014; 5:810-7. [PMID: 25113977 DOI: 10.1016/j.ttbdis.2014.06.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 05/28/2014] [Accepted: 06/12/2014] [Indexed: 12/11/2022]
Abstract
The presence of Ixodes ricinus and their associated Borrelia infections on large grazers was investigated. Carcases of freshly shot red deer, mouflon and wild boar were examined for the presence of any stage of I. ricinus. Questing ticks were collected from locations where red deer and wild boar are known to occur. Presence of Borrelia burgdorferi s.l. DNA was examined in a fraction of the collected ticks. Larvae, nymphs and adult ticks were found on the three large grazers. Red deer had the highest tick burden, with many of the nymphs and adult females attached for engorgement. Most larvae had not attached. The mean number of ticks on the animals varied from 13 to 67. Ticks were highly aggregated amongst the animals: some animals had no ticks, while others had high numbers. Larvae and nymphs were mostly found on the ears, while adult ticks were attached to the axillae. The Borrelia infection rate of questing nymphs was 8.5%. Unengorged wandering nymphs on deer had a Borrelia infection rate of 12.5%, while only 0.9% of feeding nymphs carried a Borrelia infection. The infection rate of unengorged adult male ticks was 4.5%, and that of feeding female ticks was 0.7%. The data suggest that ticks feeding on red deer and wild boar lose their Borrelia infections. The implications of the results are discussed with respect to Borrelia epidemiology and maintenance of a Borrelia reservoir as well as the role of reproductive hosts for Ixodes ricinus.
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Affiliation(s)
- F C A Pacilly
- Laboratory of Entomology, Wageningen University, PO Box 8031, 6700 EH Wageningen, The Netherlands
| | - M E Benning
- Resource Ecology Group, Wageningen University, Droevendaalsesteeg 3a, 6708 PB Wageningen, The Netherlands
| | - F Jacobs
- Laboratory of Entomology, Wageningen University, PO Box 8031, 6700 EH Wageningen, The Netherlands
| | - J Leidekker
- National Park de Hoge Veluwe, Apeldoornseweg 250, 7351 TA Hoenderloo, The Netherlands
| | - H Sprong
- Laboratory of Entomology, Wageningen University, PO Box 8031, 6700 EH Wageningen, The Netherlands; Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and Environment (RIVM), Antonie van Leeuwenhoeklaan 9, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - S E Van Wieren
- Resource Ecology Group, Wageningen University, Droevendaalsesteeg 3a, 6708 PB Wageningen, The Netherlands
| | - W Takken
- Laboratory of Entomology, Wageningen University, PO Box 8031, 6700 EH Wageningen, The Netherlands.
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O'Brien GC, Jacobs F, Evans SW, Smit NJ. First observation of African tigerfish Hydrocynus vittatus predating on barn swallows Hirundo rustica in flight. J Fish Biol 2014; 84:263-266. [PMID: 24354922 DOI: 10.1111/jfb.12278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 10/14/2013] [Indexed: 06/03/2023]
Abstract
A population of African tigerfish Hydrocynus vittatus from the Schroda Dam, actively prey on barn swallows Hirundo rustica in flight. This behaviour was discovered during a radio telemetry study and documented using a motion picture video camera. These results show that an avivorous diet is a part of the feeding biology of H. vittatus, and may occur in other populations.
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Affiliation(s)
- G C O'Brien
- Water Research Group (Ecology), Unit of Environmental Sciences and Management, North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
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Beumier M, Roberts JA, Kabtouri H, Hites M, Cotton F, Wolff F, Lipman J, Jacobs F, Vincent JL, Taccone FS. A new regimen for continuous infusion of vancomycin during continuous renal replacement therapy. J Antimicrob Chemother 2013; 68:2859-65. [DOI: 10.1093/jac/dkt261] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [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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