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Gori S, Fabi A, Angiolini C, Turazza M, Salvini P, Ferretti G, Cretella E, Gianni L, Bighin C, Toss A, Zamagni C, Vici P, De Rossi C, Russo A, Bisagni G, Frassoldati A, Borgato L, Cariello A, Cappelletti C, Bordonaro R, Cinieri S, Modena A, Valerio M, Alvisi MF, De Simone I, Galli F, Rulli E, Santoni A, Nicolis F. Neoadjuvant Systemic Therapy in Early Breast Cancer: Results of a Prospective Observational Multicenter BRIDE Study. Cancers (Basel) 2023; 15:4852. [PMID: 37835546 PMCID: PMC10572070 DOI: 10.3390/cancers15194852] [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: 08/30/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
To evaluate the rate of early breast cancer (EBC) patients treated with neoadjuvant systemic therapy (NAT) in Italy, criteria of patient selection and types of therapies delivered, an analysis of 1276 patients with stage I-II-III was conducted out of 1633 patients enrolled in the multicenter prospective observational BRIDE study. A total of 177 patients (13.9%) were treated with NAT and 1099 (85.9%) with surgery; in multivariate analysis, menopausal status, cT, cN, grade, HER2-positive and Triple negative (TN) subgroups were significantly associated with the decision to administer NAT. The type of NAT delivered was influenced by EBC subtype. NAT was administered to 53.2% of HER2+/HR-negative, 27.9% of HER2+/HR+, 7.1% of HER2-negative/HR+ and 30.3% of TN EBC patients. The pCR rates were similar to the ones reported in the literature: 74.2% in HER2+/HR-negative, 52.3% in HER2+/HR+, 17.2% in HER2-negative/HR+ and 37.9% in TN. In clinical practice, patient and tumor characteristics influenced oncologists in the decision to administer NAT in EBC and in the choice of the type of systemic therapy, according to ESMO and AIOM Guidelines. Currently, it is recommended always to evaluate the use of NAT in EBC, mainly in HER2+ and TN patients, considering that pCR is associated with significantly better survival of the patient and that effective therapies are now available for residual disease.
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Affiliation(s)
- Stefania Gori
- Medical Oncology Unit, IRCCS Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
| | - Alessandra Fabi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Catia Angiolini
- Breast Unit and Multidisciplinary Oncology Group, Department of Breast Oncology, AOU Careggi, 50134 Florence, Italy;
| | - Monica Turazza
- Medical Oncology Unit, IRCCS Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
| | - Piermario Salvini
- Oncology, Humanitas Gavazzeni, 24125 Bergamo, Italy;
- Oncological Medicine—Policlinico Ponte S Pietro di Istituti Ospedalieri Bergamaschi, 24036 Ponte San Pietro, Italy
| | - Gianluigi Ferretti
- Division of Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | | | | | | | - Angela Toss
- Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, 41125 Modena, Italy
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Claudio Zamagni
- Medical Oncology of Senology and Gynecology, IRCCS AOU Bologna, Policlinico Sant’Orsola, 40138 Bologna, Italy
| | - Patrizia Vici
- UOSD Sperimentazioni Fase IV, IRCCS Istituto Nazionale Tumori Regina Elena, 00144 Rome, Italy
| | - Costanza De Rossi
- Oncology—Ospedale dell’Angelo Azienda ULSS 3 Serenissima, 30174 Venice, Italy;
| | - Antonio Russo
- Medical Oncology, AOU Policlinico P. Giaccone, 90127 Palermo, Italy
| | - Giancarlo Bisagni
- Medical Oncology, Comprehensive Cancer Centre, AUSL-IRCCS di Reggio Emilia, 22100 Reggio Emilia, Italy;
| | | | - Lucia Borgato
- Department of Oncology, San Bortolo General Hospital, Azienda ULSS8 Berica, 36100 Vicenza, Italy
| | - Anna Cariello
- Medical Oncology, AUSL Ravenna, 48100 Ravenna, Italy;
| | | | | | - Saverio Cinieri
- Medical Oncology, Antonio Perrino Hospital, 72100 Brindisi, Italy
| | - Alessandra Modena
- Medical Oncology Unit, IRCCS Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
| | - Matteo Valerio
- Medical Oncology Unit, IRCCS Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
| | - Maria Francesca Alvisi
- Laboratory of Methodology for Clinical Research, Department of Clinical Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy (I.D.S.); (E.R.)
| | - Irene De Simone
- Laboratory of Methodology for Clinical Research, Department of Clinical Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy (I.D.S.); (E.R.)
| | - Francesca Galli
- Laboratory of Methodology for Clinical Research, Department of Clinical Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy (I.D.S.); (E.R.)
| | - Eliana Rulli
- Laboratory of Methodology for Clinical Research, Department of Clinical Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy (I.D.S.); (E.R.)
| | - Anna Santoni
- Laboratory of Methodology for Clinical Research, Department of Clinical Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy (I.D.S.); (E.R.)
| | - Fabrizio Nicolis
- Medical Direction, IRCCS Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
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Annovazzi A, Rea S, Maccora D, Pizzuti L, Ferretti G, Vici P, Cappuzzo F, Sciuto R. Prognostic value of [18F]-FDG PET/CT in patients with meta-static breast cancer treated with cyclin-dependent inhibitors. Front Oncol 2023; 13:1193174. [PMID: 37519806 PMCID: PMC10376695 DOI: 10.3389/fonc.2023.1193174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Objective The addition of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) to endocrine therapy impressively improved the outcome of patients with hormone receptor-positive metastatic breast cancer. Despite their great efficacy, not all patients respond to treatment and many of them develop acquired resistance. The aim of this retrospective study was to assess the role of [18F]-FDG PET/CT in predicting PFS and OS in breast cancer patients treated with CDK4/6i. Methods 114 patients who performed an [18F]-FDG PET/CT scan before (PET1) and 2-6 months (PET2) after starting treatment were retrospectively enrolled. Metabolic response was evaluated by EORTC, PERCIST and Deauville Score and correlated to PFS and OS. Results In patients who did not progress at PET2 (n = 90), PFS rates were not significantly different between classes of response by EORTC and PERCIST. Conversely, patients showing a Deauville score ≤3 had a longer PFS (median PFS 42 vs 21.0 months; p = 0.008). A higher total metabolic tumor volume at PET1 (TMTV1) was also associated with a shorter PFS (median 18 vs 42 months; p = 0.0026). TMTV1 and Deauville score were the only independent prognostic factors for PFS at multivariate analysis and their combination stratified the population in four definite classes of relapse risk. Conversely, the above parameters did not affect OS which was only influenced by a progressive metabolic disease at PET2 (3-years survival rate 29.8 vs 84.9%; p<0.0001). Conclusion TMTV and metabolic response by Deauville score were significant prognostic factors for PFS in patients with breast cancer treated with CDK4/6i. Their determination could help physicians to select patients who may need a closer follow up.
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Affiliation(s)
- Alessio Annovazzi
- Nuclear Medicine Unit – IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Sandra Rea
- Nuclear Medicine Unit – IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Daria Maccora
- Nuclear Medicine Unit – IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Pizzuti
- Division of Medical Oncology 2 – IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Gianluigi Ferretti
- Division of Medical Oncology 1 – IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Vici
- Phase IV Clinical Trial Unit – IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Federico Cappuzzo
- Division of Medical Oncology 2 – IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Rosa Sciuto
- Nuclear Medicine Unit – IRCCS, Regina Elena National Cancer Institute, Rome, Italy
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Cottin V, Bonniaud P, Cadranel J, Crestani B, Jouneau S, Marchand-Adam S, Nunes H, Wémeau-Stervinou L, Bergot E, Blanchard E, Borie R, Bourdin A, Chenivesse C, Clément A, Gomez E, Gondouin A, Hirschi S, Lebargy F, Marquette CH, Montani D, Prévot G, Quetant S, Reynaud-Gaubert M, Salaun M, Sanchez O, Trumbic B, Berkani K, Brillet PY, Campana M, Chalabreysse L, Chatté G, Debieuvre D, Ferretti G, Fourrier JM, Just N, Kambouchner M, Legrand B, Le Guillou F, Lhuillier JP, Mehdaoui A, Naccache JM, Paganon C, Rémy-Jardin M, Si-Mohamed S, Terrioux P. [French practical guidelines for the diagnosis and management of IPF - 2021 update, full version]. Rev Mal Respir 2022; 39:e35-e106. [PMID: 35752506 DOI: 10.1016/j.rmr.2022.01.014] [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] [Indexed: 10/17/2022]
Abstract
BACKGROUND Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients' association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.
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Affiliation(s)
- V Cottin
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France; UMR 754, IVPC, INRAE, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; Membre d'OrphaLung, RespiFil, Radico-ILD2, et ERN-LUNG, Lyon, France.
| | - P Bonniaud
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et soins intensifs respiratoires, centre hospitalo-universitaire de Bourgogne et faculté de médecine et pharmacie, université de Bourgogne-Franche Comté, Dijon ; Inserm U123-1, Dijon, France
| | - J Cadranel
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et oncologie thoracique, Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Tenon, Paris ; Sorbonne université GRC 04 Theranoscan, Paris, France
| | - B Crestani
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - S Jouneau
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Pontchaillou, Rennes ; IRSET UMR1085, université de Rennes 1, Rennes, France
| | - S Marchand-Adam
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, hôpital Bretonneau, service de pneumologie, CHRU, Tours, France
| | - H Nunes
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie, AP-HP, hôpital Avicenne, Bobigny ; université Sorbonne Paris Nord, Bobigny, France
| | - L Wémeau-Stervinou
- Centre de référence constitutif des maladies pulmonaires rares, Institut Cœur-Poumon, service de pneumologie et immuno-allergologie, CHRU de Lille, Lille, France
| | - E Bergot
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie et oncologie thoracique, hôpital Côte de Nacre, CHU de Caen, Caen, France
| | - E Blanchard
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Haut Levêque, CHU de Bordeaux, Pessac, France
| | - R Borie
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - A Bourdin
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, département de pneumologie et addictologie, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, Montpellier ; Inserm U1046, CNRS UMR 921, Montpellier, France
| | - C Chenivesse
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et d'immuno-allergologie, hôpital Albert Calmette ; CHRU de Lille, Lille ; centre d'infection et d'immunité de Lille U1019 - UMR 9017, Université de Lille, CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, Lille, France
| | - A Clément
- Centre de ressources et de compétence de la mucoviscidose pédiatrique, centre de référence des maladies respiratoires rares (RespiRare), service de pneumologie pédiatrique, hôpital d'enfants Armand-Trousseau, CHU Paris Est, Paris ; Sorbonne université, Paris, France
| | - E Gomez
- Centre de compétence pour les maladies pulmonaires rares, département de pneumologie, hôpitaux de Brabois, CHRU de Nancy, Vandoeuvre-les Nancy, France
| | - A Gondouin
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Jean-Minjoz, Besançon, France
| | - S Hirschi
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, Nouvel Hôpital civil, Strasbourg, France
| | - F Lebargy
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Maison Blanche, Reims, France
| | - C-H Marquette
- Centre de compétence pour les maladies pulmonaires rares, FHU OncoAge, département de pneumologie et oncologie thoracique, hôpital Pasteur, CHU de Nice, Nice cedex 1 ; Université Côte d'Azur, CNRS, Inserm, Institute of Research on Cancer and Aging (IRCAN), Nice, France
| | - D Montani
- Centre de compétence pour les maladies pulmonaires rares, centre national coordonnateur de référence de l'hypertension pulmonaire, service de pneumologie et soins intensifs pneumologiques, AP-HP, DMU 5 Thorinno, Inserm UMR S999, CHU Paris-Sud, hôpital de Bicêtre, Le Kremlin-Bicêtre ; Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
| | - G Prévot
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Larrey, Toulouse, France
| | - S Quetant
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et physiologie, CHU Grenoble Alpes, Grenoble, France
| | - M Reynaud-Gaubert
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, AP-HM, CHU Nord, Marseille ; Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - M Salaun
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, oncologie thoracique et soins intensifs respiratoires & CIC 1404, hôpital Charles Nicole, CHU de Rouen, Rouen ; IRIB, laboratoire QuantiIF-LITIS, EA 4108, université de Rouen, Rouen, France
| | - O Sanchez
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et soins intensifs, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | | | - K Berkani
- Clinique Pierre de Soleil, Vetraz Monthoux, France
| | - P-Y Brillet
- Université Paris 13, UPRES EA 2363, Bobigny ; service de radiologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - M Campana
- Service de pneumologie et oncologie thoracique, CHR Orléans, Orléans, France
| | - L Chalabreysse
- Service d'anatomie-pathologique, groupement hospitalier est, HCL, Bron, France
| | - G Chatté
- Cabinet de pneumologie et infirmerie protestante, Caluire, France
| | - D Debieuvre
- Service de pneumologie, GHRMSA, hôpital Emile-Muller, Mulhouse, France
| | - G Ferretti
- Université Grenoble Alpes, Grenoble ; service de radiologie diagnostique et interventionnelle, CHU Grenoble Alpes, Grenoble, France
| | - J-M Fourrier
- Association Pierre-Enjalran Fibrose Pulmonaire Idiopathique (APEFPI), Meyzieu, France
| | - N Just
- Service de pneumologie, CH Victor-Provo, Roubaix, France
| | - M Kambouchner
- Service de pathologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - B Legrand
- Cabinet médical de la Bourgogne, Tourcoing ; Université de Lille, CHU Lille, ULR 2694 METRICS, CERIM, Lille, France
| | - F Le Guillou
- Cabinet de pneumologie, pôle santé de l'Esquirol, Le Pradet, France
| | - J-P Lhuillier
- Cabinet de pneumologie, La Varenne Saint-Hilaire, France
| | - A Mehdaoui
- Service de pneumologie et oncologie thoracique, CH Eure-Seine, Évreux, France
| | - J-M Naccache
- Service de pneumologie, allergologie et oncologie thoracique, GH Paris Saint-Joseph, Paris, France
| | - C Paganon
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France
| | - M Rémy-Jardin
- Institut Cœur-Poumon, service de radiologie et d'imagerie thoracique, CHRU de Lille, Lille, France
| | - S Si-Mohamed
- Département d'imagerie cardiovasculaire et thoracique, hôpital Louis-Pradel, HCL, Bron ; Université de Lyon, INSA-Lyon, Université Claude-Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Villeurbanne, France
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Powles T, Tomczak P, Park SH, Venugopal B, Ferguson T, Symeonides SN, Hajek J, Gurney H, Chang YH, Lee JL, Sarwar N, Thiery-Vuillemin A, Gross-Goupil M, Mahave M, Haas NB, Sawrycki P, Burgents JE, Xu L, Imai K, Quinn DI, Choueiri TK, Choueiri T, Park SH, Venugopal B, Ferguson TR, Hajek J, Lin TP, Symeonides SN, Lee JL, Sawrycki P, Haas NB, Gurney HP, Mahave M, Sarwar N, Thiery-Vuillemin A, Gross-Goupil M, Chevreau C, Burke JM, Doshi G, Melichar B, Topart D, Oudard S, Kopyltsov E, Hammers HJ, Quinn DI, Alva A, Menezes JDJ, Silva AGE, Winquist EW, Hamzaj A, Procopio G, Karaszewska B, Nowakowska-Zajdel EM, Alekseev BY, Gafanov RA, Izmailov A, Semenov A, Afanasyev SG, Lipatov ON, Powles TB, Srinivas S, McDermott D, Kochuparambil ST, Davis ID, Peltola K, Sabbatini R, Chung J, Shkolnik MI, Matveev VB, Gajate Borau P, McCune S, Hutson TE, Dri A, Sales SC, Yeung C, Alcala Castro CM, Bostrom P, Laguerre B, Buttigliero C, de Giorgi U, Fomin EA, Zakharia Y, Hwang C, Singer EA, Yorio JT, Waterhouse D, Kowalyszyn RD, Alfie MS, Yanez Ruiz E, Buchler T, Kankaanranta K, Ferretti G, Kimura G, Nishimura K, Masumori N, Tamada S, Kato H, Kitamura H, Danielewicz I, Wojcik-Tomaszewska J, Sala Gonzalez N, Chiu KY, Atkins MB, Heath E, Rojas-Uribe GA, Gonzalez Fernandez ME, Feyerabend S, Pignata S, Numakura K, Cybulska Stopa B, Zukov R, Climent Duran MA, Maroto Rey PJ, Montesa Pino A, Chang CH, Vengalil S, Waddell TS, Cobb PW, Hauke R, Anderson DM, Sarantopoulos J, Gourdin T, Zhang T, Jayram G, Fein LE, Harris C, Beato PMM, Flores F, Estay A, Rubiano JA, Bedke J, Hauser S, Neisius A, Busch J, Anai S, Tsunemori H, Sawka D, Sikora-Kupis B, Arranz JA, Delgado I, Chen CH, Gunderson E, Tykodi S, Koletsky A, Chen K, Agrawal M, Kaen DL, Sade JP, Tatangelo MD, Parnis F, Barbosa FM, Faucher G, Iqbal N, Marceau D, Paradis JB, Hanna N, Acevedo A, Ibanez C, Villanueva L, Galaz PP, Durango IC, Manneh R, Kral Z, Holeckova P, Hakkarainen H, Ronkainen H, Abadie-Lacourtoisie S, Tartas S, Goebell PJ, Grimm MO, Hoefner T, Wirth M, Panic A, Schultze-Seemann W, Yokomizo A, Mizuno R, Uemura H, Eto M, Tsujihata M, Matsukawa Y, Murakami Y, Kim M, Hamberg P, Marczewska-Skrodzka M, Szczylik C, Humphreys AC, Jiang P, Kumar B, Lu G, Desai A, Karam JA, Keogh G, Fleming M, Zarba JJ, Leiva VE, Mendez GA, Harris SJ, Brown SJ, Antonio Junior JN, Costamilan RDC, Rocha RO, Muniz D, Brust L, Lalani AK, Graham J, Levesque M, Orlandi F, Kotasek R, Deville JL, Borchiellini D, Merseburger A, Rink M, Roos F, McDermott R, Oyama M, Yamamoto Y, Tomita Y, Miura Y, Ioritani N, Westgeest H, Kubiatowski T, Bal W, Girones Sarrio R, Rowe J, Prow DM, Senecal F, Hashemi-Sadraei N, Cole SW, Kendall SD, Richards DA, Schnadig ID, Gupta M. Pembrolizumab versus placebo as post-nephrectomy adjuvant therapy for clear cell renal cell carcinoma (KEYNOTE-564): 30-month follow-up analysis of a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 2022; 23:1133-1144. [PMID: 36055304 DOI: 10.1016/s1470-2045(22)00487-9] [Citation(s) in RCA: 110] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The first interim analysis of the KEYNOTE-564 study showed improved disease-free survival with adjuvant pembrolizumab compared with placebo after surgery in patients with clear cell renal cell carcinoma at an increased risk of recurrence. The analysis reported here, with an additional 6 months of follow-up, was designed to assess longer-term efficacy and safety of pembrolizumab versus placebo, as well as additional secondary and exploratory endpoints. METHODS In the multicentre, randomised, double-blind, placebo-controlled, phase 3 KEYNOTE-564 trial, adults aged 18 years or older with clear cell renal cell carcinoma with an increased risk of recurrence were enrolled at 213 hospitals and cancer centres in North America, South America, Europe, Asia, and Australia. Eligible participants had an Eastern Cooperative Oncology Group performance status of 0 or 1, had undergone nephrectomy 12 weeks or less before randomisation, and had not received previous systemic therapy for advanced renal cell carcinoma. Participants were randomly assigned (1:1) via central permuted block randomisation (block size of four) to receive pembrolizumab 200 mg or placebo intravenously every 3 weeks for up to 17 cycles. Randomisation was stratified by metastatic disease status (M0 vs M1), and the M0 group was further stratified by ECOG performance status and geographical region. All participants and investigators involved in study treatment administration were masked to the treatment group assignment. The primary endpoint was disease-free survival by investigator assessment in the intention-to-treat population (all participants randomly assigned to a treatment). Safety was assessed in the safety population, comprising all participants who received at least one dose of pembrolizumab or placebo. As the primary endpoint was met at the first interim analysis, updated data are reported without p values. This study is ongoing, but no longer recruiting, and is registered with ClinicalTrials.gov, NCT03142334. FINDINGS Between June 30, 2017, and Sept 20, 2019, 994 participants were assigned to receive pembrolizumab (n=496) or placebo (n=498). Median follow-up, defined as the time from randomisation to data cutoff (June 14, 2021), was 30·1 months (IQR 25·7-36·7). Disease-free survival was better with pembrolizumab compared with placebo (HR 0·63 [95% CI 0·50-0·80]). Median disease-free survival was not reached in either group. The most common all-cause grade 3-4 adverse events were hypertension (in 14 [3%] of 496 participants) and increased alanine aminotransferase (in 11 [2%]) in the pembrolizumab group, and hypertension (in 13 [3%] of 498 participants) in the placebo group. Serious adverse events attributed to study treatment occurred in 59 (12%) participants in the pembrolizumab group and one (<1%) participant in the placebo group. No deaths were attributed to pembrolizumab. INTERPRETATION Updated results from KEYNOTE-564 support the use of adjuvant pembrolizumab monotherapy as a standard of care for participants with renal cell carcinoma with an increased risk of recurrence after nephrectomy. FUNDING Merck Sharp & Dohme LLC, a subsidiary of Merck & Co, Inc, Rahway, NJ, USA.
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Affiliation(s)
- Thomas Powles
- Royal Free Hospital NHS Foundation Trust, University College London, London, UK; Barts Cancer Institute, Experimental Cancer Medicine Centre, Queen Mary University of London, St Bartholomew's Hospital, London, UK.
| | - Piotr Tomczak
- Poznań University of Medical Sciences, Poznań, Poland
| | - Se Hoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Balaji Venugopal
- Beatson West of Scotland Cancer Centre, Glasgow, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Stefan N Symeonides
- Cancer Research UK Edinburgh Centre, Edinburgh, UK; Edinburgh Cancer Centre, Edinburgh, UK; Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | | | - Howard Gurney
- Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
| | | | - Jae Lyun Lee
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | | | | | | | | | | | - Piotr Sawrycki
- Wojewódzki Szpital Zespolony im L Rydygiera w Toruniu, Torun, Poland
| | | | - Lei Xu
- Merck & Co, Inc, Rahway, NJ, USA
| | | | - David I Quinn
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
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Conciatori F, Salvati E, Ciuffreda L, Shirasawa S, Falcone I, Cognetti F, Ferretti G, Zeuli M, Del Bufalo D, Bazzichetto C, Milella M. Fibroblast-Induced Paradoxical PI3K Pathway Activation in PTEN-Competent Colorectal Cancer: Implications for Therapeutic PI3K/mTOR Inhibition. Front Oncol 2022; 12:862806. [PMID: 35719951 PMCID: PMC9203999 DOI: 10.3389/fonc.2022.862806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/28/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose Tumor-microenvironment interactions are important determinants of drug resistance in colorectal cancer (CRC). We, therefore, set out to understand how interactions between genetically characterized CRC cells and stromal fibroblasts might influence response to molecularly targeted inhibitors. Techniques Sensitivity to PI3K/AKT/mTOR pathway inhibitors of CRC cell lines, with known genetic background, was investigated under different culture conditions [serum-free medium, fibroblasts’ conditioned medium (CM), direct co-culture]. Molecular pathway activation was monitored using Western Blot analysis. Immunoprecipitation was used to detect specific mTOR complex activation. Immunofluorescence was used to analyze cellular PTEN distribution, while different mutant PTEN plasmids were used to map the observed function to specific PTEN protein domains. Results Exposure to fibroblast-CM resulted in increased growth-inhibitory response to double PI3K/mTOR inhibitors in PTEN-competent CRC cell lines harboring KRAS and PI3K mutations. Such functional effect was attributable to fibroblast-CM induced paradoxical PI3K/mTORC1 pathway activation, occurring in the presence of a functional PTEN protein. At a molecular level, fibroblast-CM induced C-tail phosphorylation and cytoplasmic redistribution of the PTEN protein, thereby impairing its lipid phosphatase function and favored the formation of active, RAPTOR-containing, mTORC1 complexes. However, PTEN’s lipid phosphatase function appeared to be dispensable, while complex protein-protein interactions, also involving PTEN/mTOR co-localization and subcellular distribution, were crucial for both mTORC1 activation and sensitivity to double PI3K/mTOR inhibitors. Data Interpretation Microenvironmental cues, in particular soluble factors produced by stromal fibroblasts, profoundly influence PI3K pathway signaling and functional response to specific inhibitors in CRC cells, depending on their mutational background and PTEN status.
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Affiliation(s)
- Fabiana Conciatori
- Medical Oncology 1, Regina Elena National Cancer Institute (IRCCS), Rome, Italy.,Preclinical Models and New Therapeutic Agents Unit, Regina Elena National Cancer Institute (IRCCS), Rome, Italy
| | - Erica Salvati
- Institute of Molecular Biology and Pathology -National Research Council (BPM-CNR), Rome, Italy
| | - Ludovica Ciuffreda
- Department of Research, Advanced Diagnostics, and Technological Innovation (SAFU), Regina Elena National Cancer Institute (IRCCS), Rome, Italy
| | - Senji Shirasawa
- Central Research Institute for Advanced Molecular Medicine, Fukuoka University, Fukuoka, Japan
| | - Italia Falcone
- Department of Research, Advanced Diagnostics, and Technological Innovation (SAFU), Regina Elena National Cancer Institute (IRCCS), Rome, Italy
| | - Francesco Cognetti
- Medical Oncology 1, Regina Elena National Cancer Institute (IRCCS), Rome, Italy
| | - Gianluigi Ferretti
- Medical Oncology 1, Regina Elena National Cancer Institute (IRCCS), Rome, Italy
| | - Massimo Zeuli
- Medical Oncology 1, Regina Elena National Cancer Institute (IRCCS), Rome, Italy
| | - Donatella Del Bufalo
- Preclinical Models and New Therapeutic Agents Unit, Regina Elena National Cancer Institute (IRCCS), Rome, Italy
| | - Chiara Bazzichetto
- Medical Oncology 1, Regina Elena National Cancer Institute (IRCCS), Rome, Italy.,Preclinical Models and New Therapeutic Agents Unit, Regina Elena National Cancer Institute (IRCCS), Rome, Italy
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
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Barberi V, Renna D, Annovazzi A, Ferretti G, Russillo M, Cognetti F. Palbociclib plus letrozole induces a complete metabolic response in metastatic breast cancer patient with idiopathic thrombocytopenia. Recenti Prog Med 2022; 113:376-379. [PMID: 35758116 DOI: 10.1701/3827.38111] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Breast cancer is still the leading cause of cancer-related deaths among women aged 20-59 and metastatic breast cancer remains an incurable disease. The therapeutic paradigm of patients with HR-positive HER2-negative metastatic breast cancer has been expanded by the introduction of the inhibitors of cyclin-dependent kinases 4/6. Three compounds, palbociclib, ribociclib, and abemaciclib, have already been approved by the Food and Drug Administration (FDA) for use together with endocrine therapy; abemaciclib is also approved as a single agent. In the first-line setting, all three agents - together with an aromatase inhibitor (AI) - substantially prolonged progression-free survival. Hematologic toxicities are the most common adverse events associated with CDK4/6i, mainly with palbociclib and ribociclib. Due to the hematologic toxicity, the prescribing information of palbociclib (P) recommends monitoring complete blood counts before starting therapy and at the beginning of each cycle, as well as on day 15 of the first 2 cycles. However, there are no guidelines regarding the management of patients candidate to CDK4/6i who have bone marrow impairment. Neutropenia frequently occurs during the treatment with P, whereas thrombocytopenia represents a rare event. We here report a case of a 60-year-old woman with idiopathic thrombocytopenia treated with P plus letrozole, who presented a metabolic complete response.
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Affiliation(s)
- Vittoria Barberi
- Division of Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy
| | - Davide Renna
- Division of Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy
| | - Alessio Annovazzi
- Nuclear Medicine Unit Regina Elena National Cancer Institute, Rome, Italy
| | - Gianluigi Ferretti
- Nuclear Medicine Unit Regina Elena National Cancer Institute, Rome, Italy
| | | | - Francesco Cognetti
- Division of Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy
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7
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Cicini MP, Ferretti G, Morace N, Nisticò C, Cognetti F, Rulli F. Second-Degree Type 2 Atrioventricular Block Requiring Permanent Cardiac Pacing in Patients on CDK4/6 Inhibitors: Report of Two Cases. Breast Care (Basel) 2022; 17:330-335. [PMID: 35957944 PMCID: PMC9247538 DOI: 10.1159/000519728] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/17/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction A wide spectrum of cardiovascular (CV) toxicity is associated with anticancer treatment, and nearly all chemotherapeutic agents can elicit CV toxicity. Inhibitors of cyclin-dependent kinases 4/6 (CDK4/6Is) have become standard of care in the treatment of hormone receptor-positive, human epidermal growth factor receptor 2-negative metastatic breast cancer (MBC). CV side effects are uncommon with CDK4/6Is and only include QT prolongation, with a low incidence rate. Case Presentation This paper describes 2 cases of new-onset second-degree type 2 atrioventricular (AV) blocks requiring permanent cardiac pacing involving 2 women with MBC receiving ribociclib or abemaciclib. Both our patients had no known history or risk factors of cardiac disease and a normal 12-lead resting electrocardiogram (ECG) when diagnosed with breast adenocarcinoma. Both patients have been subjected to surveillance for cardiotoxicity with serial ECG and echocardiography. No left ventricular dysfunction or arrhythmia was found during the follow-up, and cardiac biomarkers were normal. Conclusion To our knowledge, these are the first cases reported in the literature of new-onset advanced AV blocks in patients under treatment with CDK4/6Is, suggesting the clinical relevance of a more frequent ECG monitoring, besides the QT interval, in these patients.
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Affiliation(s)
- Maria Paola Cicini
- Division of Cardiology, Regina Elena National Cancer Institute, Rome, Italy,*Maria Paola Cicini,
| | - Gianluigi Ferretti
- Department of Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Nicola Morace
- Division of Cardiology, Regina Elena National Cancer Institute, Rome, Italy
| | - Cecilia Nisticò
- Department of Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Cognetti
- Department of Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Rulli
- Division of Cardiology, Regina Elena National Cancer Institute, Rome, Italy
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8
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Cottin V, Bonniaud P, Cadranel J, Crestani B, Jouneau S, Marchand-Adam S, Nunes H, Wémeau-Stervinou L, Bergot E, Blanchard E, Borie R, Bourdin A, Chenivesse C, Clément A, Gomez E, Gondouin A, Hirschi S, Lebargy F, Marquette CH, Montani D, Prévot G, Quetant S, Reynaud-Gaubert M, Salaun M, Sanchez O, Trumbic B, Berkani K, Brillet PY, Campana M, Chalabreysse L, Chatté G, Debieuvre D, Ferretti G, Fourrier JM, Just N, Kambouchner M, Legrand B, Le Guillou F, Lhuillier JP, Mehdaoui A, Naccache JM, Paganon C, Rémy-Jardin M, Si-Mohamed S, Terrioux P. [French practical guidelines for the diagnosis and management of IPF - 2021 update, short version]. Rev Mal Respir 2022; 39:275-312. [PMID: 35304014 DOI: 10.1016/j.rmr.2022.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients' association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.
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Affiliation(s)
- V Cottin
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France; UMR 754, IVPC, INRAE, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; Membre d'OrphaLung, RespiFil, Radico-ILD2, et ERN-LUNG, Lyon, France.
| | - P Bonniaud
- Service de pneumologie et soins intensifs respiratoires, centre de référence constitutif des maladies pulmonaires rares, centre hospitalo-universitaire de Bourgogne et faculté de médecine et pharmacie, université de Bourgogne-Franche Comté, Dijon ; Inserm U123-1, Dijon, France
| | - J Cadranel
- Service de pneumologie et oncologie thoracique, centre de référence constitutif des maladies pulmonaires rares, assistance publique-hôpitaux de Paris (AP-HP), hôpital Tenon, Paris ; Sorbonne université GRC 04 Theranoscan, Paris, France
| | - B Crestani
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - S Jouneau
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Pontchaillou, Rennes ; IRSET UMR1085, université de Rennes 1, Rennes, France
| | - S Marchand-Adam
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, hôpital Bretonneau, service de pneumologie, CHRU, Tours, France
| | - H Nunes
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie, AP-HP, hôpital Avicenne, Bobigny ; université Sorbonne Paris Nord, Bobigny, France
| | - L Wémeau-Stervinou
- Centre de référence constitutif des maladies pulmonaires rares, Institut Cœur-Poumon, service de pneumologie et immuno-allergologie, CHRU de Lille, Lille, France
| | - E Bergot
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie et oncologie thoracique, hôpital Côte de Nacre, CHU de Caen, Caen, France
| | - E Blanchard
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, service de pneumologie, hôpital Haut Levêque, CHU de Bordeaux, Pessac, France
| | - R Borie
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie A, AP-HP, hôpital Bichat, Paris, France
| | - A Bourdin
- Centre de compétence pour les maladies pulmonaires rares de l'adulte, département de pneumologie et addictologie, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, Montpellier ; Inserm U1046, CNRS UMR 921, Montpellier, France
| | - C Chenivesse
- Centre de référence constitutif des maladies pulmonaires rares, service de pneumologie et d'immuno-allergologie, hôpital Albert Calmette ; CHRU de Lille, Lille ; centre d'infection et d'immunité de Lille U1019 - UMR 9017, Université de Lille, CHU Lille, CNRS, Inserm, Institut Pasteur de Lille, Lille, France
| | - A Clément
- Centre de ressources et de compétences de la mucoviscidose pédiatrique, centre de référence des maladies respiratoires rares (RespiRare), service de pneumologie pédiatrique, hôpital d'enfants Armand-Trousseau, CHU Paris Est, Paris ; Sorbonne université, Paris, France
| | - E Gomez
- Centre de compétence pour les maladies pulmonaires rares, département de pneumologie, hôpitaux de Brabois, CHRU de Nancy, Vandoeuvre-les Nancy, France
| | - A Gondouin
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Jean Minjoz, Besançon, France
| | - S Hirschi
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, Nouvel Hôpital civil, Strasbourg, France
| | - F Lebargy
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Maison Blanche, Reims, France
| | - C-H Marquette
- Centre de compétence pour les maladies pulmonaires rares, FHU OncoAge, département de pneumologie et oncologie thoracique, hôpital Pasteur, CHU de Nice, Nice cedex 1 ; Université Côte d'Azur, CNRS, Inserm, Institute of Research on Cancer and Aging (IRCAN), Nice, France
| | - D Montani
- Centre de compétence pour les maladies pulmonaires rares, centre national coordonnateur de référence de l'hypertension pulmonaire, unité pneumologie et soins intensifs pneumologiques, AP-HP, DMU 5 Thorinno, Inserm UMR S999, CHU Paris-Sud, hôpital de Bicêtre, Le Kremlin-Bicêtre ; Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
| | - G Prévot
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, CHU Larrey, Toulouse, France
| | - S Quetant
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et physiologie, CHU Grenoble Alpes, Grenoble, France
| | - M Reynaud-Gaubert
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, AP-HM, CHU Nord, Marseille ; Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - M Salaun
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie, oncologie thoracique et soins intensifs respiratoires & CIC 1404, hôpital Charles Nicole, CHU de Rouen, Rouen ; IRIB, laboratoire QuantiIF-LITIS, EA 4108, université de Rouen, Rouen, France
| | - O Sanchez
- Centre de compétence pour les maladies pulmonaires rares, service de pneumologie et soins intensifs, hôpital européen Georges Pompidou, AP-HP, Paris, France
| | | | - K Berkani
- Clinique Pierre de Soleil, Vetraz Monthoux, France
| | - P-Y Brillet
- Université Paris 13, UPRES EA 2363, Bobigny ; service de radiologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - M Campana
- Service de pneumologie et oncologie thoracique, CHR Orléans, Orléans, France
| | - L Chalabreysse
- Service d'anatomie-pathologique, groupement hospitalier est, HCL, Bron, France
| | - G Chatté
- Cabinet de pneumologie et infirmerie protestante, Caluire, France
| | - D Debieuvre
- Service de Pneumologie, GHRMSA, hôpital Emile Muller, Mulhouse, France
| | - G Ferretti
- Université Grenoble Alpes, Grenoble ; service de radiologie diagnostique et interventionnelle, CHU Grenoble Alpes, Grenoble, France
| | - J-M Fourrier
- Association Pierre Enjalran Fibrose Pulmonaire Idiopathique (APEFPI), Meyzieu, France
| | - N Just
- Service de pneumologie, CH Victor Provo, Roubaix, France
| | - M Kambouchner
- Service de pathologie, AP-HP, hôpital Avicenne, Bobigny, France
| | - B Legrand
- Cabinet médical de la Bourgogne, Tourcoing ; Université de Lille, CHU Lille, ULR 2694 METRICS, CERIM, Lille, France
| | - F Le Guillou
- Cabinet de pneumologie, pôle santé de l'Esquirol, Le Pradet, France
| | - J-P Lhuillier
- Cabinet de pneumologie, La Varenne Saint-Hilaire, France
| | - A Mehdaoui
- Service de pneumologie et oncologie thoracique, CH Eure-Seine, Évreux, France
| | - J-M Naccache
- Service de pneumologie, allergologie et oncologie thoracique, GH Paris Saint-Joseph, Paris, France
| | - C Paganon
- Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France
| | - M Rémy-Jardin
- Institut Cœur-Poumon, service de radiologie et d'imagerie thoracique, CHRU de Lille, Lille, France
| | - S Si-Mohamed
- Département d'imagerie cardiovasculaire et thoracique, hôpital Louis Pradel, HCL, Bron ; Université de Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Villeurbanne, France
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9
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Borsato M, Cid Vidal X, Tsai Y, Vázquez Sierra C, Zurita J, Alonso-Álvarez G, Boyarsky A, Brea Rodríguez A, Buarque Franzosi D, Cacciapaglia G, Casais Vidal A, Du M, Elor G, Escudero M, Ferretti G, Flacke T, Foldenauer P, Hajer J, Henry L, Ilten P, Kamenik J, Kishor Jashal B, Knapen S, Kostiuk I, Redi FL, Low M, Liu Z, Oyanguren Campos A, Polycarpo E, Ramos M, Ramos Pernas M, Salvioni E, Rangel MS, Schäfer R, Sestini L, Soreq Y, Tran VQ, Timiryasov I, van Veghel M, Westhoff S, Williams M, Zupan J. Unleashing the full power of LHCb to probe stealth new physics. Rep Prog Phys 2022; 85:024201. [PMID: 34942603 DOI: 10.1088/1361-6633/ac4649] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
In this paper, we describe the potential of the LHCb experiment to detect stealth physics. This refers to dynamics beyond the standard model that would elude searches that focus on energetic objects or precision measurements of known processes. Stealth signatures include long-lived particles and light resonances that are produced very rarely or together with overwhelming backgrounds. We will discuss why LHCb is equipped to discover this kind of physics at the Large Hadron Collider and provide examples of well-motivated theoretical models that can be probed with great detail at the experiment.
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Affiliation(s)
- M Borsato
- Physikalisches Institut, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - X Cid Vidal
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Y Tsai
- Maryland Center for Fundamental Physics, Department of Physics, University of Maryland, College Park, MD 20742-4111, United States of America
- Department of Physics, University of Notre Dame, South Bend, IN 46556, United States of America
| | - C Vázquez Sierra
- European Organization for Nuclear Research (CERN), Geneva, Switzerland
| | - J Zurita
- Instituto de Física Corpuscular (CSIC-UV), Valencia, Spain
| | - G Alonso-Álvarez
- Department of Physics & McGill Space Institute, McGill University, 3600 Rue University, Montréal, QC, H3A 2T8, Canada
| | - A Boyarsky
- Intituut-Lorentz, Leiden University, 2333 CA Leiden, The Netherlands
| | - A Brea Rodríguez
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - D Buarque Franzosi
- Department of Physics, Chalmers University of Technology, Fysikgården, 41296 Göteborg, Sweden
- Physics Department, University of Gothenburg, 41296 Göteborg, Sweden
| | - G Cacciapaglia
- University of Lyon, Université Claude Bernard Lyon 1, F-69001 Lyon, France
- Institut de Physique des 2 Infinis (IP2I) de Lyon, CNRS/UMR5822, F-69622 Villeurbanne, France
| | - A Casais Vidal
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - M Du
- Department of Physics, Nanjing University, Nanjing 210093, People's Republic of China
| | - G Elor
- Department of Physics, University of Washington, Seattle, WA 98195, United States of America
| | - M Escudero
- Physik-Department, Technische Universität, München, James-Franck-Straße, 85748 Garching, Germany
| | - G Ferretti
- Department of Physics, Chalmers University of Technology, Fysikgården, 41296 Göteborg, Sweden
| | - T Flacke
- Center for Theoretical Physics of the Universe, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - P Foldenauer
- Institute for Particle Physics Phenomenology, Durham University, Durham DH1 3LE, United Kingdom
| | - J Hajer
- Centre for Cosmology, Particle Physics and Phenomenology, Université catholique de Louvain, Louvain-la-Neuve B-1348, Belgium
- Department of Physics, Universität Basel, Klingelbergstraße 82, CH-4056 Basel, Switzerland
| | - L Henry
- European Organization for Nuclear Research (CERN), Geneva, Switzerland
- Instituto de Física Corpuscular (CSIC-UV), Valencia, Spain
- INFN Sezione di Milano, Milano, Italy
| | - P Ilten
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, United States of America
| | - J Kamenik
- Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia
- Faculty of Mathematics and Physics, University of Ljubljana, Jadranska 19, 1000 Ljubljana, Slovenia
| | | | - S Knapen
- European Organization for Nuclear Research (CERN), Geneva, Switzerland
| | - Igor Kostiuk
- Nikhef National Institute for Subatomic Physics, Amsterdam, The Netherlands
| | - F L Redi
- Institute of Physics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - M Low
- Theoretical Physics Department, Fermilab, PO Box 500, Batavia, IL 60510, United States of America
| | - Z Liu
- Department of Physics, Nanjing University, Nanjing 210093, People's Republic of China
- Center for High Energy Physics, Peking University, Beijing 100871, People's Republic of China
- CAS Center for Excellence in Particle Physics, Beijing 100049, People's Republic of China
| | | | - E Polycarpo
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - M Ramos
- CAFPE and Departamento de Física Teórica y del Cosmos, Universidad de Granada, Campus de Fuentenueva, E-18071 Granada, Spain
- Laboratório de Instrumentaçao e Física Experimental de Partículas, Departamento de Física da Universidade do Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - M Ramos Pernas
- Department of Physics, University of Warwick, Coventry, United Kingdom
| | - E Salvioni
- European Organization for Nuclear Research (CERN), Geneva, Switzerland
| | - M S Rangel
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - R Schäfer
- Institute for Theoretical Physics, Heidelberg University, 69120 Heidelberg, Germany
| | - L Sestini
- Istituto Nazionale di Fisica Nucleare (INFN), Padova Division, Padova, Italy
| | - Y Soreq
- Physics Department, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - V Q Tran
- Department of Physics, Nanjing University, Nanjing 210093, People's Republic of China
| | - I Timiryasov
- Institute of Physics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - M van Veghel
- Van Swinderen Institute, University of Groningen, Groningen, The Netherlands
| | - S Westhoff
- Institute for Theoretical Physics, Heidelberg University, 69120 Heidelberg, Germany
| | - M Williams
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, MA 02139, United States of America
| | - J Zupan
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, United States of America
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10
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Fabi A, Ciccarese M, Scagnoli S, Russillo M, Schettini F, Buono G, Lorusso V, Cannita K, Arpino G, Stani S, Palleschi M, Rossello R, Sarobba G, Fabbri A, Giampaglia M, Pellegrini P, Adamo V, Morelli F, Barberi V, Ferretti G, Catania G, Pisegna S, Cognetti F, Giannarelli D. Post-Progression Treatments after Palbociclib plus Endocrine Therapy in HR+/HER2- Metastatic Breast Cancer Patients: What Is the Better Choice? Oncology 2021:000521252. [PMID: 34875670 DOI: 10.1159/000521252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND To date, a consensus has not yet been reached about the therapy sequence after disease progression (PD) on CDK4/6 inhibitors in patients with HR+/HER2- metastatic breast cancer (MBC). OBJECTIVES The present study assesses, in a real-world setting, the activity of different subsequent therapies in patients who experienced a PD on palbociclib (P) + endocrine therapy (ET), to evaluate the best therapy sequence. METHODS This is a multicenter retrospective observational study. Records of consecutive HR+/HER2- MBC patients from January 2017 to May 2019 were reviewed. The primary endpoint was the evaluation of progression-free survival (PFS) according to subsequent treatment lines after progression on P+ET. Toxicity data were also collected. RESULTS The outcomes were analyzed in 89 MBC patients that had progressed on previous P+ET: 17 patients were on hormone therapy (HT) and 31 patients on chemotherapy (CT) as second-line treatments; seven patients were on HT and 34 on CT as third-line therapies. PFS of patients treated with HT as second-line therapy is significantly improved when compared with patients treated with CT (p=0.01). Considering third-line settings, the difference in PFS was not statistically different between HT and CT. A better outcome in terms of toxicity is observed among HT patients for both second- and third-line therapies. CONCLUSIONS patients who were progressive on P+ET could still benefit from a subsequent ET. In patients who experienced a good efficacy from prior ET, without visceral metastatic sites, HT seems the most suitable option, when compared to CT, also in terms of safety.
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11
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Di Noia V, Pimpinelli F, Renna D, Barberi V, Maccallini MT, Gariazzo L, Pontone M, Monti A, Campo F, Taraborelli E, Di Santo M, Petrone F, Mandoj C, Ferraresi V, Ferretti G, Carlini P, Di Bella O, Conti L, La Malfa AM, Pellini R, Bracco D, Giannarelli D, Morrone A, Cognetti F. Immunogenicity and Safety of COVID-19 Vaccine BNT162b2 for Patients with Solid Cancer: A Large Cohort Prospective Study from a Single Institution. Clin Cancer Res 2021; 27:6815-6823. [PMID: 34583970 DOI: 10.1158/1078-0432.ccr-21-2439] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/03/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE We assessed the immunogenicity and safety of the BNT162b2 vaccine in a large cohort of patients with cancer (CP). EXPERIMENTAL DESIGN From March 1, 2021 to March 20, 2021, this prospective cohort study included 816 CP afferent to our institution and eligible for the vaccination. A cohort of 274 health care workers (HCW) was used as age- and sex-matched control group. BNT162b2 was administered as a two-dose regimen given 21 days apart. Blood samples to analyze anti-Spike (S) IgG antibodies (Ab) were collected prevaccination [timepoint (TP) 0], and at 3 weeks (TP1) and 7 weeks (TP2) after the first dose. RESULTS Patients characteristics: median age 62 (range, 21-97); breast/lung cancer/others (31/21/48%); active treatment/follow-up (90/10%). In the whole CP cohort, the serologic response rate (RR) and the titre of anti-S IgG significantly increased across the TPs; at TP2, the responders (IgG >15 AU/mL) were 94.2%. Active chemotherapy and chronic use of steroids were independent predictors of lower RR. Adverse events (AE) after the booster predicted higher likelihood of response (OR, 4.04; 95% confidence interval, 1.63-9.99; P = 0.003). Comparing the matched cohorts, the responders were significantly lower in CP than in HCW at TP1 (61.2% vs. 93.2%) and TP2 (93.3% vs. 100%), while the geometric mean concentration of IgG did not significantly differ at TP2 being significantly lower in CP (23.3) than in HCW (52.1) at TP1. BNT162b2 was well tolerated in CP; severe-grade AEs were 3.5% and 1.3% after the first and second doses, respectively. CONCLUSIONS BNT162b2 assures serologic immunization without clinically significant toxicity in CP. The second dose is needed to reach a satisfactory humoral response.
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Affiliation(s)
- Vincenzo Di Noia
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Davide Renna
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Vittoria Barberi
- Department of Clinical and Molecular Medicine, Universita' La Sapienza di Roma, Rome, Italy
| | | | - Ludovica Gariazzo
- Department of Clinical and Molecular Medicine, Universita' La Sapienza di Roma, Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Alessandro Monti
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Flaminia Campo
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Emanuela Taraborelli
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Di Santo
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabrizio Petrone
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Mandoj
- Department of Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Gianluigi Ferretti
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Carlini
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ornella Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Conti
- Department of Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonia Marina La Malfa
- Pharmacy Unit, Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Raul Pellini
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Domenico Bracco
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Institute, Rome, Italy
| | - Francesco Cognetti
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.,Department of Clinical and Molecular Medicine, Universita' La Sapienza di Roma, Rome, Italy
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12
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Couraud S, Ferretti G, Milleron B, Cortot A, Girard N, Gounant V, Laurent F, Leleu O, Quoix E, Revel MP, Wislez M, Westeel V, Zalcman G, Scherpereel A, Khalil A. [Recommendations of French specialists on screening for lung cancer]. Rev Mal Respir 2021; 38:310-325. [PMID: 33637394 DOI: 10.1016/j.rmr.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 01/25/2021] [Indexed: 12/17/2022]
Affiliation(s)
- S Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, hospices civils de Lyon, hôpital Lyon Sud, Pierre-Bénite, France; Intergroupe francophone de cancérologie thoracique, Paris, France.
| | - G Ferretti
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de radiologie diagnostique et interventionnel, CHU de Grenoble-Alpes, Grenoble, France
| | - B Milleron
- Intergroupe francophone de cancérologie thoracique, Paris, France
| | - A Cortot
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et oncologie thoracique, CHU de Lille, Lille, France
| | - N Girard
- Intergroupe francophone de cancérologie thoracique, Paris, France; Unité d'oncologie thoracique, institut Curie, Paris, France
| | - V Gounant
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
| | - F Laurent
- Service de radiologie, CHU de Bordeaux, Pessac, France
| | - O Leleu
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie, centre hospitalier Abbeville, Abbeville, France
| | - E Quoix
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie, CHRU Strasbourg, Strasbourg, France
| | - M-P Revel
- Service de radiologie, hôpital Cochin, Paris, France
| | - M Wislez
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, hôpital Cochin, Paris, France
| | - V Westeel
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et cancérologie thoracique, CHU de Besançon, Besançon, France
| | - G Zalcman
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service d'oncologie thoracique, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
| | - A Scherpereel
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de pneumologie et oncologie thoracique, CHU de Lille, Lille, France
| | - A Khalil
- Intergroupe francophone de cancérologie thoracique, Paris, France; Service de radiologie, groupe hospitalier Bichat-Claude-Bernard, AP-HP, Paris, France
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13
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Bazzichetto C, Luchini C, Conciatori F, Vaccaro V, Di Cello I, Mattiolo P, Falcone I, Ferretti G, Scarpa A, Cognetti F, Milella M. Morphologic and Molecular Landscape of Pancreatic Cancer Variants as the Basis of New Therapeutic Strategies for Precision Oncology. Int J Mol Sci 2020; 21:E8841. [PMID: 33266496 PMCID: PMC7700259 DOI: 10.3390/ijms21228841] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
To date, pancreatic cancer is still one of the most lethal cancers in the world, mainly due to the lack of early diagnosis and personalized treatment strategies. In this context, the possibility and the opportunity of identifying genetic and molecular biomarkers are crucial to improve the feasibility of precision medicine. In 2019, the World Health Organization classified pancreatic ductal adenocarcinoma cancer (the most common pancreatic tumor type) into eight variants, according to specific histomorphological features. They are: colloid carcinoma, medullary carcinoma, adenosquamous carcinoma, undifferentiated carcinoma, including also rhabdoid carcinoma, undifferentiated carcinoma with osteoclast-like giant cells, hepatoid carcinoma, and signet-ring/poorly cohesive cells carcinoma. Interestingly, despite the very low incidence of these variants, innovative high throughput genomic/transcriptomic techniques allowed the investigation of both somatic and germline mutations in each specific variant, paving the way for their possible classification according also to specific alterations, along with the canonical mutations of pancreatic cancer (KRAS, TP53, CDKN2A, SMAD4). In this review, we aim to report the current evidence about genetic/molecular profiles of pancreatic cancer variants, highlighting their role in therapeutic and clinical impact.
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Affiliation(s)
- Chiara Bazzichetto
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, 37134 Verona, Italy; (C.L.); (I.D.C.); (P.M.)
| | - Fabiana Conciatori
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Vanja Vaccaro
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Ilaria Di Cello
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, 37134 Verona, Italy; (C.L.); (I.D.C.); (P.M.)
| | - Paola Mattiolo
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, 37134 Verona, Italy; (C.L.); (I.D.C.); (P.M.)
| | - Italia Falcone
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Gianluigi Ferretti
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Aldo Scarpa
- Department ARC-Net Research Centre, University and Hospital Trust of Verona, 37126 Verona, Italy;
| | - Francesco Cognetti
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Michele Milella
- Division of Oncology, University of Verona, 37126 Verona, Italy;
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14
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Blanc D, Racine V, Khalil A, Deloche M, Broyelle JA, Hammouamri I, Sinitambirivoutin E, Fiammante M, Verdier E, Besson T, Sadate A, Lederlin M, Laurent F, Chassagnon G, Ferretti G, Diascorn Y, Brillet PY, Cassagnes L, Caramella C, Loubet A, Abassebay N, Cuingnet P, Ohana M, Behr J, Ginzac A, Veyssiere H, Durando X, Bousaïd I, Lassau N, Brehant J. Artificial intelligence solution to classify pulmonary nodules on CT. Diagn Interv Imaging 2020; 101:803-810. [PMID: 33168496 DOI: 10.1016/j.diii.2020.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 08/03/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The purpose of this study was to create an algorithm to detect and classify pulmonary nodules in two categories based on their volume greater than 100 mm3 or not, using machine learning and deep learning techniques. MATERIALS AND METHOD The dataset used to train the model was provided by the organization team of the SFR (French Radiological Society) Data Challenge 2019. An asynchronous and parallel 3-stages pipeline was developed to process all the data (a data "pre-processing" stage; a "nodule detection" stage; a "classifier" stage). Lung segmentation was achieved using 3D U-NET algorithm; nodule detection was done using 3D Retina-UNET and classifier stage with a support vector machine algorithm on selected features. Performances were assessed using area under receiver operating characteristics curve (AUROC). RESULTS The pipeline showed good performance for pathological nodule detection and patient diagnosis. With the preparation dataset, an AUROC of 0.9058 (95% confidence interval [CI]: 0.8746-0.9362) was obtained, 87% yielding accuracy (95% CI: 84.83%-91.03%) for the "nodule detection" stage, corresponding to 86% specificity (95% CI: 82%-92%) and 89% sensitivity (95% CI: 84.83%-91.03%). CONCLUSION A fully functional pipeline using 3D U-NET, 3D Retina-UNET and classifier stage with a support vector machine algorithm was developed, resulting in high capabilities for pulmonary nodule classification.
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Affiliation(s)
- D Blanc
- QuantaCell, IRMB, Hôpital Saint-Eloi, 34090 Montpellier, France
| | - V Racine
- QuantaCell, IRMB, Hôpital Saint-Eloi, 34090 Montpellier, France
| | - A Khalil
- Department of Radiology, Neuroradiology unit, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat Claude Bernard, 75018 Paris, France; Université de Paris, 75010, Paris, France
| | - M Deloche
- >IBM Cognitive Systems Lab, 34000 Montpellier, France
| | - J-A Broyelle
- >IBM Cognitive Systems Lab, 34000 Montpellier, France
| | - I Hammouamri
- >IBM Cognitive Systems Lab, 34000 Montpellier, France
| | | | - M Fiammante
- IBM Cognitive Systems France, 92270 Bois-Colombes, France
| | - E Verdier
- IBM Cognitive Systems France, 92270 Bois-Colombes, France
| | - T Besson
- IBM Cognitive Systems France, 92270 Bois-Colombes, France
| | - A Sadate
- Department of Radiology and Medical Imaging, CHU Nîmes, University Montpellier, EA2415, 30029 Nîmes, France
| | - M Lederlin
- Department of Radiology, Hôpital Universitaire Pontchaillou, 35000 Rennes, France
| | - F Laurent
- Department of thoracic and cardiovascular Imaging, Respiratory Diseases Service, Respiratory Functional Exploration Service, Hôpital universitaire de Bordeaux, CIC 1401, 33600 Pessac, France
| | - G Chassagnon
- Department of Radiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014, Paris, France & Université de Paris, 75006 Paris, France
| | - G Ferretti
- Department of Radiology and Medical Imaging, CHU Grenoble Alpes, 38700 Grenoble, France
| | - Y Diascorn
- Department of Radiology, Hôpital Universitaire Pasteur, Nice, France
| | - P-Y Brillet
- Inserm UMR 1272, Université Sorbonne Paris Nord, Assistance Publique-Hôpitaux de Paris, Department of Radiology, Hôpital Avicenne, 93430 Bobigny, France
| | - Lucie Cassagnes
- Department of radiology B, CHU Gabriel Montpied, 63003 Clermont-Ferrand, France
| | - C Caramella
- Department of Radiology, Institut Gustave Roussy, 94800 Villejuif, France
| | - A Loubet
- Department of Neuroradiology, Hôpital Gui-de-Chauliac, CHRU de Montpellier, 34000 Montpellier, France
| | - N Abassebay
- Department of Radiology, CH Douai, 59507 Douai, France
| | - P Cuingnet
- Department of Radiology, CH Douai, 59507 Douai, France
| | - M Ohana
- Department of Radiology, Nouvel Hôpital Civil, 67000 Strasbourg, France
| | - J Behr
- Department of Radiology, CHRU de Jean-Minjoz Besançon, 25030 Besançon, France
| | - A Ginzac
- Clinical Research Unit, Clinical Research and Innovation Delegation, Centre de Lutte contre le Cancer, Centre Jean Perrin, 63011 Clermont-Ferrand Cedex 1, France; Université Clermont Auvergne,INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Centre Jean Perrin, 63011 Clermont-Ferrand, France; Clinical Investigation Center, UMR501, 63011 Clermont-Ferrand, France
| | - H Veyssiere
- Clinical Research Unit, Clinical Research and Innovation Delegation, Centre de Lutte contre le Cancer, Centre Jean Perrin, 63011 Clermont-Ferrand Cedex 1, France; Université Clermont Auvergne,INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Centre Jean Perrin, 63011 Clermont-Ferrand, France; Clinical Investigation Center, UMR501, 63011 Clermont-Ferrand, France
| | - X Durando
- Clinical Research Unit, Clinical Research and Innovation Delegation, Centre de Lutte contre le Cancer, Centre Jean Perrin, 63011 Clermont-Ferrand Cedex 1, France; Université Clermont Auvergne,INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Centre Jean Perrin, 63011 Clermont-Ferrand, France; Clinical Investigation Center, UMR501, 63011 Clermont-Ferrand, France; Department of Medical Oncology, Centre Jean Perrin, 63011 Clermont-Ferrand, France
| | - I Bousaïd
- Digital Transformation and Information Systems Division, Gustave Roussy, 94800 Villejuif, France
| | - N Lassau
- Multimodal Biomedical Imaging Laboratory Paris-Saclay, BIOMAPS, UMR 1281, Université Paris-Saclay, Inserm, CNRS, CEA, Department of Radiology, Institut Gustave Roussy, 94800, Villejuif, France
| | - J Brehant
- Department of Radiology, Centre Jean Perrin, 63011 Clermont-Ferrand, France.
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15
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Fabi A, Ferretti G, Cognetti F. How to restructure the management of Italian oncological patients during and after COVID-19 pandemic? Eur Rev Med Pharmacol Sci 2020; 24:6478-6479. [PMID: 32633331 DOI: 10.26355/eurrev_202006_21626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A Fabi
- Division of Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
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16
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Fabi A, Ferretti G, Malaguti P, Gasparro S, Nisticò C, Arpino G, Papaldo P, Russillo M, Catania G, Schettini F, Giannarelli D, Cognetti F. Nanoparticle albumin-bound paclitaxel/liposomal-encapsulated doxorubicin in HER2-negative metastatic breast cancer patients. Future Oncol 2020; 16:1629-1637. [PMID: 32501121 DOI: 10.2217/fon-2019-0742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/21/2022] Open
Abstract
Aim: To investigate the toxicity of nab-paclitaxel (wNP)/nonpegylated liposome-encapsulated doxorubicin (wNPLD) combination in HER2-negative metastatic breast cancer (MBC) patients as first-line treatment. Materials & methods: Phase I, single-arm study in metastatic breast cancer patients naive to previous chemotherapy for advanced disease. A 3 + 3 dose-escalation design was used to determine the safety. Primary endpoints were the identification of dose-limiting toxicity and maximum tolerated dose. Results: In total, 12 patients (mean age: 52 years; median metastatic sites: 2) were enrolled and 97 cycles were completed. Maximum tolerated dose was wNP + wNPLD 25 mg/m2. The most common adverse events were neutropenia, nausea, diarrhea and mucositis. The objective response rate was 68% (response mean duration: 12.6 months). Conclusion: wNP/wNPLD combination constitutes an active regimen with mild toxicity.
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Affiliation(s)
- Alessandra Fabi
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Gianluigi Ferretti
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Paola Malaguti
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Simona Gasparro
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Cecilia Nisticò
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Grazia Arpino
- Clinical Medicine & Surgery Department, Division of Medical Oncology, University of Naples Federico II, Naples, Italy
| | - Paola Papaldo
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | | | - Giovanna Catania
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Francesco Schettini
- Clinical Medicine & Surgery Department, Division of Medical Oncology, University of Naples Federico II, Naples, Italy.,Translational Genomics and Targeted Therapeuticsin Solid Tumors, IDIBAPS, Barcelona, Spain.,SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Diana Giannarelli
- Biostatistic Unit, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Francesco Cognetti
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy.,Sapienza University of Rome, Rome, Italy
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17
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Fabi A, Mottolese M, Di Benedetto A, Sperati F, Ercolani C, Buglioni S, Nisticò C, Ferretti G, Vici P, Perracchio L, Malaguti P, Russillo M, Botti C, Pescarmona E, Cognetti F, Terrenato I. p53 and BLC2 Immunohistochemical Expression Across Molecular Subtypes in 1099 Early Breast Cancer Patients With Long-Term Follow-up: An Observational Study. Clin Breast Cancer 2020; 20:e761-e770. [PMID: 32580907 DOI: 10.1016/j.clbc.2020.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/03/2020] [Accepted: 05/06/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION p53 and antiapoptotic B-cell leukemia/lymphoma 2 (BLC2) have been proposed as prognostic markers for early breast cancer (BC), although their relationship with conventional parameters and patient prognosis, as well as their distribution within the molecular BC subtypes remains uncertain. PATIENTS AND METHODS In this observational study, we analyzed the immunohistochemical expression of p53 and BLC2 in 1099 early BC patients surgically treated between 2000 and 2006 and followed for at least 5 years, also considering their association with pathologic factors and molecular subtypes, as well as their influence on disease-free survival. RESULTS p53 and BLC2 are distributed differently across molecular subtypes (P < .0001); in particular, p53 positivity and BLC2 negativity seems to be associated with more aggressive conventional tumor phenotypes. Moreover, BLC2 negativity seems to be a significant discriminating factor for disease-free survival (P = .003) according to Kaplan-Meier analysis, while p53 seems to have no discriminating effect. Among patients with discordant p53/BLC2 phenotype, the combination p53+BLC2- seems to be associated with the worst outcomes (P = .007) and significantly influenced the clinical course of node-negative patients treated only with hormone therapy (P = .004). CONCLUSION These two biomarkers, in addition to conventional pathologic factors and molecular subtype, could help define the risk and outcome of BC.
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Affiliation(s)
- Alessandra Fabi
- Division of Medical Oncology 1, IRCCS, Regina Elena National Cancer Institute, Rome, Italy.
| | - Marcella Mottolese
- Division of Pathology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Anna Di Benedetto
- Division of Pathology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Cristiana Ercolani
- Division of Pathology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Simonetta Buglioni
- Division of Pathology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Cecilia Nisticò
- Division of Medical Oncology 1, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Gianluigi Ferretti
- Division of Medical Oncology 1, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Vici
- Division of Medical Oncology 2, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Letizia Perracchio
- Division of Pathology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Paola Malaguti
- Division of Medical Oncology 1, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Michelangelo Russillo
- Division of Medical Oncology 1, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Claudio Botti
- Department of Surgery, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Edoardo Pescarmona
- Division of Pathology, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Cognetti
- Division of Medical Oncology 1, IRCCS, Regina Elena National Cancer Institute, Rome, Italy; Department of Medical Oncology, Università di Roma "La Sapienza", Rome, Italy
| | - Irene Terrenato
- Biostatistics and Bioinformatic Unit, Scientific Direction, IRCCS, Regina Elena National Cancer Institute, Rome, Italy
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Charara S, Ghelfi J, Chirica M, Thony F, Ferretti G. Embolisation of left-gastric artery pseudoaneurysm with artery to hepatic vein fistula using a transjugular approach. Diagn Interv Imaging 2020; 101:257-258. [DOI: 10.1016/j.diii.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/06/2019] [Accepted: 11/10/2019] [Indexed: 10/25/2022]
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Fabi A, Russillo M, Ciccarese M, Scagnoli S, Schettini F, Buono G, Russo VL, Arpino G, Rossella R, Sarobba G, Giampaglia M, Pellegrini P, Stani S, Palleschi M, Adamo V, Morelli F, Fabbri MA, Nistico C, Ferretti G, Catania G, Pisegna S, Giannarelli D, Cognetti F. Abstract P5-11-18: Real-world evidence of efficacy and activity of palbociclib plus endocrine therapy and post-progression treatments in HR+/HER2- metastatic breast cancer patients: The PALPract study. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-11-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Several randomized clinical trials clearly demonstrated that adding palbociclib (P) to endocrine therapies (ET), such as letrozole (LT) or fulvestrant (FLV), significantly improves outcome both in first-line/endocrine sensitive and second-line/endocrine resistant hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2) metastatic breast cancer (MBC) patients (pts).
The aims of the present study were to assess efficacy, activity and toxicity of P combined with either LT or FLV in a real world setting, and to study the efficacy and activity of treatments administered after progression to P + ET.
Methods: Records of 245 consecutive HR+/HER2- MBC patients from 14 Italian cancer centers were reviewed in this observational study. Primary end-point was progression-free survival (PFS) obtained with P+ET; secondary end-points were overall response rates (ORR) and clinical benefit rate (CBR) obtained with P+ET and with post-progression treatments, as well as overall survival (OS), PFS to subsequent treatment lines and post-progression survival (PPS).
Results: Overall 245 pts were treated with P+ET from April 2014. Of them, 116 (47%) received it in first-line setting, 70 (28%) in second-line and the rest (68 pts, 25%) in subsequent lines. Median age was 60 (35-80) years and median ECOG performance status was 0. Seventy-three pts (30%) had more than two metastatic sites and 75 (31%) had visceral metastasis. Ninenty-one (37%) pts received P+LT and 92 (37%) were treated with P+FLV. For 15 (6%) premenopausal pts an LHRH analogue was added to P+ET. In 77 (41%) patients a biopsy of a metastatic lesion was performed.
Among the 116 pts treated in first-line setting, median PFS was 14.7 (95% CI 12.0-17.3) and 15.1 (95%CI 8.6-21.6) months for pts receiving P+LT and P+FLV, respectively. ORR was 48% (95% CI: 39-57%) and CBR was 75% (95% CI, 66-82%). Four (3%) complete responses (CR), 52 (45%) partial responses (PR), 31 (27%) stable disease (SD) and 11 (9%) progression disease (PD) were observed as best response; 18 pts were not yet evaluable. Among the 70 pts treated in second-line setting, median PFS was 10.8 (95%CI 0-24.3) and 7.9 (95%CI 3.3-12.5) months, for pts receiving P+LT and P+FLV, respectively. The ORR was 26% (95% CI: 16-38) and the CBR was 66% (95% CI, 53-76). One CR (1%), 17 PR (24%), 28 SD (40%) and 13 PD (18.5%) were observed as best response, while 9 were not yet evaluable. Best response was achieved after a median of 5 cycle.
At time of the current analysis, 50 pts experienced PD during P+ET. Of them, 38 (76%) received chemotherapy (capecitabine, eribulin, nab-paclitaxel, paclitaxel+bevacizumab, vinoreline) and 12 (24%) ET. To date, only 5 pts progressed during these therapies, preventing us for evaluating secondary end-points regarding efficacy and activity.
The most frequent adverse event (AE) was grade 3-4 neutropenia (31%), with febrile neutropenia reported in 5 (2%) cases. Main non-hematological AEs were fatigue and gastrointestinal symptoms (diarrhea and stypsis).
Conclusions: Our findings confirm the efficacy and safety of P+ET as first/second-line treatment for HR+/HER2- MBC pts, even in a non-selected, real world population. Since data regarding the efficacy and activity of post-progression therapies were not mature at the time of the current analysis, they will be subsequently presented.
Citation Format: Alessandra Fabi, Michelangelo Russillo, Mariangela Ciccarese, Simone Scagnoli, Francesco Schettini, Giuseppe Buono, Vito Lo Russo, Grazia Arpino, Rosalba Rossella, Giuseppina Sarobba, Marianna Giampaglia, Patrizia Pellegrini, Simonetta Stani, Michela Palleschi, Vincenzo Adamo, Francesca Morelli, Maria Agnese Fabbri, Cecilia Nistico, Gianluigi Ferretti, Giovanna Catania, Simona Pisegna, Diana Giannarelli, Francesco Cognetti. Real-world evidence of efficacy and activity of palbociclib plus endocrine therapy and post-progression treatments in HR+/HER2- metastatic breast cancer patients: The PALPract study [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-11-18.
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Affiliation(s)
| | | | | | | | - Francesco Schettini
- 4Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Napoli, Italy
| | - Giuseppe Buono
- 5Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | | | - Grazia Arpino
- 5Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
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Bazzichetto C, Conciatori F, Luchini C, Simionato F, Santoro R, Vaccaro V, Corbo V, Falcone I, Ferretti G, Cognetti F, Melisi D, Scarpa A, Ciuffreda L, Milella M. From Genetic Alterations to Tumor Microenvironment: The Ariadne's String in Pancreatic Cancer. Cells 2020; 9:cells9020309. [PMID: 32012917 PMCID: PMC7072496 DOI: 10.3390/cells9020309] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/18/2020] [Accepted: 01/23/2020] [Indexed: 02/06/2023] Open
Abstract
The threatening notoriety of pancreatic cancer mainly arises from its negligible early diagnosis, highly aggressive progression, failure of conventional therapeutic options and consequent very poor prognosis. The most important driver genes of pancreatic cancer are the oncogene KRAS and the tumor suppressors TP53, CDKN2A, and SMAD4. Although the presence of few drivers, several signaling pathways are involved in the oncogenesis of this cancer type, some of them with promising targets for precision oncology. Pancreatic cancer is recognized as one of immunosuppressive phenotype cancer: it is characterized by a fibrotic-desmoplastic stroma, in which there is an intensive cross-talk between several cellular (e.g., fibroblasts, myeloid cells, lymphocytes, endothelial, and myeloid cells) and acellular (collagen, fibronectin, and soluble factors) components. In this review; we aim to describe the current knowledge of the genetic/biological landscape of pancreatic cancer and the composition of its tumor microenvironment; in order to better direct in the intrinsic labyrinth of this complex tumor type. Indeed; disentangling the genetic and molecular characteristics of cancer cells and the environment in which they evolve may represent the crucial step towards more effective therapeutic strategies
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Affiliation(s)
- Chiara Bazzichetto
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Fabiana Conciatori
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
- Correspondence: ; Tel.: +39-06-52665185
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, 37134 Verona, Italy;
| | - Francesca Simionato
- Division of Oncology, University of Verona, 37126 Verona, Italy; (F.S.); (M.M.)
| | - Raffaela Santoro
- Medicine-Digestive Molecular Clinical Oncology Research Unit, University of Verona, 37126 Verona, Italy; (R.S.); (D.M.)
| | - Vanja Vaccaro
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Vincenzo Corbo
- ARC-Net Research Centre, University and Hospital Trust of Verona, 37126 Verona, Italy; (V.C.); (A.S.)
| | - Italia Falcone
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Gianluigi Ferretti
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Francesco Cognetti
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Davide Melisi
- Medicine-Digestive Molecular Clinical Oncology Research Unit, University of Verona, 37126 Verona, Italy; (R.S.); (D.M.)
| | - Aldo Scarpa
- ARC-Net Research Centre, University and Hospital Trust of Verona, 37126 Verona, Italy; (V.C.); (A.S.)
| | - Ludovica Ciuffreda
- SAFU, Department of Research, Advanced Diagnostics, and Technological Innovation, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Michele Milella
- Division of Oncology, University of Verona, 37126 Verona, Italy; (F.S.); (M.M.)
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Conciatori F, Bazzichetto C, Falcone I, Ferretti G, Cognetti F, Milella M, Ciuffreda L. Colorectal cancer stem cells properties and features: evidence of interleukin-8 involvement. Cancer Drug Resist 2019; 2:968-979. [PMID: 35582268 PMCID: PMC9019202 DOI: 10.20517/cdr.2019.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/13/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022]
Abstract
Colorectal cancer (CRC) still remains a disease with high percentage of death, principally due to therapy resistance and metastasis. During the time the hypothesis has been reinforced that CRC stem cells (CRCSC) are involved in allowing intratumoral heterogeneity, drug escape mechanisms and secondary tumors. CRCSC are characterized by specific surface markers (i.e., CD44 and CD133), signaling pathways activation (i.e., Wnt and Notch) and gene expression (i.e., Oct4 and Snail), which confer to CRCSC self-renewal abilities and pluripotent capacity. Interleukin (IL)-8 is correlated to CRC progression, development of liver metastases and chemoresistance; moreover, IL-8 modulates not only stemness maintenance but also stemness promotion, such as epithelial-mesenchymal transition. This review wants to give a brief and up-to-date overview on IL-8 implication in CRCSC cues.
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Affiliation(s)
- Fabiana Conciatori
- Medical Oncology 1, IRCCS - Regina Elena National Cancer Institute, Rome 00144, Italy
| | - Chiara Bazzichetto
- Medical Oncology 1, IRCCS - Regina Elena National Cancer Institute, Rome 00144, Italy
| | - Italia Falcone
- Medical Oncology 1, IRCCS - Regina Elena National Cancer Institute, Rome 00144, Italy
| | - Gianluigi Ferretti
- Medical Oncology 1, IRCCS - Regina Elena National Cancer Institute, Rome 00144, Italy
| | - Francesco Cognetti
- Medical Oncology 1, IRCCS - Regina Elena National Cancer Institute, Rome 00144, Italy
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona 37126, Italy
| | - Ludovica Ciuffreda
- Medical Oncology 1, IRCCS - Regina Elena National Cancer Institute, Rome 00144, Italy.,SAFU, Department of Research, Advanced Diagnostics, and Technological Innovation, IRCCS - Regina Elena National Cancer Institute, Rome 00144, Italy
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Moro-Sibilot D, Cozic N, Pérol M, Mazières J, Otto J, Souquet PJ, Bahleda R, Wislez M, Zalcman G, Guibert SD, Barlési F, Mennecier B, Monnet I, Sabatier R, Bota S, Dubos C, Verriele V, Haddad V, Ferretti G, Cortot A, De Fraipont F, Jimenez M, Hoog-Labouret N, Vassal G. Crizotinib in c-MET- or ROS1-positive NSCLC: results of the AcSé phase II trial. Ann Oncol 2019; 30:1985-1991. [PMID: 31584608 DOI: 10.1093/annonc/mdz407] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [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] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In 2013, the French National Cancer Institute initiated the AcSé program to provide patients with secure access to targeted therapies outside of their marketed approvals. Efficacy and safety was then assessed using a two-stage Simon phase II trial design. When the study design was designed, crizotinib was approved only as monotherapy for adults with anaplastic lymphoma kinase plus non-small-cell lung cancers (NSCLC). PATIENTS AND METHODS Advanced NSCLC patients with c-MET ≥6 copies, c-MET-mutated, or ROS-1-translocated tumours were enrolled in one of the three cohorts. Patients were treated with crizotinib 250 mg twice daily. Efficacy was assessed using the objective response rate (ORR) after two cycles of crizotinib as primary outcome. Secondary outcomes included disease control rate at four cycles, best ORR, progression-free survival, overall survival, and drug tolerance. RESULTS From August 2013 to March 2018, 5606 patients had their tumour tested for crizotinib targeted molecular alterations: 252 patients had c-MET ≥6 copies, 74 c-MET-mutation, and 78 ROS-1-translocated tumour. Finally, 25 patients in the c-MET ≥6 copies cohort, 28 in the c-MET-mutation cohort, and 37 in the ROS-1-translocation cohort were treated in the phase II trial. The ORR was 16% in the c-MET ≥6 copies cohort, 10.7% in the mutated, and 47.2% in the ROS-1 cohort. The best ORR during treatment was 32% in the c-MET-≥6 copies cohort, 36% in the c-MET-mutated, and 69.4% in the ROS-1-translocation cohort. Safety data were consistent with that previously reported. CONCLUSIONS Crizotinib activity in patients with ROS1-translocated tumours was confirmed. In the c-MET-mutation and c-MET ≥6 copies cohorts, despite insufficient ORR after two cycles of crizotinib, there are signs of late response not sufficient to justify the development of crizotinib in this indication. The continued targeting of c-MET with innovative therapies appears justified. CLINICAL TRIAL NUMBER NCT02034981.
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Affiliation(s)
- D Moro-Sibilot
- Thoracic Oncology Unit, Grenoble-Alpes University Hospital, Grenoble; Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris.
| | - N Cozic
- Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, INSERM U1018, ESP, Paris-Saclay and Paris-Sud Universities, Villejuif
| | - M Pérol
- Department of Medical Oncology, Léon Bérard Cancer Centre, Lyon
| | - J Mazières
- Pneumology Department, Toulouse University Hospital and Paul Sabatier University, Toulouse
| | - J Otto
- Department of Medicine, Antoine Lacassagne Cancer Centre, Nice
| | - P J Souquet
- Department of Pneumology and Thoracic Oncology, Lyon Sud Hospital Center, Hospices Civils de Lyon, Pierre Bénite
| | - R Bahleda
- Drug Development Department (DITEP), Gustave Roussy Cancer Campus, Villejuif
| | - M Wislez
- Pneumology Department, Tenon Hospital, AP-HP and "Pierre and Marie Curie" University, Paris
| | - G Zalcman
- Thoracic Oncology Department-CIC INSERM 1425, Bichat University Hospital, AP-HP, Paris; Paris-Diderot University, Paris
| | | | - F Barlési
- Multidisciplinary Oncology & Therapeutic Innovations Department, APHM and Aix Marseille University, INSERM, CNRS, CRCM, Marseille
| | - B Mennecier
- Pneumology Department, Strasbourg University Hospital, Strasbourg
| | - I Monnet
- Pneumology Department, CHIC Creteil, Créteil
| | - R Sabatier
- Department of Medical Oncology, Inserm 1068, CNRS UMR7258, CRCM, Paoli-Calmettes Institute and Aix-Marseille University, Marseille
| | - S Bota
- Pneumology Department, Charles Nicolle Hospital, Rouen University Hospital, Rouen
| | - C Dubos
- Pneumology Department, François Baclesse Cancer Centre, Caen
| | - V Verriele
- Anatomy and Pathological Cytologies Department, Paul Papin Cancer Centre, ICO, Angers
| | - V Haddad
- Department of Tumour Biology, Léon Bérard Cancer Centre, Lyon
| | - G Ferretti
- Radiology and Medical Imaging Department, Grenoble-Alpes University Hospital, Grenoble
| | - A Cortot
- Department of Thoracic Oncology, Lille University Hospital and University of Lille, Lille
| | - F De Fraipont
- Molecular Genetic Unit: Hereditary Diseases and Oncology, Grenoble-Alpes University Hospital, Grenoble
| | - M Jimenez
- Research and Development UNICANCER, Paris
| | | | - G Vassal
- Clinical Research Division, Gustave Roussy Cancer Campus, Villejuif, France
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Rossi V, Berchialla P, Giannarelli D, Nisticò C, Ferretti G, Gasparro S, Russillo M, Catania G, Vigna L, Mancusi RL, Bria E, Montemurro F, Cognetti F, Fabi A. Should All Patients With HR-Positive HER2-Negative Metastatic Breast Cancer Receive CDK 4/6 Inhibitor As First-Line Based Therapy? A Network Meta-Analysis of Data from the PALOMA 2, MONALEESA 2, MONALEESA 7, MONARCH 3, FALCON, SWOG and FACT Trials. Cancers (Basel) 2019; 11:cancers11111661. [PMID: 31717791 PMCID: PMC6896062 DOI: 10.3390/cancers11111661] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 11/16/2022] Open
Abstract
Background: We aim to understand whether all patients with hormonal receptor (HR)-positive (+)/human epidermal growth factor receptor-2 (HER2)-negative (-) metastatic breast cancer (MBC) should receive cyclin D-dependent kinase (CDK) 4/6 inhibitor-based therapy as a first-line approach. METHODS A network meta-analysis (NMA) using the Bayesian hierarchical arm-based model, which provides the estimates for various effect sizes, were computed. RESULTS First-line treatment options in HR+/HER2- MBC, including CDK 4/6 inhibitors combined with aromatase inhibitors (AIs) or fulvestrant (F), showed a significantly longer progression-free survival (PFS) in comparison with AI monotherapy, with a total of 26% progression risk reduction. In the indirect comparison across the three classes of CDK 4/6 inhibitors and F endocrine-based therapies, the first strategy resulted in longer PFS, regardless of specific CDK 4/6 inhibitor (HR: 0.68; 95% CrI: 0.53-0.87 for palbociclib + AI, HR: 0.65; 95% CrI: 0.53-0.79 for ribociclib + AI, HR: 0.63; 95% CrI: 0.47-0.86 for abemaciclib + AI) and patient's characteristics. Longer PFS was also found in patients with bone-only and soft tissues limited disease treated with CDK 4/6 inhibitors. CONCLUSIONS CDK 4/6 inhibitors have similar efficacy when associated with an AI in the first-line treatment of HR+ MBC, and are superior to either F or AI monotherapy, regardless of any other patients or tumor characteristics.
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Affiliation(s)
- Valentina Rossi
- Breast Unit, S. Camillo-Forlanini Hospital of Rome, 00152 Rome, Italy; (V.R.); (L.V.)
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, 10124 Turin, Italy;
| | - Diana Giannarelli
- Department of Medical Statistics, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy;
| | - Cecilia Nisticò
- Division of Medical Oncology1, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy; (C.N.); (G.F.); (S.G.); (M.R.); (G.C.)
| | - Gianluigi Ferretti
- Division of Medical Oncology1, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy; (C.N.); (G.F.); (S.G.); (M.R.); (G.C.)
| | - Simona Gasparro
- Division of Medical Oncology1, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy; (C.N.); (G.F.); (S.G.); (M.R.); (G.C.)
| | - Michelangelo Russillo
- Division of Medical Oncology1, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy; (C.N.); (G.F.); (S.G.); (M.R.); (G.C.)
| | - Giovanna Catania
- Division of Medical Oncology1, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy; (C.N.); (G.F.); (S.G.); (M.R.); (G.C.)
| | - Leonardo Vigna
- Breast Unit, S. Camillo-Forlanini Hospital of Rome, 00152 Rome, Italy; (V.R.); (L.V.)
| | | | - Emilio Bria
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
- Department of Medical Oncology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Filippo Montemurro
- Direzione Day Hospital Oncologico Multidisciplinare, Istituto di Candiolo, FPO-IRCCS, 10060 Candiolo, Italy;
| | | | - Alessandra Fabi
- Division of Medical Oncology1, IRCCS Regina Elena National Cancer Institute, 00128 Rome, Italy; (C.N.); (G.F.); (S.G.); (M.R.); (G.C.)
- Correspondence: ; Tel.: +39-065266-5144
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Benet J, Toffart A, Frey G, Chollier T, Ruckly S, Villa J, Emprou C, Pinsolle J, Dumas I, Guillem P, Ferretti G, Moro-Sibilot D, Levra MG. P2.18-10 Importance of the Multidisciplinary Tumor Board in the Treatment Strategy of Stage III Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nelson S, Milgrom P, Albert JM, Selvaraj D, Cunha-Cruz J, Curtan S, Copeland T, Heima M, Rothen M, Beck G, Ferretti G, Riedy C. Randomized Trial Based on the Common-Sense Model of Self-regulation to Increase Child Dental Visits. JDR Clin Trans Res 2019; 4:323-332. [PMID: 30931720 DOI: 10.1177/2380084419830662] [Citation(s) in RCA: 5] [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] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION School screening and the note home (pinned to a backpack) informing parents/caregivers that their child needs to see a dentist have not been effective. OBJECTIVES The Family Access to a Dentist Study (FADS) evaluated the effectiveness of school interventions based on the common-sense model of self-regulation (CSM) among K-4 children needing restorative treatment. METHODS FADS was a multisite double-blind randomized controlled trial with 5 arms. FADS tested a CSM-driven referral letter and dental information guide (DIG) to move caregivers from inaccurate to accurate perceptions of dental caries. Six school districts from Ohio and Washington (14 schools) participated in school years 2015 to 2016 and 2016 to 2017. A total of 611 caregivers were randomized, and 86% (n = 597 children) completed the exit examination. The primary outcome was receipt of care based on a change in oral health status determined clinically within 1 school year. RESULTS In accordance with our primary aims, 5 arms were collapsed into 3: CSM letter and reduced CSM letter (combined), CSM letter + DIG and reduced CSM letter + reduced DIG (combined), and standard letter. Among all sites, 39.7% received restorative care (237 of 597). Combined analysis of sites revealed that the CSM referral letter (with and without the DIG) did not increase dental visits when compared with the standard letter. However, for combined sites (East Cleveland, Ohio; Washington), the CSM + DIG increased dental visits when compared with standard letter in univariate analysis (51.3% vs. 40.9%), indicating 1.6-times increased odds of a dental visit (95% CI, 0.97 to 2.58) after imputation and adjustment for covariates. The CSM + DIG group had 1.9-times increased odds (95% CI, 1.21 to 3.08) of care when compared the CSM letter alone. CONCLUSION A CSM-driven approach to informing caregivers of the chronic nature of caries with resources in an illustrative manner can increase the benefit of school oral health screening (ClinicalTrials.gov NCT02395120). KNOWLEDGE TRANSFER STATEMENT A school dental referral (note home) that tells a parent that the child has cavities has not been effective. In this trial, a referral based on the common-sense model of self-regulation increased follow-up care for children with restorative needs.
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Affiliation(s)
- S Nelson
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - P Milgrom
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - J M Albert
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - D Selvaraj
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - J Cunha-Cruz
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - S Curtan
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - T Copeland
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - M Heima
- Department of Pediatric Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - M Rothen
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - G Beck
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - G Ferretti
- Department of Pediatric Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - C Riedy
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
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Rossi V, Giannarelli D, Berchialla P, Montemurro F, Ferretti G, Nistico' C, Vigna L, Cognetti F, Fabi A. Abstract P2-08-34: The network metanalysis of data from PALOMA 2, MONALEESA 2, MONARCH 3, FALCON, SWOG and FACT trials: Progression free survival (PFS) benefit from first-line endocrine-based therapies in postmenopausal women with HR+ HER2- metastatic breast cancer (MBC) according to different prognostic subgroups. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
The three classes of Cycline Dependend Kinase (CDK) 4/6 inhibitors, Palbociclib (P), Ribociclib (R) and Abemaciclib (A), in combination with non-Steroidal Aromatase Inhibitors (nSAIs) showed improvement on Progression Free Survival (PFS) in patients with HR+/HER2- MBC compared to AIs monotherapy.
Fulvestrant (F) also showed a PFS benefit over AIs in first-line setting of endocrine naive patients (pts) which was even greater in pts whithout visceral disease.
The absence of direct comparison between F and CDK 4/6 combination therapies and their less favorable toxicity profile generated great interest in the identification of a specific subgroup of pts based on clinical and pathological factors for decision-making in the use of endocrine monotherapy.
This analysis combines data from six randomized phase III trials investigating the role of endocrine-based therapies in the first-line setting of HR+/HER2- MBC to identify clinical factors in the choice among available drugs.
Methods
A Bayesian network meta-analysis was carried out for PFS; Hazard Ratio (HR) and 95% CI were reported. Potential treatment effect modifying covariates were investigated using sub-group analysis, stratifying by age, ECOG, ethnicity, prior chemotherapy or endocrine therapy exposure, measurable disease at the time of metastasis occurrence, visceral or bone only disease, time from the initial diagnosis of breast cancer to the metastasis onset. Data analysis was performed using R Statistical Software version 3.5.0
Results
In the absence of direct comparison between CDK 4/6 inhibitors + nAIs and F endocrine-based therapies, all these therapeutic options resulted in significant PFS benefit compared to nAIs monotherapy (HR: 0.74; 95% CI 0.67-0.80). However, among the three classes of CDK 4/6 inhibitors and F a significant longer PFS was observed according to some clinical-pathological factors as followed reported: from P + nAIs in “bone only” disease (HR 0.47; CI 0.25-0.86); from A + nAis in “de novo” subgroup (HR 0.60; CI 0.37-0.97), in “Asian” population (HR 0.37; CI 0.16-0.85) and “non visceral” disease (HR 0.48 CI 0.25-0.89); from R + nAIs in “de novo” subgroup (HR 0.55; CI 0.32-0.95) and in “visceral” disease (HR 0.66 CI 0.45-0.96); from all the three combination strategies (A, P and R) in “prior endocrine” exposure subgroup (HR 0.47 CI 0.25-0.87; HR 0.60 CI 0.45-0.80; HR 0.64 CI 0.41-1.0, respectively). Even though no significant PFS benefit was observed in the remaining subgroups, combined CDK 4/6 strategies appeared more effective than F according to relative HR.
Conclusions
CDK 4/6 inhibitors endocrine-based therapies as first-line treatment for postmenopausal women with HR+/HER2- MBC showed PFS improvement, regardless of prognostic subgroup and additionally advantage was emerged by indirect comparison with F. Further direct comparative studies are needed to explore greater benefits from different therapeutic options.
Citation Format: Rossi V, Giannarelli D, Berchialla P, Montemurro F, Ferretti G, Nistico' C, Vigna L, Cognetti F, Fabi A. The network metanalysis of data from PALOMA 2, MONALEESA 2, MONARCH 3, FALCON, SWOG and FACT trials: Progression free survival (PFS) benefit from first-line endocrine-based therapies in postmenopausal women with HR+ HER2- metastatic breast cancer (MBC) according to different prognostic subgroups [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-34.
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Affiliation(s)
- V Rossi
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
| | - D Giannarelli
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
| | - P Berchialla
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
| | - F Montemurro
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
| | - G Ferretti
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
| | - C Nistico'
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
| | - L Vigna
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
| | - F Cognetti
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
| | - A Fabi
- Breast Tumour Unit, S.Camillo-Forlanini Hospital of Rome, Rome, Italy; Istituto Regina Elena of Rome, Rome, Italy; University of Turin, Turin, Italy; Investigative Clinical Oncology (INCO)-Fondazione del Piemonte per l'Oncologia, Candiolo, Turin, Italy
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Mazières J, Montané L, Barlesi F, Quantin X, Trédaniel J, Le Treut J, Avrillon V, Lavolé A, Westeel V, Orsini Piocelle F, Pichon E, Thiberville L, Borel C, Renault P, Jaffro M, Collot S, Ferretti G, Legrand F, Mahier Ait Oukhatar C, Blay J. Vemurafenib in patients (pts) harboring BRAF V600 mutation: Results of non-small cell lung cancer (NSCLC) cohort from the AcSé trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mazieres J, Montané L, Barlesi F, Coudert B, Souquet P, Otto J, Gervais R, Moro-Sibilot D, Monnet I, Brain E, Huillard O, Quéré G, Debieuvre D, Fabre E, Jaffro M, Collot S, Ferretti G, Tiffon C, Mahier - Ait Oukhatar C, Blay J. OA12.05 Vemurafenib in Patients Harboring V600 and Non V600 BRAF Mutations: Final Results of the NSCLC Cohort from the AcSé Trial. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rossi V, Giannarelli D, Berchialla P, Nisticò C, Ferretti G, Gasparro S, Malaguti P, Russillo M, Catania G, Vigna L, Mancusi R, Cognetti F, Fabi A. Progression free survival (PFS) benefit from first line endocrine based therapies in postmenopausal women with HR+ HER2- metastatic breast cancer (MBC) according to different prognostic subgroups: A combined analysis of data from PALOMA 2, MONALEESA 2, MONARCH 3, FALCON, SWOG and FACT trials. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fabi A, Alesini D, Valle E, Moscetti L, Caputo R, Caruso M, Carbognin L, Ciccarese M, La Verde N, Arpino G, Cannita K, Paris I, Santini D, Montemurro F, Russillo M, Ferretti G, Filippelli G, Rossello R, Fabbri A, Zambelli A, Leonardi V, D'Ottavio AM, Nisticò C, Stani S, Giampaglia M, Scandurra G, Catania G, Malaguti P, Giannarelli D, Cognetti F. T-DM1 and brain metastases: Clinical outcome in HER2-positive metastatic breast cancer. Breast 2018; 41:137-143. [PMID: 30092500 DOI: 10.1016/j.breast.2018.07.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/11/2018] [Accepted: 07/11/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND We reported the results of an Italian large retrospective analysis that evaluated the effectiveness and safety of T-DM1 in 'field-practice' breast cancer patients. We performed a sub-analysis to investigate the clinical activity of T-DM1 in patients with brain metastases (BMs). METHODS The records of 87 adult women with HER2-positive breast cancer and BMs treated with T-DM1 were reviewed. Their clinical outcomes were compared with those of 216 patients without central nervous system (CNS) involvement. RESULTS Response to T-DM1 treatment in BMs was available for 53 patients in the BM group (60.9%): two patients reported a complete response (3.8%), 11 patients obtained partial response (20.7%; overall response rate: 24.5%), 16 patients had a stable disease (30.1%). Regarding extracranial disease, a total of 77 and 191 patients were evaluable for response in BM group and non-BM group, respectively. The overall response rate was 35.1% in the BM group and 38.3% in the non-BM group; disease control rate was 53.3% and 66.6%, respectively. At a median follow-up of 16 months (range: 1-55), median cumulative progression-free survival (PFS) was 7 months (95% CI: 5.4-8.6) in the BM group and 8 months (95% CI: 5.7-10.3) in the non-BM group. In the second-line setting, PFS was 5 (95% CI: 3.1-6.9) versus 11 (95% CI: 7.1-14.9) months (p = 0.01). Overall survival was 14 months (95% CI: 12.2-15.8) in the BM group and 32 months (95% CI: 24.4-39.6) in the non-BM group (p < 0.0001). CONCLUSIONS T-DM1 is active in breast cancer patients with BMs.
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Affiliation(s)
- Alessandra Fabi
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy.
| | - Daniele Alesini
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | | | | | | | | | | | - Nicla La Verde
- Oncologia Medica, PO Fatebenefratelli e Oftalmico, Milano, Italy
| | - Grazia Arpino
- Oncologia Medica, Università Federico II, Napoli, Italy
| | - Katia Cannita
- Oncologia Medica, Ospedale S. Salvatore, Università dell'Aquila, Italy
| | - Ida Paris
- Oncologia e Ginecologica Polo Donna, Policlinico A.Gemelli, Roma, Italy
| | - Daniele Santini
- Oncologia Medica, Campus Bio-medico Universitario, Roma, Italy
| | - Filippo Montemurro
- Investigative Clinical Oncology, Cancer Institute-FPO, IRCCS, Candiolo, Torino, Italy
| | | | - Gianluigi Ferretti
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | - Rosalba Rossello
- Oncologia Medica, Ospedale S. Vincenzo, Taormina, Messina, Italy
| | | | | | | | | | - Cecilia Nisticò
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | | | | | - Giusy Scandurra
- Oncologia Medica, Ospedale per le Emergenze Cannizzaro, Catania, Italy
| | - Giovanna Catania
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | - Paola Malaguti
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | - Diana Giannarelli
- Unità di Biostatistica, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
| | - Francesco Cognetti
- Oncologia Medica 1, Istituto Nazionale Tumori "Regina Elena", Roma, Italy
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Russillo M, Ferretti G, Vidiri A, Gasparro S, Cognetti F, Pellegrini D, Fabi A. Impressive Long-term Response with Pertuzumab and Trastuzumab in HER2-positive Breast Cancer with Brain Metastasis. In Vivo 2018; 32:839-842. [PMID: 29936468 DOI: 10.21873/invivo.11317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/03/2018] [Accepted: 04/10/2018] [Indexed: 11/10/2022]
Abstract
This is a case report of a 40-year-old woman who, after conservative breast cancer treatment, developed a HER2 positive solitary brain metastasis in the left temporal lobe, without extracranial disease. She underwent surgery resection followed by stereotactic radiotherapy and, because of early brain progression, she was submitted to the first line therapy with pertuzumab, trastuzumab and weekly paclitaxel. After six months of treatment, a brain magnetic resonance imaging revealed a complete disappearance of brain recurrence, which persisted for more than 24 months.
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Affiliation(s)
| | - Gianluigi Ferretti
- Division of Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy
| | - Antonello Vidiri
- Department of Neuroscience, Imaging Diagnostic, Regina Elena National Cancer Institute, Rome, Italy
| | - Simona Gasparro
- Division of Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Cognetti
- Division of Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy
| | - Domenica Pellegrini
- Division of Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy
| | - Alessandra Fabi
- Division of Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy
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Silvestris N, Di Cosimo S, Ferretti G, Angelini F, De Benedetti G, D'Alberto A, Caselli M, D'Aprile M. Breast Cancer Metastatic to the Choroid in a Male Patient Case Report. Tumori 2018; 89:333-5. [PMID: 12908795 DOI: 10.1177/030089160308900321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Choroidal metastases have been observed in about 8% of patients with metastatic breast cancer, even if their true incidence is likely to be higher, as they are not routinely investigated in the absence of symptoms. Radiotherapy is the treatment of choice for symptom palliation. The prognosis is traditionally poor, with a reported average survival of one year. Here we describe the third case reported in the literature of a metastatic tumor to the choroid from a male breast carcinoma.
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Affiliation(s)
- Nicola Silvestris
- Operative Unit of Medical Oncology, Oncology Center Giorgio Porfiri, Hospital Santa Maria Goretti, Latina, Italy.
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Affiliation(s)
- A. Taboni
- Department of Clinical and Experimental Sciences; University of Brescia; Brescia Italy
| | - N. Fagoni
- Department of Clinical and Experimental Sciences; University of Brescia; Brescia Italy
| | - G. Vinetti
- Department of Clinical and Experimental Sciences; University of Brescia; Brescia Italy
| | - G. Ferretti
- Department of Molecular and Translational Medicine; University of Brescia; Brescia Italy
- Departments APSI and NEUFO; University of Geneva; Geneva Switzerland
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De Placido S, Gallo C, De Laurentiis M, Bisagni G, Arpino G, Sarobba MG, Riccardi F, Russo A, Del Mastro L, Cogoni AA, Cognetti F, Gori S, Foglietta J, Frassoldati A, Amoroso D, Laudadio L, Moscetti L, Montemurro F, Verusio C, Bernardo A, Lorusso V, Gravina A, Moretti G, Lauria R, Lai A, Mocerino C, Rizzo S, Nuzzo F, Carlini P, Perrone F, Agostara B, Aieta M, Alabiso O, Alicicco MG, Amadori D, Amaducci L, Amiconi G, Antuzzi G, Ardine M, Ardizzoia A, Aversa C, Badalamenti G, Barni S, Basurto C, Berardi R, Bergamasco C, Bidoli P, Bighin C, Biondi E, Bisagni G, Boni C, Borgonovo K, Botta M, Bravi S, Bruzzi P, Buono G, Butera A, Caldara A, Candeloro G, Cappelletti C, Cardalesi C, Carfora E, Cariello A, Carrozza F, Cartenì G, Caruso M, Casadei V, Casanova C, Castori L, Cavanna L, Cavazzini G, Cazzaniga M, Chilelli M, Chiodini P, Chiorrini S, Ciardiello F, Ciccarese M, Cinieri S, Clerico M, Coccaro M, Comande M, Corbo C, Cortino G, Cusenza S, Daniele G, D'arco AM, D'auria G, Dazzi C, De Angelis C, de Braud F, De Feo G, De Matteis A, De Tursi M, Di Blasio A, di Lucca G, Di Lullo L, Di Rella F, Di Renzo G, Di Stefano P, Di Stefano A, Diana A, Donati S, Fabbri A, Fabi A, Faedi M, Farina G, Farris A, Febbraro A, Fedele P, Federico P, Ferraù F, Ferretti G, Ferro A, Floriani I, Forcignanò R, Forciniti S, Forestieri V, Fornari G, Frisinghelli M, Fusco V, Gallizzi G, Galvano A, Gambardella A, Gambi A, Gebbia V, Gervasi E, Ghilardi M, Giacobino A, Giardina G, Giotta F, Giraudi S, Giuliano M, Grassadonia A, Grasso D, Grosso F, Guizzaro L, Incoronato P, Incorvaia L, Iodice G, La Verde N, Labonia V, Landi G, Latorre A, Leonardi V, Levaggi A, Limite G, Lina Bascialla L, Livi L, Maiello E, Mandelli D, Marcon I, Menon D, Montedoro M, Moraca L, Moretti A, Morritti MG, Morselli P, Mura A, Mura S, Musacchio M, Muzio A, Natale D, Natoli C, Nigro C, Nisticò C, Nuzzo A, Orditura M, Orlando L, Pacilio C, Palumbo G, Palumbo R, Pasini F, Paterno E, Pazzola A, Pelliccioni S, Pensabene M, Perroni D, Pesenti Gritti A, Petrelli F, Piccirillo MC, Pinotti G, Pogliani C, Poli D, Prader S, Recchia F, Rizzi D, Romano C, Rossello R, Rossini C, Salvucci G, Sanna V, Santini A, Saracchini S, Savastano C, Scambia G, Schettini F, Schiavone P, Schirone A, Seles E, Signoriello S, Signoriello G, Silva RR, Silvestri A, Simeon V, Spagnoletti I, Tamberi S, Teragni C, Thalmann V, Thomas R, Thomas G, Tienghi A, Tinari N, Tinessa V, Tomei F, Tonini G, Torri V, Traficante D, Tudini M, Turazza M, Vignoli R, Vitale MG, Zacchia A, Zagarese P, Zanni A, Zavallone L, Zavettieri M, Zoboli A. Adjuvant anastrozole versus exemestane versus letrozole, upfront or after 2 years of tamoxifen, in endocrine-sensitive breast cancer (FATA-GIM3): a randomised, phase 3 trial. Lancet Oncol 2018; 19:474-485. [PMID: 29482983 DOI: 10.1016/s1470-2045(18)30116-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/04/2018] [Accepted: 01/08/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Uncertainty exists about the optimal schedule of adjuvant treatment of breast cancer with aromatase inhibitors and, to our knowledge, no trial has directly compared the three aromatase inhibitors anastrozole, exemestane, and letrozole. We investigated the schedule and type of aromatase inhibitors to be used as adjuvant treatment for hormone receptor-positive early breast cancer. METHODS FATA-GIM3 is a multicentre, open-label, randomised, phase 3 trial of six different treatments in postmenopausal women with hormone receptor-positive early breast cancer. Eligible patients had histologically confirmed invasive hormone receptor-positive breast cancer that had been completely removed by surgery, any pathological tumour size, and axillary nodal status. Key exclusion criteria were hormone replacement therapy, recurrent or metastatic disease, previous treatment with tamoxifen, and another malignancy in the previous 10 years. Patients were randomly assigned in an equal ratio to one of six treatment groups: oral anastrozole (1 mg per day), exemestane (25 mg per day), or letrozole (2·5 mg per day) tablets upfront for 5 years (upfront strategy) or oral tamoxifen (20 mg per day) for 2 years followed by oral administration of one of the three aromatase inhibitors for 3 years (switch strategy). Randomisation was done by a computerised minimisation procedure stratified for oestrogen receptor, progesterone receptor, and HER2 status; previous chemotherapy; and pathological nodal status. Neither the patients nor the physicians were masked to treatment allocation. The primary endpoint was disease-free survival. The minimum cutoff to declare superiority of the upfront strategy over the switch strategy was assumed to be a 2% difference in disease-free survival at 5 years. Primary efficacy analyses were done by intention to treat; safety analyses included all patients for whom at least one safety case report form had been completed. Follow-up is ongoing. This trial is registered with the European Clinical Trials Database, number 2006-004018-42, and ClinicalTrials.gov, number NCT00541086. FINDINGS Between March 9, 2007, and July 31, 2012, 3697 patients were enrolled into the study. After a median follow-up of 60 months (IQR 46-72), 401 disease-free survival events were reported, including 211 (11%) of 1850 patients allocated to the switch strategy and 190 (10%) of 1847 patients allocated to upfront treatment. 5-year disease-free survival was 88·5% (95% CI 86·7-90·0) with the switch strategy and 89·8% (88·2-91·2) with upfront treatment (hazard ratio 0·89, 95% CI 0·73-1·08; p=0·23). 5-year disease-free survival was 90·0% (95% CI 87·9-91·7) with anastrozole (124 events), 88·0% (85·8-89·9) with exemestane (148 events), and 89·4% (87·3 to 91·1) with letrozole (129 events; p=0·24). No unexpected serious adverse reactions or treatment-related deaths occurred. Musculoskeletal side-effects were the most frequent grade 3-4 events, reported in 130 (7%) of 1761 patients who received the switch strategy and 128 (7%) of 1766 patients who received upfront treatment. Grade 1 musculoskeletal events were more frequent with the upfront schedule than with the switch schedule (924 [52%] of 1766 patients vs 745 [42%] of 1761 patients). All other grade 3-4 adverse events occurred in less than 2% of patients in either group. INTERPRETATION 5 years of treatment with aromatase inhibitors was not superior to 2 years of tamoxifen followed by 3 years of aromatase inhibitors. None of the three aromatase inhibitors was superior to the others in terms of efficacy. Therefore, patient preference, tolerability, and financial constraints should be considered when deciding the optimal treatment approach in this setting. FUNDING Italian Drug Agency.
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Affiliation(s)
- Sabino De Placido
- Dipartimento di Clinica Medica e Chirurgia, Università Federico II, Naples, Italy
| | - Ciro Gallo
- Statistica Medica, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Michelino De Laurentiis
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
| | - Giancarlo Bisagni
- Dipartimento di Oncologia, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Grazia Arpino
- Dipartimento di Clinica Medica e Chirurgia, Università Federico II, Naples, Italy
| | | | | | - Antonio Russo
- Dipartimento di Scienze Chirurgiche, Oncologiche e Stomatologiche, Sezione di Oncologia Medica, Università di Palermo, Palermo, Italy
| | - Lucia Del Mastro
- Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova-Oncologia Medica, Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Francesco Cognetti
- Divisione Oncologia Medica 1, Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Stefania Gori
- Oncologia Medica, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | | | | | - Domenico Amoroso
- Oncologia Medica, Ospedale della Versilia, Lido di Camaiore (LU), Istituto Toscano Tumori, Florence, Italy
| | | | - Luca Moscetti
- Dipartimento di Oncologia Medica, Ospedale Belcolle, Viterbo, Italy
| | - Filippo Montemurro
- Divisione di Oncologia Clinica Investigativa dell'Istituto di Candiolo-IRCCS, Candiolo, Italy
| | | | | | - Vito Lorusso
- Polo Oncologico, Ospedale Vito Fazzi, Lecce, Italy
| | - Adriano Gravina
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
| | - Gabriella Moretti
- Dipartimento di Oncologia, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Rossella Lauria
- Dipartimento di Clinica Medica e Chirurgia, Università Federico II, Naples, Italy
| | - Antonella Lai
- Oncologia Medica, Azienda Ospedaliera Universitaria, Sassari, Italy
| | | | - Sergio Rizzo
- Dipartimento di Scienze Chirurgiche, Oncologiche e Stomatologiche, Sezione di Oncologia Medica, Università di Palermo, Palermo, Italy
| | - Francesco Nuzzo
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
| | - Paolo Carlini
- Divisione Oncologia Medica 1, Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Francesco Perrone
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Pascale, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy.
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Fabi A, Alesini D, Valle E, Carbognin L, Arpino G, Montemurro F, Ciccarese M, Cannita K, Paris I, Cursano MC, Moscetti L, Ferretti G, De Laurentiis M, Zambelli A, La Verde N, Nisticò C, Gasparro S, Giannarelli D, Cognetti F. Abstract P1-17-02: Ado-trastuzumab emtansine (TDM-1) treatment and brain metastases in HER2 positive metastatic breast cancer patients: Final analysis of an italian multicenter study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-17-02] [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: 11/16/2022]
Abstract
Abstract
Background: Ado-trastuzumab emtansine (T-DM1) is a drug-antibody conjugate whose activity has been confirmed in HER2+ advanced breast cancer (BC) patients by the phase 3 EMILIA trial (Verma et al, NEJM 2012). Within the 991 patients enrolled in this trial, about 10% were affected with brain metastases (BM); in this subgroup, safety and efficacy of T-DM1 were confirmed although without any PFS improvement.
Patients and methods: In an Italian, multicenter, retrospective analysis involving 303 patients with advanced BC treated with T-DM1 (Fabi et al, Oncotarget 2017), we analyzed 87 patients with BM (BM-group). The study wanted to evaluate the efficacy of T-DM1 on BM; furthermore we compared BM-group with the remaining 216 patients without BM (nBM-group) in order to study outcome of disease. MRI was used as assessment imaging.
The number of extracranial metastatic sites in the BM-group and in the nBM-group was 1 for 10 (11.5%) and for 74 patients (34.3%), 2 for 23 (26.4%) and 93 (43%) patients, 3 for 25 (28.7% and 38 (17.6%) and 4 or more for 29 (33%) and 11 (5%), respectively.
In the BM-group, 5 patients (5.7%) had received surgery alone as local treatment for brain metastases, 13 (14.9%) surgery plus stereotactic radio-surgery (SRS), 4 (4.7%) surgery plus whole-brain radiotherapy (WBRT), 23 (26.5%) SRS alone, 40 (45.9%)WBRT alone and 2 (2.3%) WBRT followed by SRS. Twenty-eight patients (32.9%) and 89 (42.4%) in the BM-group and nBM-group, respectively, received T-DM1 as second line, 24 (28.2%) and 49 (23.3%) as third line and 33 (38.8%) and 72 (34.3%) as fourth line. Mean number of cycles was 6 in both groups.
Results:Among BM-group, 53 patients (60.9%) were evaluable for response. Two (3.8%) obtained brain complete response, 14 (26.4%) partial response and 13 (24.5%) stable disease [brain disease control rate: 54.7%); 24 (45.3%) progressed during T-DM1.
Regarding extracranial metastases, overall response rate was 35.1% in the BM-group and 38.3% in the nBM-group; 6 months-clinical benefit was 50.6% and 52.3%, respectively. Median PFS was 7 months in the BM-group and 8 months in the nBM-group; when T-DM1 was given as second line, median PFS was 5 months in the BM-group and 11 months in nBM-group (p=0.01) while as third, line in which 76% of patients received lapatinib/capacitabine before TDM1, median PFS was 12 and 13 months (p=NS), respectively.
Conclusions: T-DM1 showed a good activity on BM in BC patients. A better outcome was shown in patients previously treated with lapatinib. The identification of clinical and biological prognostic factors could be needed to better select more responder patients with BM to T-DM1.
Citation Format: Fabi A, Alesini D, Valle E, Carbognin L, Arpino G, Montemurro F, Ciccarese M, Cannita K, Paris I, Cursano MC, Moscetti L, Ferretti G, De Laurentiis M, Zambelli A, La Verde N, Nisticò C, Gasparro S, Giannarelli D, Cognetti F. Ado-trastuzumab emtansine (TDM-1) treatment and brain metastases in HER2 positive metastatic breast cancer patients: Final analysis of an italian multicenter study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-17-02.
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Affiliation(s)
- A Fabi
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - D Alesini
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - E Valle
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - L Carbognin
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - G Arpino
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - F Montemurro
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - M Ciccarese
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - K Cannita
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - I Paris
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - MC Cursano
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - L Moscetti
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - G Ferretti
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - M De Laurentiis
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - A Zambelli
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - N La Verde
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - C Nisticò
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - S Gasparro
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - D Giannarelli
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
| | - F Cognetti
- Regina Elena National Cancer Institute, Roma, RM, Italy; Oncologia Medica, Ospedale Businco, Cagliari, RM, Italy; University Verona, Italy, Italy; University Federico II Napoli, Italy; Ospedale Vito Fazi, Lecce, Italy; Istituto Piemontese A Carattere Scientifico, Italy; Ospedale Civile, L'Aquila, Italy; Ospedale G. Gemelli, Roma, Italy; Università Campus Biomedico, Rome, Italy; Ospedale Modena, Modena, Italy; Regina Elena National Cancer Institute, Rome, Italy; Pascale Institute, Napoli, Italy; Ospedale Riuniti, Bergamo, Italy; Ospedale San Raffele, Milano, Italy
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Pinsolle J, Duruisseaux M, Mondet J, Phillips Houlbracq M, Magnat N, Fauré J, Chatagnon A, De Fraipont F, Giaj Levra M, Toffart A, Ferretti G, Hainaut P, Brambilla E, Lantuejoul S, Moro-Sibilot D, Mcleer A. Détection des variants de fusion du gène ALK par séquençage massif parallèle ciblé à partir d’ARN et réponse au crizotinib dans les cancers pulmonaires non à petites cellules. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fabi A, Giannarelli D, Moscetti L, Santini D, Zambelli A, Laurentiis MD, Caruso M, Generali D, Valle E, Leonardi V, Cannita K, Arpino G, Filippelli G, Ferretti G, Giampaglia M, Montemurro F, Nisticò C, Gasparro S, Cognetti F. Ado-trastuzumab emtansine (T-DM1) in HER2+ advanced breast cancer patients: does pretreatment with pertuzumab matter? Future Oncol 2017; 13:2791-2797. [DOI: 10.2217/fon-2017-0336] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We evaluated the outcomes of patients treated with ado-trastuzumab emantasine (T-DM1) after first-line pertuzumab/trastuzumab, compared with those receiving a trastuzumab-only-based regimen. Patients & methods: Patients who received second-line T-DM1 after pertuzumab/trastuzumab (n = 34) were compared with those who received only trastuzumab (n = 73). Results: Overall response rate was 33.3% in patients with prior pertuzumab and 57.1% in the remaining subjects. Disease control rate was 47 and 43%, respectively, and the clinical benefit rate was 43.3 and 71.1%, respectively. Median progression-free survival was 5.0 and 11.0 months, respectively (hazard ratio: 2.02; 95% CI: 1.14–3.58; p = 0.01). Conclusion: Patients treated with T-DM1 who previously received pertuzumab present poorer clinical outcomes compared with those receiving a trastuzumab-only-based regimen in the first-line setting.
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Affiliation(s)
- Alessandra Fabi
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | - Diana Giannarelli
- Unità di Biostatistica, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | - Luca Moscetti
- Oncologia Medica, Ospedale Modena, Modena, 41125, Italy
| | - Daniele Santini
- Oncologia Medica, Campus Bio-medico Universitario, Roma, 00128, Italy
| | - Alberto Zambelli
- Oncologia Medica, Ospedale Papa Giovanni XXIII, Bergamo, 24127, Italy
| | | | - Michele Caruso
- Humanitas Centro Catanese di Oncologia, Catania, 95126, Italy
| | - Daniele Generali
- Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste, 34127, Trieste, Italy
| | | | - Vita Leonardi
- Oncologia Medica, ARNAS Civico, Palermo, 90127 Italy
| | - Katia Cannita
- Oncologia Medica Ospedale L'Aquila, L'Aquila, 67100, Italy
| | - Grazia Arpino
- Oncologia Medica, Università Federico II, Napoli, 80138, Italy
| | | | - Gianluigi Ferretti
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | | | - Filippo Montemurro
- Investigative Clinical Oncology, Candiolo Cancer Institute-FPO, IRCCS, 10060 Candiolo, Torino, Italy
| | - Cecilia Nisticò
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | - Simona Gasparro
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
| | - Francesco Cognetti
- Oncologia Medica 1, Istituto Nazionale Tumori ‘Regina Elena’, Roma, 00144, Italy
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Falanga A, Cremonesi M, Zaccanelli M, Floriani I, Viganò M, Rosti A, Cazzaniga M, Ferretti G, Cabiddu M, Barni S, Mandalà M. The extension of disease is associated to an increased risk of venous thromboembolism (VTE) in patients with gastrointestinal (GI) carcinoma. Thromb Haemost 2017. [DOI: 10.1160/th05-10-0657] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Cottin V, Crestani B, Cadranel J, Cordier JF, Marchand-Adam S, Prévot G, Wallaert B, Bergot E, Camus P, Dalphin JC, Dromer C, Gomez E, Israel-Biet D, Jouneau S, Kessler R, Marquette CH, Reynaud-Gaubert M, Aguilaniu B, Bonnet D, Carré P, Danel C, Faivre JB, Ferretti G, Just N, Lebargy F, Philippe B, Terrioux P, Thivolet-Béjui F, Trumbic B, Valeyre D. French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis – 2017 update. Full-length version. Rev Mal Respir 2017; 34:900-968. [DOI: 10.1016/j.rmr.2017.07.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Cottin V, Crestani B, Cadranel J, Cordier JF, Marchand-Adam S, Prévot G, Wallaert B, Bergot E, Camus P, Dalphin JC, Dromer C, Gomez E, Israel-Biet D, Jouneau S, Kessler R, Marquette CH, Reynaud-Gaubert M, Aguilaniu B, Bonnet D, Carré P, Danel C, Faivre JB, Ferretti G, Just N, Lebargy F, Philippe B, Terrioux P, Thivolet-Béjui F, Trumbic B, Valeyre D. French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis: 2017 update. Summary. Rev Mal Respir 2017; 34:834-851. [DOI: 10.1016/j.rmr.2017.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cottin V, Crestani B, Cadranel J, Cordier JF, Marchand-Adam S, Prévot G, Wallaert B, Bergot E, Camus P, Dalphin JC, Dromer C, Gomez E, Israel-Biet D, Jouneau S, Kessler R, Marquette CH, Reynaud-Gaubert M, Aguilaniu B, Bonnet D, Carré P, Danel C, Faivre JB, Ferretti G, Just N, Lebargy F, Philippe B, Terrioux P, Thivolet-Béjui F, Trumbic B, Valeyre D. [French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis. 2017 update. Full-length update]. Rev Mal Respir 2017:S0761-8425(17)30209-7. [PMID: 28943227 DOI: 10.1016/j.rmr.2017.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- V Cottin
- Centre national de référence des maladies pulmonaires rares, pneumologie, hôpital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard-Lyon 1, Lyon, France.
| | - B Crestani
- Service de pneumologie A, centre de compétences pour les maladies pulmonaires rares, CHU Bichat, université Paris Diderot, Paris, France
| | - J Cadranel
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, hôpital Tenon, université Pierre-et-Marie-Curie, Paris 6, GH-HUEP, Assistance publique-Hôpitaux de Paris, Paris, France
| | - J-F Cordier
- Centre national de référence des maladies pulmonaires rares, pneumologie, hôpital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard-Lyon 1, Lyon, France
| | - S Marchand-Adam
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Tours, Tours, France
| | - G Prévot
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU Larrey, Toulouse, France
| | - B Wallaert
- Service de pneumologie et immuno-allergologie, centre de compétences pour les maladies pulmonaires rares, hôpital Calmette, CHRU de Lille, Lille, France
| | - E Bergot
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, CHU de Caen, Caen, France
| | - P Camus
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, CHU Dijon-Bourgogne, Dijon, France
| | - J-C Dalphin
- Service de pneumologie, allergologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, hôpital Jean-Minjoz, CHRU de Besançon, Besançon, France
| | - C Dromer
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital Haut-Lévèque, CHU de Bordeaux, Bordeaux, France
| | - E Gomez
- Département de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Nancy, Vandœuvre-lès-Nancy, France
| | - D Israel-Biet
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital européen Georges-Pompidou, université Paris-Descartes, Paris, France
| | - S Jouneau
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Rennes, IRSET UMR 1085, université de Rennes 1, Rennes, France
| | - R Kessler
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital civil, CHU de Strasbourg, Strasbourg, France
| | - C-H Marquette
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Nice, FHU Oncoage, université Côte d'Azur, France
| | - M Reynaud-Gaubert
- Service de pneumologie, centre de compétence des maladies pulmonaires rares, CHU Nord, Marseille, France
| | | | - D Bonnet
- Service de pneumologie, centre hospitalier de la Côte-Basque, Bayonne, France
| | - P Carré
- Service de pneumologie, centre hospitalier, Carcassonne, France
| | - C Danel
- Département de pathologie, hôpital Bichat-Claude-Bernard, université Paris Diderot, Assistance publique-Hôpitaux de Paris, Paris 7, Paris, France
| | - J-B Faivre
- Service d'imagerie thoracique, hôpital Calmette, CHRU de Lille, Lille, France
| | - G Ferretti
- Clinique universitaire de radiologie et imagerie médicale, CHU Grenoble-Alpes, Grenoble, France
| | - N Just
- Service de pneumologie, centre hospitalier Victor-Provo, Roubaix, France
| | - F Lebargy
- Service des maladies respiratoires, CHU Maison-Blanche, Reims, France
| | - B Philippe
- Service de pneumologie, centre hospitalier René-Dubos, Pontoise, France
| | - P Terrioux
- Service de pneumologie, centre hospitalier de Meaux, Meaux, France
| | - F Thivolet-Béjui
- Service d'anatomie et cytologie pathologiques, hôpital Louis-Pradel, Lyon, France
| | | | - D Valeyre
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital Avicenne, CHU Paris-Seine-Saint-Denis, Bobigny, France
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Cottin V, Crestani B, Cadranel J, Cordier JF, Marchand-Adam S, Prévot G, Wallaert B, Bergot E, Camus P, Dalphin JC, Dromer C, Gomez E, Israel-Biet D, Jouneau S, Kessler R, Marquette CH, Reynaud-Gaubert M, Aguilaniu B, Bonnet D, Carré P, Danel C, Faivre JB, Ferretti G, Just N, Lebargy F, Philippe B, Terrioux P, Thivolet-Béjui F, Trumbic B, Valeyre D. [French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis: 2017 update. Summary]. Rev Mal Respir 2017:S0761-8425(17)30212-7. [PMID: 28935496 DOI: 10.1016/j.rmr.2017.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- V Cottin
- Centre national de référence des maladies pulmonaires rares, pneumologie, hôpital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard-Lyon 1, Lyon, France.
| | - B Crestani
- Service de pneumologie A, centre de compétences pour les maladies pulmonaires rares, CHU Bichat, université Paris Diderot, Paris, France
| | - J Cadranel
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, hôpital Tenon, université Pierre-et-Marie-Curie, Paris 6, GH-HUEP, Assistance publique-Hôpitaux de Paris, Paris, France
| | - J-F Cordier
- Centre national de référence des maladies pulmonaires rares, pneumologie, hôpital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard-Lyon 1, Lyon, France
| | - S Marchand-Adam
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Tours, Tours, France
| | - G Prévot
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU Larrey, Toulouse, France
| | - B Wallaert
- Service de pneumologie et immuno-allergologie, centre de compétences pour les maladies pulmonaires rares, hôpital Calmette, CHRU de Lille, Lille, France
| | - E Bergot
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, CHU de Caen, Caen, France
| | - P Camus
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, CHU Dijon-Bourgogne, Dijon, France
| | - J-C Dalphin
- Service de pneumologie, allergologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, hôpital Jean-Minjoz, CHRU de Besançon, Besançon, France
| | - C Dromer
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital Haut-Lévèque, CHU de Bordeaux, Bordeaux, France
| | - E Gomez
- Département de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Nancy, Vandœuvre-lès-Nancy, France
| | - D Israel-Biet
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital européen Georges-Pompidou, université Paris-Descartes, Paris, France
| | - S Jouneau
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Rennes, IRSET UMR 1085, université de Rennes 1, Rennes, France
| | - R Kessler
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital civil, CHU de Strasbourg, Strasbourg, France
| | - C-H Marquette
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Nice, FHU Oncoage, université Côte d'Azur, France
| | - M Reynaud-Gaubert
- Service de pneumologie, centre de compétence des maladies pulmonaires rares, CHU Nord, Marseille, France
| | | | - D Bonnet
- Service de pneumologie, centre hospitalier de la Côte-Basque, Bayonne, France
| | - P Carré
- Service de pneumologie, centre hospitalier, Carcassonne, France
| | - C Danel
- Département de pathologie, hôpital Bichat-Claude-Bernard, université Paris Diderot, Assistance publique-Hôpitaux de Paris, Paris 7, Paris, France
| | - J-B Faivre
- Service d'imagerie thoracique, hôpital Calmette, CHRU de Lille, Lille, France
| | - G Ferretti
- Clinique universitaire de radiologie et imagerie médicale, CHU Grenoble-Alpes, Grenoble, France
| | - N Just
- Service de pneumologie, centre hospitalier Victor-Provo, Roubaix, France
| | - F Lebargy
- Service des maladies respiratoires, CHU Maison-Blanche, Reims, France
| | - B Philippe
- Service de pneumologie, centre hospitalier René-Dubos, Pontoise, France
| | - P Terrioux
- Service de pneumologie, centre hospitalier de Meaux, Meaux, France
| | - F Thivolet-Béjui
- Service d'anatomie et cytologie pathologiques, hôpital Louis-Pradel, Lyon, France
| | | | - D Valeyre
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital Avicenne, CHU Paris-Seine-Saint-Denis, Bobigny, France
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Cottin V, Crestani B, Cadranel J, Cordier JF, Marchand-Adam S, Prévot G, Wallaert B, Bergot E, Camus P, Dalphin JC, Dromer C, Gomez E, Israel-Biet D, Jouneau S, Kessler R, Marquette CH, Reynaud-Gaubert M, Aguilaniu B, Bonnet D, Carré P, Danel C, Faivre JB, Ferretti G, Just N, Lebargy F, Philippe B, Terrioux P, Thivolet-Béjui F, Trumbic B, Valeyre D. [French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis: 2017 update. Short-length version]. Rev Mal Respir 2017:S0761-8425(17)30211-5. [PMID: 28935497 DOI: 10.1016/j.rmr.2017.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V Cottin
- Centre national de référence des maladies pulmonaires rares, pneumologie, hôpital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard-Lyon 1, Lyon, France.
| | - B Crestani
- Service de pneumologie A, centre de compétences pour les maladies pulmonaires rares, CHU Bichat, université Paris Diderot, Paris, France
| | - J Cadranel
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, hôpital Tenon, université Pierre-et-Marie-Curie, Paris 6, GH-HUEP, Assistance publique-Hôpitaux de Paris, Paris, France
| | - J-F Cordier
- Centre national de référence des maladies pulmonaires rares, pneumologie, hôpital Louis-Pradel, hospices civils de Lyon, université Claude-Bernard-Lyon 1, Lyon, France
| | - S Marchand-Adam
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Tours, Tours, France
| | - G Prévot
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU Larrey, Toulouse, France
| | - B Wallaert
- Service de pneumologie et immuno-allergologie, centre de compétences pour les maladies pulmonaires rares, hôpital Calmette, CHRU de Lille, Lille, France
| | - E Bergot
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, CHU de Caen, Caen, France
| | - P Camus
- Service de pneumologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, CHU Dijon-Bourgogne, Dijon, France
| | - J-C Dalphin
- Service de pneumologie, allergologie et oncologie thoracique, centre de compétences pour les maladies pulmonaires rares, hôpital Jean-Minjoz, CHRU de Besançon, Besançon, France
| | - C Dromer
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital Haut-Lévèque, CHU de Bordeaux, Bordeaux, France
| | - E Gomez
- Département de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Nancy, Vandœuvre-lès-Nancy, France
| | - D Israel-Biet
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital européen Georges-Pompidou, université Paris-Descartes, Paris, France
| | - S Jouneau
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Rennes, IRSET UMR 1085, université de Rennes 1, Rennes, France
| | - R Kessler
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital civil, CHU de Strasbourg, Strasbourg, France
| | - C-H Marquette
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, CHU de Nice, FHU Oncoage, université Côte d'Azur, France
| | - M Reynaud-Gaubert
- Service de pneumologie, centre de compétence des maladies pulmonaires rares, CHU Nord, Marseille, France
| | | | - D Bonnet
- Service de pneumologie, centre hospitalier de la Côte-Basque, Bayonne, France
| | - P Carré
- Service de pneumologie, centre hospitalier, Carcassonne, France
| | - C Danel
- Département de pathologie, hôpital Bichat-Claude-Bernard, université Paris Diderot, Assistance publique-Hôpitaux de Paris, Paris 7, Paris, France
| | - J-B Faivre
- Service d'imagerie thoracique, hôpital Calmette, CHRU de Lille, Lille, France
| | - G Ferretti
- Clinique universitaire de radiologie et imagerie médicale, CHU Grenoble-Alpes, Grenoble, France
| | - N Just
- Service de pneumologie, centre hospitalier Victor-Provo, Roubaix, France
| | - F Lebargy
- Service des maladies respiratoires, CHU Maison-Blanche, Reims, France
| | - B Philippe
- Service de pneumologie, centre hospitalier René-Dubos, Pontoise, France
| | - P Terrioux
- Service de pneumologie, centre hospitalier de Meaux, Meaux, France
| | - F Thivolet-Béjui
- Service d'anatomie et cytologie pathologiques, hôpital Louis-Pradel, Lyon, France
| | | | - D Valeyre
- Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, hôpital Avicenne, CHU Paris-Seine-Saint-Denis, Bobigny, France
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Perolat R, Stephanov O, Mounier A, Thiebaut A, Pirvu A, Hamidfar R, Ferretti G. Signe du halo inversé chez un patient neutropénique fébrile. Rev Mal Respir 2017; 34:778-781. [DOI: 10.1016/j.rmr.2016.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/29/2016] [Indexed: 10/20/2022]
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Mc Leer A, Duruisseaux M, Pinsolle J, Dubourg S, Mondet J, Phillips-Houlbracq M, Magnat N, Fauré J, Chatagnon A, de Fraipont F, Giaj Levra M, Toffart A, Ferretti G, Brambilla E, Hainaut P, Moro-Sibilot D, Lantuéjoul S. ALK fusion variants detection by targeted RNA-next generation sequencing and clinical responses to crizotinib in ALK-positive non-small cell lung cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Morabito V, Novelli S, Poli L, Ferretti G, Ruberto F, Pugliese F, Pretagostini R, Berloco PB, Rossi M. Adacolumn Granulocyte-Apheresis for Alcoholic Hepatitis: Preliminary Study. Transplant Proc 2017; 48:352-8. [PMID: 27109954 DOI: 10.1016/j.transproceed.2015.12.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/30/2015] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Alcoholic hepatitis (AH) is an acute-on-chronic inflammatory response affecting the liver. It has been recognized that white blood cells (WBCs) are involved in the pathogenesis and in the prognosis of AH. The aim of study was to use Adacolumn, which can selectively adsorb myeloid linage leucocytes (granulocytes and monocytes/macrophages) from the blood in the column and improve the clinical status of patients. MATERIALS Six patients with a diagnosis of AH were treated with Adacolumn granulocyte-apheresis therapy. INCLUSION CRITERIA patients not responders to corticosteroids therapy with Maddrey Discriminant Function (MDF) >32 and MELD score 20-26. The patients underwent five 1-hour sessions for 5 consecutive days with a follow-up at 28 days. The column was placed in an extracorporeal setting with a perfusion rate of 30 mL/min and a duration of 60 minutes. Liver parameters, WBC count, proinflammatory cytokines, coagulation, and predictive scores were valued before and after the cycle of apheresis treatment. RESULTS After 5 days, the findings showed a significant improvement of WBC count (P < .014) and cytokines such as interleukin (IL)-6 (P < .019), tumor necrosis factor α (TNFα) (P < .02), and IL-8 (P < .029). The results probably determined a reduction of aspartate transaminase (AST; P < .02) and alanine transaminase (ALT; P < .011), although we did not observe a significant improve in bilirubin, prothrombin time (PT), and Maddrey score. The improvement of MELD score, depending on an improvement of international normalized ratio for administration of plasma, was not considered. At day 28 of follow-up, PT, IL-6, TNFα, AST and ALT results significantly improved. CONCLUSIONS The Adacolumn apheresis was safe and was able to determine an improvement of clinical status of patients with reduction of inflammatory markers. More patients are needed to validate these results.
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Affiliation(s)
- V Morabito
- Italian National Transplant Center, Rome, Italy.
| | - S Novelli
- Department of Aerospace and Mechanical Engineering, Sapienza University of Rome, Rome, Italy
| | - L Poli
- Italian National Transplant Center, Rome, Italy
| | - G Ferretti
- Department of Infectious Disease, Sapienza University of Rome, Rome, Italy
| | - F Ruberto
- Department of Anesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy
| | - F Pugliese
- Department of Anesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy
| | | | - P B Berloco
- Italian National Transplant Center, Rome, Italy
| | - M Rossi
- Italian National Transplant Center, Rome, Italy
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47
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Grosso F, Roveta A, Gallizzi G, Muzio A, Zai S, Ugo F, Aurelio A, Libener R, Mancuso M, Ferretti G, Franzone P, Pastormerlo M, Piccolini E, Degiovanni D, Numico G. Frequency, patterns and prognostic impact of distant metastases in a large mono-institutional series of malignant pleural mesothelioma (MPM): Not necessarily bad news. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw391.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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48
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Blay JY, Mazieres J, Perol D, Barlesi F, Moro-Sibilot D, Quere G, Tredaniel J, Troussard X, Leboulleux S, Malka D, Flechon A, Linassier C, Ray-Coquard I, Arnulf B, Bieche I, Ferretti G, Nowak F, Jimenez M, Hoog-Labouret N, Buzyn A. Vemurafenib (VM) in non-melanoma V600 and non-V600 BRAF mutated cancers: first results of the ACSE trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Ferretti G, Bacchetti T, Principi F, Di Ludovico F, Viti B, Angeleri VA, Danni M, Provinciali L. Increased levels of lipid hydroperoxides in plasma of patients with multiple sclerosis: a relationship with paraoxonase activity. Mult Scler 2016; 11:677-82. [PMID: 16320727 DOI: 10.1191/1352458505ms1240oa] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Paraoxonase, an enzyme associated with high density lipoproteins (HDL), plays an important role in the anti-oxidant and anti-inflammatory properties exerted by HDL. Increasing evidence supports a role of free radicals and oxidative stress in the inflammatory processes and in the pathogenesis of multiple sclerosis (MS). The aim of this study was to further investigate the relationship between oxidative damage and MS; therefore we compared the paraoxonase activity and levels of cholesteryl ester hydroperoxides (CE-OOH), as marker of lipid peroxidation, in plasma isolated from healthy subjects (n=89) and from MS patients (n=24) in the early stage disability (EDSSB<3.5). Our results demonstrated for the first time that the activity of paraoxonase in the plasma of MS subjects was significantly lower with respect to controls (p<0.001). Moreover, our results showed a significant increase in the levels of CE-OOH in plasma from MS subjects (p<0.001). CE-OOH are biologically active substances derived from the oxidation of cholesteryl ester localized in the hydrophobic core of plasma lipoproteins (HDL, LDL). Therefore, our study demonstrates alterations of lipoprotein peroxidation in MS and provides further evidence that oxidative stress and impairment of the anti-oxidant system may play a role in MS.
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Affiliation(s)
- G Ferretti
- Facoltà di Medicina e Chirurgia, Istituto di Biochimica, Università Politecnica delle Marche, Ancona, Italia.
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50
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Fabi A, Cannita K, Ferretti G, Ciccarese M, Arpino G, Montemurro F, La Verde NM, Generali DG, Scandurra G, Filippelli G, Russillo M, Paris I, Stani S, Fabbri A, Minelli M, Cognetti F, Giannarelli D. Real-life effectiveness of T-DM1 in heavily pretreated HER2-positive advanced breast cancer patients: An Italian observational study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e12019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Alessandra Fabi
- Division of Medical Oncology, “Regina Elena” National Cancer Institute, Rome, Italy
| | | | | | | | | | - Filippo Montemurro
- Fondazione del Piemonte per l'Oncologia, Candiolo Cancer Center, Candiolo, Italy
| | | | | | | | | | | | - Ida Paris
- Catholic University of the Sacred Heart, Rome, Italy
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