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Silic-Benussi M, Sharova E, Corradin A, Urso L, Raimondi V, Cavallari I, Buldini B, Francescato S, Minuzzo SA, D’Agostino DM, Ciminale V. Repurposing Verapamil to Enhance Killing of T-ALL Cells by the mTOR Inhibitor Everolimus. Antioxidants (Basel) 2023; 12:antiox12030625. [PMID: 36978873 PMCID: PMC10045900 DOI: 10.3390/antiox12030625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
New therapies are needed for patients with T-cell lymphoblastic leukemia (T-ALL) who do not respond to standard chemotherapy. Our previous studies showed that the mTORC1 inhibitor everolimus increases reactive oxygen species (ROS) levels, decreases the levels of NADPH and glucose-6-phosphate dehydrogenase (G6PD), the rate-limiting enzyme of the pentose phosphate pathway (PPP), and induces apoptosis in T-ALL cells. Studies in T-ALL-xenografted NOD/SCID mice demonstrated that everolimus improved their response to the glucocorticoid (GC) dexamethasone. Here we show that verapamil, a calcium antagonist used in the treatment of supraventricular tachyarrhythmias, enhanced the effects of everolimus on ROS and cell death in T-ALL cell lines. The death-enhancing effect was synergistic and was confirmed in assays on a panel of therapy-resistant patient-derived xenografts (PDX) and primary samples from T-ALL patients. The verapamil-everolimus combination produced a dramatic reduction in the levels of G6PD and induction of p38 MAPK phosphorylation. Studies of NOD/SCID mice inoculated with refractory T-ALL PDX cells demonstrated that the addition of verapamil to everolimus plus dexamethasone significantly reduced tumor growth in vivo. Taken together, our results provide a rationale for repurposing verapamil in association with mTORC inhibitors and GC to treat refractory T-ALL.
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Affiliation(s)
- Micol Silic-Benussi
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padova, Italy
- Correspondence: (M.S.-B.); (V.C.)
| | | | | | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
| | - Vittoria Raimondi
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
| | | | - Barbara Buldini
- Pediatric Hemato Oncology, Maternal and Child Health Department, University of Padova, 35128 Padova, Italy
| | - Samuela Francescato
- Pediatric Hemato Oncology, Maternal and Child Health Department, University of Padova, 35128 Padova, Italy
| | - Sonia A. Minuzzo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
| | - Donna M. D’Agostino
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padova, Italy
- Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
| | - Vincenzo Ciminale
- Veneto Institute of Oncology IOV—IRCCS, 35128 Padova, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
- Correspondence: (M.S.-B.); (V.C.)
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Cavallari I, Cerciello F, Giovannetti E, Urso L. Editorial: Moving beyond the molecular mechanisms of malignant pleural mesothelioma: Cues for novel biomarkers and drug targets. Front Oncol 2023; 13:1163144. [PMID: 36950549 PMCID: PMC10025518 DOI: 10.3389/fonc.2023.1163144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Affiliation(s)
- Ilaria Cavallari
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto – Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
- *Correspondence: Ilaria Cavallari, ; Elisa Giovannetti, ; Ferdinando Cerciello, ; Loredana Urso,
| | - Ferdinando Cerciello
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- *Correspondence: Ilaria Cavallari, ; Elisa Giovannetti, ; Ferdinando Cerciello, ; Loredana Urso,
| | - Elisa Giovannetti
- Laboratory Medical Oncology, Department Medical Oncology, Cancer Center Amsterdam, Amsterdam Universitair Medische Centra (UMC), Vrije Universiteit, Amsterdam, Netherlands
- Cancer Pharmacology Lab, Fondazione Pisana per la Scienza, Pisa, Italy
- *Correspondence: Ilaria Cavallari, ; Elisa Giovannetti, ; Ferdinando Cerciello, ; Loredana Urso,
| | - Loredana Urso
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto – Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
- *Correspondence: Ilaria Cavallari, ; Elisa Giovannetti, ; Ferdinando Cerciello, ; Loredana Urso,
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Griguolo G, Dieci M, Bisagni G, Frassoldati A, Bianchi G, Urso L, Pascual T, Pare Brunet L, Galván P, Giorgi C, Bottosso M, Vernaci G, Miglietta F, Indraccolo S, Conte P, Prat A, Guarneri V. 97P Genomic bases of endocrine sensitivity in triple-positive early breast cancer: A translational analysis of the PerELISA trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Silic-Benussi M, Sharova E, Ciccarese F, Cavallari I, Raimondi V, Urso L, Corradin A, Kotler H, Scattolin G, Buldini B, Francescato S, Basso G, Minuzzo SA, Indraccolo S, D'Agostino DM, Ciminale V. mTOR inhibition downregulates glucose-6-phosphate dehydrogenase and induces ROS-dependent death in T-cell acute lymphoblastic leukemia cells. Redox Biol 2022; 51:102268. [PMID: 35248829 PMCID: PMC8899410 DOI: 10.1016/j.redox.2022.102268] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
| | | | | | | | - Vittoria Raimondi
- Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Loredana Urso
- Veneto Institute of Oncology IOV - IRCCS, Padova, Italy; Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Alberto Corradin
- Istituto Tecnico Industriale Statale "Alessandro Rossi", Vicenza, Italy
| | - Harel Kotler
- Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Gloria Scattolin
- Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Barbara Buldini
- Pediatric Hemato Oncology, Maternal and Child Health Department, University of Padova, Padova, Italy
| | - Samuela Francescato
- Pediatric Hemato Oncology, Maternal and Child Health Department, University of Padova, Padova, Italy
| | - Giuseppe Basso
- Pediatric Hemato Oncology, Maternal and Child Health Department, University of Padova, Padova, Italy; Italian Institute for Genomic Medicine, Turin, Italy
| | - Sonia A Minuzzo
- Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Stefano Indraccolo
- Veneto Institute of Oncology IOV - IRCCS, Padova, Italy; Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Donna M D'Agostino
- Veneto Institute of Oncology IOV - IRCCS, Padova, Italy; Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Vincenzo Ciminale
- Veneto Institute of Oncology IOV - IRCCS, Padova, Italy; Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy.
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Dieci MV, Guarneri V, Tosi A, Bisagni G, Musolino A, Spazzapan S, Moretti G, Vernaci GM, Griguolo G, Giarratano T, Urso L, Schiavi F, Pinato C, Magni G, Lo Mele M, De Salvo GL, Rosato A, Conte P. Neoadjuvant Chemotherapy and Immunotherapy in Luminal B-like Breast Cancer: Results of the Phase II GIADA Trial. Clin Cancer Res 2022; 28:308-317. [PMID: 34667023 PMCID: PMC9401542 DOI: 10.1158/1078-0432.ccr-21-2260] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/31/2021] [Accepted: 10/12/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE The role of immunotherapy in hormone receptor (HR)-positive, HER2-negative breast cancer is underexplored. PATIENTS AND METHODS The neoadjuvant phase II GIADA trial (NCT04659551, EUDRACT 2016-004665-10) enrolled stage II-IIIA premenopausal patients with Luminal B (LumB)-like breast cancer (HR-positive/HER2-negative, Ki67 ≥ 20%, and/or histologic grade 3). Patients received: three 21-day cycles of epirubicin/cyclophosphamide followed by eight 14-day cycles of nivolumab, triptorelin started concomitantly to chemotherapy, and exemestane started concomitantly to nivolumab. Primary endpoint was pathologic complete response (pCR; ypT0/is, ypN0). RESULTS A pCR was achieved by 7/43 patients [16.3%; 95% confidence interval (CI), 7.4-34.9]; the rate of residual cancer burden class 0-I was 25.6%. pCR rate was significantly higher for patients with PAM50 Basal breast cancer (4/8, 50%) as compared with other subtypes (LumA 9.1%; LumB 8.3%; P = 0.017). Tumor-infiltrating lymphocytes (TIL), immune-related gene-expression signatures, and specific immune cell subpopulations by multiplex immunofluorescence were significantly associated with pCR. A combined score of Basal subtype and TILs had an AUC of 0.95 (95% CI, 0.89-1.00) for pCR prediction. According to multiplex immunofluorescence, a switch to a more immune-activated tumor microenvironment occurred following exposure to anthracyclines. Most common grade ≥3 treatment-related adverse events (AE) during nivolumab were γ-glutamyltransferase (16.7%), alanine aminotransferase (16.7%), and aspartate aminotransferase (9.5%) increase. Most common immune-related AEs were endocrinopathies (all grades 1-2; including adrenal insufficiency, n = 1). CONCLUSIONS Luminal B-like breast cancers with a Basal molecular subtype and/or a state of immune activation may respond to sequential anthracyclines and anti-PD-1. Our data generate hypotheses that, if validated, could guide immunotherapy development in this context.
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Affiliation(s)
- Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.,Corresponding Author: Maria Vittoria Dieci, Department of Surgery, Oncology and Gastroenterology - University of Padova, Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128, Padova, Italy. Phone: 3904-9821-5295; Fax: 3904-9821-5932; E-mail:
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Anna Tosi
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Giancarlo Bisagni
- Department of Oncology and Advanced Technologies, Oncology Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Antonino Musolino
- Medical Oncology and Breast Unit, University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Simon Spazzapan
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Gabriella Moretti
- Department of Oncology and Advanced Technologies, Oncology Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Grazia Maria Vernaci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Tommaso Giarratano
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Francesca Schiavi
- UOSD Hereditary Tumors, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Claudia Pinato
- UOSD Hereditary Tumors, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Giovanna Magni
- Clinical Research Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Marcello Lo Mele
- Department of Pathology, Azienda Ospedale Università Padova, Padova, Italy
| | - Gian Luca De Salvo
- Clinical Research Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Antonio Rosato
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Pierfranco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
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Tonini E, Panareo S, Longo M, Longo L, Urso L, Caracciolo M, Uccelli L, Cittanti C, Turra A, Bartolomei M. PRRT for patients with neuroendocrine tumor: how does the reduction in the number of SPECT CT studies affect tumor and OAR dosimetry? Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Tonini E, Panareo S, Longo M, Longo L, Urso L, Caracciolo M, Uccelli L, Cittanti C, Turra A, Bartolomei M. PRRT in patients with neuroendocrine tumor: preliminary results of OAR dosimetry and dose-response relationship for NET hepatic metastases. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00448-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Cavallari I, Ciccarese F, Sharova E, Urso L, Raimondi V, Silic-Benussi M, D’Agostino DM, Ciminale V. The miR-200 Family of microRNAs: Fine Tuners of Epithelial-Mesenchymal Transition and Circulating Cancer Biomarkers. Cancers (Basel) 2021; 13:5874. [PMID: 34884985 PMCID: PMC8656820 DOI: 10.3390/cancers13235874] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
The miR-200 family of microRNAs (miRNAs) includes miR-200a, miR-200b, miR-200c, miR-141 and miR-429, five evolutionarily conserved miRNAs that are encoded in two clusters of hairpin precursors located on human chromosome 1 (miR-200b, miR-200a and miR-429) and chromosome 12 (miR-200c and miR-141). The mature -3p products of the precursors are abundantly expressed in epithelial cells, where they contribute to maintaining the epithelial phenotype by repressing expression of factors that favor the process of epithelial-to-mesenchymal transition (EMT), a key hallmark of oncogenic transformation. Extensive studies of the expression and interactions of these miRNAs with cell signaling pathways indicate that they can exert both tumor suppressor- and pro-metastatic functions, and may serve as biomarkers of epithelial cancers. This review provides a summary of the role of miR-200 family members in EMT, factors that regulate their expression, and important targets for miR-200-mediated repression that are involved in EMT. The second part of the review discusses the potential utility of circulating miR-200 family members as diagnostic/prognostic biomarkers for breast, colorectal, lung, ovarian, prostate and bladder cancers.
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Affiliation(s)
- Ilaria Cavallari
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Francesco Ciccarese
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Evgeniya Sharova
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Loredana Urso
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padova, Italy
| | - Vittoria Raimondi
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Micol Silic-Benussi
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
| | - Donna M. D’Agostino
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
- Department of Biomedical Sciences, University of Padua, 35131 Padova, Italy
| | - Vincenzo Ciminale
- Veneto Institute of Oncology IOV–IRCCS, 35128 Padova, Italy; (I.C.); (F.C.); (E.S.); (L.U.); (V.R.); (M.S.-B.)
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padova, Italy
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Dieci M, Griguolo G, Bisagni G, Musolino A, Spazzapan S, Moretti G, Schiavi F, Pinato C, Vernaci G, Giarratano T, Urso L, Tosi A, Magni G, Lo Mele M, De Salvo G, Rosato A, Guarneri V, Conte P. 129P Integration of gene expression and tumor-infiltrating lymphocytes (TILs) to predict pCR after neoadjuvant chemotherapy and nivolumab for patients with luminal B-like breast cancer in the phase II GIADA trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Cacciapaglia F, De Lorenzis E, Lazzaroni MG, Corrado A, Fornaro M, Natalello G, Montini F, Altomare A, Urso L, Cantatore FP, Bosello SL, Airò P, Iannone F. POS0891 IMPROVED SURVIVAL IN SYSTEMIC SCLEROSIS PATIENTS DURING LAST DECADE: CURRENT FINDINGS AND COMPARISON WITH DIFFERENT PREVIOUS ITALIAN COHORTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic Sclerosis (SSc) is a chronic rheumatic disease characterized by an autoimmune disorder with vasculopathy that leads to an excess in collagen and other extracellular matrix proteins deposition. This process results in progressive fibrotic and vascular damage of skin and visceral organs. According to observational studies conducted in last decades, mean survival of SSc patients had improved with significant changes in causes of death.Objectives:To assess the 10-years survival in a large Italian multicentre cohort of SSc patients in the last decade compared to previous periods published since the 1980s, and to identify features that can justify any change.Methods:We retrospectively analysed all medical records of our longitudinal SSc cohorts, fulfilling 1980 ARA and/or 2013 EULAR/ACR Classification Criteria, with a median (IQR) follow-up of 91.5 (51-120) months from 4 Scleroderma Units since January 2009. All clinical, laboratory and instrumental findings have been recorded and analysed. Survival rate was calculated with Kaplan-Meier curves and log-rank tests, and Cox proportional hazards models were used to identify any predictor. Then, observed SSc survival was compared to those previously published and to that expected in the general population, calculated using official data published on the website United Nation World Population Prospects (www.macrotrends.net/countries/ITA/italy/death-rate).Results:Of 912 SSc patients (91.6% female; mean (SD) age at first non-Raynaud symptom (RS) 51 (15.4) years; median (IQR) disease duration from non-RS 24 (0-84.7) months) diffuse cutaneous involvement was defined in 182 (20%) patients. Anti-centromere and anti-topoisomerase-I were detected in 390 (42.8%) and 302 (33.1%) patients, respectively, while 220 (24.1%) presented antibodies for other extractible nuclear antigens. Prevalent non-Raynaud manifestations were interstitial lung disease detected in 459 (50.3%), digital ulcers in 395 (43.3%) and oesophagopathy in 371 (40.7%) patients, respectively, while other gastrointestinal manifestations were reported in 234 (25.7%) patients. Chronic renal failure was observed in 61 (6.7%) patients and pulmonary arterial hypertension (PAH) was confirmed at right heart catheterization in 38 (4.2%) patients. Three hundred twenty-two (35.3%) patients received immunosuppressant, 215 (23.5%) assumed an endothelin receptor antagonist and/or a 5-phosphodiesterase inhibitor, and 72 (7.9%) were treated with a biologic agent. The global 10-years survival was 89.4%; female gender (HR 0.33, CI95% 0.17-0.67), diffuse cutaneous involvement (HR 2.14, CI95% 1.17-3.91), presence of pulmonary hypertension (HR 2.61, CI95%1.31-5.16) and older age at non-RS (HR 1.1, CI95% 1.06-1.12) affected survival. Furthermore, as compared to previous Italian studies, our cohort showed a significant improvement in rate (see Figure 1).Conclusion:Survival in SSc patients has improved in last 5 decades but still reduced compared to that expected in general population above all 5 years after diagnosis. Early diagnosis, with reduced renal involvement, along with better screening and innovative therapeutic strategies may explain these achievements.Figure 1.Ten-years survival in SSc patients since 2009 (left); comparison of survival across different Italian SSc cohorts (box: current analysis) (right).References:[1]Giordano M, et al. The Journal of Rheumatology. 1986; 13:911-916.[2]Ferri C, et al. Medicine. 2002; 81:139-53.[3]Vettori S, et al. Reumatismo. 2010; 62(3):202-209.[4]Ferri C, et al. Autoimmun Rev. 2014; 13(10):1026-34.Disclosure of Interests:None declared
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Pezzuto F, Lunardi F, Vedovelli L, Fortarezza F, Urso L, Grosso F, Ceresoli GL, Kern I, Vlacic G, Faccioli E, Schiavon M, Gregori D, Rea F, Pasello G, Calabrese F. P14/ARF-Positive Malignant Pleural Mesothelioma: A Phenotype With Distinct Immune Microenvironment. Front Oncol 2021; 11:653497. [PMID: 33828993 PMCID: PMC8019896 DOI: 10.3389/fonc.2021.653497] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/01/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The CDKN2A gene plays a central role in the pathogenesis of malignant pleural mesothelioma (MPM). The gene encodes for two tumor suppressor proteins, p16/INK4A and p14/ARF, frequently lost in MPM tumors. The exact role of p14/ARF in MPM and overall its correlation with the immune microenvironment is unknown. We aimed to determine whether there is a relationship between p14/ARF expression, tumor morphological features, and the inflammatory tumor microenvironment. METHODS Diagnostic biopsies from 76 chemo-naive MPMs were evaluated. Pathological assessments of histotype, necrosis, inflammation, grading, and mitosis were performed. We evaluated p14/ARF, PD-L1 (tumor proportion score, TPS), and Ki-67 (percentage) by immunohistochemistry. Inflammatory cell components (CD3+, CD4+, CD8+ T lymphocytes; CD20+ B-lymphocytes; CD68+ and CD163+ macrophages) were quantified as percentages of positive cells, distinguishing between intratumoral and peritumoral areas. The expression of p14/ARF was associated with several clinical and pathological characteristics. A random forest-based machine-learning algorithm (Boruta) was implemented to identify which variables were associated with p14/ARF expression. RESULTS p14/ARF was evaluated in 68 patients who had a sufficient number of tumor cells. Strong positivity was detected in 14 patients (21%) (11 epithelioid and 3 biphasic MPMs). At univariate analysis, p14/ARF-positive epithelioid mesotheliomas showed higher nuclear grade (G3) (p = 0.023) and higher PD-L1 expression (≥50%) (p = 0.042). The percentages of CD4 and CD163 in peritumoral areas were respectively higher and lower in p14/ARF positive tumors but did not reach statistical significance with our sample size (both p = 0.066). The Boruta algorithm confirmed the predictive value of PD-L1 percentage for p14/ARF expression in all histotypes. CONCLUSIONS p14/ARF-positive epithelioid mesotheliomas may mark a more aggressive pathological phenotype (higher nuclear grade and PD-L1 expression). Considering the results regarding the tumor immune microenvironment, p14/ARF-negative tumors seem to have an immune microenvironment less sensitive to immune checkpoint inhibitors, being associated with low PD-L1 and CD4 expression, and high CD163 percentage. The association between p14/ARF-positive MPMs and PD-L1 expression suggests a possible interaction of the two pathways. Confirmation of our preliminary results could be important for patient selection and recruitment in future clinical trials with anticancer immunotherapy.
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Affiliation(s)
- Federica Pezzuto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Francesca Lunardi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Luca Vedovelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Francesco Fortarezza
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Federica Grosso
- Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Mesothelioma and Rare Cancer Unit, Alessandria, Italy
| | | | - Izidor Kern
- Pathology Laboratory, University Clinic Golnik, Golnik, Slovenia
| | - Gregor Vlacic
- Pathology Laboratory, University Clinic Golnik, Golnik, Slovenia
| | - Eleonora Faccioli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Marco Schiavon
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Dario Gregori
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Federico Rea
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Giulia Pasello
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Department of Oncology, Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Fiorella Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
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12
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Urso L, Vernaci G, Carlet J, Lo Mele M, Fassan M, Zulato E, Faggioni G, Menichetti A, Di Liso E, Griguolo G, Falci C, Conte P, Indraccolo S, Guarneri V, Dieci MV. ESR1 Gene Mutation in Hormone Receptor-Positive HER2-Negative Metastatic Breast Cancer Patients: Concordance Between Tumor Tissue and Circulating Tumor DNA Analysis. Front Oncol 2021; 11:625636. [PMID: 33777770 PMCID: PMC7991720 DOI: 10.3389/fonc.2021.625636] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/29/2021] [Indexed: 12/18/2022] Open
Abstract
Endocrine therapy represents the cornerstone of treatment in hormone receptor-positive (HR+), HER2-negative metastatic breast cancer (mBC). The natural course of this disease is marked by endocrine resistance, mainly due to Estrogen Receptor 1 (ESR1) acquired mutations. The aim of this study is to evaluate the concordance between ESR1 status in metastatic tumor specimens and matched circulating tumor DNA (ctDNA). Forty-three patients with HR+, HER2-negative mBC underwent both a metastatic tumor biopsy and a liquid biopsy at the time of disease progression. DNA extracted from formalin fixed paraffin embedded (FFPE) tumor specimens and ctDNA from matched plasma were analyzed by droplet digital (dd)PCR for the main ESR1 mutations (Y537S, Y537C, Y537N, D538G, E380Q). We observed a total mutation rate of 21%. We found six mutations on tissue biopsy: Y537S (1), D538G (2), Y537N (1), E380Q (2). Three patients with no mutations in tumor tissue had mutations detected in ctDNA. The total concordance rate between ESR1 status on tumor tissue and plasma was 91%. Our results confirm the potential role of liquid biopsy as a non-invasive alternative to tissue biopsy for ESR1 mutation assessment in mBC patients.
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Affiliation(s)
- Loredana Urso
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy
| | - Grazia Vernaci
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Jessica Carlet
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Marcello Lo Mele
- Department of Pathology, Azienda Ospedaliera Universitaria, Padova, Italy
| | - Matteo Fassan
- Department of Medicine-DIMED, Surgical Pathology and Cytopathology Unit, University of Padua, Padova, Italy
| | - Elisabetta Zulato
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Giovanni Faggioni
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Alice Menichetti
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | | | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Cristina Falci
- Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Pierfranco Conte
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Stefano Indraccolo
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy.,Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
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13
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Prat A, Guarneri V, Paré L, Griguolo G, Pascual T, Dieci MV, Chic N, González-Farré B, Frassoldati A, Sanfeliu E, Cejalvo JM, Muñoz M, Bisagni G, Brasó-Maristany F, Urso L, Vidal M, Brandes AA, Adamo B, Musolino A, Miglietta F, Conte B, Oliveira M, Saura C, Pernas S, Alarcón J, Llombart-Cussac A, Cortés J, Manso L, López R, Ciruelos E, Schettini F, Villagrasa P, Carey LA, Perou CM, Piacentini F, D'Amico R, Tagliafico E, Parker JS, Conte P. A multivariable prognostic score to guide systemic therapy in early-stage HER2-positive breast cancer: a retrospective study with an external evaluation. Lancet Oncol 2020; 21:1455-1464. [PMID: 33152285 DOI: 10.1016/s1470-2045(20)30450-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/06/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND In early-stage HER2-positive breast cancer, escalation or de-escalation of systemic therapy is a controversial topic. As an aid to treatment decisions, we aimed to develop a prognostic assay that integrates multiple data types for predicting survival outcome in patients with newly diagnosed HER2-positive breast cancer. METHODS We derived a combined prognostic model using retrospective clinical-pathological data on stromal tumour-infiltrating lymphocytes, PAM50 subtypes, and expression of 55 genes obtained from patients who participated in the Short-HER phase 3 trial. The trial enrolled patients with newly diagnosed, node-positive, HER2-positive breast cancer or, if node negative, with at least one risk factor (ie, tumour size >2 cm, histological grade 3, lymphovascular invasion, Ki67 >20%, age ≤35 years, or hormone receptor negativity), and randomly assigned them to adjuvant anthracycline plus taxane-based combinations with either 9 weeks or 1 year of trastuzumab. Trastuzumab was administered intravenously every 3 weeks (8 mg/kg loading dose at first cycle, and 6 mg/kg thereafter) for 18 doses or weekly (4 mg/kg loading dose in the first week, and 2 mg/kg thereafter) for 9 weeks, starting concomitantly with the first taxane dose. Median follow-up was 91·4 months (IQR 75·1-105·6). The primary objective of our study was to derive and evaluate a combined prognostic score associated with distant metastasis-free survival (the time between randomisation and distant recurrence or death before recurrence), an exploratory endpoint in Short-HER. Patient samples in the training dataset were split into a training set (n=290) and a testing set (n=145), balancing for event and treatment group. The training set was further stratified into 100 iterations of Monte-Carlo cross validation (MCCV). Cox proportional hazard models were fit to MCCV training samples using Elastic-Net. A maximum of 92 features were assessed. The final prognostic model was evaluated in an independent combined dataset of 267 patients with early-stage HER2-positive breast cancer treated with different neoadjuvant and adjuvant anti-HER2-based combinations and from four other studies (PAMELA, CHER-LOB, Hospital Clinic, and Padova) with disease-free survival outcome data. FINDINGS From Short-HER, data from 435 (35%) of 1254 patients for tumour size (T1 vs rest), nodal status (N0 vs rest), number of tumour-infiltrating lymphocytes (continuous variable), subtype (HER2-enriched and basal-like vs rest), and 13 genes composed the final model (named HER2DX). HER2DX was significantly associated with distant metastasis-free survival as a continuous variable (p<0·0001). HER2DX median score for quartiles 1-2 was identified as the cutoff to identify low-risk patients; and the score that distinguished quartile 3 from quartile 4 was the cutoff to distinguish medium-risk and high-risk populations. The 5-year distant metastasis-free survival of the low-risk, medium-risk, and high-risk populations were 98·1% (95% CI 96·3-99·9), 88·9% (83·2-95·0), and 73·9% (66·0-82·7), respectively (low-risk vs high-risk hazard ratio [HR] 0·04, 95% CI 0·0-0·1, p<0·0001). In the evaluation cohort, HER2DX was significantly associated with disease-free survival as a continuous variable (HR 2·77, 95% CI 1·4-5·6, p=0·0040) and as group categories (low-risk vs high-risk HR 0·27, 0·1-0·7, p=0·005). 5-year disease-free survival in the HER2DX low-risk group was 93·5% (89·0-98·3%) and in the high-risk group was 81·1% (71·5-92·1). INTERPRETATION The HER2DX combined prognostic score identifies patients with early-stage, HER2-positive breast cancer who might be candidates for escalated or de-escalated systemic treatment. Future clinical validation of HER2DX seems warranted to establish its use in different scenarios, especially in the neoadjuvant setting. FUNDING Instituto Salud Carlos III, Save the Mama, Pas a Pas, Fundación Científica, Asociación Española Contra el Cáncer, Fundación SEOM, National Institutes of Health, Agenzia Italiana del Farmaco, International Agency for Research on Cancer, and the Veneto Institute of Oncology, and Italian Association for Cancer Research.
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Affiliation(s)
- Aleix Prat
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain.
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto, IRCCS, Padova, Italy
| | - Laia Paré
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto, IRCCS, Padova, Italy
| | - Tomás Pascual
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Lineberger Comprehensive Cancer Center, Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maria V Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto, IRCCS, Padova, Italy
| | - Núria Chic
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Blanca González-Farré
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Pathology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Antonio Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara, Italy
| | - Esther Sanfeliu
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Pathology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Juan M Cejalvo
- Department of Medical Oncology, Hospital Clínico Universitario of Valencia, Valencia, Spain
| | - Montserrat Muñoz
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Giancarlo Bisagni
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy
| | - Fara Brasó-Maristany
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Loredana Urso
- Medical Oncology 2, Istituto Oncologico Veneto, IRCCS, Padova, Italy
| | - Maria Vidal
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Alba A Brandes
- Medical Oncology, Azienda Unità Sanitaria Locale di Bologna-IRCCS Istituto delle Scienze Neurologiche, Bologna
| | - Barbara Adamo
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonino Musolino
- Department of Medicine and Surgery, and the Medical Oncology and Breast Unit, University Hospital of Parma, Piacenza, Italy
| | - Federica Miglietta
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto, IRCCS, Padova, Italy
| | - Benedetta Conte
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Mafalda Oliveira
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Vall d'Hebron University Hospital; Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Cristina Saura
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Vall d'Hebron University Hospital; Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Sònia Pernas
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Institut Català d'Oncologia Hospitalet, Hospitalet de Llobregat, Spain
| | - Jesús Alarcón
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitario Son Espases, Carretera de Valldemossa, Palma de Mallorca, Spain
| | | | - Javier Cortés
- Department of Medical Oncology, Vall d'Hebron University Hospital; Vall d'Hebron Institute of Oncology, Barcelona, Spain; IOB Institute of Oncology, Quiron Group, Barcelona, Spain
| | - Luis Manso
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Hospital 12 de Octubre, Madrid, Spain
| | - Rafael López
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Complejo Universitario de Santiago de Compostela-CIBERONC, Santiago de Compostela, Spain
| | - Eva Ciruelos
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Department of Medical Oncology, Hospital 12 de Octubre, Madrid, Spain
| | - Francesco Schettini
- SOLTI Breast Cancer Research Group, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Medical Oncology, University of Naples Federico II, Naples, Italy
| | | | - Lisa A Carey
- Lineberger Comprehensive Cancer Center, Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles M Perou
- Lineberger Comprehensive Cancer Center, Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Federico Piacentini
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberto D'Amico
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Tagliafico
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy; Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy
| | - Joel S Parker
- Lineberger Comprehensive Cancer Center, Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Pierfranco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto, IRCCS, Padova, Italy; Department of Medical Oncology UO Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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14
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Boscolo A, Fortarezza F, Lunardi F, Comacchio G, Urso L, Frega S, Menis J, Bonanno L, Guarneri V, Rea F, Conte P, Calabrese F, Pasello G. Combined Immunoscore for Prognostic Stratification of Early Stage Non-Small-Cell Lung Cancer. Front Oncol 2020; 10:564915. [PMID: 33072595 PMCID: PMC7544833 DOI: 10.3389/fonc.2020.564915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background To date, no combined immunoscore has been evaluated for prognostic stratification of early stage non-small-cell lung cancer (NSCLC). The main goal of this study was to investigate the prognostic impact of programmed death ligand 1 (PD-L1) expression and different immune cell components (CD4+, CD8+ T-lymphocytes, and CD68+ macrophages) in early stage NSCLC patients, distinguishing peritumoral (PT) and intratumoral (IT) localizations. The secondary aim was to identify a combined immunoscore to optimize the prognostic stratification of NSCLC patients. Methods This retrospective study included surgical specimens from consecutive chemo-naive stage II-III radically resected NSCLC patients. Immunohistochemistry was carried out to evaluate PD-L1 expression and to quantify IT and PT CD4+, CD8+ T-lymphocytes, and CD68+ macrophages. The impact of a single marker and of a combination of multiple markers on overall survival (OS) was investigated. Results Seventy-nine patients were included in the study. PD-L1 expression was associated with worse prognosis (3 years OS: 58% in high- compared with 67% in low-expressing tumors), even though without statistical significance. When integrating PT CD8+, CD4+, and CD68 into a combined PT immunoscore, a significant prognostic stratification of patients was obtained and confirmed at multivariate analysis (3 years OS: 86% in patients with low PT immunoscore vs. 59% in patients with high PT immunoscore, p = 0.018). The integration of derived neutrophil/lymphocyte ratio (dNLR) with combined PT immunoscore improved prognostic stratification, with longer OS in patients with low PT immunoscore and low dNLR (p = 0.002). Conclusion The combined PT immunoscore (CD8+, CD4+, and CD68) integrated with dNLR may be a promising marker for the development of an integrated Tumor, Node, Metastasis (TNM) immunoscore.
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Affiliation(s)
- Alice Boscolo
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Francesco Fortarezza
- Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Francesca Lunardi
- Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giovanni Comacchio
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Loredana Urso
- Oncology Unit 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Stefano Frega
- Oncology Unit 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Jessica Menis
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.,Oncology Unit 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Laura Bonanno
- Oncology Unit 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.,Oncology Unit 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Federico Rea
- Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - PierFranco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.,Oncology Unit 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - Fiorella Calabrese
- Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giulia Pasello
- Oncology Unit 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
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15
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Guarneri V, Dieci MV, Bisagni G, Brandes AA, Frassoldati A, Cavanna L, Musolino A, Giotta F, Rimanti A, Garrone O, Bertone E, Cagossi K, Nanni O, Piacentini F, Orvieto E, Griguolo G, Curtarello M, Urso L, Paré L, Chic N, D'Amico R, Prat A, Conte P. PIK3CA Mutation in the ShortHER Randomized Adjuvant Trial for Patients with Early HER2 + Breast Cancer: Association with Prognosis and Integration with PAM50 Subtype. Clin Cancer Res 2020; 26:5843-5851. [PMID: 32843527 DOI: 10.1158/1078-0432.ccr-20-1731] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/22/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE We explored the prognostic effect of PIK3CA mutation in HER2+ patients enrolled in the ShortHER trial. PATIENTS AND METHODS The ShortHER trial randomized 1,253 patients with HER2+ breast cancer to 9 weeks or 1 year of adjuvant trastuzumab combined with chemotherapy. PIK3CA hotspot mutations in exon 9 and 20 were analyzed by pyrosequencing. Expression of 60 genes, including PAM50 genes was measured using the nCounter platform. RESULTS A mutation of the PIK3CA gene was detected in 21.7% of the 803 genotyped tumors. At a median follow-up of 7.7 years, 5-year disease-free survival (DFS) rates were 90.6% for PIK3CA mutated and 86.2% for PIK3CA wild-type tumors [HR, 0.84; 95% confidence interval (CI), 0.56-1.27; P = 0.417]. PIK3CA mutation showed a favorable prognostic impact in the PAM50 HER2-enriched subtype (n = 232): 5-year DFS 91.8% versus 76.1% (log-rank P = 0.049; HR, 0.46; 95% CI, 0.21-1.02). HER2-enriched/PIK3CA mutated versus wild-type tumors showed numerically higher tumor-infiltrating lymphocytes (TIL) and significant upregulation of immune-related genes (including CD8A, CD274, PDCD1, and MYBL2, a proliferation gene involved in immune processes). High TILs as well as the upregulation of PDCD1 and MYBL2 were associated with a significant DFS improvement within the HER2-enriched subtype (HR, 0.82; 95% CI, 0.68-0.99; P = 0.039 for 10% TILs increment; HR, 0.81; 95% CI, 0.65-0.99; P = 0.049 for PDCD1 expression; HR, 0.72; 95% CI, 0.53-0.99; P = 0.042 for MYBL2 expression). CONCLUSIONS PIK3CA mutation showed no prognostic impact in the ShortHER trial. Within the HER2-enriched molecular subtype, patients with PIK3CA mutated tumors showed better DFS versus PIK3CA wild-type, which may be partly explained by upregulation of immune-related genes.
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Affiliation(s)
- Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy. .,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Giancarlo Bisagni
- Department of Oncology and Advanced Technologies, Reggio Emilia, Italy
| | - Alba A Brandes
- Medical Oncology, Azienda Unità Sanitaria Locale di Bologna-IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Antonio Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara, Italy
| | - Luigi Cavanna
- Department of Oncology-Hematology, G. da Saliceto Hospital, Piacenza, Italy
| | - Antonino Musolino
- Medical Oncology and Breast Unit, University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Anita Rimanti
- Medical Oncology, Azienda Ospedaliera di Mantova, Mantova, Italy
| | - Ornella Garrone
- Breast Unit, Medical Oncology, A.O.S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Elena Bertone
- Department of Gynecology and Obstetrics, Ospedale S. Anna, Turin, Italy
| | - Katia Cagossi
- Breast Unit Ausl Modena, Ramazzini Hospital, Carpi, Italy
| | - Oriana Nanni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Federico Piacentini
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Modena, Italy
| | | | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Matteo Curtarello
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Laia Paré
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Nuria Chic
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Roberto D'Amico
- Department of Medical and Surgical Sciences for Children & Adults, University of Modena, Modena, Italy.,Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Aleix Prat
- SOLTI Breast Cancer Research Group, Barcelona, Spain.,Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Pierfranco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
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Guarneri V, Dieci MV, Bisagni G, Frassoldati A, Bianchi GV, De Salvo GL, Orvieto E, Urso L, Pascual T, Paré L, Galván P, Ambroggi M, Giorgi CA, Moretti G, Griguolo G, Vicini R, Prat A, Conte PF. De-escalated therapy for HR+/HER2+ breast cancer patients with Ki67 response after 2-week letrozole: results of the PerELISA neoadjuvant study. Ann Oncol 2020; 30:921-926. [PMID: 30778520 PMCID: PMC6594455 DOI: 10.1093/annonc/mdz055] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In human epidermal growth factor receptor 2 (HER2+) breast cancers, neoadjuvant trials of chemotherapy plus anti-HER2 treatment consistently showed lower pathologic complete response (pCR) rates in hormone receptor (HR) positive versus negative tumors. The PerELISA study was aimed to evaluate the efficacy of a de-escalated, chemotherapy-free neoadjuvant regimen in HR+/HER2+ breast cancer patients selected on the basis of Ki67 inhibition after 2-week letrozole. PATIENTS AND METHODS PerELISA is a phase II, multicentric study for postmenopausal patients with HR+/HER2+ operable breast cancer. Patients received 2-week letrozole, and then underwent re-biopsy for Ki67 evaluation. Patients classified as molecular responders (Ki67 relative reduction >20% from baseline) continued letrozole and started trastuzumab-pertuzumab for five cycles. Patients classified as molecular non-responders started weekly paclitaxel for 13 weeks combined with trastuzumab-pertuzumab. Primary aim was breast and axillary pCR. According to a two-stage Simon's design, to reject the null hypothesis, at least 8/43 pCR had to be documented. RESULTS Sixty-four patients were enrolled, 44 were classified as molecular responders. All these patients completed the assigned treatment with letrozole-trastuzumab-pertuzumab and underwent surgery. A pCR was observed in 9/44 cases (20.5%, 95% confidence interval 11.1% to 34.5%). Among molecular non-responders, 16/17 completed treatment and underwent surgery, with pCR observed in 81.3% of the cases. PAM50 intrinsic subtype was significantly associated with Ki67 response and pCR. Among molecular responders, the pCR rate was significantly higher in HER2-enriched than in other subtypes (45.5% versus 13.8%, P = 0.042). CONCLUSIONS The primary end point of the study was met, by reaching the pre-specified pCRs. In patients selected using Ki67 reduction after short-term letrozole exposure, a meaningful pCR rate can be achieved without chemotherapy. PAM50 intrinsic subtyping further refines our ability to identify a subset of patients for whom chemotherapy might be spared. EUDRACT NUMBER 2013-002662-40. CLINICALTRIALS.GOV IDENTIFIER NCT02411344.
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Affiliation(s)
- V Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova.
| | - M V Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova
| | - G Bisagni
- Department of Oncology and Advanced Technologies, Oncology Unit, Azienda USL-IRCCS di Reggio Emilia
| | - A Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara
| | - G V Bianchi
- Medical Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - G L De Salvo
- Clinical Trials and Biostatistics Unit, Istituto Oncologico Veneto IOV - IRCCS, Padova
| | - E Orvieto
- Pathology Unit, Azienda ULSS 5 Polesana, Rovigo, Italy
| | - L Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova
| | - T Pascual
- Department of Medical Oncology, Hospital Clinic, Barcelona; Translational Genomics and Targeted Therapeutics in Solid Tumours Lab, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Paré
- Department of Medical Oncology, Hospital Clinic, Barcelona; Translational Genomics and Targeted Therapeutics in Solid Tumours Lab, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - P Galván
- Department of Medical Oncology, Hospital Clinic, Barcelona; Translational Genomics and Targeted Therapeutics in Solid Tumours Lab, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Ambroggi
- Department of Oncology-Hematology, Ospedale "G. da Saliceto", Piacenza
| | - C A Giorgi
- Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova
| | - G Moretti
- Department of Oncology and Advanced Technologies, Oncology Unit, Azienda USL-IRCCS di Reggio Emilia
| | - G Griguolo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova; Translational Genomics and Targeted Therapeutics in Solid Tumours Lab, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - R Vicini
- Department of Diagnostic and Clinical Medicine and Public Health, Statistics Unit, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - A Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona; Translational Genomics and Targeted Therapeutics in Solid Tumours Lab, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - P F Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova
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Cacciapaglia F, De Lorenzis E, Corrado A, Bosello SL, Fornaro M, Montini F, Urso L, Verardi L, Altomare A, Cantatore FP, Gremese E, Iannone F. FRI0230 THE 2009-2019 SURVIVAL AND MORTALITY PREDICTORS IN A LARGE MULTICENTRE SYSTEMIC SCLEROSIS COHORT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Systemic sclerosis (SSc) is one of the connective tissue diseases with the poorer prognosis and disease-related causes, particularly pulmonary fibrosis, PAH and cardiac involvement, accounting the most deaths.Objectives:This multicentre study aimed to evaluate the global survival and any predictor of mortality in a large multicentric cohort of SSc patients.Methods:We performed a retrospective analysis examining the medical records of our longitudinal SSc cohorts with a median (IQR) follow-up of 11 (6-18) years from 3 Scleroderma Units since January 2009. All clinical, laboratory and instrumental findings have been recorded and analyzed using Chi-squared tests, Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models.Results:Data from 750 SSc patients (91.9% female; mean (SD) age at first Non-Raynaud symptom 48.4 (15.3) years, median (IQR) disease duration 3 (0-8) years; diffuse cutaneous involvement 162 (21.6%) patients) fulfilling the 1980 ARA and/or 2013 ACR/EULAR classification criteria, were collected. All patients were positive for ANA, anti-Topo-I Abs were found in 235 (31.3%) and Cenp-B Abs in 300 (40%) patients. 98 (13.1%) patients were positive to other Abs (Anti-RNA polymerase III, anti-Pm/Scl) and anti-ENA were negative/unknown for 117 (15.6%) patients. Interstitial lung disease (ILD) was present in 202 (26.9%), pulmonary arterial hypertension (PAH) was found in 29 (3.9%), and 50/750 (6.7%) patients presented pulmonary hypertension combined with ILD (PH-ILD). The overall 10-years survival was 93.1% and, it was significantly impaired by the presence of ILD, PAH or PH-ILD [Figure]. The univariate analysis showed that female gender, higher age at first Non-Raynaud symptom, earlier referral to a tertiary Scleroderma center, absence of any ENA antibodies, and PH-ILD presence were survival predictors. After multivariate analysis the significance of PH-ILD was lost [Table]. Disease duration, basal Rodnan skin score, smoking, renal or gastrointestinal comorbidities, NYHA functional class, steroid or immune-suppressive treatments did not reach the statistically significance.Conclusion:Our study demonstrated a global 10-years survival rate over 93%. Male patients and rapid evolution of Non-Raynaud symptoms represent the main death predictors in our SSc cohort. A rapid referral to a tertiary rheumatological centre and early treatment with effective agents are associated to a better prognosis.Figure.Kaplan-Meier curves for 5-years survival in SSc patients (Log-rank 8.96, p=0.03).Table.Prognostic factors for 10-years survival at univariate and multivariate analysis.UNIVARIATE ANALYSISMULTIVARIATE ANALYSISHR95%ICPHR95%ICPFemale gender0.350.15-0.810.010.310.15-0.660.002Age at first Non-Raynaud symptom1.071.04-1.10.0011.081.05-1.110.001Time referral to a tertiary SSc centre0.830.76-0.920.0010.840.77-0.930.001Absence of any ENA antibodies0.080.01-0.620.010.090.01-0.710.02PH-ILD presence2.61.01-6.820.042.40.93-6.10.069Disclosure of Interests:Fabio Cacciapaglia Speakers bureau: BMS; Roche; Pfizer; Abbvie, Enrico De Lorenzis: None declared, Addolorata Corrado: None declared, Silvia Laura Bosello Speakers bureau: Abbvie, Pfizer, Boehringer, Marco Fornaro: None declared, Fabio Montini: None declared, Livio Urso: None declared, Lucrezia Verardi: None declared, Alberto Altomare: None declared, Francesco Paolo Cantatore: None declared, Elisa Gremese Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Florenzo Iannone Consultant of: Speaker and consulting fees from AbbVie, Eli Lilly, Novartis, Pfizer, Roche, Sanofi, UCB, MSD, Speakers bureau: Speaker and consulting fees from AbbVie, Eli Lilly, Novartis, Pfizer, Roche, Sanofi, UCB, MSD
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Urso L, Cavallari I, Sharova E, Ciccarese F, Pasello G, Ciminale V. Metabolic rewiring and redox alterations in malignant pleural mesothelioma. Br J Cancer 2020; 122:52-61. [PMID: 31819191 PMCID: PMC6964675 DOI: 10.1038/s41416-019-0661-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 08/13/2019] [Revised: 10/21/2019] [Accepted: 11/04/2019] [Indexed: 02/08/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare malignancy of mesothelial cells with increasing incidence, and in many cases, dismal prognosis due to its aggressiveness and lack of effective therapies. Environmental and occupational exposure to asbestos is considered the main aetiological factor for MPM. Inhaled asbestos fibres accumulate in the lungs and induce the generation of reactive oxygen species (ROS) due to the presence of iron associated with the fibrous silicates and to the activation of macrophages and inflammation. Chronic inflammation and a ROS-enriched microenvironment can foster the malignant transformation of mesothelial cells. In addition, MPM cells have a highly glycolytic metabolic profile and are positive in 18F-FDG PET analysis. Loss-of-function mutations of BRCA-associated protein 1 (BAP1) are a major contributor to the metabolic rewiring of MPM cells. A subset of MPM tumours show loss of the methyladenosine phosphorylase (MTAP) locus, resulting in profound alterations in polyamine metabolism, ATP and methionine salvage pathways, as well as changes in epigenetic control of gene expression. This review provides an overview of the perturbations in metabolism and ROS homoeostasis of MPM cells and the role of these alterations in malignant transformation and tumour progression.
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Affiliation(s)
- Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | | | | | | | | | - Vincenzo Ciminale
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
- Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
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Pasello G, Boscolo A, Fortarezza F, Lunardi F, Urso L, Frega S, Comacchio G, Bonanno L, Guarneri V, Rea F, Calabrese F, Conte P. Combined immunoscore for prognostic stratification of early stage NSCLC patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz258.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pasello G, Urso L, Boscolo A, Pezzuto F, Silic-Benussi M, Vuljian S, Frega S, Bonanno L, Schiavon M, Rea F, Ciminale V, Conte P, Calabrese F. Immune microenvironment modulation by p14/ARF in malignant pleural mesothelioma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266.009] [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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Cavallari I, Urso L, Sharova E, Pasello G, Ciminale V. Liquid Biopsy in Malignant Pleural Mesothelioma: State of the Art, Pitfalls, and Perspectives. Front Oncol 2019; 9:740. [PMID: 31475103 PMCID: PMC6705182 DOI: 10.3389/fonc.2019.00740] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 06/03/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive tumor linked to asbestos exposure. Although the risk factors for MPM are well-known, the majority of MPM patients are diagnosed at an advanced stage and have a very poor prognosis. Circulating biomarkers for early diagnosis remain to be identified, and the current standard for MPM diagnosis relies on pleural biopsies. Robust non-invasive tests for the screening of asbestos-exposed subjects are therefore an important unmet clinical need. This review provides a critical summary of recent liquid biopsy-based studies aimed at discovering novel blood-based circulating biomarkers for the early diagnosis and prognostic stratification of MPM patients.
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Affiliation(s)
- Ilaria Cavallari
- Immunologia e Diagnostica Molecolare Oncologica (IDMO), Istituto Oncologico Veneto IOV- IRCCS, Padova, Italy
| | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padova, Italy
| | - Evgeniya Sharova
- Immunologia e Diagnostica Molecolare Oncologica (IDMO), Istituto Oncologico Veneto IOV- IRCCS, Padova, Italy
| | - Giulia Pasello
- Immunologia e Diagnostica Molecolare Oncologica (IDMO), Istituto Oncologico Veneto IOV- IRCCS, Padova, Italy
| | - Vincenzo Ciminale
- Immunologia e Diagnostica Molecolare Oncologica (IDMO), Istituto Oncologico Veneto IOV- IRCCS, Padova, Italy.,Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padova, Italy
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22
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Dal Maso A, Lorenzi M, Roca E, Pilotto S, Macerelli M, Polo V, Cecere FL, Del Conte A, Nardo G, Buoro V, Scattolin D, Monteverdi S, Urso L, Zulato E, Frega S, Bonanno L, Indraccolo S, Calabrese F, Conte P, Pasello G. Clinical Features and Progression Pattern of Acquired T790M-positive Compared With T790M-negative EGFR Mutant Non-small-cell Lung Cancer: Catching Tumor and Clinical Heterogeneity Over Time Through Liquid Biopsy. Clin Lung Cancer 2019; 21:1-14.e3. [PMID: 31601525 DOI: 10.1016/j.cllc.2019.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/18/2019] [Accepted: 07/26/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Clinical-pathologic predictors of acquired T790M epidermal growth factor receptor (EGFR) mutation in Caucasian patients with non-small-cell lung cancer (NSCLC) progressing after first-/second-generation tyrosine kinase inhibitors (TKIs) is an open field for research. Similarly, the best time point for T790M detection by liquid or tissue biopsy after disease progression is currently matter of debate. PATIENTS AND METHODS This is an observational study at 7 Italian centers enrolling patients with EGFR-mutant NSCLC progressing after first-/second-generation EGFR TKIs, between 2014 and 2018, aiming at comparing baseline clinical-pathologic features and progression patterns in acquired T790M-positive compared with T790M-negative cases. RESULTS A total of 235 patients received first-line treatment with gefitinib (N = 126; 53%), erlotinib (N = 51; 22%), or afatinib (N = 58; 25%). In 120 (51%) cases, T790M was detected in liquid biopsy, tissue biopsy, or both. Age younger than 65 years (P = .037), the presence of common mutations (P = .004), and better response to first-line TKI (P = .023) were correlated with T790M positivity. T790M detection was associated with higher number of new progressing sites (P = .04), liver progression (P = .002), and a lower frequency of lung metastases (P = .027). When serial liquid biopsies were performed (N = 15), an oligoprogressive disease was correlated with a negative test outcome, whereas systemic progression was observed at the time of T790M positivity. CONCLUSION This study on a Caucasian population showed that age, type of EGFR mutation at diagnosis, response to first-line treatment, and peculiar progression pattern are associated with T790M status. Serial liquid biopsy might be useful for treatment selection, especially when tissue rebiopsy is not feasible.
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Affiliation(s)
- Alessandro Dal Maso
- Department of Oncology 2, Istituto Oncologico Veneto - IRCCS, Padova, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Martina Lorenzi
- Department of Oncology 2, Istituto Oncologico Veneto - IRCCS, Padova, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Elisa Roca
- Department of Medical Oncology, ASST - Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Sara Pilotto
- Department of Medical Oncology, University of Verona, AOUI Verona, Verona, Italy
| | - Marianna Macerelli
- Department of Medical Oncology - ASUIUD Santa Maria della Misericordia, Udine, Italy
| | - Valentina Polo
- Oncology Unit, AULSS 2 Marca Trevigiana, Ca' Foncello Hospital, Treviso, Italy
| | - Fabiana Letizia Cecere
- Department of Oncology 1, Regina Elena National Cancer Institute IRCCS Rome, Rome, Italy
| | - Alessandro Del Conte
- Department of Medical Oncology and Immunorelated Tumors, Centro di Riferimento Oncologico (CRO) - IRCCS, Aviano (PN), Italy
| | - Giorgia Nardo
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto - IRCCS, Padova, Italy
| | - Vanessa Buoro
- Department of Medical Oncology - ASUIUD Santa Maria della Misericordia, Udine, Italy
| | - Daniela Scattolin
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Sara Monteverdi
- Department of Medical Oncology, University of Verona, AOUI Verona, Verona, Italy
| | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Elisabetta Zulato
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto - IRCCS, Padova, Italy
| | - Stefano Frega
- Department of Oncology 2, Istituto Oncologico Veneto - IRCCS, Padova, Italy
| | - Laura Bonanno
- Department of Oncology 2, Istituto Oncologico Veneto - IRCCS, Padova, Italy
| | - Stefano Indraccolo
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto - IRCCS, Padova, Italy
| | - Fiorella Calabrese
- Pathology Unit, Department of Cardio-Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - PierFranco Conte
- Department of Oncology 2, Istituto Oncologico Veneto - IRCCS, Padova, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Giulia Pasello
- Department of Oncology 2, Istituto Oncologico Veneto - IRCCS, Padova, Italy.
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Pasello G, Dal Maso A, Lorenzi M, Roca E, Pilotto S, Macerelli M, Polo V, Del Conte A, Nardo G, Buoro V, Scattolin D, Monteverdi S, Urso L, Zulato E, Frega S, Bonanno L, Indraccolo S, Calabrese F, Conte P. Clinical features and progression pattern of T790M+ compared with T790M-EGFR mutant NSCLC. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e20612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20612 Background: Acquired T790M EGFR mutation (mut) is not predictable by any clinical-pathological feature. The best time point for T790M mut detection by liquid or tissue biopsy is currently undefined. Methods: This is an observational study at 6 Italian Centers enrolling EGFR mutant NSCLC patients (pts) progressing after first/second generation EGFR TKI, between 2014 and 2018. The primary endpoint of the study was to compare clinical features in acquired T790M+ compared with T790M- cases. The secondary endpoint was to assess different progression (PD) patterns between the two groups. We also explored the PD pattern at the time of cfDNA negativity and subsequent positivity, in a subgroup of pts receiving serial liquid biopsies. Statistical analysis was performed by the Chi-square test to correlate clinical features with T790M status, and by the Kaplan-Meier estimator to evaluate median progression free (mPFS) and overall survival (mOS). Multiple logistic regression and log-rank tests were applied. Results: 219 pts were included. Median follow-up since diagnosis was 25 months. First line treatment was gefitinib (N = 119, 54%), erlotinib (N = 48, 22%) or afatinib (N = 52, 24%). In 108 (49%) cases a T790M acquired mut was detected in liquid (70), tissue (31) biopsy or both (7). Age younger than 65 years ( p= 0.05) and presence of sensitizing exon 19 deletion ( p= 0.04) were correlated with T790M mut; this association was confirmed at multivariate analysis ( p= 0.010 and p= 0.006, respectively). At the time of PD, new PD sites ( p= 0.005) and liver PD ( p< 0.001) were more commonly observed in T790M+ group; at multivariate analysis statistical significance was confirmed ( p= 0.01 and p= 0.008, respectively). Longer mOS was observed in T790M+ cases at univariate (53 versus 22 months, p < 0.0001) and multivariate analysis. In 13 pts undergoing serial liquid biopsies, an oligoprogressive disease was correlated with a negative test outcome, while PS/symptoms worsening, higher number of new lesions and PD sites were observed at the time of T790M positivity, although without statistical significance. Conclusions: This is the first caucasian series showing different clinical features and progression patterns of T790M+ versus T790M- EGFR mutant NSCLC.
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Affiliation(s)
| | | | | | - Elisa Roca
- Oncology Department, Spedali Civili Hospital, Brescia, Italy
| | - Sara Pilotto
- University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | | | - Giorgia Nardo
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Vanessa Buoro
- Department of Medicine (DAME) - University of Udine, Udine, Italy, Udine, Italy
| | | | | | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Elisabetta Zulato
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy
| | - Stefano Frega
- Medical Oncology 2, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | | | - Stefano Indraccolo
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Fiorella Calabrese
- Department of CardioThoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Pierfranco Conte
- University of Padova and Istituto Oncologico Veneto, Padova, Italy
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Conte PF, Griguolo G, Dieci MV, Bisagni G, Brandes AA, Frassoldati A, Cavanna L, Musolino A, Giotta F, Rimanti A, Garrone O, Galvan P, Brasó Maristany F, Orvieto E, Urso L, Maiorana A, Balduzzi S, D'Amico R, Guarneri V, Prat A. PAM50 HER2-enriched subtype as an independent prognostic factor in early-stage HER2+ breast cancer following adjuvant chemotherapy plus trastuzumab in the ShortHER trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
544 Background: We investigated the prognostic role of the PAM50 HER2-enriched (HER2-E) subtype in HER2+ early breast cancer enrolled in the randomized Phase III ShortHER trial. Methods: The ShortHER study randomized 1254 HER2+ early breast cancer patients to receive 9 weeks vs 1 year of adjuvant trastuzumab combined with chemotherapy. Gene expression measured using nCounter platform was available for 438 surgical samples. Intrinsic subtyping was determined using the research-based PAM50 predictor. Metastasis-free survival (MFS) was calculated from randomization to distant disease recurrence or death (median follow up 72 months). Uni- and multi-variable analysis were performed using Cox models. Results: PAM50 subtype distribution was: HER2-E 53% (N = 233), Luminal A 20% (N = 87), Luminal B 10% (N = 43), Normal-like 11% (N = 48) and Basal-like 6% (N = 27). HER2-E subtype was associated with hormone receptor-negative status (p < 0.001) and TILs ≥20% (p < 0.001), but not with stage and age ( < or ≥60 yrs). HER2-E subtype was associated with worse MFS vs other PAM50 subtypes overall (HR 2.78, p = 0.001), in the short (HR 2.24, p = 0.046), and in the long arm (HR 4.04, p = 0.011). Multivariable Cox model confirmed the independent prognostic value of HER2-E subtype (Table). HER2-E subtype added significant prognostic value on top of clinicopathological variables (Likelihood ratio test p < 0.001). Conclusions: HER2-E intrinsic subtype is an independent prognostic factor for HER2+ early breast cancer patients treated with adjuvant chemotherapy and trastuzumab. Integration of PAM50 subtype in prognostic algorithms can help refine risk stratification. These findings warrant independent validation. Clinical trial information: NCT00629278. [Table: see text]
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Affiliation(s)
- Pier Franco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Gaia Griguolo
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Giancarlo Bisagni
- Oncology Unit, Department of Oncology and Advanced Technologies, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Alba Ariela Brandes
- Medical Oncology, Azienda Unita` Sanitaria Locale di Bologna-IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Antonio Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara, Italy
| | - Luigi Cavanna
- Department of Oncology-Hematology, G. da Saliceto Hospital, Piacenza, Italy
| | - Antonino Musolino
- University Hospital of Parma, Medical Oncology and Breast Unit, Parma, Italy
| | - Francesco Giotta
- Division of Medical Oncology, IRCCS, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Anita Rimanti
- Medical Oncology, Azienda Ospedaliera di Mantova, Mantova, Italy
| | - Ornella Garrone
- Medical Oncology, A.O. S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Patricia Galvan
- Department of Medical Oncology, Hospital Clínic de Barcelona. Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain
| | - Fara Brasó Maristany
- Department of Medical Oncology, Hospital Clínic de Barcelona. Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Italy
| | | | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Antonino Maiorana
- Department of Diagnostic Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Sara Balduzzi
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Modena, Italy
| | - Roberto D'Amico
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Modena, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Medical Oncology 2, Instituto Oncologico Veneto IRCCS, Padova, Italy
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clínic de Barcelona. Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS). SOLTI Breast Cancer Cooperative Group, Barcelona, Spain
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Prat A, Griguolo G, Dieci MV, Bisagni G, Frassoldati A, Bianchi GV, Pascual T, Pare L, Galvan P, Urso L, Conte P, Guarneri V. Abstract P6-17-05: Independent validation of a combined biomarker based on the PAM50 HER2-enriched subtype and ERBB2 mRNA levels following HER2 blockade without chemotherapy in the PerELISA phase II trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-17-05] [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: A combined biomarker based on HER2-enriched subtype (HER2-E) and ERBB2 mRNA predicts response and survival in HER2+ breast cancer following trastuzumab +/- lapatinib in the absence of chemotherapy (Prat et al. ASCO 2018). Here, we tested the ability of the combined biomarker to predict pathological complete response (pCR) following neoadjuvant trastuzumab, pertuzumab and endocrine therapy.
Methods: RNA from 40 baseline tumor samples from the phase II PerELISA trial were evaluated. PerELISA evaluated the efficacy of a de-escalated, chemotherapy-free neoadjuvant regimen based on dual HER2 blockade with trastuzumab and pertuzumab in combination with letrozole in HER2+/hormone receptor-positive breast cancer selected on the basis of Ki67 response after short course letrozole-alone (Guarneri ASCO 2018). Ki67 response was defined by protocol as relative Ki67 reduction ≥20% from baseline at day 14. Gene-expression was measured using the nCounter platform. Intrinsic subtypes and ERBB2 levels were determined by the PAM50 gene expression predictor. A pre-specified ERBB2 cutoff was determined to define ERBB2-high. Univariate and multivariable logistic regression analyses were performed.
Results: The proportion of HER2-E disease within the ERBB2-high and ERBB2-low groups was 46.2% (6/13) and 18.5% (5/27), respectively. The discordance rate at the individual level was 30% (12/40). A total of 6 (15%) and 34 (85%) samples were HER2-E/ERBB2-high and others, respectively. The magnitude of Ki67 reduction of the HER2-E/ERBB2-high and others groups was 64.8% and 63.2%, respectively (p=0.88). The pCR rate of HER2-E/ERBB2-high was 66.7%. The pCR rate of the others group was 14.7%. The univariate odds ratio between HER2-E/ERBB2-high tumors and the others groups was 11.60 (95% CI 1.66-81.10; p=0.014). No other clinical-pathological variable was significantly associated with pCR.
Conclusion: The combined HER2-E/ERBB2-high biomarker can identify patients who might be good candidates to receive dual HER2 blockade alone without chemotherapy.
Citation Format: Prat A, Griguolo G, Dieci MV, Bisagni G, Frassoldati A, Bianchi GV, Pascual T, Pare L, Galvan P, Urso L, Conte P, Guarneri V. Independent validation of a combined biomarker based on the PAM50 HER2-enriched subtype and ERBB2 mRNA levels following HER2 blockade without chemotherapy in the PerELISA phase II trial [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 P6-17-05.
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Affiliation(s)
- A Prat
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - G Griguolo
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - MV Dieci
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - G Bisagni
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - A Frassoldati
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - GV Bianchi
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - T Pascual
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - L Pare
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - P Galvan
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - L Urso
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - P Conte
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - V Guarneri
- Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain; Istituto Oncologico Veneto IRCCS, Padova, Italy; University of Padova, Padova, Italy; Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; S Anna University Hospital, Ferrara, Italy; Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
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Pasello G, Zago G, Lunardi F, Urso L, Kern I, Vlacic G, Grosso F, Mencoboni M, Ceresoli G, Schiavon M, Pezzuto F, Pavan A, Vuljan S, Del Bianco P, Conte P, Rea F, Calabrese F. Malignant pleural mesothelioma immune microenvironment and checkpoint expression: correlation with clinical–pathological features and intratumor heterogeneity over time. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy086] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Urso L, Cavallari I, Silic-Benussi M, Biasini L, Zago G, Calabrese F, Conte PF, Ciminale V, Pasello G. Synergistic targeting of malignant pleural mesothelioma cells by MDM2 inhibitors and TRAIL agonists. Oncotarget 2018; 8:44232-44241. [PMID: 28562336 PMCID: PMC5546476 DOI: 10.18632/oncotarget.17790] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 04/24/2017] [Indexed: 12/29/2022] Open
Abstract
Malignant Pleural Mesothelioma (MPM) is a chemoresistant tumor characterized by low rate of p53 mutation and upregulation of Murine Double Minute 2 (MDM2), suggesting that it may be effectively targeted using MDM2 inhibitors. In the present study, we investigated the anticancer activity of the MDM2 inhibitors Nutlin 3a (in vitro) and RG7112 (in vivo), as single agents or in combination with rhTRAIL. In vitro studies were performed using MPM cell lines derived from epithelioid (ZL55, M14K), biphasic (MSTO211H) and sarcomatoid (ZL34) MPMs. In vivo studies were conducted on a sarcomatoid MPM mouse model. In all the cell lines tested (with the exception of ZL55, which carries a biallelic loss-of-function mutation of p53), Nutlin 3a enhanced p21, MDM2 and DR5 expression, and decreased survivin expression. These changes were associated to cell cycle arrest but not to a significant induction of apoptosis. A synergistic pro-apoptotic effect was obtained through the association of rhTRAIL in all the cell lines harboring functional p53. This synergistic interaction of MDM2 inhibitor and TRAIL agonist was confirmed using a mouse preclinical model. Our results suggest that the combined targeting of MDM2 and TRAIL might provide a novel therapeutic option for treatment of MPM patients, particularly in the case of sarcomatoid MPM with MDM2 overexpression and functional inactivation of wild-type p53.
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Affiliation(s)
- Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128, Padova, Italy
| | - Ilaria Cavallari
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IRCCS, 35128, Padova, Italy
| | - Micol Silic-Benussi
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IRCCS, 35128, Padova, Italy
| | - Lorena Biasini
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IRCCS, 35128, Padova, Italy
| | - Giulia Zago
- Medical Oncology Unit 2, Veneto Institute of Oncology, IRCCS, 35128, Padova, Italy
| | - Fiorella Calabrese
- Department of Cardio-Thoracic and Vascular Sciences, University of Padova, 35128, Padova, Italy
| | - Pier Franco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128, Padova, Italy.,Medical Oncology Unit 2, Veneto Institute of Oncology, IRCCS, 35128, Padova, Italy
| | - Vincenzo Ciminale
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128, Padova, Italy.,Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IRCCS, 35128, Padova, Italy
| | - Giulia Pasello
- Medical Oncology Unit 2, Veneto Institute of Oncology, IRCCS, 35128, Padova, Italy
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Guarneri V, Dieci MV, Bisagni G, Brandes AA, Frassoldati A, Cavanna L, Musolino A, Giotta F, Cavazzini G, Garrone O, Bertone E, Cagossi K, Nanni O, Ferro A, Donadio M, Aieta M, Zamagni C, Piacentini F, Maiorana A, Ragazzi M, Cucchi MC, Querzoli P, Orsi N, Curtarello M, Urso L, Amadori A, Orvieto E, Vicini R, Balduzzi S, D'Amico R, Conte P. Abstract P1-13-02: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-13-02] [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
This abstract was withdrawn by the authors.
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Affiliation(s)
- V Guarneri
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - MV Dieci
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - G Bisagni
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - AA Brandes
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Frassoldati
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - L Cavanna
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Musolino
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - F Giotta
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - G Cavazzini
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - O Garrone
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - E Bertone
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - K Cagossi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - O Nanni
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Ferro
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - M Donadio
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - M Aieta
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - C Zamagni
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - F Piacentini
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Maiorana
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - M Ragazzi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - MC Cucchi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - P Querzoli
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - N Orsi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - M Curtarello
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - L Urso
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Amadori
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - E Orvieto
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - R Vicini
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - S Balduzzi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - R D'Amico
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - P Conte
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
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Diener A, Hartmann P, Urso L, Vives I Batlle J, Gonze MA, Calmon P, Steiner M. Approaches to modelling radioactive contaminations in forests - Overview and guidance. J Environ Radioact 2017; 178-179:203-211. [PMID: 28892730 DOI: 10.1016/j.jenvrad.2017.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/01/2017] [Accepted: 09/02/2017] [Indexed: 06/07/2023]
Abstract
Modelling the radionuclide cycle in forests is important in case of contamination due to acute or chronic releases to the atmosphere and from underground waste repositories. This article describes the most important aspects to consider in forest model development. It intends to give an overview of the modelling approaches available and to provide guidance on how to address the quantification of radionuclide transport in forests. Furthermore, the most important gaps in modelling the radionuclide cycle in forests are discussed and suggestions are presented to address the variability of forest sites.
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Affiliation(s)
- A Diener
- Bundesamt für Strahlenschutz (BfS), Ingolstaedter Landstr. 1, 85764 Oberschleissheim, Germany.
| | - P Hartmann
- Bundesamt für Strahlenschutz (BfS), Ingolstaedter Landstr. 1, 85764 Oberschleissheim, Germany
| | - L Urso
- Bundesamt für Strahlenschutz (BfS), Ingolstaedter Landstr. 1, 85764 Oberschleissheim, Germany
| | | | - M A Gonze
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), France
| | - P Calmon
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), France
| | - M Steiner
- Bundesamt für Strahlenschutz (BfS), Ingolstaedter Landstr. 1, 85764 Oberschleissheim, Germany
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Frega S, Macerelli M, Del Conte A, Bonanno L, Bartoletti M, Polo V, Zago G, Follador A, Attili I, Pavan A, Urso L, Basso S, Fasola G, Conte P, Pasello G. Clinical features of never smoker patients with lung squamous cell carcinoma: a retrospective multicenter study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Zago G, Lunardi F, Calabrese F, Vuljan S, Urso L, Frega S, Pavan A, Polo V, Bonanno L, Attili I, Rea F, Conte P, Pasello G. Malignant pleural mesothelioma immune microenvironment and checkpoint expression before and after systemic cytotoxic treatment. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx389.004] [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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32
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Frega S, Macerelli M, Del Conte A, Bonanno L, Bartoletti M, Polo V, Zago G, Follador A, Attili I, Pavan A, Urso L, Basso S, Fasola G, Conte P, Pasello G. Clinical features of never smoker patients with lung squamous cell carcinoma: A retrospective multicenter study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pasello G, Urso L, Mencoboni M, Grosso F, Ceresoli GL, Lunardi F, Vuljan SE, Bertorelle R, Sacchetto V, Ciminale V, Rea F, Favaretto A, Conte P, Calabrese F. MDM2 and HIF1alpha expression levels in different histologic subtypes of malignant pleural mesothelioma: correlation with pathological and clinical data. Oncotarget 2016; 6:42053-66. [PMID: 26544728 PMCID: PMC4747209 DOI: 10.18632/oncotarget.5974] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 05/04/2015] [Accepted: 10/20/2015] [Indexed: 12/29/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive tumor with poor prognosis and limited treatment options. Sarcomatoid/biphasic mesotheliomas are characterized by more aggressive behaviour and a poorer prognosis compared with the epithelioid subtype. To date prognostic and tailored therapeutic biomarkers are lacking. The present study analyzed the expression levels of MDM2 and HIF1alpha in different histologic subtypes from chemonaive MPM patients. Diagnostic biopsies of MPM patients from four Italian cancer centers were centrally collected and analyzed. MDM2 and HIF1alpha expression levels were investigated through immunohistochemistry and RT-qPCR. Pathological assessment of necrosis, inflammation and proliferation index was also performed. Molecular markers, pathological features and clinical characteristics were correlated to overall survival (OS) and progression free survival (PFS). Sixty MPM patients were included in the study (32 epithelioid and 28 non-epithelioid). Higher levels of MDM2 (p < 0.001), HIF1alpha (p = 0.013), necrosis (p = 0.013) and proliferation index (p < 0.001) were seen mainly in sarcomatoid/biphasic subtypes. Higher levels of inflammation were significantly associated with epithelioid subtype (p = 0.044). MDM2 expression levels were correlated with HIF1alpha levels (p = 0.0001), necrosis (p = 0.008) and proliferation index (p = 0.009). Univariate analysis showed a significant correlation of non-epithelioid histology (p = 0.04), high levels of necrosis (p = 0.037) and proliferation index (p = 0.0002) with shorter PFS. Sarcomatoid/biphasic and epithelioid mesotheliomas showed different MDM2 and HIF1alpha expression levels and were characterized by different levels of necrosis, proliferation and inflammation. Further studies are warranted to confirm a prognostic and predictive role of such markers and features.
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Affiliation(s)
- Giulia Pasello
- Department of Clinical and Experimental Oncology, Medical Oncology 2, Istituto Oncologico Veneto IRCCS Padova, Italy
| | - Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | | | - Federica Grosso
- Oncohematologic Department, Mesothelioma Unit, Oncology, SS Antonio e Biagio General Hospital, Alessandria, Italy
| | | | - Francesca Lunardi
- Department of Cardio-Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Stefania Edith Vuljan
- Department of Cardio-Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Roberta Bertorelle
- Department of Clinical and Experimental Oncology, Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Valeria Sacchetto
- Department of Clinical and Experimental Oncology, Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Vincenzo Ciminale
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Department of Clinical and Experimental Oncology, Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Federico Rea
- Department of Cardio-Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Adolfo Favaretto
- Department of Clinical and Experimental Oncology, Medical Oncology 2, Istituto Oncologico Veneto IRCCS Padova, Italy
| | - PierFranco Conte
- Department of Clinical and Experimental Oncology, Medical Oncology 2, Istituto Oncologico Veneto IRCCS Padova, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Fiorella Calabrese
- Department of Cardio-Thoracic and Vascular Sciences, University of Padova, Padova, Italy
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Pasello G, Urso L, Polo V, Bonanno L, Nannini N, Lunardi F, Vuljan S, Conte P, Rea F, Calabrese F. 211P: Inflammatory cells characterization and localization in malignant pleural mesothelioma (MPM) tissue samples: Correlation with histologic subtype and prognosis. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30318-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Urso L, Calabrese F, Favaretto A, Conte P, Pasello G. Critical review about MDM2 in cancer: Possible role in malignant mesothelioma and implications for treatment. Crit Rev Oncol Hematol 2015; 97:220-30. [PMID: 26358421 DOI: 10.1016/j.critrevonc.2015.08.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 07/02/2015] [Accepted: 08/18/2015] [Indexed: 02/07/2023] Open
Abstract
The tumor suppressor p53 regulates genes involved in DNA repair, metabolism, cell cycle arrest, apoptosis and senescence. p53 is mutated in about 50% of the human cancers, while in tumors with wild-type p53 gene, the protein function may be lost because of overexpression of Murine Double Minute 2 (MDM2). MDM2 targets p53 for ubiquitylation and proteasomal degradation. p53 reactivation through MDM2 inhibitors seems to be a promising strategy to sensitize p53 wild-type cancer cells to apoptosis. Moreover, additional p53-independent molecular functions of MDM2, such as neoangiogenesis promotion, have been suggested. Thus, MDM2 might be a target for anticancer treatment because of its antiapoptotic and proangiogenetic role. Malignant pleural mesothelioma (MPM) is an aggressive asbestos-related tumor where wild-type p53 might be present. The present review gives a complete landscape about the role of MDM2 in cancer pathogenesis, prognosis and treatment, with particular focus on Malignant Pleural Mesothelioma.
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Affiliation(s)
- Loredana Urso
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy
| | - Fiorella Calabrese
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Adolfo Favaretto
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - PierFranco Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Giulia Pasello
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
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Pasello G, Carli P, Canova F, Bonanno L, Polo V, Zago G, Urso L, Conte P, Favaretto A. Epirubicin plus paclitaxel regimen as second-line treatment of patients with small-cell lung cancer. Anticancer Res 2015; 35:2183-2189. [PMID: 25862876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIM Most patients with small cell lung cancer (SCLC) experience relapse within one year after first-line treatment. The aim of this study was to describe activity and safety of second-line with epirubicin at 70 mg/m(2) followed by paclitaxel at 135 mg/m(2) on day 1 every three weeks for a maximum of six cycles. PATIENTS AND METHODS This is a retrospective review of all patients with SCLC evaluated for second-line treatment between 2003 and 2013 at our Institution. RESULTS Sixty-eight patients received the study regimen of epirubicin with paclitaxel. We observed partial response in 19 (30%), stable disease in 22 (34%) and total early failure rate in 23 (36%) patients. Median progression free and overall survival were 21.8 and 26.5 weeks, respectively. Haematological toxicities were as follows: grade 3-4 leukopenia and neutropenia in 18 (31%) and 30 (22%) of patients, respectively; grade 3 anaemia and grade 4 thrombocytopenia were reported in 2 (3%) and 5 (9%) of patients, respectively. CONCLUSION Epirubicin with paclitaxel is an active and tolerable second-line regimen in patients with SCLC.
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Affiliation(s)
- Giulia Pasello
- Medical Oncology 2, Venetian Oncological Institute, Padova, Italy
| | - Paolo Carli
- Medical Oncology Unit, Ca' Foncello Hospital, Treviso, Italy
| | - Fabio Canova
- Medical Oncology 2, Venetian Oncological Institute, Padova, Italy
| | - Laura Bonanno
- Medical Oncology 2, Venetian Oncological Institute, Padova, Italy
| | - Valentina Polo
- Medical Oncology 2, Venetian Oncological Institute, Padova, Italy
| | - Giulia Zago
- Medical Oncology 2, Venetian Oncological Institute, Padova, Italy
| | - Loredana Urso
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Pierfranco Conte
- Medical Oncology 2, Venetian Oncological Institute, Padova, Italy Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Adolfo Favaretto
- Medical Oncology 2, Venetian Oncological Institute, Padova, Italy
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Mencoboni M, Zucali PA, Pasello G, Favaretto AG, Ceresoli GL, Sauta MG, Perrino M, De Vincenzo F, Polo V, Urso L, Bruzzone A, DelCorso L, Filiberti R, Tunesi G, Simonassi C, Covesnon MG, La Camera A. Clinicopathologic features of patients with malignant mesothelioma in a multicenter, retrospective study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e18544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Matteo Perrino
- Department of Oncology, Humanitas Cancer Center, Rozzano, Italy
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Fline-Barthes MH, Vandendriessche D, Gaugue J, Urso L, Therby D, Subtil D. [Psychosocial vulnerability and substance use screening during pregnancy: Evaluation of a composite auto-questionnaire versus usual medical questioning]. ACTA ACUST UNITED AC 2014; 44:433-42. [PMID: 24793907 DOI: 10.1016/j.jgyn.2014.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 03/14/2014] [Accepted: 03/29/2014] [Indexed: 11/26/2022]
Abstract
AIM To evaluate auto-questionnaire use for psychosocial vulnerability and substance use (smoking, alcohol consumption, depression, intimate violence) screening during pregnancy versus usual medical report. MATERIAL AND METHODS An auto-questionnaire based on validated tests (Fagerström/HSI, T-ACE, EPDS, SSQ6) was proposed to 1977 pregnant patients at their first obstetrical consultation. We compared results of auto-questionnaire and usual medical questioning. RESULTS The auto-questionnaire was filled by 1676 pregnant patients (89.4 %). The two Fagerström/HIS questions showed that 20.7 % smoked during pregnancy. T-ACE score was better than usual medical questioning to detect excessive alcohol consumption (4.0 % vs 0.1 %, P<0.05). Drug use before pregnancy was reported by 9.8 % patients in auto-questionnaire, but was only found in 4.9 % of medical files (P<0.001). Seven percent patients reported at least 3 depressive symptoms on 4 purposed in auto-questionnaire. Intimate violence, physical or psychological, was reported in 9.4 %. All of these vulnerability factors were linked together, in auto-questionnaire or in usual medical reports. CONCLUSION Using auto-questionnaire based on standardized screening tests could help medical practioneers to detect psychosocial vulnerability and/or substance use during pregnancy.
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Affiliation(s)
- M-H Fline-Barthes
- Maternité Jeanne-de-Flandre, hôpital Jeanne-de-Flandre, université Lille Nord de France, CHRU de Lille, 59037 Lille cedex, France
| | - D Vandendriessche
- Maternité Jeanne-de-Flandre, hôpital Jeanne-de-Flandre, université Lille Nord de France, CHRU de Lille, 59037 Lille cedex, France; Service d'addictologie, maternité Paul-Gellé, centre hospitalier de Roubaix, 59100 Roubaix, France.
| | - J Gaugue
- Service d'addictologie, maternité Paul-Gellé, centre hospitalier de Roubaix, 59100 Roubaix, France
| | - L Urso
- Service d'addictologie, maternité Paul-Gellé, centre hospitalier de Roubaix, 59100 Roubaix, France
| | - D Therby
- Service d'addictologie, maternité Paul-Gellé, centre hospitalier de Roubaix, 59100 Roubaix, France
| | - D Subtil
- Maternité Jeanne-de-Flandre, hôpital Jeanne-de-Flandre, université Lille Nord de France, CHRU de Lille, 59037 Lille cedex, France; EA 2694, université Lille Nord de France, CHRU de Lille, 59037 Lille cedex, France
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Urso L, Kaiser JC, Woda C, Helebrant J, Hulka J, Kuca P, Prouza Z. A fast and simple approach for the estimation of a radiological source from localised measurements after the explosion of a radiological dispersal device. Radiat Prot Dosimetry 2014; 158:453-460. [PMID: 24214910 DOI: 10.1093/rpd/nct263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
After an explosion of a radiological dispersal device, decision-makers need to implement countermeasures as soon as possible to minimise the radiation-induced risks to the population. In this work, the authors present a tool, which can help providing information about the approximate size of source term and radioactive contamination based on a Gaussian Plume model with the use of available measurements for liquid or aerosolised radioactivity. For two-field tests, the source term and spatial distribution of deposited radioactivity are estimated. A sensitivity analysis of the dependence on deposition velocity is carried out. In case of weak winds, a diffusive process along the wind direction is retained in the model.
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Affiliation(s)
- L Urso
- Institut für Strahlenschutz (ISS) - Helmholtz Zentrum München HMGU, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
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Abstract
Type 2 diabetes mellitus patients are at higher cancer risk, probably because of hyperinsulinemia and insulin growth factor 1 pathway activation. The effects of antidiabetic drugs on cancer risk have been described and discussed in several studies suggesting opposite effects of the biguanide metformin and sulfonylureas on cancer incidence and mortality. The anticancer mechanisms of metformin have been clarified, and some clinical studies, particularly in breast cancer patients, have been published or are currently ongoing; however, data about the effects of sulfonylureas on cancer growth are less consistent. The aims of this work are to review preclinical evidence of second-generation sulfonylureas effects on tumor growth, to clarify the potential mechanisms of action, and to identify possible metabolic targets for patient selection. Most evidence is on the adenosine triphosphate-sensitive potassium channels inhibitor glibenclamide, which interacts with reactive oxygen species production thus inducing cancer cell death. Among diarylsulfonylureas, next-generation DW2282 derivatives are particularly promising because of the proapoptotic activity in multidrug-resistant cells.
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Affiliation(s)
- Giulia Pasello
- Second Medical Oncology Unit, Istituto Oncologico Veneto, Padua, Italy
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Urso L, Kaiser JC, Andersson KG, Andorfer H, Angermair G, Gusel C, Tandler R. Modeling of the fate of radionuclides in urban sewer systems after contamination due to nuclear or radiological incidents. J Environ Radioact 2013; 118:121-127. [PMID: 23334288 DOI: 10.1016/j.jenvrad.2012.12.002] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 10/17/2012] [Accepted: 12/07/2012] [Indexed: 06/01/2023]
Abstract
After an accidental radioactive contamination by aerosols in inhabited areas, the radiation exposure to man is determined by complex interactions between different factors such as dry or wet deposition, different types of ground surfaces, chemical properties of the radionuclides involved and building development as well as dependence on bomb construction e.g. design and geometry. At short-term, the first rainfall is an important way of natural decontamination: deposited radionuclides are washed off from surfaces and in urban areas the resulting contaminated runoff enters the sewer system and is collected in a sewage plant. Up to now the potential exposure caused by this process has received little attention and is estimated here with simulation models. The commercial rainfall-runoff model for urban sewer systems KANAL++ has been extended to include transport of radionuclides from surfaces through the drainage to various discharge facilities. The flow from surfaces is modeled by unit hydrographs, which produce boundary conditions for a system of 1d coupled flow and transport equations in a tube system. Initial conditions are provided by a map of surface contamination which is produced by geo-statistical interpolation of γ-dose rate measurements taking into account the detector environment. The corresponding methodology is implemented in the Inhabited Area Monitoring Module (IAMM) software module as part of the European decision system JRODOS. A hypothetical scenario is considered where a Radiation Dispersal Device (RDD) with Cs-137 is detonated in a small inhabited area whose drainage system is realistically modeled. The transition of deposited radionuclides due to rainfall into the surface runoff is accounted for by different nuclide-specific entrainment coefficients for paved and unpaved surfaces. The concentration of Cs-137 in water is calculated at the nodes of the drainage system and at the sewage treatment plant. The external exposure to staff of the treatment plant is estimated. For Cs-137 radiation levels in the plant are low since wash-off of cesium from surfaces is an ineffective process.
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Affiliation(s)
- L Urso
- Institüt für Strahlenschutz (ISS) - HelmholtzZentrum München HMGU, Department of Radiation Science, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany.
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Mainini G, Incoronato M, Urso L, Scaffa C. Serum osteoprotegerin correlates with age and bone mass in postmenopausal, but not in fertile age women. CLIN EXP OBSTET GYN 2011; 38:355-359. [PMID: 22268274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE OF INVESTIGATION Osteoprotegerin (OPG) and receptor activator of nuclear factor kappaB ligand (RANKL) are bone turnover modulators expressed by osteoblasts. The aim of this study was to assess the relationship between the circulating OPG/RANKL system, age and bone mass, in fertile age and postmenopausal women. METHODS In this cross-sectional observational study on 48 patients (fertile age, n = 22; postmenopause, n = 26), we investigated the correlation between serum OPG and RANKL, age and bone mineral density (BMD). Serum concentrations of OPG and RANKL were determined by enzyme-linked immunosorbent assay (ELISA); estimate BMD evaluation was performed with heel quantitative ultrasonometry (QUS). RESULTS Serum OPG significantly increased (p = 0.003) and serum RANKL significantly decreased (p = 0.002), in the postmenopausal group compared to fertile age women. A significant correlation of serum OPG with age (r(s) = 0.39, p = 0.047) and BMD (r(s) = 0.45, p = 0.023) in postmenopausal women, and between RANKL and BMD (r(s) = 0.48, p = 0.024) in fertile age was found. CONCLUSION These data demonstrate in vivo that the OPG/RANKL system is significantly associated with menopausal status and could play a role in postmenopausal osteoporosis.
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Affiliation(s)
- G Mainini
- Fondazione IRCCS SDN, Naples, Italy.
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Muscella A, Calabriso N, Vetrugno C, Urso L, Fanizzi FP, De Pascali SA, Marsigliante S. Sublethal concentrations of the platinum(II) complex [Pt(O,O'-acac)(gamma-acac)(DMS)] alter the motility and induce anoikis in MCF-7 cells. Br J Pharmacol 2010; 160:1362-77. [PMID: 20590627 DOI: 10.1111/j.1476-5381.2010.00782.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND PURPOSE We showed previously that a new Pt(II) complex ([Pt(O,O'-acac)(gamma-acac)(DMS)]) exerted high and fast apoptotic processes in MCF-7 cells. The objective of this study was to investigate the hypothesis that [Pt(O,O'-acac)(gamma-acac)(DMS)] is also able to exert anoikis and alter the migration ability of MCF-7 cells, and to show some of the signalling events leading to these alterations. EXPERIMENTAL APPROACH Cells were treated with sublethal doses of [Pt(O,O'-acac)(gamma-acac)(DMS)], and the efficiency of colony initiation and anchorage-independent growth was assayed; cell migration was examined by in vitro culture wounding assay. Gelatin zymography for MMP-2 and -9 activities, Western blottings of MMPs, MAPKs, Src, PKC-epsilon and FAK, after [Pt(O,O'-acac)(gamma-acac)(DMS)] treatment, were also performed. KEY RESULTS Sub-cytotoxic drug concentrations decreased the: (i) anchorage-dependent and -independent growth; (ii) migration ability; and (iii) expression and activity of MMP-2 and MMP-9. [Pt(O,O'-acac)(gamma-acac)(DMS)] provoked the generation of reactive oxygen species (ROS), and the activation of p38MAPK, Src and PKC-epsilon. p38MAPK phosphorylation, cell anoikis and migration due to [Pt(O,O'-acac)(gamma-acac)(DMS)] were blocked by PKC-epsilon inhibition. Furthermore, Src inhibition blocked the [Pt(O,O'-acac)(gamma-acac)(DMS)]-provoked activation of PKC-epsilon, while ROS generation blockage inhibited the activation of Src, and also the decrement of phosphorylated FAK observed in detached [Pt(O,O'-acac)(gamma-acac)(DMS)]-treated cells. CONCLUSIONS AND IMPLICATIONS Sublethal concentrations of [Pt(O,O'-acac)(gamma-acac)(DMS)] induced anoikis and prevented events leading to metastasis via alterations in cell migration, anchorage independency, stromal interactions and MMP activity. Hence, [Pt(O,O'-acac)(gamma-acac)(DMS)] may be a promising therapeutic agent for preventing growth and metastasis of breast cancer.
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Affiliation(s)
- Antonella Muscella
- Dipartimento di Scienze e Tecnologie Biologiche e Ambientali, Università del Salento, Lecce, Italy
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Incoronato M, Garofalo M, Urso L, Romano G, Quintavalle C, Zanca C, Iaboni M, Nuovo G, Croce CM, Condorelli G. miR-212 increases tumor necrosis factor-related apoptosis-inducing ligand sensitivity in non-small cell lung cancer by targeting the antiapoptotic protein PED. Cancer Res 2010; 70:3638-46. [PMID: 20388802 DOI: 10.1158/0008-5472.can-09-3341] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PED/PEA-15 (PED) is a death effector domain family member of 15 kDa with a broad antiapoptotic function found overexpressed in a number of different human tumors, including lung cancer. To date, the mechanisms that regulate PED expression are unknown. Therefore, we address this point by the identification of microRNAs that in non-small cell lung cancer (NSCLC) modulate PED levels. In this work, we identify miR-212 as a negative regulator of PED expression. We also show that ectopic expression of this miR increases tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced cell death in NSCLC cells. In contrast, inhibition of endogenous miR-212 by use of antago-miR results in increase of PED protein expression and resistance to TRAIL treatment. Besides, in NSCLC, we show both in vitro and in vivo that PED and miR-212 expressions are inversely correlated, that is, PED is upregulated and miR-212 is rarely expressed. In conclusion, these findings suggest that miR-212 should be considered as a tumor suppressor because it negatively regulates the antiapoptotic protein PED and regulates TRAIL sensitivity.
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Urso L, Muscella A, Calabriso N, Vetrugno C, Jiménez E, Montiel M, Marsigliante S. Effects of cisplatin on matrix metalloproteinase-2 in transformed thyroid cells. Biochem Pharmacol 2009; 79:810-6. [PMID: 19874802 DOI: 10.1016/j.bcp.2009.10.013] [Citation(s) in RCA: 5] [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] [Received: 08/23/2009] [Revised: 10/14/2009] [Accepted: 10/15/2009] [Indexed: 10/20/2022]
Abstract
We investigated the effects of cisplatin (cisPt) on matrix metalloproteinase-2 (MMP-2) gelatinolitic activity in transformed PC E1Araf rat thyroid cells. Cells incubated with increasing cisPt concentrations showed dose- and time-dependent decrease of the MMP-2 protein and activity. CisPt provoked the translocation from the cytosol to the plasma membrane of atypical protein kinase C-zeta (PKC-zeta) and the activation of PKB/AKT. The effect of cisPt on MMP-2 was dependent on PKC-zeta activation since it was potentiated by a myristoylated PKC-zeta pseudo substrate peptide or by PKC-zeta down-regulation by siRNA. Moreover, MMP-2 activity modulation by cisPt was also dependent on PKB/AKT activation since it was decreased by PKB/AKT down-regulation by siRNA or by pharmacological inhibition of PI3K, thus indicating the importance of the balance of PKB/AKT and PKC-zeta in regulating the cisPt effect on MMP-2 activity. The PC E1Araf cells displayed a migratory capacity that was blocked by MMP-2 down-regulation using siRNA or pharmacological inhibition. The inhibition of cell migration was also obtained with cisPt; in cisPt-treated cells the administration of MMP-2 active protein was able to restore cell migration capacity. In conclusion, the decrease of MMP-2 secretion after cisPt was allowed by PKB/AKT and counteracted by PKC-zeta; the cisPt-provoked inhibition of MMP-2 secretion ended in reduction of cell migration.
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Affiliation(s)
- L Urso
- Department of Biological and Environmental Sciences and Technologies (Di.S.Te.B.A.), Università del Salento, Lecce, Italy
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Montiel M, Urso L, de la Blanca EP, Marsigliante S, Jiménez E. Cisplatin reduces endothelial cell migration via regulation of type 2-matrix metalloproteinase activity. Cell Physiol Biochem 2009; 23:441-8. [PMID: 19471112 DOI: 10.1159/000218191] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2009] [Indexed: 11/19/2022] Open
Abstract
AIMS In this study we investigated the effect of cisplatin on endothelial cell migration, an essential process for vascular remodeling and regeneration in several physiological and pathological situations. MATERIAL AND METHODS Human umbilical vein endothelial cells (HUVEC) were treated with cisplatin and endothelial cell migration analyzed by fluorescence and scratch-wound migration assay. MMP2 and MMP9 activity were determined by zymographic assay, and MAPK activation by Western blotting analysis. RESULTS We demonstrated that cisplatin provoked a time- and dose-dependent decrease of HUVEC migration; this effect was clearly independent from its well known cytotoxic activity. In addition, cisplatin markedly reduced MMP2 activity in both conditioned media and cell lysates, increased p38 MAPK and JNK phosphorylation, but did not affect ERK phosphorylation. Endothelial cell migration was attenuated by treatment of cells with GM6001, a non-specific inhibitor of MMPs, or by a selective anti-MMP2 antibody. However, treatment of cells with SB202190 or SP600125, inhibitors of p38 MAPK and JNK respectively, did not affect HUVEC migration. CONCLUSION These results suggested that cisplatin induced a reduction of endothelial cell migration through an inhibition of MMP2 activity by downstream signal transduction pathways independent of JNK and p38 MAPK activation.
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Affiliation(s)
- Mercedes Montiel
- Department of Biochemistry and Molecular Biology, University of Malaga, Malaga, Spain
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Muscella A, Urso L, Calabriso N, Vetrugno C, Fanizzi FP, Storelli C, Marsigliante S. Functions of epidermal growth factor receptor in cisplatin response of thyroid cells. Biochem Pharmacol 2009; 77:979-92. [DOI: 10.1016/j.bcp.2008.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 11/28/2008] [Accepted: 12/01/2008] [Indexed: 11/28/2022]
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Muscella A, Urso L, Calabriso N, Vetrugno C, Rochira A, Storelli C, Marsigliante S. Anti-apoptotic effects of protein kinase C-delta and c-fos in cisplatin-treated thyroid cells. Br J Pharmacol 2009; 156:751-63. [PMID: 19254279 DOI: 10.1111/j.1476-5381.2008.00049.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND PURPOSE We showed previously that cisplatin inititates a signalling pathway mediated by PKC-delta/extracellular signal-regulated kinase (ERK), important for maintaining viability in PC Cl3 thyroid cells. The studies described herein examined whether c-fos was associated with cisplatin resistance and the signalling link between c-fos and PKC-delta/ERK. EXPERIMENTAL APPROACH Cells were treated with various pharmacological inhibitors of PKCs and ERK, or were depleted of c-fos, PKC-delta, PKC-epsilon and caspase-3 by small interfering RNA (siRNA), then incubated with cisplatin and cytotoxicity assessed. KEY RESULTS Cisplatin provokes the induction of c-fos and the activation of conventional PKC-beta, and novel PKC-delta and -epsilon. The cisplatin-provoked c-fos induction was decreased by Gö6976, a PKC-beta inhibitor; by siRNA for PKC-delta- but not that for PKC-epsilon or by PD98059, a mitogen-activated protein kinase/ERK kinase inhibitor. Expression of c-fos was abolished by GF109203X, an inhibitor of all PKC isoforms, or by PD98059 plus Gö6976 or by PKC-delta-siRNA plus Gö6976. When c-fos expression was blocked by siRNA, cisplatin cytotoxicity was strongly enhanced with increased caspase-3 activation. In PKC-delta-depleted cells treated with cisplatin, caspase-3 activation was increased and cell viability decreased. In these PKC-delta-depleted cells, PD98059 did not affect caspase-3 activation. CONCLUSIONS AND IMPLICATIONS In PC Cl3 cells, in the cell signalling pathways that lead to cisplatin resistance, PKC-delta controls ERK activity and, together with PKC-beta, also the induction of c-fos. Hence, the protective role of c-fos in thyroid cells has the potential to provide new opportunities for therapeutic intervention.
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Affiliation(s)
- Antonella Muscella
- Department of Biological and Environmental Sciences and Technologies (Di.S.Te.B.A.), Università del Salento, Lecce, Italy
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Jiménez E, Pérez de la Blanca E, Urso L, González I, Salas J, Montiel M. Angiotensin II induces MMP 2 activity via FAK/JNK pathway in human endothelial cells. Biochem Biophys Res Commun 2009; 380:769-74. [PMID: 19338750 DOI: 10.1016/j.bbrc.2009.01.142] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 01/23/2009] [Indexed: 10/21/2022]
Abstract
Matrix metalloproteinases (MMPs) play an important role in the pathogenesis of cardiovascular diseases and are modified in response to a variety of stimuli such as bioactive peptides, cytokines and/or grown factors. In this study, we demonstrated that angiotensin II (Ang II) induces a time- and dose-dependent increase in the activity of metalloproteinase 2 (MMP 2) in human umbilical vein endothelial cells (HUVEC). The effect of Ang II was markedly attenuated in cells pretreated with wortmannin and LY294002, two selective inhibitors of phosphatidylinositol-3-kinase (PI3K), indicating that PI3K plays a key role in regulating MMP 2 activity. Similar results were observed when HUVEC were pretreated with genistein, a non-selective tyrosine kinases inhibitor, or with the specific Src-family tyrosine kinase inhibitor PP2, demonstrating the involvement of protein tyrosine kinases, and particularly Src-family tyrosine kinases on the downstream signaling pathway of Ang II receptors. Furthermore, Ang II-induced MMP 2 activation was markedly blocked by SP600125, a selective c-Jun N-terminal kinase (JNK) inhibitor, or pre-treatment of cells with antisense oligonucleotide to focal adhesion kinase (FAK), indicating that both molecules were important for the activation of MMP 2 by Ang II receptor stimulation. In conclusion, these results suggest that Ang II mediates an increase in MMP 2 activity in macrovascular endothelial cells through signal transduction pathways dependent on PI3K and Src-family tyrosine kinases activation, as well as JNK and FAK phosphorylation.
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Affiliation(s)
- Eugenio Jiménez
- Departamento de Bioquímica y Biología Molecular, Universidad de Málaga, Boulevard Louis Pasteur 32, 29071 Málaga, Spain
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Muscella A, Marsigliante S, Verri T, Urso L, Dimitri C, Bottà G, Paulmichl M, Beck-Peccoz P, Fugazzola L, Storelli C. PKC-epsilon-dependent cytosol-to-membrane translocation of pendrin in rat thyroid PC Cl3 cells. J Cell Physiol 2008; 217:103-12. [PMID: 18459119 DOI: 10.1002/jcp.21478] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We studied the expression and the hormonal regulation of the PDS gene product, pendrin, which is, in thyrocytes, responsible for the iodide transport out of the cell. We show that PC Cl3 cells, a fully differentiated thyroid cell line, grown without TSH and insulin, express very low level of PDS mRNA; such expression is greatly increased after stimulation with insulin or TSH. (125)I pre-loaded cells showed an (125)I efflux accelerated in chloride-containing buffer with respect to chloride-free buffer, suggesting that this efflux is chloride dependent. By immunoblotting, pendrin was found in agonists-stimulated cells, whereas it was barely detectable in un-stimulated cells. An increase in both PDS mRNA and protein was also obtained using phorbol ester PMA, or using 8-Br-cAMP and forskolin. Stimulation with insulin (1 microg/ml; 0-40 min) provoked the cytosol-to-membrane translocation of pendrin and a decrease of intracellular I(-) content in (125)I pre-loaded cells. Insulin- or PMA-treated cells also showed a cytosol-to-membrane translocation of PKC-delta and -epsilon. Inhibition of both PKC-delta and -epsilon activities by GF109203X blocked pendrin translocation, whilst the inhibition of PKA did not. The selective inhibition of PKC-delta by rottlerin did not affect the insulin-provoked translocation of pendrin whilst it was inhibited by a PKC-epsilon translocation inhibitor peptide and also by PKC-epsilon downregulation using the small interfering RNA, thus indicating that such translocation was due to PKC-epsilon activity. In conclusion, our study demonstrates that, in PC Cl3 cells, pendrin expression and localisation are regulated by insulin and influenced by a PKC-epsilon-dependent intracellular pathway.
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Affiliation(s)
- A Muscella
- Department of Biological and Environmental Sciences and Technologies (Di.S.Te.B.A.), Università del Salento, Italy
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