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De Summa S, Traversa D, Daniele A, Palumbo O, Carella M, Stallone R, Tufaro A, Oliverio A, Bruno E, Digennaro M, Danza K, Pasanisi P, Tommasi S. miRNA deregulation and relationship with metabolic parameters after Mediterranean dietary intervention in BRCA-mutated women. Front Oncol 2023; 13:1147190. [PMID: 37081976 PMCID: PMC10110888 DOI: 10.3389/fonc.2023.1147190] [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: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 04/07/2023] Open
Abstract
BackgroundBreast cancer onset is determined by a genetics-environment interaction. BRCA1/2 gene alterations are often genetically shared in familial context, but also food intake and hormonal assessment seem to influence the lifetime risk of developing this neoplasia. We previously showed the relationship between a six-months Mediterranean dietary intervention and insulin, glucose and estradiol levels in BRCA1/2 carrier subjects. The aim of the present study was to evidence the eventual influence of this dietary intervention on the relationship between circulating miRNA expression and metabolic parameters in presence of BRCA1/2 loss of function variants.MethodsPlasma samples of BRCA-women have been collected at the baseline and at the end of the dietary intervention. Moreover, subjects have been randomized in two groups: dietary intervention and placebo. miRNA profiling and subsequent ddPCR validation have been performed in all the subjects at both time points.ResultsddPCR analysis confirmed that five (miR-185-5p, miR-498, miR-3910, miR-4423 and miR-4445) of seven miRNAs, deregulated in the training cohort, were significantly up-regulated in subjects after dietary intervention compared with the baseline measurement. Interestingly, when we focused on variation of miRNA levels in the two timepoints, it could be observed that miR-4423, miR-4445 and miR-3910 expressions are positively correlated with variation in vitaminD level; whilst miR-185-5p difference in expression is related to HDL cholesterol variation.ConclusionsWe highlighted the synergistic effect of a healthy lifestyle and epigenetic regulation in BC through the modulation of specific miRNAs. Different miRNAs have been reported involved in the tumor onset acting as tumor suppressors by targeting tumor-associated genes that are often downregulated.
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Affiliation(s)
- Simona De Summa
- Pharmacological and Molecular Diagnostics Unit, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Debora Traversa
- Pharmacological and Molecular Diagnostics Unit, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Antonella Daniele
- Clinical Pathology Unit, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Orazio Palumbo
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Massimo Carella
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Raffaella Stallone
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Antonio Tufaro
- Biobank, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Andreina Oliverio
- Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Eleonora Bruno
- Department of Experimental Oncology IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Maria Digennaro
- Heredo-Familiar Cancer Clinic, IRCCS, Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Katia Danza
- Clinical Pathology Unit, “S. S. Annunziata” Hospital, Taranto, Italy
| | - Patrizia Pasanisi
- Department of Experimental Oncology IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Stefania Tommasi
- Pharmacological and Molecular Diagnostics Unit, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
- *Correspondence: Stefania Tommasi,
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Lazzeroni M, Puntoni M, Guerrieri-Gonzaga A, Serrano D, Boni L, Buttiron Webber T, Fava M, Briata IM, Giordano L, Digennaro M, Cortesi L, Falcini F, Serra P, Avino F, Millo F, Cagossi K, Gallerani E, De Simone A, Cariello A, Aprile G, Renne M, Bonanni B, DeCensi A. Randomized Placebo Controlled Trial of Low-Dose Tamoxifen to Prevent Recurrence in Breast Noninvasive Neoplasia: A 10-Year Follow-Up of TAM-01 Study. J Clin Oncol 2023:JCO2202900. [PMID: 36917758 DOI: 10.1200/jco.22.02900] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
Abstract
PURPOSE Five-year data of the phase III trial TAM-01 showed that low-dose tamoxifen at 5 mg once daily administered for 3 years in women with intraepithelial neoplasia (IEN) reduced by 52% the recurrence of invasive breast cancer or ductal carcinoma in situ (DCIS), without additional adverse events over placebo. Here, we present the 10-year results. METHODS We randomly assigned 500 women with breast IEN (atypical ductal hyperplasia, lobular carcinoma in situ [LCIS], or hormone-sensitive or unknown DCIS) to low-dose tamoxifen or placebo after surgery with or without irradiation. The primary end point was the incidence of invasive breast cancer or DCIS. RESULTS The TAM-01 population included 500 women (20% atypical ductal hyperplasia, 11% LCIS, and 69% DCIS). The mean (±SD) age at the start of treatment was 54 ± 9 years, and 58% of participants were postmenopausal. After a median follow-up of 9.7 years (IQR, 8.3-10.9 years), 66 breast cancers (15 in situ; 51 invasive) were diagnosed: 25 in the tamoxifen group and 41 in the placebo group (annual rate per 1,000 person-years, 11.3 with tamoxifen v 19.5 with placebo; hazard ratio [HR], 0.58; 95% CI, 0.35 to 0.95; log-rank P = .03). Most recurrences were invasive (77%) and ipsilateral (59%). Regarding contralateral breast cancer incidence, there were six events in the tamoxifen arm and 16 in the placebo arm (HR, 0.36; 95% CI, 0.14 to 0.92; P = .025). The number needed to be treated to prevent one case of breast event with tamoxifen therapy was 22 in 5 years and 14 in 10 years. The benefit was seen across all patient subgroups. There was a significant 50% reduction of recurrence with tamoxifen in the DCIS cohort, which represents 70% of the overall population (HR, 0.50; 95% CI, 0.28 to 0.91; P = .02). No between-group difference in the incidence of serious adverse events was reported during the prolonged follow-up period. CONCLUSION Tamoxifen 5 mg once daily for 3 years significantly prevents recurrence from noninvasive breast cancer after 7 years from treatment cessation without long-term adverse events.
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Affiliation(s)
| | - Matteo Puntoni
- Clinical and Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | | | | | - Luca Boni
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | | | | | - Livia Giordano
- Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Laura Cortesi
- Azienda Ospedaliera-Universitaria Policlinico di Modena, Modena, Italy
| | - Fabio Falcini
- Dipartimento Onco-ematologico AUSL-Romagna, Ravenna, Italy.,IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori"-IRST S.r.l., Meldola, (FC), Italy
| | - Patrizia Serra
- IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori"-IRST S.r.l., Meldola, (FC), Italy
| | - Franca Avino
- Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Francesco Millo
- Ospedali Riuniti ASL AL-Ospedale SS. Antonio e Margherita, Tortona (AL), Italy
| | | | | | | | | | - Giuseppe Aprile
- Dipartimento di Oncologia, Ospedale San Bortolo, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Maria Renne
- Azienda Ospedaliera Mater Domini, Catanzaro, Italy
| | | | - Andrea DeCensi
- IEO-European Institute of Oncology IRCCS, Milan, Italy.,Ente Ospedaliero Ospedali Galliera, Genoa, Italy.,Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Costanzo S, De Summa S, Maurmo L, Digennaro M, Patruno M, Paradiso A. Remote vs in-person BRCA1/2 non-carriers test disclosure: patients' choice during Covid-19 pandemic restriction. Fam Cancer 2023; 22:43-48. [PMID: 35867288 PMCID: PMC9304797 DOI: 10.1007/s10689-022-00307-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/09/2022] [Indexed: 01/17/2023]
Abstract
During Covid-19 pandemic most hospitals have restricted in-person delivery of non-essential healthcare services, including genetic testing delivery, to slow the spread of the virus. Our Onco-Genetic Service also faced this challenging period and had to re-organize its clinical practice with the use of tele-health. Aim of the present paper is to understand whether and how Covid-19-related changes in medical practice influenced patients' satisfaction about the health service provided. 125 BRCA1/2 non carriers (109/125, 87.2% female and 16/125, 12.8% male) in Istituto Tumori "Giovanni Paolo II" of Bari were enrolled. All participants were asked to choose whether they prefer in-person or remote post-test counselling session. Basing on patients' choice, two groups of subjects were composed. One week after the post-test counselling session, participants were phone called and asked to complete: a socio-demographic form, a brief structured interview about their Covid-19 related worries and their satisfaction with the health service provided, Hospital Anxiety and Depression Scale and Fear of Covid-19 scale. Qualitative information about patients' choice were also collected. No significant difference about patients' satisfaction with the health service provided emerged between groups. Patients who preferred remote post-test counselling had higher anxiety, worries and fear-of Covid-19 than the others. All remote-counselling subjects preferred tele-genetics because of Covid-19 security, would choose it again and would recommend it to others. Cancer tele-genetics offers good guarantees of comfort and efficacy, but patients' choices are related to personal and psychological variables. The use of tele-genetics has to be a patient's choice.
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Affiliation(s)
- Silvia Costanzo
- Experimental Oncology and Biobanking Unit, Heredo-Familiar Cancer Clinic, IRCCS - Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Simona De Summa
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS - Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Leonarda Maurmo
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS - Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Maria Digennaro
- Experimental Oncology and Biobanking Unit, Heredo-Familiar Cancer Clinic, IRCCS - Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Margherita Patruno
- Experimental Oncology and Biobanking Unit, Heredo-Familiar Cancer Clinic, IRCCS - Istituto Tumori "Giovanni Paolo II", Bari, Italy.
| | - Angelo Paradiso
- Scientific Direction, IRCCS - Istituto Tumori “Giovanni Paolo II”, Bari, Italy
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Daniele A, Divella R, Pilato B, Tommasi S, Pasanisi P, Patruno M, Digennaro M, Minoia C, Dellino M, Pisconti S, Casamassima P, Savino E, Paradiso AV. Can harmful lifestyle, obesity and weight changes increase the risk of breast cancer in BRCA 1 and BRCA 2 mutation carriers? A Mini review. Hered Cancer Clin Pract 2021; 19:45. [PMID: 34706754 PMCID: PMC8554866 DOI: 10.1186/s13053-021-00199-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/20/2021] [Indexed: 12/21/2022] Open
Abstract
Background and aim The BRCA 1 and BRCA 2 genes are associated with an inherited susceptibility to breast cancer with a cumulative risk of 60% in BRCA 1 mutation carriers and of 30% in BRCA 2 mutation carriers. Several lifestyle factors could play a role in determining an individual’s risk of breast cancer. Obesity, changes in body size or unhealthy lifestyle habits such as smoking, alcohol consumption and physical inactivity have been evaluated as possible determinants of breast cancer risk. The aim of this study was to explore the current understanding of the role of harmful lifestyle and obesity or weight change in the development of breast cancer in female carriers of BRCA 1/2 mutations. Methods Articles were identified from MEDLINE in October 2020 utilizing related keywords; they were then read and notes, study participants, measures, data analysis and results were used to write this review. Results Studies with very large case series have been carried out but only few of them have shown consistent results. Additional research would be beneficial to better determine the actual role and impact of such factors.
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Affiliation(s)
- A Daniele
- Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Viale Orazio Flacco 65, 70124, Bari, Italy.
| | - R Divella
- Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Viale Orazio Flacco 65, 70124, Bari, Italy
| | - B Pilato
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - S Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - P Pasanisi
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M Patruno
- Experimental Oncology, Center for Study of Heredo-Familial Tumors, IRCCS- Istituto "Tumori "Giovanni Paolo II", Bari, Italy
| | - M Digennaro
- Experimental Oncology, Center for Study of Heredo-Familial Tumors, IRCCS- Istituto "Tumori "Giovanni Paolo II", Bari, Italy
| | - C Minoia
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - M Dellino
- Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - S Pisconti
- Medical Oncology Unit, Ospedale Moscati, Taranto, Italy
| | - P Casamassima
- Clinical Pathology Laboratory Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - E Savino
- Clinical Pathology Laboratory Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - A V Paradiso
- Science Direction, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
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Patruno M, De Summa S, Resta N, Caputo M, Costanzo S, Digennaro M, Pilato B, Bagnulo R, Pantaleo A, Simone C, Natalicchio MI, De Matteis E, Tarantino P, Tommasi S, Paradiso A. Spectrum of Germline Pathogenic Variants in BRCA1/2 Genes in the Apulian Southern Italy Population: Geographic Distribution and Evidence for Targeted Genetic Testing. Cancers (Basel) 2021; 13:cancers13184714. [PMID: 34572941 PMCID: PMC8467705 DOI: 10.3390/cancers13184714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 01/02/2023] Open
Abstract
Simple Summary BRCA1 and BRCA2 are two major high-penetrance breast/ovarian cancer predisposition genes, whose mutations can lead to high risk and early onset of breast and ovarian cancer. Numerous studies are focused on spectrum and prevalence of BRCA1/2 mutations worldwide. This is the first study that exclusively focused on native Apulian probands. We found that ten recurrent BRCA1/2 pathogenic variants account for more than half of the patients with proven HBOC syndrome from Apulia. Besides BRCA1 c.5266dupC, which is present in significant numbers in every Apulian province, the other PVs occur at a high frequency in some areas and not others. In-depth knowledge of the mutation spectrum of the target population and of the relatively small number of recurrent mutations is crucial to develop a specific cost-effective strategy for mutation screening and a program for breast–ovarian cancer control and prevention through more liberal, yet rational, genetic testing and counseling. Abstract BRCA1/2-associated hereditary breast and ovarian cancer is the most common form of hereditary breast and ovarian cancer and occurs in all ethnicities and racial populations. Different BRCA1/BRCA2 pathogenic variants (PVs) have been reported with a wide variety among populations. In this study, we retrospectively analyzed prevalence and geographic distribution of pathogenic germline BRCA1/2 variants in families from Apulia in southern Italy and evaluated the genotype–phenotype correlations. Data were collected from Oncogenetic Services present in Apulian hospitals and a shared database was built containing Apulian native probands (n = 2026) that had undergone genetic testing from 2004 to 2019. PVs were detected in 499 of 2026 (24.6%) probands and 68.5% of them (342 of 499) were in the BRCA1 gene. We found 65 different PVs in BRCA1 and 46 in BRCA2. There were 10 most recurrent PVs and their geographical distribution appears to be significantly specific for each province. We have assumed that these PVs are related to the historical and geopolitical changes that occurred in Apulia over time and/or to a “founder effect”. Broader knowledge of BRCA1/2 prevalence and recurring PVs in specific geographic areas could help establish more flexible genetic testing strategies that may enhance our ability to detect high-risk subjects.
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Affiliation(s)
- Margherita Patruno
- Center for Hereditary Tumors Research, Istituto Tumori Bari, Giovani Paolo II, IRCCS, 70124 Bari, Italy; (S.C.); (M.D.); (A.P.)
- Correspondence: (M.P.); (S.D.S.)
| | - Simona De Summa
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-IstitutoTumori “Giovanni Paolo II”, 70124 Bari, Italy; (M.C.); (B.P.); (S.T.)
- Correspondence: (M.P.); (S.D.S.)
| | - Nicoletta Resta
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, “Aldo Moro” University of Bari, Policlinico Hospital Bari, 70124 Bari, Italy; (N.R.); (R.B.); (A.P.); (C.S.)
| | - Mariapia Caputo
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-IstitutoTumori “Giovanni Paolo II”, 70124 Bari, Italy; (M.C.); (B.P.); (S.T.)
| | - Silvia Costanzo
- Center for Hereditary Tumors Research, Istituto Tumori Bari, Giovani Paolo II, IRCCS, 70124 Bari, Italy; (S.C.); (M.D.); (A.P.)
| | - Maria Digennaro
- Center for Hereditary Tumors Research, Istituto Tumori Bari, Giovani Paolo II, IRCCS, 70124 Bari, Italy; (S.C.); (M.D.); (A.P.)
| | - Brunella Pilato
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-IstitutoTumori “Giovanni Paolo II”, 70124 Bari, Italy; (M.C.); (B.P.); (S.T.)
| | - Rosanna Bagnulo
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, “Aldo Moro” University of Bari, Policlinico Hospital Bari, 70124 Bari, Italy; (N.R.); (R.B.); (A.P.); (C.S.)
| | - Antonino Pantaleo
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, “Aldo Moro” University of Bari, Policlinico Hospital Bari, 70124 Bari, Italy; (N.R.); (R.B.); (A.P.); (C.S.)
| | - Cristiano Simone
- Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, “Aldo Moro” University of Bari, Policlinico Hospital Bari, 70124 Bari, Italy; (N.R.); (R.B.); (A.P.); (C.S.)
- Medical Genetics, National Institute of Gastroenterology “S. de Bellis” Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | | | | | - Paolo Tarantino
- Medical Genetics Unit, “Vito Fazzi” Hospital, 73100 Lecce, Italy;
| | - Stefania Tommasi
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-IstitutoTumori “Giovanni Paolo II”, 70124 Bari, Italy; (M.C.); (B.P.); (S.T.)
| | - Angelo Paradiso
- Center for Hereditary Tumors Research, Istituto Tumori Bari, Giovani Paolo II, IRCCS, 70124 Bari, Italy; (S.C.); (M.D.); (A.P.)
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DeCensi A, Puntoni M, Johansson H, Guerrieri-Gonzaga A, Caviglia S, Avino F, Cortesi L, Ponti A, Pacquola MG, Falcini F, Gulisano M, Digennaro M, Cariello A, Cagossi K, Pinotti G, Lazzeroni M, Serrano D, Briata IM, Buttiron Webber T, Boni L, Bonanni B. Effect Modifiers of Low-Dose Tamoxifen in a Randomized Trial in Breast Noninvasive Disease. Clin Cancer Res 2021; 27:3576-3583. [PMID: 33608319 DOI: 10.1158/1078-0432.ccr-20-4213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/21/2020] [Accepted: 02/17/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Low-dose tamoxifen halved recurrence after surgery in a phase III trial in breast noninvasive disease without increasing adverse events. We explored the effect of low-dose tamoxifen in clinically relevant subgroups, including menopausal status, estradiol levels, smoking, body mass index, and proliferation of baseline lesion. PATIENTS AND METHODS Incidence of invasive breast cancer or ductal carcinoma in situ was the primary endpoint. HRs and interaction terms were estimated using Cox models. RESULTS A favorable HR and 95% confidence interval (CI) could be demonstrated for postmenopausal status (HR = 0.30; 95% CI, 0.11-0.82 vs. HR = 0.73; 95% CI, 0.30-1.76 in premenopausal women; P interaction = 0.13), women with estradiol less than 15.8 pg/mL, presence of menopausal symptoms at baseline, and never smoking (P interaction = 0.07), although the interaction P value was >0.05 for all characteristics. Efficacy was similar in all body mass index categories. Tumors with Ki-67 above the median level of 10% had a greater benefit (HR = 0.27; 95% CI, 0.09-0.81) than those with Ki-67 ≤10% (HR = 1.58; 95% CI, 0.45-5.60; P interaction = 0.04). CONCLUSIONS The efficacy of low-dose tamoxifen seems to be greater in postmenopausal women and in women with lower estradiol levels. Benefits appear to be larger also in women with menopausal symptoms, never smokers, and tumors with Ki-67 >10%. Our results by menopausal status provide important insight into low-dose tamoxifen personalized treatment, although caution is necessary given their exploratory nature. Observation of an improved response in tumors with Ki-67 >10% is consistent but the use of the marker in this setting is investigational.See related commentary by Fabian, p. 3510.
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Affiliation(s)
- Andrea DeCensi
- E.O. Ospedali Galliera, Genoa, Italy. .,Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | | | | | | | | | - Franca Avino
- Istituto Nazionale Tumori "Fondazione Pascale," Naples, Italy
| | - Laura Cortesi
- A. O. Universitaria Policlinico di Modena, Modena, Italy
| | - Antonio Ponti
- CPO Piemonte, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Fabio Falcini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy
| | | | | | | | | | | | | | | | | | | | - Luca Boni
- IRCCS Ospedale San Martino, Genova, Italy
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7
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Bruno E, Oliverio A, Paradiso A, Daniele A, Tommasi S, Terribile DA, Filippone A, Digennaro M, Pilato B, Danza K, Guarino D, Rossi C, Rossi MM, Venturelli E, Giussani M, Peissel B, Pasanisi P. Lifestyle Characteristics in Women Carriers of BRCA Mutations: Results From an Italian Trial Cohort. Clin Breast Cancer 2020; 21:e168-e176. [PMID: 33357965 DOI: 10.1016/j.clbc.2020.11.002] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/12/2020] [Accepted: 11/04/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Women with deleterious mutations in BRCA1/2 have a high lifetime penetrance of developing breast cancer and/or ovarian cancer. Genetic and/or environmental factors may influence BRCA penetrance, and identifying modifiable exposures might be valuable for prevention. PATIENTS AND METHODS We implemented a multicenter prospective 2-arm (1:1) randomized controlled trial to investigate whether a Mediterranean dietary intervention with moderate protein restriction would reduce potential modulators of BRCA penetrance such as insulin-like growth factor 1 (IGF-1), body weight, and metabolic risk factors. We studied the baseline characteristics of women with BRCA-positive disease who joined the trial cohort, focusing on the relationships between selected lifestyle exposures, metabolic/anthropometric parameters, and BRCA-related cancer. RESULTS A total of 502 women (304 with a previous diagnosis of breast cancer and/or ovarian cancer and 198 unaffected) with deleterious BRCA mutations, with or without a previous cancer, aged 18 to 70 years and without metastases were included. Late age at menarche and pregnancy were negatively associated with BRCA-related cancer, especially in women with BRCA1-positive disease. Higher fat mass and the presence of 4 or 5 metabolic risk factors were significantly associated with BRCA-related cancer (hazard ratio, 1.87, 95% confidence interval, 1.21-2.88; and hazard ratio, 1.87, 95% confidence interval, 1.11-3.19, respectively), with greater effect in BRCA2-positive women. CONCLUSIONS Our findings confirm previous observations about reproductive factors in women with BRCA disease and suggest a potential impact of metabolic factors in BRCA-related cancer. The prospective follow-up of the trial cohort will enable us to study the environmental modulators of BRCA penetrance and their impact in relation to the history of BRCA-related cancer. [ClinicalTrials.gov NCT03066856].
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Affiliation(s)
- Eleonora Bruno
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Andreina Oliverio
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Angelo Paradiso
- Experimental Oncology, Center for Study of Heredo-Familial Tumors, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - Antonella Daniele
- Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - Stefania Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - Daniela A Terribile
- Department of Women Health Area, Università Cattolica, Rome, Italy; Department of Women and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Maria Digennaro
- Experimental Oncology, Center for Study of Heredo-Familial Tumors, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - Brunella Pilato
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | - Katia Danza
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Bari, Italy
| | | | - Cristina Rossi
- Department of Women and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Maddalena Rossi
- Department of Women and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elisabetta Venturelli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Marta Giussani
- Unit of Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Bernard Peissel
- Unit of Medical Genetics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Patrizia Pasanisi
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
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8
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Paradiso AV, Patruno M, Digennaro M, Tommasi S, Pilato B, Argentiero A, Brunetti O, Silvestris N. Somatic BRCA Mutation in a Cholangiocarcinoma Patient for HBOC Syndrome Detection. Front Oncol 2020; 10:1292. [PMID: 32903564 PMCID: PMC7438755 DOI: 10.3389/fonc.2020.01292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022] Open
Abstract
BRCA-associated hereditary breast and ovarian cancer syndrome (HBOC) is characterized by an increased risk of developing other malignancies including cholangiocarcinoma (CCA). Somatic BRCA mutations have been reported in CCA, but they have yet to be utilized in a proband case to identify HBOC in families. Two healthy daughters of a deceased female patient who had had metachronous breast cancer and CCA received genetic counseling to assess their cancer risk. Somatic BRCA1/2 mutation analysis was performed by next-generation sequencing on the DNA extracted from a formalin-fixed, paraffin-embedded CCA biopsy specimen of their mother. A pathogenic variant was identified (c.6468_6469delTC in a BRCA2 gene mutation). Germline BRCA mutation analysis of the two daughters detected the same pathogenic variant in one of them. For the first time, a CCA somatic BRCA mutation has been used to identify a family with HBOC.
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Affiliation(s)
- Angelo Virgilio Paradiso
- Experimental Oncology-Center for the Study of Hereditary Cancers, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy.,Scientific Direction, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Margherita Patruno
- Experimental Oncology-Center for the Study of Hereditary Cancers, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Maria Digennaro
- Experimental Oncology-Center for the Study of Hereditary Cancers, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Stefania Tommasi
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Brunella Pilato
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | - Oronzo Brunetti
- Medical Oncology Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy.,Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
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9
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Daniele A, Paradiso AV, Divella R, Digennaro M, Patruno M, Tommasi S, Pilato B, Tufaro A, Barone M, Minoia C, Colangelo D, Savino E, Casamassima P, Bruno E, Oliverio A, Pasanisi P. The Role of Circulating Adiponectin and SNP276G>T at ADIPOQ Gene in BRCA-mutant Women. Cancer Genomics Proteomics 2020; 17:301-307. [PMID: 32345671 PMCID: PMC7259884 DOI: 10.21873/cgp.20190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/13/2020] [Accepted: 02/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Environmental factors may influence the lifetime risk of cancer (penetrance) in women with a BRCA mutation. MATERIALS AND METHODS In 89 BRCA-mutant women, affected or unaffected by breast/ovarian cancer, we explored serum levels of adipokines and their relation with the polymorphism SNP276G>T as modulators of BRCA penetrance. RESULTS Affected women had significantly lower adiponectin than healthy women. Affected women with rs1501299 TT had significantly lower adiponectin and higher leptin than GT and GG genotypes. GT genotype was significantly associated with the disease status [odds ratio (OR)=3.24, 95% confidence interval (95% CI)=1.03-10.17]. Women in the lower tertile of serum adiponectin had a RR of BRCA-associated cancer of 2.80, 95% CI=1.1-7.1 (p for trend=0.03) compared with women in the higher tertile. CONCLUSION In the SNP rs1501299 the T allele was significantly associated with lower serum levels of adiponectin in affected women, suggesting that the T allele might be related to cancer.
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Affiliation(s)
- Antonella Daniele
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Angelo Virgilio Paradiso
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Rosa Divella
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Maria Digennaro
- Experimental Oncology - Center for Study of Heredo-Familial Tumors - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Margherita Patruno
- Experimental Oncology - Center for Study of Heredo-Familial Tumors - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Stefania Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Brunella Pilato
- Molecular Diagnostics and Pharmacogenetics Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Antonio Tufaro
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Michele Barone
- Gastroenterology Section, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Carla Minoia
- Onco-Hematology Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Donatella Colangelo
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Eufemia Savino
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Porzia Casamassima
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Eleonora Bruno
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Andreina Oliverio
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Patrizia Pasanisi
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Johansson H, Puntoni M, Macis D, Aristarco V, Guerrieri-Gonzaga A, Serrano D, Caviglia S, Cortesi L, Taverniti C, Ponti A, Pacquola MG, Gulisano M, Falcini F, Digennaro M, Carriello A, Cagossi K, Pinotti G, Webber TB, Lazzeroni M, Bonanni B, Boni L, DeCensi A. Abstract PD3-08: Effects of low dose tamoxifen on circulating risk biomarkers in a phase III trial in breast pre-invasive disease. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-pd3-08] [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: We recently showed that low dose (5mg/d) tamoxifen (babytam) for 3 years can halve the incidence of new breast neoplastic events in hormone sensitive or unknown breast pre-invasive neoplasia after surgery with limited toxicity (DeCensi et al JCO 2019; 37:1629-37). Here we report the results of circulating surrogate endpoint biomarkers of breast cancer risk with special attention to the risk of ovarian stimulation observed with the full dose in premenopausal women. Methods: Five hundred women 75 years old or younger were randomized to babytam or placebo (PLA). A subgroup of 406 women consented for collection of morning fasting serum at baseline (0), 1 (1Y) and 3 years (3Y) of treatment. There was a loss of about 25% of blood sampling at 3Y. Serum IGF-I, IGFBP-3, SHBG and C-reactive Protein (CRP) were performed on all available samples. Estradiol and testosterone were determined in a subsample (n=285) to determine the extent of ovarian stimulation by babytam in premenopausal women. We used Mann-Whitney test for univariate comparisons and linear regression modeling for multivariate analyses setting changes from baseline (1Y or 3Y minus baseline values) as dependent variable and treatment arm, age, BMI and baseline biomarkers values as explanatory factors. We tested treatment*menopausal status as interaction term. COX P-H model was used to calculate hazard ratio for CRP increase. Results: At baseline, all biomarkers were evenly balanced between arms (data not shown). IGF-I decreased significantly on babytam as compared to PLA. The difference of the changes between arms was -20 ng/mL after 1Y (p<0.001) and -23 after 3Y (p<0.001). A treatment by menopausal status interaction was observed after 1Y (p=0.017) and 3Y (p=0.058), with a steeper decrease in postmenopausal (-25, p<0.001 both after 1Y and 3Y) as compared to premenopausal women (-15, p=0.007 after 1Y and -17, p=0.009 after 3Y). IGFBP-3 increased significantly on babytam, without effect modification by menopausal status. The difference between arms was +0.26 ug/mL after 1Y (p=0.006) and +0.19 after 3Y (p=0.024). SHBG increased markedly on babytam, irrespective of menopausal status. The difference between arms from 0 to 1Y and 3Y was 24 nMol/L (p<0.001). CRP levels followed a trend towards a decrease with babytam (-0.172 mg/dL, p=0.057 after 1Y and -0.091, p=0.108 after 3Y), without effect modification by menopausal status. There was no significant increase in serum estradiol after 1Y with babytam overall (+12 pg/mL, p=0.106), but a trend to an interaction with menopausal status (p=0.079): +17 (p=0.361) in premenopausal women versus +3 (p=0.284) in postmenopausal women. Similarly, there was no overall effect of babytam on testosterone after 1Y (-0.008 ng/mL, p=0.518), but a significant effect modification by menopausal status (p=0.001), showing an increase of +0.056 (p=0.006) in premenopausal women, and a decrease of -0.045 (p=0.006) in postmenopausal women. Irrespective of treatment, the increase in CRP at 3Y was significantly higher in women who experienced recurrence compared to women who did not (Mann-Whitney p=0.009). An increase in CRP was associated with a HR of 2.9 (95% CI, 1.0-8.3, p=0.05) as compared to women with a decreased or stable CRP levels. Conclusions: Babytam for 3 years exhibits a favorable effect on sex hormones and IGFs with only a slight increase of estradiol in premenopausal women which is far below that observed with 20 mg and is well compensated by a significant increase in SHBG. These findings further support the use of babytam as an effective and safe treatment for high risk individuals. ClinicalTrials.gov Identifier: NCT01357772. Supported by the Italian Ministry of Health (RFPS-2006-339898), the Italian Association for Cancer Research (IG 2008 Grant No 5611) and the Italian League against Cancer (LILT 7-08).
Citation Format: Harriet Johansson, Matteo Puntoni, Debora Macis, Valentina Aristarco, Aliana Guerrieri-Gonzaga, Davide Serrano, Silvia Caviglia, Laura Cortesi, Cristiana Taverniti, Antonio Ponti, Maria Grazia Pacquola, Marcella Gulisano, Fabio Falcini, Maria Digennaro, Anna Carriello, Katia Cagossi, Graziella Pinotti, Tania Buttiron Webber, Matteo Lazzeroni, Bernardo Bonanni, Luca Boni, Andrea DeCensi. Effects of low dose tamoxifen on circulating risk biomarkers in a phase III trial in breast pre-invasive disease [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr PD3-08.
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Affiliation(s)
| | | | | | | | | | | | | | - Laura Cortesi
- 3Azienda Ospedaliera-Universitaria Policlinico di Modena, Modena, Italy
| | - Cristiana Taverniti
- 4Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonio Ponti
- 4Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Fabio Falcini
- 7Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | | | - Anna Carriello
- 9Azienda Unità Sanitaria Locale della Romagna, Ravenna, Italy
| | | | | | | | | | | | - Luca Boni
- 12Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
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11
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Costanzo S, Cormio C, Romito F, Digennaro M, Patruno M, Fanizzi A, Paradiso A. Oncological genetic counseling (OGC) for high-risk hereditary cancer: what can hospital anxiety and depression scale (HADs) tell us? J BUON 2020; 25:566-573. [PMID: 32277684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE This study aimed to verify whether and how anxiety and depression symptoms are associated both to socio-demographic and clinical variables (age, civil status, type of cancer diagnosed, time elapsed between cancer diagnosis and Oncologic Genetic Counseling/OGC, number of relatives affected by cancer) and to psychological features (presence/absence of previous psychological suffering), subjective cancer risk perception, psychological attitude approaching/OGC) in a sample of Caucasian patients accessing OGC. METHODS 201 participants (193 female and 8 male) accessing OGC in the Istituto di Ricovero e Cura Carattere Scientifico (IRCCS) Giovanni Paolo II in Bari completed the Hospital Depression and Anxiety Scale (HADs) that was analyzed as global scoring, anxiety (HAD-A) and depression subscale (HAD-D). RESULTS In our sample, higher HADs, HAD-A and HAD-D scorings were associated in different ways to both socio-demographic information (age: p value 0.019), clinical and medical features (personal history of cancer: HAD-D p value 0.02; months elapsed between diagnosis and OGC, HAD-A p value 0.004 and HADs p value 0.008) and psychological dimensions (approaching genetic counseling: anxiety p value 0.06; fear p value 0.02; duty p value 0.04). CONCLUSION This study showed that during the process of oncological genetic counseling the importance of taking into consideration not only medical variables but also cognitive and emotional aspects from both the individual and family spheres, in order to assure adequate care of the patient.
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Affiliation(s)
- Silvia Costanzo
- Experimental Oncology -Center for Study of Heredo-Familial Tumors, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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12
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Paradiso AV, Digennaro M, Patruno M, De Summa S, Tommasi S, Berindan-Neagoe I. BRCA germline mutation test for all woman with ovarian cancer? BMC Cancer 2019; 19:641. [PMID: 31253107 PMCID: PMC6599356 DOI: 10.1186/s12885-019-5829-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 06/12/2019] [Indexed: 01/09/2023] Open
Abstract
Background Delivering widespread BRCA testing to patients with ovarian cancer has been suggested by several scientists, recommended by professional societies and solicited by patients organizations. However, based on the lack of studies clearly demonstrating the cost-effectiveness of such approach compared to standard practice, we evaluated the possibility to better select subgroups of ovarian cancer (OC) patients with higher probability to be a BRCA mutation carrier’. Methods We analyzed the database of 2222 germline BRCA analyses from OC patients recently published by Song et al. (Song 2014) by applying multivariate and conditional inference regression tree-analyses. Results Overall, 178/2192 (8.1%) evaluable OC women showed pathogenic germline mutations in BRCA genes (84 BRCA1;94 BRCA2). BRCA mutations resulted significantly more frequent in Epithelial tumors (10.7%), less differentiated tumours (11.0%) and younger subjects (13.4%). Regression tree analysis permitted to individualize a subset of 66% OC patients with particularly low risk (3.5%) to carry a BRCA mutation vs a subgroup (24% of the series), with a probability higher than 17% to carry a pathogenic mutation. Younger age, OC and Breast Cancer family history were confirmed powerful factors in selecting subgroups of patients with significantly different BRCA mutation probability. Conclusions Our regression tree-analysis can represent an innovative approach taking into consideration all main clinical pathological information to select OC patients to be candidated for BRCA test.
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Affiliation(s)
- A V Paradiso
- Experimental Oncology - Center for Study of Heredo-Familial Tumors, IRCCS-Istituto Tumori "Giovanni Paolo II", viale Orazio Flacco, 65, 70124, Bari, Italy. .,Centro Studi Tumori Eredo-Familiari, Istituto Tumori G Paolo II IRCCS National Cancer Research Centre, Via O Flacco, 65, 70124, Bari, Italy.
| | - M Digennaro
- Experimental Oncology - Center for Study of Heredo-Familial Tumors, IRCCS-Istituto Tumori "Giovanni Paolo II", viale Orazio Flacco, 65, 70124, Bari, Italy
| | - M Patruno
- Experimental Oncology - Center for Study of Heredo-Familial Tumors, IRCCS-Istituto Tumori "Giovanni Paolo II", viale Orazio Flacco, 65, 70124, Bari, Italy
| | - S De Summa
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-Istituto Tumori "Giovanni Paolo II", viale Orazio Flacco, 65, 70124, Bari, Italy
| | - S Tommasi
- Molecular and Pharmacogenetics Diagnostic Laboratory, IRCCS-Istituto Tumori "Giovanni Paolo II", viale Orazio Flacco, 65, 70124, Bari, Italy
| | - I Berindan-Neagoe
- Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", University of Medicine and Pharmacy Iuliu Hatieganu- Center for Functional Genomics and Center for Advanced Medicine Medfuture, Republicii 34th street; Marinescu 23, Pasteur 4-6, 400015, Cluj-Napoca, Romania
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13
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De Censi A, Puntoni M, Guerrieri-Gonzaga A, Caviglia S, Avino F, Cortesi L, Ponti A, Paquola MG, Falcini F, Gulisano M, Digennaro M, Cariello A, Cagossi K, Johansson HA, Pinotti G, Lazzeroni M, Buttiron Webber T, Corradengo D, Boni L, Bonanni B. Effect modifiers in a randomized phase III trial of low-dose tamoxifen in breast preinvasive disease. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1500 Background: Low-dose tamoxifen (babytam) at 5 mg/day for 3 years decreases local or contralateral recurrence by 52% in women with hormone sensitive breast pre-invasive neoplasia after surgery (DeCensi et al JCO 2019). Here we report the results of exploratory analyses to assess whether the benefit of babytam varies among subgroups of patients defined by individual characteristics. Methods: Post-hoc subgroup analyses were performed according to a mixed approach based on the test for interaction and biological plausibility. Incidence of invasive breast cancer or DCIS was the primary endpoint. HRs were estimated using Cox proportional-hazards modeling. Results: Age at menopause, smoking status and Ki-67 exhibited a significant interaction with treatment. Specifically, the effect of babytam was greater in women aged > 50y (n = 293, HR = 0.27, 95%CI: 0.10-0.73) than in women aged ≤50y (n = 207, HR = 0.86, 0.35-2.07), p-interaction = .09. Never smokers (n = 307) had a greater benefit than former (n = 68) or current smokers (n = 97): HR = 0.28, 0.11-0.70 vs HR = 0.57, 0.09-3.45 vs HR = 1.51, 0.41-5.64, respectively (p = .05). Tumors with Ki-67 above the median level of 10% (n = 133) had a greater effect (HR = 0.27, 0.09-0.81) than Ki-67 ≤10% (n = 145, HR = 1.58, 0.45-5.60, p = .04). Weaker statistical interactions (p > .1) were also found for waist circumference and hot flashes (HF) at baseline. Women with waist circumference ≥89 cm (metabolic syndrome, n = 208) had a greater effect (HR = 0.22, 0.07-0.78) than women < 89 cm (n = 228, HR = 0.61, 0.25-1.46). Compared with placebo and no HF, babytam effect was stronger in women with HF (HR = 0.13, 0.02-0.96) than in women on babytam and no HF (HR = 0.50, 0.24-1.03) or placebo and HF (HR = 0.72, 0.31-1.69, log-rank p-trend = .004). Additional subgroups according to obesity, family history of breast or ovarian cancer, alcohol use, extent of surgery, radiotherapy for DCIS, ER and HER2 expression, positive margins and treatment compliance showed no significant heterogeneity of treatment. Conclusions: Exploratory analyses showed a trend to a higher effect of babytam in women aged 50 or older, never smokers, women with hot flashes or abdominal obesity and tumors with Ki-67 above 10%. Our results provide insight into the efficacy of babytam towards a personalized preventive approach. Clinical trial information: NCT01357772.
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Affiliation(s)
- Andrea De Censi
- Division of Medical Oncology, E.O. Galliera Hospital, Genoa, Italy
| | - Matteo Puntoni
- Clinical Trial Unit, Office of the Scientific Director, E.O. Galliera Hospital, Genoa, Italy
| | | | - Silvia Caviglia
- Division of Medical Oncology, E.O. Galliera Hospital, Genoa, Italy
| | | | | | | | | | | | | | - Maria Digennaro
- Irccs Istituto Oncologico "Giovanni Paolo II" Bari, Bari, Italy
| | | | - Katia Cagossi
- Division of Medical Oncology, Ramazzini Hospital, Carpi, Italy
| | | | | | - Matteo Lazzeroni
- Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy
| | | | | | - Luca Boni
- Clinical Trial Coordinating Center, AOU Careggi, Florence, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention & Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
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14
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DeCensi A, Puntoni M, Guerrieri-Gonzaga A, Caviglia S, Avino F, Cortesi L, Taverniti C, Pacquola MG, Falcini F, Gulisano M, Digennaro M, Cariello A, Cagossi K, Pinotti G, Lazzeroni M, Serrano D, Branchi D, Campora S, Petrera M, Buttiron Webber T, Boni L, Bonanni B. Randomized Placebo Controlled Trial of Low-Dose Tamoxifen to Prevent Local and Contralateral Recurrence in Breast Intraepithelial Neoplasia. J Clin Oncol 2019; 37:1629-1637. [PMID: 30973790 PMCID: PMC6601429 DOI: 10.1200/jco.18.01779] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [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] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Tamoxifen administered for 5 years at 20 mg/d is effective in breast cancer treatment and prevention, but toxicity has limited its broad use. Biomarker trials showed that 5 mg/d is not inferior to 20 mg/d in decreasing breast cancer proliferation. We hypothesized that a lower dose given for a shorter period could be as effective in preventing recurrence from breast intraepithelial neoplasia but have a lower toxicity than the standard dose. PATIENTS AND METHODS We conducted a multicenter randomized trial of tamoxifen, 5 mg/d or placebo administered for 3 years after surgery in women with hormone-sensitive or unknown breast intraepithelial neoplasia, including atypical ductal hyperplasia and lobular or ductal carcinoma in situ. The primary end point was the incidence of invasive breast cancer or ductal carcinoma in situ. RESULTS Five hundred women 75 years of age or younger were included. After a median follow-up of 5.1 years (interquartile range, 3.9-6.3 years), there were 14 neoplastic events with tamoxifen and 28 with placebo (11.6 v 23.9 per 1,000 person-years; hazard ratio, 0.48; 95% CI, 0.26 to 0.92; P = .02), which resulted in a 5-year number needed to treat of 22 (95% CI, 20 to 27). Tamoxifen decreased contralateral breast events by 75% (three v 12 events; hazard ratio, 0.25; 95% CI, 0.07 to 0.88; P = .02). Patient-reported outcomes were not different between arms except for a slight increase in frequency of daily hot flashes with tamoxifen (P = .02). There were 12 serious adverse events with tamoxifen and 16 with placebo, including one deep vein thrombosis and one stage I endometrial cancer with tamoxifen and one pulmonary embolism with placebo. CONCLUSION Tamoxifen at 5 mg/d for 3 years can halve the recurrence of breast intraepithelial neoplasia with a limited toxicity, which provides a new treatment option in these disorders.
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Affiliation(s)
- Andrea DeCensi
- 1 Ente Ospedaliero Ospedali Galliera, Genoa, Italy.,2 Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | | | | | - Franca Avino
- 4 Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Laura Cortesi
- 5 Azienda Ospedaliera-Universitaria Policlinico di Modena, Modena, Italy
| | - Cristiana Taverniti
- 6 Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Fabio Falcini
- 8 Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | | | | | - Anna Cariello
- 11 Azienda Unità Sanitaria Locale della Romagna, Ravenna, Italy
| | | | | | | | | | | | - Sara Campora
- 1 Ente Ospedaliero Ospedali Galliera, Genoa, Italy
| | | | | | - Luca Boni
- 14 Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
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15
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DeCensi A, Puntoni M, Guerrieri Gonzaga A, Avino F, Cortesi L, Donadio M, Pacquola M, Falcini F, Gulisano M, Digennaro M, Tienghi A, Cagossi K, Pinotti G, Varicchio C, Caviglia S, Boni L, Bonanni B. Abstract GS3-01: A randomized placebo controlled phase III trial of low dose tamoxifen for the prevention of recurrence in women with operated hormone sensitive breast ductal or lobular carcinoma in situ. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs3-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Tamoxifen is an effective drug for breast cancer prevention and treatment, but the risk of endometrial cancer and venous thromboembolism has limited its broader use. We have repeatedly shown in biomarker trials that the minimal effective dose of tamoxifen is lower than 20 mg/day, but a definitive answer on efficacy and safety required a phase III trial. The optimal treatment of ductal carcinoma in situ (DCIS) is still controversial.
Methods: We conducted a phase III trial of tamoxifen (T), 5 mg/day versus placebo (P) in women with operated hormone sensitive breast intraepithelial neoplasia (DCIS or LCIS). Women with G3, positive margins or comedo/necrosis DCIS received radiotherapy. Women were seen every 6 months with an annual mammography for at last 5 years after randomization. Initial statistical calculations were revised according to the lower than expected accrual, and the Independent Data Safety Monitoring Board recommended the disclosure of results as 80% of the originally expected events were observed.
Results: Between November 1, 2008 and March 31, 2015 a total of 500 women were randomized to either T, 5 mg/day or P for 3 years. A total of 10 patients are not assessable becuse of consent withdrawal or drop out. The main subject characteristics were well balanced between arms. As of May 31, 2018, after a median follow-up of 5.1 years (interquartile range, 3.9-6.3), there were 14 recurrences in the T arm and 29 in the P arm (hazard ratio=0.48, 95% CI, 0.25-0.89, p=0.02). The incidence rate of events was 11.8/1000 py in the T arm and 24.9/1000 py in the P arm. Most recurrences were invasive breast cancers: 11/14 (78%) in the T arm and 16/29 (55%) in the P arm. There were 8 serious adverse events in the T arm and 12 in the P arm, including 2 arterial events in each arm, 2 superficial phlebitis in the T arm and 1 endometrial cancer (annual rate 0.85/1000 py) in the T arm. There were 6 versus 4 second primary cancers in the T and P arm, respectively, and 2 deaths in the P arm. Menopausal symptoms were more frequent in the T arm and will be reported in details at the conference.
Baseline characteristics Tamoxifen (n=246)Placebo (n=244) mean (SD)mean (SD)Age (yrs) 54.0 (9.4)53.7 (9.1)Body Mass Index (kg/m2) 25.7 (4.8)25.3 (4.2) n (%)n (%)Menopausal statusPre-110 (45)107 (44) Post-136 (55)137 (56)Type of lesionDCIS221 (89)220 (90) LCIS25 (10)24 (10)Type of surgeryConservative (Q/L)206 (84)200 (82) Mastectomy39 (16)44 (18) Axillary dissection1 (0)-SD=standard deviation; DCIS=ductal carcinoma in situ; LCIS=lobular carcinoma in situ; Q=quadrantectomy; L=lumpectomy
Conclusions: Tamoxifen at the dose of 5 mg/day can halve the incidence of recurrence in women with operated hormone sensitive DCIS or LCIS with a limited toxicity, providing a valid treatment option in women with disease. In addition, this study has important implications for the preventive therapy of high risk unaffected women.
ClinicalTrials.gov Identifier: NCT01357772; Supported by the Italian Ministry of Health - RFPS-2006-1-339898 and the Italian Association for Cancer Research (AIRC) - IG 2008 Grant no. 5611.
Citation Format: DeCensi A, Puntoni M, Guerrieri Gonzaga A, Avino F, Cortesi L, Donadio M, Pacquola M, Falcini F, Gulisano M, Digennaro M, Tienghi A, Cagossi K, Pinotti G, Varicchio C, Caviglia S, Boni L, Bonanni B. A randomized placebo controlled phase III trial of low dose tamoxifen for the prevention of recurrence in women with operated hormone sensitive breast ductal or lobular carcinoma in situ [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 GS3-01.
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Affiliation(s)
- A DeCensi
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - M Puntoni
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - A Guerrieri Gonzaga
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - F Avino
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - L Cortesi
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - M Donadio
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - M Pacquola
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - F Falcini
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - M Gulisano
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - M Digennaro
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - A Tienghi
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - K Cagossi
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - G Pinotti
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - C Varicchio
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - S Caviglia
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - L Boni
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
| | - B Bonanni
- E.O. Ospedali Galliera, Genoa, Italy; European Institute of Oncology, Milan, Italy; Istituto Nazionale Tumori "Fondazione Pascale, Naples, Italy; A. O. Universitaria Policlinico di Modena, Modena, Italy; A.O. Universitaria S. Giovanni Battista - “Le Molinette”, Turin, Italy; Ospedale SS Antonio e Margherita-ASL AL, Tortona, Italy; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Meldola, Italy; ULSS 6 Vicenza, Vicenza, Italy; Ospedale Oncologico di Bari - Istituto Tumori “G. Paolo II”, Bari, Italy; Ospedale Santa Maria delle Croci, Ravenna, Italy; Ospedale Bernardino Ramazzini, Carpi (MO), Italy; Asst Sette Laghi, Varese, Italy; AOU Careggi, Firenze, Italy
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Paradiso A, Bruno M, Cicoria O, Digennaro M, Longo S, Rinaldi M, Schittulli F. Analysis of the Reasons for Accepting or Declining Participation in Genetic Research for Breast Cancer: A Hospital-Based Population Study. Tumori 2018; 90:435-6. [PMID: 15510991 DOI: 10.1177/030089160409000415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The majority of a hospital-based population accepted to participate in a molecular screening project for familial breast cancer, giving their informed consent to blood sampling. Only 9.5% of patients declined to sign the consent form. Here we report the reasons for refusal and we critically review our methodological approach to obtain consent for a blood test for genetic research in a clinical setting.
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Affiliation(s)
- Angelo Paradiso
- Laboratorio di Oncologia Sperimentale Clinica, Dipartimento di Oncologia Sperimentale, Istituto Oncologico di Bari, Italy.
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17
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Simone G, Diotaiuti S, Digennaro M, Sambiasi D, De Summa S, Tommasi S, Altieri R, Mangia A, Dantona C, Paradiso A. Comment on 'Renewed interest in the progesterone receptor in breast cancer'. Br J Cancer 2017; 117:e1. [PMID: 28399113 PMCID: PMC5520524 DOI: 10.1038/bjc.2017.90] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Giovanni Simone
- Pathology Unit, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
| | - Sergio Diotaiuti
- Senology Unit, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
| | - Maria Digennaro
- Experimental Medical Oncology, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
| | - Domenico Sambiasi
- Experimental Medical Oncology, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
| | - Simona De Summa
- Molecular Genetics, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
| | - Stefania Tommasi
- Molecular Genetics, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
| | - Rosanna Altieri
- Senology Unit, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
| | - Annita Mangia
- Functional Biomorphology, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
| | - Caterina Dantona
- Department of General Surgery,Ospedale Civico di Lugano, Via Tesserete 46, 6900 Lugano, Switzerland
| | - Angelo Paradiso
- Experimental Medical Oncology, Istituto Tumori Giovanni Paolo II, IRCCS, National Cancer Research Institute, via O Flacco 65, Bari I-70124, Italy
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Digennaro M, Sambiasi D, Tommasi S, Pilato B, Diotaiuti S, Kardhashi A, Trojano G, Tufaro A, Paradiso AV. Hereditary and non-hereditary branches of family eligible for BRCA test: cancers in other sites. Hered Cancer Clin Pract 2017; 15:7. [PMID: 28559958 PMCID: PMC5445420 DOI: 10.1186/s13053-017-0067-8] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 05/17/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The analysis of relationships of BRCA alterations with cancer at sites other than breast/ovary may provide innovative information concerning BRCA pathogenic role and support additional clinical decisions. Aim of this study is to compare presence of cancers in other sites in members of hereditary (H) and not-hereditary (nH) branches of families of patients eligible to BRCA test. METHODS We retrospectively analyzed the incidence of cancer in other sites in members of 136 families eligible for hereditary breast/ovarian cancer genetic counseling at Centro Studi Tumori Eredo-familiari of our Institute; we compared the frequency of other cancer types in 1156 members of the H-branch with respect to 1062 members of nH-Branch. The families belonging to a proband case and with informative members in at least three generation entered the present study. RESULTS The frequency of other Cancers in members of H-branch was significantly higher than that in members of nH-branch (161 vs 75 cancers; p < 0.0001). In specific, members of H-branch had a significantly higher probability to have more lung cancer (38 vs 9;p < 0.0006), kidney cancer (23 vs 5;p < 0.0005), liver cancer (13 vs 3;p < 0.02) and larynx cancer (14 vs 4;p < 0.03). Interestingly, to belong to H-branch resulted significantly associated with a higher probability of lung cancer (OR 4.5; 2.15-9.38 95%C.I.), liver cancer (OR: 4.02; 1.14-14.15 95% C.I.) and larynx cancer (OR:3.4; 1.12-10.39 95%C.I.) independently from Gender and Age. CONCLUSIONS Members belonging to the H-branch of families of patients eligible to BRCA test have a higher risk of tumors in lung, larynx and liver. Clinicians should consider the increased risk for these cancers to activate prevention/early diagnosis practices in members of families with breast/ovarian familial cancer syndrome.
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Affiliation(s)
- M Digennaro
- Centro Studi Tumori Eredo-familiari. Istituto Tumori G Paolo II,IRCCS, 70124 Bari, Italy
| | - D Sambiasi
- Centro Studi Tumori Eredo-familiari. Istituto Tumori G Paolo II,IRCCS, 70124 Bari, Italy
| | - S Tommasi
- Laboratorio Genetica Molecolare; Istituto Tumori G Paolo II, IRCCS, 70124 Bari, Italy
| | - B Pilato
- Laboratorio Genetica Molecolare; Istituto Tumori G Paolo II, IRCCS, 70124 Bari, Italy
| | - S Diotaiuti
- UO Senologia Tumori. Istituto Tumori G Paolo II,IRCCS, 70124 Bari, Italy
| | - A Kardhashi
- UO Senologia Tumori. Istituto Tumori G Paolo II,IRCCS, 70124 Bari, Italy.,UO Ginecologia Oncologica, Istituto Tumori G Paolo II, IRCCS, 70124 Bari, Italy
| | - G Trojano
- ASST Fatebene Fratelli, Milan, Italy
| | - A Tufaro
- Biobanca Istituzionale, Istituto Tumori G Paolo II, IRCCS, 70124 Bari, Italy
| | - A V Paradiso
- Centro Studi Tumori Eredo-familiari. Istituto Tumori G Paolo II,IRCCS, 70124 Bari, Italy.,Centro Studi Tumori Eredo-Familiari, Istituto Tumori G Paolo II, IRCCS, Via O. Flacco, 65, 70124 Bari, Italy
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19
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Danza K, De Summa S, Pinto R, Pilato B, Palumbo O, Carella M, Popescu O, Digennaro M, Lacalamita R, Tommasi S. TGFbeta and miRNA regulation in familial and sporadic breast cancer. Oncotarget 2017; 8:50715-50723. [PMID: 28881597 PMCID: PMC5584195 DOI: 10.18632/oncotarget.14899] [Citation(s) in RCA: 16] [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: 11/04/2016] [Accepted: 12/27/2016] [Indexed: 01/20/2023] Open
Abstract
The term ‘BRCAness’ was introduced to identify sporadic malignant tumors sharing characteristics similar to those germline BRCA-related. Among all mechanisms attributable to BRCA1 expression silencing, a major role has been assigned to microRNAs. MicroRNAs role in familial and sporadic breast cancer has been explored but few data are available about microRNAs involvement in homologous recombination repair control in these breast cancer subgroups. Our aim was to seek microRNAs associated to pathways underlying DNA repair dysfunction in breast cancer according to a family history of the disease. Affymetrix GeneChip microRNA Arrays were used to perform microRNA expression analysis in familial and sporadic breast cancer. Pathway enrichment analysis and microRNA target prediction was carried out using DIANA miRPath v.3 web-based computational tool and miRWalk v.2 database. We analyzed an external gene expression dataset (E-GEOD-49481), including both familial and sporadic breast cancers. For microRNA validation, an independent set of 19 familial and 10 sporadic breast cancers was used. Microarray analysis identified a signature of 28 deregulated miRNAs. For our validation analyses by real time PCR, we focused on miR-92a-1*, miR-1184 and miR-943 because associated to TGF-β signalling pathway, ATM and BRCA1 genes expression. Our results highlighted alterations in miR-92a-1*, miR-1184 and miR-943 expression levels suggesting their involvement in repair of DNA double-strand breaks through TGF-beta pathway control.
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Affiliation(s)
- Katia Danza
- IRCCS 'Giovanni Paolo II', Molecular Genetics Laboratory, Bari 70124, Italy
| | - Simona De Summa
- IRCCS 'Giovanni Paolo II', Molecular Genetics Laboratory, Bari 70124, Italy
| | - Rosamaria Pinto
- IRCCS 'Giovanni Paolo II', Molecular Genetics Laboratory, Bari 70124, Italy
| | - Brunella Pilato
- IRCCS 'Giovanni Paolo II', Molecular Genetics Laboratory, Bari 70124, Italy
| | - Orazio Palumbo
- IRCCS 'Casa Sollievo della Sofferenza', Medical Genetics Unit, San Giovanni Rotondo 71013, Italy
| | - Massimo Carella
- IRCCS 'Casa Sollievo della Sofferenza', Medical Genetics Unit, San Giovanni Rotondo 71013, Italy
| | - Ondina Popescu
- IRCCS 'Giovanni Paolo II', Anatomopathology Unit, Bari 70124, Italy
| | - Maria Digennaro
- IRCCS 'Giovanni Paolo II', Experimental Medical Oncology Unit, Bari 70124, Italy
| | - Rosanna Lacalamita
- IRCCS 'Giovanni Paolo II', Molecular Genetics Laboratory, Bari 70124, Italy
| | - Stefania Tommasi
- IRCCS 'Giovanni Paolo II', Molecular Genetics Laboratory, Bari 70124, Italy
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Sambiasi D, Lambo R, Pilato B, Tommasi S, Trojano G, Kardhashi A, Digennaro M, Trojano V, Simone G, Paradiso A. BRCA1/2 and clinical outcome in a monoinstitutional cohort of women with hereditary breast cancer. Oncol Rep 2013; 31:365-9. [PMID: 24145998 DOI: 10.3892/or.2013.2802] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 12/17/2012] [Indexed: 11/05/2022] Open
Abstract
The clinical outcome of BRCA mutation carriers and non-carriers still remains a topic of discussion. In order to interpret controversial data, in the present study, we analyzed a large consecutive monoinstitutional series of breast cancer patients and relatives with familial features carrying or not carrying BRCA mutations. The intense research in recent years regarding the clinical genetics of patients with breast or ovarian cancer and their relatives has allowed the organization of a unique database comprising anamnestic, clinical, pathological and molecular data. Families with two or more cases of breast cancer under the age of 50 years, or with three cases at any age, were identified. From June, 2003 to June, 2010, a total of 202 patients (136 probands + 66 relatives) from 45 families were included in the analysis. A total of 136 (49 carrier and 87 non-carrier) cases had a cancer diagnosis at the time of their genetic testing. Twenty and 24 events were observed in the carrier and control group, respectively. The 10-year disease-free suvival rate was 57% for patients in the control group compared with 50% for patients carrying a BRCA mutation (P=0.15 by log-rank test). Finally, 66 (32 genetic and 34 control) cases were unaffected at the time of molecular analysis, and 6 new cases of cancer were observed in the carriers, while no new cases were detected in the control cohort. Thus, at age 50, 40% of carriers had a high risk of disease (P=0.0069 by log-rank test). Our data support the hypothesis that the presence of BRCA mutations does not alter the clinical outcome for hereditary breast cancer patients. Conversely, BRCA mutations are proven to be crucial for prediction of risk in healthy relatives from carrier families.
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Affiliation(s)
- Domenico Sambiasi
- National Cancer Research Centre 'Giovanni Paolo II', I-70124 Bari, Italy
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Bruno M, Digennaro M, Tommasi S, Stea B, Danese T, Schittulli F, Paradiso A. Attitude towards genetic testing for breast cancer susceptibility: a comparison of affected and unaffected women. Eur J Cancer Care (Engl) 2009; 19:360-8. [PMID: 19912305 DOI: 10.1111/j.1365-2354.2009.01067.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The objective of this study is to evaluate women's awareness and interest in genetic testing for breast cancer risk, to identify socio-demographic factors, to analyse the reasons for wanting or not wanting to be tested and finally to determine whether breast cancer patients and healthy women have different attitudes towards genetic testing. Consecutive series of 879 women without and with breast cancer participated in a 20-item self-completing questionnaire. Among breast cancer patients, 57% answered that they would definitely or probably accept being tested, compared with 84% of women without breast cancer. At the multiple logistic regression analysis only to have a diagnosis of breast cancer conditioned significantly the interest to have genetic testing. Surprisingly, a family history of breast cancer was found to have no significant impact. The most frequently cited reason for being interested in genetic testing was 'to learn about your children's risk'. Although women's awareness about breast cancer genes is inadequate, the interest in genetic testing is substantial and higher both in healthy women and in women with breast cancer. These results provide important indications for the development of educational strategies.
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Affiliation(s)
- M Bruno
- Experimental Oncology Department, Cancer Institute of Bari, Bari, Italy.
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Tommasi S, Pilato B, Pinto R, Monaco A, Bruno M, Campana M, Digennaro M, Schittulli F, Lacalamita R, Paradiso A. Molecular and in silico analysis of BRCA1 and BRCA2 variants. Mutat Res 2008; 644:64-70. [PMID: 18694767 DOI: 10.1016/j.mrfmmm.2008.07.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 06/11/2008] [Accepted: 07/09/2008] [Indexed: 05/26/2023]
Abstract
Germline mutations of high penetrant BRCA1 and BRCA2 genes have been associated to hereditary breast cancer risk, while polymorphic variants of the two genes still have an unknown role in breast pathogenesis. The aim of our study was to characterize BRCA1 and BRCA2 genes polymorphic variants in familial breast cancer. 110 patients affected by familial breast and/or ovarian cancer have been consecutively enrolled according to family history and BRCA mutation risk. All of them have been screened for BRCA1 and BRCA2 pathogenetic mutations, SNPs and intronic variants. In silico analysis have been also performed using different computational methods to individualize genetic variations that can alter the two genes expression and function. BRCA1 resulted mutated in 14% while BRCA2 in 3% of cases, while 80% of patients presented at least one polymorphism. A neural network splicing prediction model individualized one BRCA1 and one BRCA2 intronic variants able to determine alternative splicing. Furthermore, Q356R BRCA1 and N289H BRCA2 appear to show a possible harmful role also due to their location in functional regions of the two genes. However, in silico data are not always consistent with biological evidences. In conclusion, SNPs profile provides a basis for DNA-based cancer risk classification and help to define the gene alterations that could influence biochemistry activity protein or could modify drug sensitivity.
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Affiliation(s)
- Stefania Tommasi
- National Cancer Institute "Giovanni Paolo II"- v. Hahnemann 10, 70126 Bari, Italy.
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Tommasi S, Crapolicchio A, Lacalamita R, Bruno M, Monaco A, Petroni S, Schittulli F, Longo S, Digennaro M, Calistri D, Mangia A, Paradiso A. BRCA1 mutations and polymorphisms in a hospital-based consecutive series of breast cancer patients from Apulia, Italy. Mutat Res 2005; 578:395-405. [PMID: 16026807 DOI: 10.1016/j.mrfmmm.2005.06.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2005] [Revised: 06/07/2005] [Accepted: 06/09/2005] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Hereditary breast cancer has been partly attributed to germline mutations in the BRCA1 gene that are deleterious for BRCA1 protein activity. This paper analyzes the incidence and characteristics of detectable BRCA1 mutations and polymorphisms in a hospital-based consecutive series of breast cancer patients from southern Italy to investigate the incidence and the association of these molecular alterations with breast cancer biology and family history. METHODS One hundred cases with familial characteristics were selected from a consecutive series of 511 patients with a first diagnosis of breast cancer. DNA from peripheral blood was screened for whole BRCA1 gene mutations utilizing dHPLC as a pre-screening analysis and automatic DNA sequencing for the identification of specific alterations. RESULTS In the overall series of 511 patients, 100 had a family history of breast cancer and were investigated for BRCA1 mutations. Two types of BRCA1 mutations were identified, 5382insC in six cases and 4566delA in one case. The 5382insC mutation was present in two out of six cases with ovarian cancer while 4566delA in one case of male cancer. The most frequent missense polymorphisms were E1038G, P871L, K1183R in exon 11, S1613G, M1652I in exon 16 and D1778G in exon 22. Confirming what found in previous studies, patients in whom pathological BRCA1 mutations were detected had early-onset breast cancer (p=0.05), positive nodal status (p=0.05), lower ER (p=0.02) and PgR (p=0.01) content. Interestingly, the K1183R polymorphism and, less strongly, S1613G polymorphism were associated to mutational risk (K1183R: OR 0.1 p=0.03; S1613G: OR 2.7 p=0.08). CONCLUSION Mutations in the BRCA1 gene are frequent also in our consecutive series of patients from southern Italy. An association between two detected single nucleotide polymorphisms (SNPs) and BRCA1 mutational risk was ascertained. Finally, we confirm the fact that peculiar clinical-pathological features seem to characterize patients with a family history of breast cancer and BRCA1 alterations.
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Affiliation(s)
- S Tommasi
- Clinical Experimental Oncology Laboratory, National Cancer Institute, v. Amendola 209, 70126 Bari, Italy
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Brandi M, Cataldi A, Di Corato G, Altieri R, Digennaro M, Longo S, Ranieri G, Schittulli F, Petroni. Efficacy and influence of neoadjuvant epirubicin/vinorelbine chemotherapy (EN) on molecular markers in inflammatory breast cancer (IBC) and preliminary results of a randomized study testing as adjuvant chemotherapy the same EN-combination versus docetaxel (TXT). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.886] [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)
- M. Brandi
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
| | - A. Cataldi
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
| | - G. Di Corato
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
| | - R. Altieri
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
| | - M. Digennaro
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
| | - S. Longo
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
| | - G. Ranieri
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
| | - F. Schittulli
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
| | - Petroni
- Onc Inst of Bari, Bari, Italy; City Bari Hospital; Women Department - Breast Unit; Pathology Service and Radio-surgery of Oncology Institute
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